Key result
Higher BMI is linked to greater radiation exposure during TAVI, with median air kerma-area product reaching ~166 Gy·cm2.
Why the study?
The amount of radiation received by patients undergoing fluoroscopic-guided TAVI had never been registered in Thailand, despite concerns about high radiation doses.
Observational (n=68)
No
Patients undergoing TAVI receive substantial radiation doses, which are highest in those with a BMI ≥30.0 kg/m2, highlighting the need for operators to minimize fluoroscopy time.
Provides first Thai TAVI radiation benchmarks; leaves open sex/BMI effects on dose, needing prospective validation.
Background: The trend in the use of fluoroscopic-guided transcatheter aortic valve implantation (TAVI) is increasing because the procedure is less invasive than surgical procedure. However, high radiation doses have been reported with the procedure. Moreover, the amount of radiation received by patients undergoing TAVI has never before been registered in Thailand. Objectives: This study aimed to investigate the radiation dose and the effects of sex and body mass index (BMI) on the radiation dose received by patients undergoing TAVI at Chulabhorn Hospital. Materials and methods: Data were collected on the radiation dose received by patients undergoing the TAVI procedure during the first 26 months after the operation at the Cardiology Center, Chulabhorn Hospital. We recorded patient demographic data including age, sex, and BMI and the following measures of radiation dose from the procedure: the number of exposure images, air kerma-area product (PKA), cumulative air kerma at the patient entrance reference point (Ka,r), and total fluoroscopy time. Results: In total, 68 patients (35 male and 33 female) underwent TAVI, with median exposure images, PKA, Ka,r, and total fluoroscopy time of 1,067 images, 166.14 Gy/cm2, 1,171.50 mGy, and 31.90 minutes, respectively. The patient’s sex did not affect total fluoroscopy time or the radiation dose received. Patients with BMI ≥30.0 kg/m2 had the highest median values of PKA, Ka,r, and total fluoroscopy time. Moreover, patients with BMI ≥18.5-24.9 kg/m2 received higher doses of radiation than patients with BMI ≥25.0-29.9 kg/m2; the result corresponded with longer total fluoroscopy time in the lower BMI category. Conclusion: The amount of radiation that patients received during TAVI was appropriate for diagnosis and treatment. However, to ensure patient safety, operators should consider reducing the duration of radiation during the procedure. Data from this study are a starting point for the recording of radiation doses received by patients undergoing TAVI and can be used as a future dose reference.
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Kawvised et al. (2023) conducted an observational in Aortic stenosis undergoing TAVI (n=68). Transcatheter aortic valve implantation (TAVI) was evaluated on Median air kerma-area product (PKA) in Gy/cm2. Patients undergoing TAVI received a median air kerma-area product of 166.14 Gy/cm2 and cumulative air kerma of 1,171.50 mGy, with the highest radiation doses observed in patients with a BMI ≥30.0 kg/m2.
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