Background: During interventional cardiology processes, patients especially women and children receive high radiation doses due to their sensitivity. Objective: In this study, we evaluated a pediatric patient dose separately in those undergone intervention cardiac procedure. Material and Methods: In this cross sectional study, a public hospital with 252 patients, Entrance Skin Dose (ESD) and Dose-Area Product (DAP) were recorded. Prior to the beginning of fluoroscopic procedure, the chest thickness and Body Mass Index (BMI) of patients were measured. Furthermore, kV, mAs, angle of tube and time of angiography and angioplasty were recorded. Results: Children ratio to all patients underwent the cardiovascular imaging was 1.8. The means of patients’ ESD, DAP and fluoroscopy time were 178.3±17 mGy, 1123.6±11 μGycm2 and 281.4±181.2 s, respectively for coronary angiography. The females were 96.8 under 30 years and their dose mean was 276±37 mGy, 368±24 μGycm2 for ESD and DAP received, respectively with 376s fluoroscopy time. Mean mAs was 359±34 and kV was 71.23±2.7. Above all, a direct and significant correlation was found between the patients’ chest thickness with kV (p=0.037, r = 0.11) and mAs (p<0.001, r = 0.28) variations. Conclusion: The results demonstrated that the number of children referred to the cardiology department and also the dose rate received by them during this test was higher than the data provided for children in developing countries. Paying attention to the children’s perception of high-fluorescence time is necessary in comparison with total angiography time in order to reduce the number of radiation injuries among pediatrics. |
- Tsapaki V. Radiation dose in interventional cardiology. Imaging Med. 2010;2:303-12.
- Pantos I, Patatoukas G, Katritsis DG, Efstathopoulos E. Patient radiation doses in interventional cardiology procedures. Curr Cardiol Rev. 2009;5:1-11. doi: 10.2174/157340309787048059. PubMed PMID: 20066141. PubMed PMCID: PMC2803281.
- Backe EM, Seidler A, Latza U, Rossnagel K, Schumann B. The role of psychosocial stress at work for the development of cardiovascular diseases: a systematic review. Int Arch Occup Environ Health. 2012;85:67-79. doi: 10.1007/s00420-011-0643-6. PubMed PMID: 21584721. PubMed PMCID: PMC3249533.
- Dionysia N. Factors affecting the quality of life in children with congenital heart disease. Health Science Journal. 2010;4(2):94-100.
- Lage K, Greenway SC, Rosenfeld JA, Wakimoto H, Gorham JM, Segre AV, et al. Genetic and environmental risk factors in congenital heart disease functionally converge in protein networks driving heart development. Proc Natl Acad Sci U S A. 2012;109:14035-40. doi: 10.1073/pnas.1210730109. PubMed PMID: 22904188. PubMed PMCID: PMC3435181.
- Naghavi-Behzad M, Alizadeh M, Azami S, Foroughifar S, Ghasempour-Dabbaghi K, Karzad N, et al. Risk Factors of Congenital Heart Diseases: A Case-Control Study inNorthwest Iran. J Cardiovasc Thorac Res. 2013;5:5-9. doi: 10.5681/jcvtr.2013.002. PubMed PMID: 24251002. PubMed PMCID: PMC3825379.
- Silva MSR, Khoury HJ, Borrás C, Oliveira AF, Vianna HF, Oliveira FR, et al. Radiation dosimetry in patients and physicians during percutaneous coronary angioplasty in Recife, Pernambuco, Brazil. Radiologia Brasileira. 2011;44:90-6.
- Khalafalla EH, Habbani F, Gar-elnabi M. Effective Dose to Patients during Cardiac Interventional Procedures (Khartoum-Sudan). International Journal of Science and Research (IJSR). 2016;5:3;138-141.
- Nayar AK, White BM, Stone KE, Slim AM. Radiation exposure and associated cancer risk with cardiac diagnostic imaging. Journal of the American Osteopathic College of Radiology. 2013;2:14-20.
- Hill KD, Frush DP, Han BK, Abbott BG, Armstrong AK, DeKemp RA, et al. Radiation Safety in Children With Congenital and Acquired Heart Disease: A Scientific Position Statement on Multimodality Dose Optimization From the Image Gently Alliance. JACC Cardiovasc Imaging. 2017;10:797-818. doi: 10.1016/j.jcmg.2017.04.003. PubMed PMID: 28514670
- Hernanz-Schulman M, Goske MJ, Bercha IH, Strauss KJ. Pause and pulse: ten steps that help manage radiation dose during pediatric fluoroscopy. AJR Am J Roentgenol. 2011;197:475-81. doi: 10.2214/AJR.10.6122.
- Ubeda C, Miranda P, Vano E, Nocetti D, Manterola C. Organ and effective doses from paediatric interventional cardiology procedures in Chile. Phys Med. 2017;40:95-103. doi: 10.1016/j.ejmp.2017.07.015. PubMed PMID: 28743619.
- Hung MC, Hwang JJ. Cancer risk from medical radiation procedures for coronary artery disease: a nationwide population-based cohort study. Asian Pac J Cancer Prev. 2013;14:2783-7. PubMed PMID: 23803032.
- Herrmann TL, Fauber TL, Gill J, Hoffman C, Orth DK, Peterson PA, et al. Best practices in digital radiography. Radiol Technol. 2012;84:83-9.
- Shah A, Das P, Subkovas E, Buch AN, Rees M, Bellamy C. Radiation dose during coronary angiogram: relation to body mass index. Heart Lung Circ. 2015;24:21-5. doi: 10.1016/j.hlc.2014.05.018. PubMed PMID: 25065542.
- Chida K, Saito H, Otani H, Kohzuki M, Takahashi S, Yamada S, et al. Relationship between fluoroscopic time, dose-area product, body weight, and maximum radiation skin dose in cardiac interventional procedures. American Journal of roentgenology. 2006;186:774-8.
- Koenig TR, Mettler FA, Wagner LK. Skin injuries from fluoroscopically guided procedures: part 2, review of 73 cases and recommendations for minimizing dose delivered to patient. AJR Am J Roentgenol. 2001;177:13-20. doi: 10.2214/ajr.177.1.1770013. PubMed PMID: 11418390.
- United Nations Scientific Committee on the Effects of Atomic Radiation. Sources, effects and risks of ionizing radiation. Report to the General Assembly, with annexes; New York: United Nations; 1988.
- Harbron RW, Dreuil S, Bernier MO, Pearce MS, Thierry-Chef I, Chapple CL, et al. Patient radiation doses in paediatric interventional cardiology procedures: a review. J Radiol Prot. 2016;36:R131-R44. doi: 10.1088/0952-4746/36/4/R131. PubMed PMID: 27893455.
- Vano E, Ubeda C, Leyton F, Miranda P. Radiation dose and image quality for paediatric interventional cardiology. Phys Med Biol. 2008;53:4049-62. doi: 10.1088/0031-9155/53/15/003. PubMed PMID: 18612174.
- Fransson SG, Persliden J. Patient radiation exposure during coronary angiography and intervention. Acta Radiol. 2000;41:142-4. PubMed PMID: 10741786.
- Mesbahi A, Aslanabadi N, Mehnati P. A study on the impact of operator experience on the patient radiation exposure in coronary angiography examinations. Radiat Prot Dosimetry. 2008;132:319-23. doi: 10.1093/rpd/ncn300. PubMed PMID: 19088105.
- Seguchi S, Aoyama T, Koyama S, Kawaura C. Evaluation of radiation doses to patients undergoing coronary angiography and percutaneous coronary intervention based on the dosimetry in an anthropomorphic phantom. Japanese Journal of Health Physics. 2006;41:234-48.
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