1. Radiological exposure of patients undergoing transcatheter aortic valve implantation in contemporary practice
- Author
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Marco Moccetti, Luigi Biasco, Francesco Faletra, T. Moccetti, Enrico Ferrari, Davide Aviano, Luca Bellesi, Matteo Badini, Stefanos Demertzis, Stefano Presilla, Elena Pasotti, Giovanni Pedrazzini, Catherine Klersy, Ole De Backer, University of Zurich, and Biasco, Luigi
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Transcatheter aortic ,610 Medicine & health ,030204 cardiovascular system & hematology ,Lower risk ,Coronary Angiography ,Radiation Dosage ,Radiography, Interventional ,11171 Cardiocentro Ticino ,2705 Cardiology and Cardiovascular Medicine ,030218 nuclear medicine & medical imaging ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Multidetector Computed Tomography ,medicine ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Age Factors ,General Medicine ,Aortic Valve Stenosis ,Radiation Exposure ,Surgery ,Treatment Outcome ,Radiological weapon ,Aortic Valve ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Radiological exposure associated with transcatheter aortic valve implantation (TAVI) is unknown and might impact on broadening indications to lower risk patients. Radiological exposure of TAVI patients and its predictors are herein reported.Radiological exposure derived from exams/procedures performed within 30 days preceding/following TAVI were acquired and converted into effective-dose. Total effective-dose was defined as the sum of each single dose derived from diagnostic/therapeutic sources. Univariable and multivariable analyses were performed to recognize correlates of exposure.Seventy-five patients aged 82.6 ± 6.0 years with a median Euroscore II 3.6 [IQR 1.93-6.65] were analysed. Median total effective-dose was 41.39 mSv [IQR 27.93-60.88], with TAVI accounting for 47% of it. Age (coefficient -0.031, 95% CI -0.060 to -0.002; P = 0.031) and previous history of cerebrovascular accidents (CVA; coefficient -0.545; 95% CI -1.039 to -0.010; P = 0.046) resulted as inversely correlated to total effective-dose (log-transformed), whereas left ventricular ejection fraction (LVEF) less than 50% (coefficient 0.430, 95% CI 0.031-0.828; P = 0.035) was directly associated.Multiple radiological sources are responsible for the observed exposure, with TAVI being the prominent source. Age is inversely related to the radiological exposure.
- Published
- 2018