B-16 | Radiation Reduction in Congenital Cardiac Catheterization by Optimizing Fluoroscopy and Minimizing Cineangiography

Limiting radiation exposure is critically important in pediatric patients. We report radiation dose and exposure values in pediatric patients undergoing interventional procedures in the cath lab using a latest generation digital imaging system and adherence to the ALARA (As Low As Reasonably Achievable) principle. Retrospective single center review for quality improvement of select cardiac catheterizations performed in 2023 using the ARTIS icono imaging system (Siemens Healthcare). Data collected included demographics, fluoroscopy time, dose (Air KERMA) and exposure (Dose Area Product). Procedures tracked included ASD (atrial septal defect) and PDA (patent ductus arteriosus) device closure, coarctation intervention, and pulmonary valvuloplasty. Comparison was made to published data (Lamers et al using Q.Zen Siemens system and Cevallos et al. using various imaging systems). Radiation reduction was obtained by reducing pulsed fluoroscopy to 2.5 pulses/sec, use of a low dose/pulse setting, and replacement of cineangiography with a higher dose and pulse rate fluoroscopy setting. We found a significant reduction in radiation dose and exposure when compared to published data. Median radiation dose was reduced by 50% and 89% for ASD closure, 70% and 89% for PDA closure, 80% and 90% for coarctation interventions and 81% and 92% for pulmonary valvuloplasty, when compared to Lamers et al and Cevallos et al respectively. Improvements in the Siemens ARTIS icono imaging system and adherence to ALARA principle has resulted in significant reduction in radiation dose and exposure for select congenital cardiac procedures.