Radiation Dose Benchmarks During Cardiac Catheterization for Congenital Heart Disease in the United States

Radiation dose benchmarks in pediatric cardiac catheterization: A prospective multi‐center C3PO‐QI study

“…Further, as life expectancy in children with congenital heart disease increases, often from the interventional procedures themselves, these children may be subject to repeated catheterizations, resulting in higher cumulative radiation exposure over their lifetimes . As a result of increased awareness and publication on radiation exposure in children with congenital heart disease, many pediatric catheterization labs have begun to participate in radiation reduction initiatives, such as implementing local radiation safety protocols, as well as collaborating in national and international radiation reduction quality improvement (QI) efforts . However, there is a paucity of published radiation dose metrics for reference and comparison among pediatric cardiac catheterization procedures.…”

Radiation exposure in transcatheter patent ductus arteriosus closure: time to tune?

“…Our irradiation doses are significantly lower than reported studies. The recent US benchmarks published in 2014 by Ghelani et al, 3 the Congenital Cardiac Catheterization Project on Outcomes collaborative multicentre group, presents the radiation doses according to the type of procedures and the age classes. The median dose area product for patent ductus arteriosus closure was 7 (75th percentile: 16 Gy.cm 2 ) or seven times higher than us (and even 16 times current radiation exposure when using 7.5 frames/ second), the median fluoroscopic time was 12 (75th percentile: 17) min or 4.3 times higher than us, and the median air kerma was 109 (75th percentile: 175) mGy or 4.2 times higher than us.…”

Balancing competing risks

“…5 With the Congenital Cardiac Catheterization Outcomes Project -Quality Improvement C3PO-QI initiative, increased operator experience, and shorter procedure times, the amount of radiation to which patients are exposed has decreased over time. The radiation exposure for total air kerma and dose area product is lower than the ones reported previously by Ghelani et al 6,7 The lowest dose exposure occurs during pulmonary valvuloplasty and the highest during transcatheter pulmonary valve implantation. The risk to benefit ratio of a procedure is in large part determined by an assessment of the radiation exposure necessary to perform the procedure and the overall clinical value of the procedure as compared to alternative therapies.…”