Article

Radiation dose typical values per procedure complexity for transcatheter ventricular septal defect closure in pediatrics

¹ Lebanese Atomic Energy Commission, National Council for Scientific Research, 11-8281 Beirut, Lebanon
² Hotel Dieu de France University Medical Center, Department of Pediatrics, Saint Joseph University, Alfred Naccache Boulevard, Achrafieh, Beirut, Lebanon
³ Hotel Dieu de France University Medical Center, Department of Pediatric Cardiology, Saint Joseph University, Alfred Naccache Boulevard, Achrafieh, Beirut, Lebanon
⁴ Paris-Sud University Hospitals, Radiology and Nuclear Medicine Department, 94270 Le Kremlin-Bicêtre, France

^* Corresponding author: c.rizk@laec-cnrs.gov.lb

Received: 19 August 2020
Accepted: 12 February 2021

Abstract

This study aims to establish radiation dose typical values (TV) for ventricular septal defect (VSD) percutaneous closures based on patient-, device- and procedure-related characteristics. Clinical and exposure data were retrospectively reviewed for 92 consecutive pediatric patients with VSD in whom transcatheter closure attempt was undertaken between March 2016 and December 2019 at a single reference center. TV were derived as the median value of total air kerma-area product (P_KA,T), air kerma at the patient entrance reference point, fluoroscopy time and number of frames. Statistical analyses were conducted to investigate the exposure variability according to patient, device- and procedure-related characteristics. For (5–< 15 kg) patients, TV were 27 Gy · cm² in term of P_KA,T for venous vs. 9 Gy · cm² for arterial approach. For (15–< 30 kg) patients, TV were 53 Gy · cm² for muscular vs. 18 Gy · cm² for perimembranous defects and 36 Gy · cm² for Amplatzer^TM vs. 14 Gy · cm² for the Lifetech^TM device. Procedures conducted with the assistance of a fellow, venous approach, muscular VSD, Amplatzer^TM devices, and procedural incidents increased the exposure levels significantly. The established TV provide benchmarks on patient exposure per procedure complexity and should help promote better patient radiation protection.