Cumulative Exposure to Medical Radiation for Children Requiring Surgery for Congenital Heart Disease

Glatz, Andrew C.; Purrington, Kristen; Klinger, Amanda; King, Amanda R.; Hellinger, Jeffrey C.; Zhu, Xiaowei; Gruber, Stephen B.; Gruber, Peter J.

doi:10.1016/j.jpeds.2013.10.074

Cited by 81 publications

(55 citation statements)

References 26 publications

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“…Populations at risk for more exposure to low-dose ionizing radiation procedures and repetitive imaging are children, especially those with complex CHD, and those with genetic syndromes. 314,335,336 Johnson et al 334 demonstrated a wide range of radiation exposure depending on CHD complexity: 0.19 mSv (95% confidence interval, 0.07-29.28) for atrial septal defect repair compared with 28.93 mSv (95% confidence interval, 0.08-76.93) for those who underwent the Norwood operation. The lifetime exposure for an adolescent with CHD is estimated to be ≈20 mSv.…”

Section: Low-dose Ionizing Radiation and Malignancy In Chdmentioning

confidence: 99%

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Lui¹,

Saïdi²,

Bhatt³

et al. 2017

Circulation

175

136

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ABSTRACT:Life expectancy and quality of life for those born with congenital heart disease (CHD) have greatly improved over the past 3 decades. While representing a great advance for these patients, who have been able to move from childhood to successful adult lives in increasing numbers, this development has resulted in an epidemiological shift and a generation of patients who are at risk of developing chronic multisystem disease in adulthood. Noncardiac complications significantly contribute to the morbidity and mortality of adults with CHD. Reduced survival has been documented in patients with CHD with renal dysfunction, restrictive lung disease, anemia, and cirrhosis. Furthermore, as this population ages, atherosclerotic cardiovascular disease and its risk factors are becoming increasingly prevalent. Disorders of psychosocial and cognitive development are key factors affecting the quality of life of these individuals. It is incumbent on physicians who care for patients with CHD to be mindful of the effects that disease of organs other than the heart may have on the well-being of adults with CHD. Further research is needed to understand how these noncardiac complications may affect the long-term outcome in these patients and what modifiable factors can be targeted for preventive intervention.

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Section: Low-dose Ionizing Radiation and Malignancy In Chdmentioning

confidence: 99%

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Lui¹,

Saïdi²,

Bhatt³

et al. 2017

Circulation

175

136

View full text Add to dashboard Cite

show abstract

“…We previously described cumulative exposure to medical sources of radiation for a large cohort of patients undergoing congenital heart surgery. 2 Comparing lesionby-lesion radiation dose estimates with the present report reveals a number of disparities. This is undoubtedly because of differences in the method of dose measurement, equipment used, operator techniques, practice patterns, and time period.…”

Section: To the Editormentioning

confidence: 58%

Letter by Glatz et al Regarding Article, “Cumulative Radiation Exposure and Cancer Risk Estimation in Children With Heart Disease”

2015

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“…Two smaller, singlecenter cohort studies of LDIR exposure have described similar rates of imaging and therapeutic procedure use. In the first of these, among patients with CHD undergoing cardiac surgery, Glatz and colleagues 18 demonstrated that although the majority of children with CHD received an overall low cumulative level of LDIR exposure (<3 mSv/y) from medical procedures, a subset of patients, including neonates, patients with genetic syndromes, and patients with some severe CHD lesions, were exposed to >20 mSv/y. Additionally, Johnson and colleagues 19 collected data from 337 children with severe CHD lesions at their hospital over a 5-year follow-up period beginning in 2005.…”

Section: Discussionmentioning

confidence: 99%

Exposure to Low-Dose Ionizing Radiation From Cardiac Procedures in Patients With Congenital Heart Disease

et al. 2016

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Background— The burden of low-dose ionizing radiation (LDIR) exposure from medical procedures among individuals with congenital heart disease (CHD) is unknown. In this longitudinal population-based study, we sought to determine exposure to LDIR-related cardiac imaging and therapeutic procedures in children and adults with CHD. Methods and Results— In an analysis of the Quebec CHD database, exposure to the following LDIR-related cardiac procedures was recorded: catheter-based diagnostic procedures, structural heart interventions, coronary interventions, computed tomography scans of the chest, nuclear procedures, and pacemaker/implantable cardioverter-defibrillator insertion and repair. From 1990 to 2005, there were 16 253 LDIR-exposed patients with CHD with 317 988 patient-years of available follow-up. The total number of LDIR-related procedures increased from 18.5 to 51.9 per 1000 CHD patients per year ( P <0.0001). This increase was attributable to increases in rates per 1000 CHD patients in diagnostic cardiac catheterizations (11.7 to 13.7 per 1000), structural heart interventions (1.0 to 5.2 per 1000), coronary interventions (1.0 to 2.4 per 1000), pacemaker/implantable cardioverter-defibrillator insertions (1.6 to 4.4 per 1000), nuclear procedures (4.2 to 13.8 per 1000), and computed tomography scans of the chest (2.5 to 12.3 per 1000). Over time, among children with CHD, the median age at first LDIR procedure decreased from 5.0 years to 9.6 months. Severity of CHD significantly predicted extent of exposure. Conclusions— From 1990 to 2005, patients with CHD were exposed to increasing numbers of LDIR-emitting cardiac procedures. This exposure occurred at progressively younger ages. These findings provide an important perspective on longitudinal LDIR exposure in this at-risk population.

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Cumulative Exposure to Medical Radiation for Children Requiring Surgery for Congenital Heart Disease

Cited by 81 publications

References 26 publications

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Letter by Glatz et al Regarding Article, “Cumulative Radiation Exposure and Cancer Risk Estimation in Children With Heart Disease”

Exposure to Low-Dose Ionizing Radiation From Cardiac Procedures in Patients With Congenital Heart Disease

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