Pregnancy in the Cardiac Catheterization Laboratory

2021 ◽  
Vol 14 (4) ◽  
Author(s):  
Amy E. Cheney ◽  
Logan L. Vincent ◽  
James M. McCabe ◽  
Kathleen E. Kearney
Keyword(s):  
Radiation Exposure ◽  
Cardiac Catheterization ◽  
New Technologies ◽  
Female Representation ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Exposure During Pregnancy ◽  
Available Information ◽  
The Impact ◽  
Occupational Radiation

Concerns over radiation exposure are ubiquitous to all interventional cardiologists; however, fear of exposure during childbearing years disproportionately deters women from entering the field. This review summarizes the available data on occupational radiation exposure during pregnancy with an emphasis on radiation quantification, the impact of exposure at various stages of fetal development, societal recommendations for safe levels of exposure during gestation, threshold levels necessary to induce fetal harm, and safe practices for the pregnant interventionalist. Reconciling the available information, we conclude that pregnancy in the cardiac catheterization laboratory is both safe and feasible. This review also highlights new technologies that may augment standard radiation safety techniques and are of particular interest to the pregnant interventional cardiologist. Finally, we propose steps to improve female representation in this field, underscoring the importance of a sex-balanced workforce.

scholarly journals Radiation Dose Reduction during Radial Cardiac Catheterization: Evaluation of a Dedicated Radial Angiography Absorption Shielding Drape

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Andrew Ertel ◽  
Jeffrey Nadelson ◽  
Adhir R. Shroff ◽  
Ranya Sweis ◽  
Dean Ferrera ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Cardiac Catheterization ◽  
Patient Comfort ◽  
Bleeding Complications ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Radiation Scatter ◽  
The Right ◽  
The Impact

Objectives. Radiation scatter protection shield drapes have been designed with the goal of decreasing radiation dose to the operators during transfemoral catheterization. We sought to investigate the impact on operator radiation exposure of various shielding drapes specifically designed for the radial approach. Background. Radial access for cardiac catheterization has increased due to improved patient comfort and decreased bleeding complications. There are concerns for increased radiation exposure to patients and operators. Methods. Radiation doses to a simulated operator were measured with a RadCal Dosimeter in the cardiac catheterization laboratory. The mock patient was a 97.5 kg fission product phantom. Three lead-free drape designs were studied. The drapes were placed just proximal to the right wrist and extended medially to phantom’s trunk. Simulated diagnostic coronary angiography included 6 minutes of fluoroscopy time and 32 seconds of cineangiography time at 4 standard angulated views (8 s each), both 15 frames/s. ANOVA with Bonferroni correction was used for statistical analysis. Results. All drape designs led to substantial reductions in operator radiation exposure compared to control (P<0.0001). The greatest decrease in radiation exposure (72%) was with the L-shaped design. Conclusions. Dedicated radial shielding drapes decrease radiation exposure to the operator by up to 72% during simulated cardiac catheterization.

scholarly journals Reduced radiation exposure in the cardiac catheterization laboratory with a novel vertical radiation shield

2019 ◽  
Vol 95 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Carmelo J. Panetta ◽  
Erin M. Galbraith ◽  
Marat Yanavitski ◽  
Patrick K. Koller ◽  
Binita Shah ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Cardiac Catheterization ◽  
Radiation Shield ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory

scholarly journals Effective Reduction of Radiation Exposure during Cardiac Catheterization

2019 ◽  
Vol 46 (3) ◽  
pp. 167-171 ◽  
Author(s):  
Alejandro Gutiérrez-Barrios ◽  
Hugo Camacho-Galán ◽  
Francisco Medina-Camacho ◽  
Dolores Cañadas-Pruaño ◽  
Antonio Jimenez-Moreno ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Cardiac Catheterization ◽  
Fine Tuning ◽  
Radiation Doses ◽  
Dose Area Product ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Percutaneous Coronary ◽  
Procedural Complications ◽  
Area Product

Exposure to ionizing radiation during cardiac catheterization can have harmful consequences for patients and for the medical staff involved in the procedures. Minimizing radiation doses during the procedures is essential. We investigated whether fine-tuning the radiation protocol reduces radiation doses in the cardiac catheterization laboratory. In January 2016, we implemented a new protocol with reduced radiation doses in the Hospital de Jerez catheterization laboratory. We analyzed 170 consecutive coronary interventional procedures (85 of which were performed after the new protocol was implemented) and the personal dosimeters of the interventional cardiologists who performed the procedures. Overall, the low-radiation protocol reduced air kerma (dose of radiation) by 44.9% (95% CI, 18.4%–70.8%; P=0.001). The dose-area product decreased by 61% (95% CI, 30.2%–90.1%; P &lt;0.001) during percutaneous coronary interventions. We also found that the annual deep (79%, P=0.026) and shallow (62.2%, P=0.035) radiation doses to which primary operators were exposed decreased significantly under the low-radiation protocol. These dose reductions were achieved without increasing the volume of contrast media, fluoroscopy time, or rates of procedural complications, and without reducing the productivity of the laboratory. Optimizing the radiation safety protocol effectively reduced radiation exposure in patients and operators during cardiac catheterization procedures.

scholarly journals Timeout for Contrast: Using Physician Behavior Modification to Reduce Contrast in the Catheterization Laboratory

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Robby Singh ◽  
Marcel Zughaib
Keyword(s):  
Cardiac Catheterization ◽  
Physician Behavior ◽  
First Year ◽  
Behavioral Modification ◽  
Contrast Induced Nephropathy ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
The Mean ◽  
Second Year ◽  
The Impact

Background. As the number of procedures using contrast media continues to rise, the ensuing complications place an ever increasing burden on the healthcare system. Contrast-induced nephropathy (CIN) is a common postprocedural complication after cardiac catheterization. Objectives. The purpose of our study was to evaluate the impact of physician behavioral modification on reducing the amount of contrast used during the procedure. Methods. All patients who underwent procedures in the cardiac catheterization laboratory from January 2013 to August 2016 were identified in addition to the total contrast used during the procedure, the type of procedure performed, and the operator performing the procedure. A new addition was made to the preprocedure checklist in September-October 2013 in the form of maximum allowed contrast for the patient. Results. A total of 12,118 cases were identified. Across all procedures, the mean contrast used during the 8 months prior to the intervention was 118 ml per procedure. Mean contrast used per procedure for the first year after the revised timeout was 105 ml, for the second year was 106 ml, and for the third year was 99 ml. Conclusion. A significant reduction in radiocontrast use across all operators and procedures after the introduction of a revised timeout procedure that was seen, which is a change that was sustained over a period of three years. With this straightforward intervention involving physician behavioral modification, patients were exposed to less of the nephrotoxic contrast and were consequently at a lower risk of developing dose-depended CIN and other associated complications.

scholarly journals Relationship of Beam Angulation and Radiation Exposure in the Cardiac Catheterization Laboratory

2014 ◽  
Vol 7 (5) ◽  
pp. 558-566 ◽  
Author(s):  
Shikhar Agarwal ◽  
Akhil Parashar ◽  
Navkaranbir Singh Bajaj ◽  
Imran Khan ◽  
Imran Ahmad ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Cardiac Catheterization ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Relationship Of
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