Skip to main content
SpringerLink
Log in

Impact of radiation to the eye of operators during endo-cardiovascular surgery and the importance of protection

  • Original Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Objective

To verify the amount of radiation exposure to the eye of operators during endocardiovascular surgery (ECVS) in hybrid operating room (HOR), which increases the risk of cataracts in surgeons.

Methods

Fifty cases of ECVS (including 36 transcatheter aortic valve implantation and 14 thoracic endovascular repair) using the transfemoral approach performed from February 2020 to July 2020 were included. A measurement device was attached to the left side of the head of the operators and their assistants to measure the cumulative dose (CD) of intraoperative radiation exposure. The subjects were divided into the control group (Group C, n = 26), received conventional protection using the protective curtain in HOR and the protected group (Group R, n = 24), received conventional protection and protection sheet. The normalized CD by dose area product (CD/DAP) was evaluated.

Results

The CD/DAP of the surgeons was significantly decreased in Group R, averaging at 5.97 μSV/Gy cm2 in Group C group and 4.40 μSV/Gy cm2 in Group R (p < 0.01). Moreover, CD/DAP of the assistant was significantly reduced in the Group R, with an average of 1.87 μSV/Gy cm2 in the Group C and 1.01 μSV/Gy cm2 in Group R (p < 0.01).

Conclusions

The radiation exposure to the surgeon’s eye could be significantly reduced by protection sheet.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Vano E, Kleiman NJ, Duran A, Rehani MM, Echeverri D, Cabrera M. Radiation cataract risk in interventional cardiology personnel. Radiat Res. 2010;174:490–5.

    Article  CAS  Google Scholar 

  2. Della Vecchia E, Modenese A, Loney T, Muscatello M, Silva Paulo M, Rossi G, et al. Risk of cataract in health care workers exposed to ionizing radiation: a systematic review. Med Lav. 2020;111(4):269–84. https://doi.org/10.23749/mdl.v111i4.9045 (PMID: 32869764).

    Article  PubMed  PubMed Central  Google Scholar 

  3. Domienik-Andrzejewska J, Kałużny P, Piernik G, Jurewicz J. Occupational exposure to ionizing radiation and lens opacity in interventional cardiologists. Int J Occup Med Environ Health. 2019;32(5):663–75. https://doi.org/10.13075/ijomeh.1896.01456 (Epub 2019 Oct 4 PMID: 31588928).

    Article  PubMed  Google Scholar 

  4. Cousins C, Miller DL, Bernardi G, Rehani MM, Schofield P, Vañó E, et al. ICRP Publication 120: radiological protection in cardiology. Ann ICRP. 2013;42(1):1–125. https://doi.org/10.1016/j.icrp.2012.09.001 (PMID: 23141687).

    Article  CAS  PubMed  Google Scholar 

  5. Merrachi NA, Bouchard-Bellavance R, Perreault P, Gilbert P, Soulez G, Bouchard L, et al. Eye lens dosimetry in interventional radiology: assessment with dedicated HP(3) dosimeters. Can Assoc Radiol J. 2020. https://doi.org/10.1177/0846537120911755 (Epub ahead of print. PMID: 32216558).

    Article  PubMed  Google Scholar 

  6. Alazzoni A, Gordon CL, Syed J, Natarajan MK, Rokoss M, Schwalm JD, et al. Randomized controlled trial of radiation protection with a patient lead shield and a novel, nonlead surgical cap for operators performing coronary angiography or intervention. Circ Cardiovasc Interv. 2015;8(8): e002384. https://doi.org/10.1161/CIRCINTERVENTIONS.115.002384 (PMID: 26253734).

    Article  PubMed  Google Scholar 

  7. Uthoff H, Quesada R, Roberts JS, Baumann F, Schernthaner M, Zaremski L, et al. Radioprotective lightweight caps in the interventional cardiology setting: a randomised controlled trial (PROTECT). EuroIntervention. 2015;11(1):53–9. https://doi.org/10.4244/EIJV11I1A9 (PubMed PMID: 25982649).

    Article  PubMed  Google Scholar 

  8. van Rooijen BD, de Haan MW, Das M, Arnoldussen CW, de Graaf R, van Zwam WH, Backes WH, Jeukens CR. Efficacy of radiation safety glasses in interventional radiology. Cardiovasc Intervent Radiol. 2014;37(5):1149–55. https://doi.org/10.1007/s00270-013-0766-0 (Epub 2013 Nov 2 PMID: 24185812).

    Article  PubMed  Google Scholar 

  9. Geber T, Gunnarrson M, Mattsson S. Eye lens dosimetry for interventional procedures—relation between the absorbed dose to the lens and dose at measurement positions In. Radiat Meas. 2011;46:1238–51.

    Article  Google Scholar 

  10. da Silva HE, Vanhavere F, Struelens L, Covens P, Buls N. Effect of protective devices on the radiation dose received by the brains of interventional cardiologists. EuroIntervention. 2018;13(15):e1778–84. https://doi.org/10.4244/EIJ-D-17-00759 (PMID: 29039310).

    Article  Google Scholar 

  11. Burns S, Thornton R, Dauer LT, Quinn B, Miodownik D, Hak DJ. Leaded eyeglasses substantially reduce radiation exposure of the surgeon’s eyes during acquisition of typical fluoroscopic views of the hip and pelvis. J Bone Joint Surg Am. 2013;95(14):1307–11. https://doi.org/10.2106/JBJS.L.00893 (PMID: 23864179).

    Article  PubMed  Google Scholar 

  12. Vlastra W, Delewi R, Sjauw KD, Beijk MA, Claessen BE, Streekstra GJ, et al. Efficacy of the RADPAD protection drape in reducing operators’ radiation exposure in the catheterization laboratory: a sham-controlled randomized trial. Circ Cardiovasc Interv. 2017;10(11): e006058. https://doi.org/10.1161/CIRCINTERVENTIONS.117.006058 (PMID: 29089313).

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Surgery, Osaka University, Yamada-Oka 2-2, Suita, Osaka, Japan

    Junki Yokota, Toru Kuratani, Kazuo Shimamura, Takayuki Shijo, Kizuku Yamashita, Toru Ide, Ryota Matsumoto & Shigeru Miyagawa

Authors
  1. Junki Yokota
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toru Kuratani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kazuo Shimamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takayuki Shijo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kizuku Yamashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Toru Ide
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ryota Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Shigeru Miyagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Toru Kuratani.

Ethics declarations

Conflict of interest

All authors have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yokota, J., Kuratani, T., Shimamura, K. et al. Impact of radiation to the eye of operators during endo-cardiovascular surgery and the importance of protection. Gen Thorac Cardiovasc Surg 70, 347–351 (2022). https://doi.org/10.1007/s11748-021-01701-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-021-01701-6

Keywords

Search

Navigation