Comparison of Radiation Exposure Among Interventional Echocardiographers, Interventional Cardiologists, and Sonographers During Percutaneous Structural Heart Interventions

• DOI: 10.1001/jamanetworkopen.2022.20597
• Publication Date: 2022-07-07T15:32:29Z
• Authors: David A. McNamara; Rajus Chopra; Jeffrey M. Decker; Michael W. McNamara; Stacie M. VanOost...; Duane C. Berkompas; Musa I. Dahu; Mohamad A. Kenaan; Wassim I. Jawad; William M. Merhi; Jessica L. Parker; Ryan D. Madder
• Keywords: Interventional radiology; Interventional cardiology

<h3>Importance</h3> Transesophageal echocardiography during percutaneous left atrial appendage closure (LAAO) and transcatheter edge-to-edge mitral valve repair (TEER) require an interventional echocardiographer to stand near the radiation source patient, primary of scatter radiation. Despite previous work demonstrating high exposure for cardiologists performing coronary structural heart interventions, similar data echocardiographers are lacking. <h3>Objective</h3> To assess whether exposed greater doses than sonographers procedures. <h3>Design, Setting, Participants</h3> In this single-center cross-sectional study, were collected from echocardiographers, cardiologists, at a quaternary care center 30 sequential LAAO TEER procedures July 1, 2016, January 31, 2018. Participants study personnel blinded through analysis (January 2020, October 12, 2021). <h3>Exposures</h3> Occupation defined as sonographers. <h3>Main Outcomes Measures</h3> Measured personal dose equivalents per case recorded using real-time dosimeters. <h3>Results</h3> A total 60 (30 LAAO) performed in patients (mean [SD] age, 79 [8] years; 32 [53.3%] male) with cardiovascular risk factor burden. The median was higher (10.6 μSv; IQR, 4.2-22.4 μSv) (2.1 0.2-8.3 μSv;<i>P</i> &lt; .001). During TEER, received 10.5 μSv (IQR, 3.1-20.5 μSv), which by (0.9 0.1-12.2 procedures, 10.6 5.8-24.1 among 3.5 1.3-6.3 (<i>P</i> Compared exhibited low both (0.2 0.0-1.6 .001) (0.0 0.0-0.1 <h3>Conclusions Relevance</h3> whereas demonstrated comparatively lower doses. Higher indicate previously underappreciated occupational faced has implications rapidly expanding team.