title: Radiation Exposure by Three-Dimensional Rotational Angiography (3DRA) During Trans-catheter Melody Pulmonary Valve Procedures (TMPV) in a Pediatric Cardiac Catheterization Laboratory.
abstract: This retrospective study aims to evaluate radiation exposure by three-dimensional rotational angiography (3DRA) during trans-catheter Melody pulmonary valve (TMPV) procedures. 3DRA has been reported to have added value in the management of complex congenital heart disease aiding in the performance of interventional procedures albeit with concerns of higher radiation exposure. We test the hypothesis that 3DRA does not cause additional radiation exposure during TMPV procedures. We analyzed all 81 TMPV procedures performed at St. Louis Children's Hospital, MO, USA, from January 1, 2011 to December 31, 2014. Dose-area product (DAP), DAP indexed to body weight (DAP/BW), fluoroscopy time (FT), and weight-fluoroscopy time product of each procedure were recorded. We reviewed each procedure's images to determine whether additional interventions were performed (e.g., pulmonary artery angioplasty or treatment of conduit pseudo-aneurysm). 3DRA was used in 36 % of the procedures. 3DRA group had a higher number of additional procedures performed. The 3DRA group did not differ from the non-3DRA group in DAP, DAP/BW, and weight-fluoroscopy time product. 3DRA does not cause greater radiation exposure during TMPV procedures.
authors.affiliation: Division of Cardiology, Department of Pediatrics, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8116-NWT, St. Louis, MO, 63110-1093, USA. nguyen_h@kids.wustl.edu.|Division of Cardiology, Department of Pediatrics, Rush University Medical College, Chicago, IL, 60612, USA. nguyen_h@kids.wustl.edu.
authors.forename: Hoang H
authors.initials: HH
authors.lastname: Nguyen
authors.affiliation: Division of Cardiology, Department of Pediatrics, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8116-NWT, St. Louis, MO, 63110-1093, USA.
authors.forename: David T
authors.initials: DT
authors.lastname: Balzer
authors.affiliation: Division of Cardiology, Department of Pediatrics, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8116-NWT, St. Louis, MO, 63110-1093, USA.|Division of Cardiology, Department of Pediatrics, Rush University Medical College, Chicago, IL, 60612, USA.
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Murphy
authors.affiliation: Division of Cardiology, Department of Pediatrics, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8116-NWT, St. Louis, MO, 63110-1093, USA.
authors.forename: Ramzi
authors.initials: R
authors.lastname: Nicolas
authors.affiliation: Division of Cardiology, Department of Pediatrics, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8116-NWT, St. Louis, MO, 63110-1093, USA.
authors.forename: Shabana
authors.initials: S
authors.lastname: Shahanavaz
mesh_terms: D000792:Angiography; D006328:Cardiac Catheterization; D002648:Child; D005471:Fluoroscopy; D006801:Humans; D021621:Imaging, Three-Dimensional; D011664:Pulmonary Valve; D011829:Radiation Dosage; D000069079:Radiation Exposure; D012189:Retrospective Studies
keywords: Congenital heart disease; Right ventricular outflow tract dysfunction; Tetralogy of Fallot