Hostname: page-component-848d4c4894-2pzkn Total loading time: 0 Render date: 2024-06-04T09:31:34.895Z Has data issue: false hasContentIssue false
  • English
  • Français

Effects of reducing frame rate from 7.5 to 4 frames per second on radiation exposure in transcatheter atrial septal defect closure

Published online by Cambridge University Press:  30 July 2018

Younes Boudjemline
Younes Boudjemline*
Affiliation:
Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Hôpital Necker Enfants Malades, Assistance Publique des Hôpitaux de Paris, Paris, France Université Paris Descartes, Paris, France Heart Center, Sidra Medicine, Doha, Qatar
*
Author for correspondence: Y. Boudjemline, MD, PhD, Director of Cardiac Catheterization Laboratories, Heart Center, Sidra Medicine, Doha 26999, Qatar. Tel: +974 4003 6602; Fax: +974 4404 2177; E-mail: yboudjemline@yahoo.fr
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

The aim of this study was to evaluate the reduction of frame rate from 7.5 to 4 frames per second on radiation exposure and to provide new standards of radiation exposure.

Background

Frame rate is a large contributor to radiation exposure. The use of 4 frames per second for closure of atrial septal defects has been reported not to affect the level of radiation exposure.

Methods

We retrospectively reviewed radiation data from all patients referred to our catheterisation laboratory for closure of an atrial septal defect between January, 2015 and June, 2017. Fluoroscopic time, dose area product (μGy.m2), and total air kerma (mGy) were collected. These values were compared according to the frame rate used for closure of atrial septal defects.

Results

A total of 49 atrial septal defects were closed using 7.5 frames per second and 85 using 4 frames per second. Baseline characteristics were similar in both groups. Procedural success was similar in both groups (100 versus 98.8%). Median total air kerma and dose area product were statistically lower in the 4 frames per second group (4 versus 1.3 mGy [p=0.00012]), 43.7 versus 13.1 μGy.m2 [p<0.00001]). There was no increase in median procedure and fluoroscopic times (respectively, 10 and 1.1 min for 7.5 and 4 frames per second), or complications (4.1 versus 2.3%, p>0.05).

Conclusion

Reduction of frame rate allows reducing significantly the radiation exposure while maintaining excellent clinical results in transcatheter closure of atrial septal defects. We recommend implementing this little change in every laboratory in order to achieve drastic reduction of radiation exposure to the patients and laboratory personnel.

Keywords

Radiation exposureatrial septal defecttranscatheter closure
Type
Original Article
Information
Cardiology in the Young , Volume 28 , Issue 11 , November 2018 , pp. 1323 - 1328
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Everett, AD, Jennings, J, Sibinga, E, et al. Community use of the amplatzer atrial septal defect occluder: results of the multicenter MAGIC atrial septal defect study. Pediatr Cardiol 2009; 30: 240–247.Google Scholar
2. Vijayalakshmi, K, Kelly, D, Chapple, CL, et al. Cardiac catheterisation: radiation doses and lifetime risk of malignancy. Heart 2007; 93: 370–371.Google Scholar
3. Harbron, RW, Chapple, CL, O’Sullivan, JJ, Best, KE, Berrington de González, A, Pearce, MS. Survival adjusted cancer risks attributable to radiation exposure from cardiac catheterisations in children. Heart 2017; 103: 341–346.Google Scholar
4. Hendee, WR, Edwards, FM. ALARA and an integrated approach to radiation protection. Semin Nucl Med 1986; 16: 142–150.Google Scholar
5. Sitefane, F, Malekzadeh-Milani, S, Villemain, O, Ladouceur, M, Boudjemline, Y. Reduction of radiation exposure in transcatheter atrial septal defect closure: how low must we go? Arch Cardiovasc Dis 2018; 111: 189–198.Google Scholar
6. Hiremath, G, Meadows, J, Moore, P. How slow can we go? 4 Frames per second (fps) versus 7.5 fps fluoroscopy for atrial septal defects (ASDs) device closure. Pediatr Cardiol 2015; 36: 1057–1061.Google Scholar
7. Borik, S, Devadas, S, Mroczek, D, Lee, KJ, Chaturvedi, R, Benson, LN. Achievable radiation reduction during pediatric cardiac catheterization: how low can we go? Catheter Cardiovasc Interv 2015; 86: 841–848.Google Scholar
8. Verghase, GR, McElhinney, DB, Strauss, KJ, Bergersen, L. Characterization of radiation exposure and effect of a radiation monitoring policy in a large volume pediatric cardiac catheterization lab. Catheter Cardiovasc Interv 2012; 79: 294–300.Google Scholar
9. Ghelani, SJ, Glatz, AC, David, S, et al. Radiation dose benchmarks during cardiac catheterization for congenital heart disease in the United States. JACC Cardiovasc Interv 2014; 7: 1060–1069.Google Scholar
10. Cevallos, PC, Armstrong, AK, Glatz, AC, et al. Radiation dose benchmarks in pediatric cardiac catheterization: a prospective multi-center C3PO-QI study. Catheter Cardiovasc Interv 2017; 90: 269–280.Google Scholar
11. El-Sayed, T, Patel, AS, Cho, JS, et al. Radiation-induced DNA damage in operators performing endovascular aortic repair. Circulation 2017; 136: 2406–2416.Google Scholar
12. Borghini, A, Vecoli, C, Mercuri, A, et al. Low-dose exposure to ionizing radiation deregulates the brain-specific microRNA-134 in interventional cardiologists. Circulation 2017; 136: 2516–2518.Google Scholar