Research finds high radiation risk from interventional heart procedure

Research finds high radiation risk from interventional heart procedure
Fred and Lena Meijer Heart Center. <strong> Courtesy Spectrum Health </strong>

A recent Spectrum Health study found interventional echocardiographers receive higher radiation levels than that of other interventional cardiologists. 

An echocardiogram uses sound waves to produce images of the heart, enabling a doctor to see the inner workings of the heart and use the images to identify potential heart disease. 

During common interventional echocardiography procedures — such as transesophageal echocardiography (done by inserting a probe down the esophagus); percutaneous left atrial appendage closure (LAAO); and transcatheter edge-to-edge mitral valve repair (TEER), a minimally invasive procedure that treats leakage of the mitral valve without open heart surgery — an interventional echocardiographer is required to stand near a radiation source and patient. 

Interventional echocardiography has rapidly evolved in health care as an increasing number of structural heart interventions now require real-time imaging guidance for device placement and immediate functional evaluation. 

But researchers at Spectrum Health determined interventional echocardiographers receive greater head-level radiation doses than interventional cardiologists during two commonly performed structural heart cases.

Despite previous work demonstrating high radiation exposure for interventional cardiologists, similar data for interventional echocardiographers is lacking, according to Spectrum Health.

In a study of 60 structural heart procedures, radiation doses were collected from interventional echocardiographers, interventional cardiologists and sonographers during 30 LAAO and 30 TEER procedures from July 1, 2016, to Jan. 31, 2018.

As a result of the study, researchers determined interventional echocardiographers experienced higher head-level radiation doses than interventional cardiologists and sonographers.

“These comparatively higher radiation doses indicate a previously underappreciated occupational risk faced by interventional echocardiographers,” said first study author Dr. David McNamara. “These findings have implications for the rapidly expanding field of structural heart procedures.” 

McNamara said future studies are planned to further target interventions and reduce these radiation doses.

Results of the study were published July 7 in JAMA Network Open, and the work was funded by the Frederik Meijer Heart & Vascular Institute, Spectrum Health and Corindus, A Siemens Healthineers Company.

Dr. Ryan Madder served as senior author. Additional authors include Dr. Rajus Chopra, Dr. Jeffrey Decker, Dr. Michael McNamara, Dr. Stacie VanOosterhout, Dr. Duane Berkompas, Dr. Musa Dahu, Dr. Mohamad Kenaan, Dr. Wassim Jawad, Dr. William Merhi, and Dr. Jessica Parker

All authors are affiliated with Frederik Meijer Heart & Vascular Institute, Spectrum Health.

“Spectrum Health has a strong national reputation in radiation exposure work led by Dr. Ryan Madder from our cardiology group,” McNamara said. “This has focused predominantly on radiation exposure during heart catheterizations for coronary artery disease work. The current study builds upon the foundation from prior published studies to expand into the growing field of interventional echocardiography and structural heart interventions.”