No abstract

Catheterization for structural heart disease (SHD) requires fluoroscopic guidance, which exposes health care professionals to radiation exposure risk. Nevertheless, existing freestanding radiation shields for anesthesiologists are typically simple, uncomfortable rectangles. Therefore, we devised a new perforated radiation shield that allows anesthesiologists and echocardiographers to access a patient through its apertures during SHD catheterization. No report of the relevant literature has described the degree to which the anesthesiologist’s radiation dose can be reduced by installing radiation shields. For estimating whole-body doses to anesthesiologists and air dose distributions in the operating room, we used a Monte Carlo system for a rapid dose-estimation system used with interventional radiology. The simulations were performed under four conditions: no radiation shield, large apertures, small apertures and without apertures. With small apertures, the doses to the lens, waist and neck surfaces were found to be comparable to those of a protective plate without an aperture, indicating that our new radiation shield copes with radiation protection and work efficiency. To simulate the air-absorbed dose distribution, results indicated that a fan-shaped area of the dose rate decrease was generated in the area behind the shield, as seen from the tube sphere. For the aperture, radiation was found to wrap around the backside of the shield, even at a height that did not match the aperture height. The data presented herein are expected to be of interest to all anesthesiologists who might be involved in SHD catheterization. The data are also expected to enhance their understanding of radiation exposure protection.

Objective: Recently, the number of structural heart disease (SHD) procedures has increased, leading to increased radiation exposure doses of physicians. Information about SHD physicians' exposure is insufficient to elucidate their degree of exposure. Physicians' radioprotection is therefore poor or sometimes overly cautious. This study uses quantitative evaluation with a physical simulation to elucidate the exposure dose sustained by physicians during SHD procedures. Methods: The reported Monte Carlo system was used for dose estimation while using statistical sampling to simulate particle interactions in matter. The simulation geometry resembled an actual SHD procedure. Body models were posturally transformed to simulate a physician's posture for the procedure faithfully and correctly. Results: Doses for the left eye lens in the upper body were about 1.5 times higher than doses for the right eye lens under all fluoroscopic directions. Doses for the left-hand skin were twice those for the right side. Hand skin doses varied depending on the direction. The same applied to doses for abdominal skin. Conclusion:The results of this study suggest that physicians' exposures differ significantly depending on the fluoroscopic directions. Physicians should understand the dose differences and endeavor to reduce risks posed by self-exposure.