Impact of intracardiac echocardiography on radiation exposure during adult congenital heart disease catheter-based interventions.
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.
Rigatelli
Gianluca
G
Interventional Cardiology Unit, Division of Cardiology, Department of Emergency, Rovigo General Hospital, Rovigo, Italy. jackyheart@hotmail.com
Cardaioli
Paolo
P
Roncon
Loris
L
Giordan
Massimo
M
Bedendo
Emiliano
E
Oliva
Laura
L
Panin
Stefano
S
Zonzin
Pietro
P
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*