Radiogenic risks to patients and staff from fluoro-assisted therapeutic cardiac catheterizations

Advances in sectional imaging have led to prolonged x-ray fluoro-assisted therapeutic cardiac catheterizations. Given the frequency of such procedures, limited data are available for patient and staff doses. For certain pediatric cardiac catheterization procedures we examine: (i) effective and organ doses, also the radiogenic and tissue reaction risks and; (ii) staff effective dose during cardiac interventions. At four cardiac catheterization centres, patient doses were measured with a calibrated kerma area product (KAP) meter; staff doses were measured using calibrated TLDs. The mean and range of age (years) and weight (kg) for patients were 4.3 (0.04–14.0) and 10.8 (3.0–46.0) respectively; the overall mean and range of fluoroscopic time (min) was 13.0 (1.4–54.8). For coronary angiography and pacemaker procedures the overall mean and range of cumulative kerma area product (CKAP, cGy.cm²) were 350 (12.0–510). The average annual staff dose of 9.0 (7.2–14.4) mSv is relatively low given the current workload. Some patients received high doses approaching the threshold for tissue reactions. Optimisation of radiation dose is required as is follow-up of patients receiving high doses to detect the possibility of tissue reactions.