title: Impact of intracardiac echocardiography on radiation exposure during adult congenital heart disease catheter-based interventions.
abstract: BACKGROUND
  Intracardiac echocardiography (ICE) is a widespread approach in many cardiovascular procedures in which it has the potential to reduce the fluoroscopy time and patients radiation exposure. We sought to assess the patient radiation exposure during transcatheter closure of interatrial communications with and without ICE-guidance.
  
  
  METHODS
  In a prospective consecutive series of 25 consecutive patients who underwent transcatheter closure of interatrial communications between May and October 2005 with (15 patients) and without (10 patients) ICE-guidance in a single secondary care referral centre, we measured the dose-area product (DAP), the fluoroscopy dose-area product (FDAP), the total dose-area product (TDAP), and the mean procedural time.
  
  
  RESULTS
  In patients underwent ICE-guided transcatheter closure procedure the mean fluoroscopy time, the mean DAP, mean FDAP, and mean TDAP resulted significantly lower than in control patients: 2.0 +/- 0.21 (range 1.6-2.2) versus 5.05 +/- 0.54 (range 4.2-5.8) minutes (P < 0.001) , 13.72 +/- 9.03 (range 11.36-14.63) versus 21.95 +/- 6.93 (range 20.90-23.93) Gycm2 (P < 0.001), 8.25 +/- 1.22 (range 6.60-9.50) versus 20.15 +/- 8.83 (range 18.90-20.93) Gycm2 (P < 0.001), and 29.33 +/- 1.51(range 27.16-31.00) versus 32.61 +/- 2.53 (range 29.20-35.55) Gycm2 (P < 0.01). On the contrary, the mean procedural time, was significantly higher in ICE-guided transcatheter closure patients: 30.2 +/- 2.45 (range 23-40) versus 24.5 +/- 2.45 (range 24-31) minutes (P = 0.03).
  
  
  CONCLUSIONS
  The radiation exposure during ICE-guided transcatheter closure of interatrial communications in this group of patients was quite lower than that reported in literature for such procedures and compared favourably with radiation exposure of patients in whom the intervention was performed without ICE guidance.
authors.affiliation: Interventional Cardiology Unit, Division of Cardiology, Department of Emergency, Rovigo General Hospital, Rovigo, Italy. jackyheart@hotmail.com
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rigatelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Cardaioli
authors.forename: Loris
authors.initials: L
authors.lastname: Roncon
authors.forename: Massimo
authors.initials: M
authors.lastname: Giordan
authors.forename: Emiliano
authors.initials: E
authors.lastname: Bedendo
authors.forename: Laura
authors.initials: L
authors.lastname: Oliva
authors.forename: Stefano
authors.initials: S
authors.lastname: Panin
authors.forename: Pietro
authors.initials: P
authors.lastname: Zonzin
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D004452:Echocardiography / Q000379:methods; D017548:Echocardiography, Transesophageal; D019160:Endosonography / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011829:Radiation Dosage; D015641:Radiography, Interventional; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000379:methods*