Title

Radiation dose benchmarks in pediatric cardiac catheterization: A prospective multi-center C3PO-QI study.

Year of Publication

2017

Number of Pages

269-80

Date Published

2017 Aug 1

ISSN Number

1522-726X

Abstract

<p><strong>OBJECTIVES: </strong>This study sought to update benchmark values to use a quality measure prospectively.</p>

<p><strong>BACKGROUND: </strong>Congenital Cardiac Catheterization Outcomes Project - Quality Improvement (C3PO-QI), a multi-center registry, defined initial radiation dose benchmarks retrospectively across common interventional procedures. These data facilitated a dose metric endorsed by the American College of Cardiology in 2014.</p>

<p><strong>METHODS: </strong>Data was collected prospectively by 9 C3PO-QI institutions with complete case capture between 1/1/2014 and 6/30/2015. Radiation was measured in total air kerma (mGy), dose area product (DAP) (µGy*M(2) ), DAP per body weight, and fluoroscopy time (min), and reported by age group as median, 75(th) and 95(th) %ile for the following six interventional procedures: (1) atrial septal defect closure; (2) aortic valvuloplasty; (3) treatment of coarctation of the aorta; (4) patent ductus arteriosus closure; (5) pulmonary valvuloplasty; and (6) transcatheter pulmonary valve implantation.</p>

<p><strong>RESULTS: </strong>The study was comprised of 1,680 unique cases meeting inclusion criteria. Radiation doses were lowest for pulmonary valvuloplasty (age &lt;1 yrs, median mGy: 59, DAP: 249) and highest in transcatheter pulmonary valve implantation (age &gt;15 yrs, median mGy: 1835, DAP: 17990). DAP/kg standardized outcome measures across weights within an age group and procedure type significantly more than DAP alone. Radiation doses decreased for all procedures compared to those reported previously by both median and median weight-based percentile curves. These differences in radiation exposure were observed without changes in median fluoroscopy time.</p>

<p><strong>CONCLUSIONS: </strong>This study updates previously established benchmarks to reflect QI efforts over time. These thresholds can be applied for quality measurement and comparison. © 2017 Wiley Periodicals, Inc.</p>

DOI

10.1002/ccd.26911

Alternate Title

Catheter Cardiovasc Interv

PMID

28198573

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