Efficacy of a Protective Sheet for Reducing Ocular Radiation Exposure During Transcatheter Aortic Valve Implantation

• Published in: Circulation Journal Vol. 86; no. 11; pp. 1764 - 1768
• Main Authors: Yokota, Junki, Kuratani, Toru, Shimamura, Kazuo, Maeda, Koichi, Kawamura, Ai, Yamashita, Kizuku, Mizote, Isamu, Nakamura, Daisuke, Mukai, Takashi, Sakata, Yasushi, Miyagawa, Shigeru
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 25.10.2022
• Subjects: Aortic Valve - surgery; Aortic Valve Stenosis - surgery; Eyes; Fluoroscopy - adverse effects; Humans; Radiation Dosage; Radiation exposure; Radiation Exposure - adverse effects; Radiation Exposure - prevention & control; Radiation protection; Risk Factors; Transcatheter aortic valve implantation; Transcatheter Aortic Valve Replacement - adverse effects; Transcatheter Aortic Valve Replacement - methods; Treatment Outcome; Transcatheter aortic valve implantation; Radiation exposure; Eyes; Radiation protection
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-22-0400

Background: The use of hybrid operating rooms (HOR) for transcatheter aortic valve implantation (TAVI) has increased, so radiation exposure during procedures that use X-ray fluoroscopy is a fundamental problem not only for patients but also for surgeons and interventional cardiologists, increasing the risk of cataracts among operators. We investigated the efficacy of leaded glasses and protective sheets for ocular radiation protection.Methods and Results: Between January 2020 and February 2021 we enrolled 54 TAVI procedures using the transfemoral approach. The subjects were divided into a curtain protection group (Group C, n=20), glass protection group (Group G, n=17), and sheet protection group (Group S, n=17). The cumulative dose (CD) of the operators showed a decreasing trend in Group S compared with the other two groups. The CD normalized by dose area product (CD/DAP) of the operators was significantly reduced in Group S compared with Group C. However, Group G showed no significant difference compared with Group C. Regarding the distribution of CD/DAP, Group S had a significantly lower distribution than that in groups C and G.Conclusions: Protective sheets provide more stable radiation protection than conventional curtains or leaded glasses.