title: Patient radiation exposure during transcatheter aortic valve replacement procedures.
abstract: OBJECTIVE
  To describe patient radiation utilisation during transcatheter aortic valve replacement (TAVR) on a series of consecutive patients.
  
  
  RESULTS
  Data on radiation exposure were prospectively collected for consecutive patients undergoing TAVR and percutaneous coronary interventions at our centre. Radiation dose during the procedure was recorded using the US Food and Drug Administration (FDA) reference point (Ka,r) and the dose area product (PKA). In addition to quantifying overall radiation doses during TAVR, radiation exposure during transfemoral (TF) (n=79) and transapical (TA) (n=26) cases was compared. The median radiation dose during TAVR was 1,639 mGy (983-2,420), or 188 (106-321) Gy*cm2. Radiation dose was significantly lower among TA patients using either the reference point (TA: 946 [777-1,261] vs. TF: 1,932 [1,383-2,614] mGy; p<0.001) or the dose area product (TA: 89 [60-115] vs. TF: 236 [164-338] Gy*cm2; p<0.001). Fluoroscopy time was lower for TA patients (TA: 10 [8-11] vs. TF: 30 [24-34] minutes; p<0.001). Operators experience did not affect radiation exposure for TF cases.
  
  
  CONCLUSIONS
  Radiation exposure during TAVR appears similar to other percutaneous coronary interventions of moderate complexity. Radiation doses were significantly lower for TA procedures. A higher dose of radiation in TF patients may be related to additional imaging requirements to optimise percutaneous vascular access and closure.
authors.affiliation: Columbia University Medical Center/New York-Presbyterian Hospital, New York, NY 10032, USA.
authors.forename: Benoit
authors.initials: B
authors.lastname: Daneault
authors.forename: Stephen
authors.initials: S
authors.lastname: Balter
authors.forename: Susheel K
authors.initials: SK
authors.lastname: Kodali
authors.forename: Mathew R
authors.initials: MR
authors.lastname: Williams
authors.forename: Philippe
authors.initials: P
authors.lastname: Généreux
authors.forename: George R
authors.initials: GR
authors.lastname: Reiss
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Paradis
authors.forename: Philip
authors.initials: P
authors.lastname: Green
authors.forename: Ajay J
authors.initials: AJ
authors.lastname: Kirtane
authors.forename: Craig
authors.initials: C
authors.lastname: Smith
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Moses
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D015992:Body Mass Index; D001835:Body Weight; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000592:standards; D002983:Clinical Competence; D005260:Female; D005471:Fluoroscopy; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000592:standards; D015641:Radiography, Interventional / Q000009:adverse effects / Q000592:standards; D012189:Retrospective Studies; D013997:Time Factors