Comparative Radiation Exposure to Interventional Echocardiographers During Percutaneous Mitral Valve Repair and Left Atrial Appendage Closure

Interventional echocardiographers are exposed to similar doses of radiation during percutaneous left atrial appendage closure (PLAAC) and percutaneous mitral valve repair (PMVR), according to the findings of a study presented at the ACC.20 World Congress of Cardiology. 

“Interventional echocardiographers are at risk for considerable radiation exposure while performing transesophageal echocardiography during structural heart interventions,” the authors wrote in their abstract. “The risk posed by different types of structural heart interventions to interventional echocardiographers remains unknown.” 

To conduct this study, researchers analyzed real-time radiation exposure data during 30 consecutive PLAAC and 30 consecutive PMVR procedures, respectively. All physicians and procedural staff were blinded to radiation data, and dosimeters were used to record interventional echocardiographer and interventional radiation doses.  

The results showed that compared to PLAAC, PMVR procedures were characterized by a higher average fluoroscopy time (20.9 [12.6, 26.0] minutes vs. 9.2 [6.9, 14.2] minutes, P<0.001). The researchers observed that interventional echocardiographers received an average radiation dose of 10.5 [3.1, 20.5] μSv during PMVR and a median radiation dose of 10.6 [5.8, 24.1] μSv during PLAAC (P=0.36). Overall, interventional echocardiographers received notably higher radiation doses than interventional cardiologists during both PMVR (10.5 [3.1, 20.5] μSv vs. 0.9 [0.1, 12.2] μSv, P<0.001) and during PLAAC (10.6 [5.8, 24.1] μSv vs. 3.5 [1.3, 6.3] μSv, P<0.001). 

Researchers wrote that similar levels of radiation exposure “occurred despite PMVR procedures being associated with greater fluoroscopy times, adding that the “observation that interventional echocardiographers received greater radiation doses than interventional cardiologists in both PMVR and PLAAC should prompt the development of additional radiation safety measures to protect interventional echocardiographers during structural heart interventions.” 

Regfahiyat L. Comparative Radiation Exposure to Interventional Echocardiographers During Percutaneous Mitral Valve Repair and Left Atrial Appendage Closure. Presented at the ACC.20 World Congress of Cardiology; March 28-30, Chicago, IL.