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- Document type:
- Journal Article
- Author(s):
- Michel, Jonathan M; Hashorva, Desard; Kretschmer, Angela; Alvarez-Covarrubias, Hector A; Mayr, N Patrick; Pellegrini, Costanza; Rheude, Tobias; Frangieh, Antonio H; Giacoppo, Daniele; Kastrati, Adnan; Schunkert, Heribert; Xhepa, Erion; Joner, Michael; Kasel, A Markus
- Title:
- Evaluation of a Low-Dose Radiation Protocol During Transcatheter Aortic Valve Implantation.
- Abstract:
- We aimed to evaluate the efficacy and safety of a low-dose imaging protocol to reduce intraprocedural radiation during transcatheter aortic valve implantation (TAVI). Observational analysis: 802 transfemoral TAVI patients receiving balloon-expandable devices ≥23 mm at a high-volume centre. After propensity score matching, a standard-dose group (SD, n = 333) treated between January 2014 and February 2016 was compared with a low-dose group (LD, n = 333) treated between August 2017 and March 2019 after departmental uptake of a low-dose imaging protocol (reduced field size, high table height, use of "fluoro save," 3.75 frames/second acquisition, increased filtering). Primary end point was dose-area product (DAP). Secondary safety end points were VARC-2 device success and a composite of in-hospital complications. The LD protocol was associated with lower DAP (4.64 [2.93, 8.42] vs 22.73 [12.31, 34.58] Gy⋅cm2, p <0.001) and fluoroscopy time (10.4 [8.1, 13.9] vs 11.5 [9.1, 15.3] minutes, p = 0.001). Contrast use was higher in the LD group (LD 110 [94, 130] vs SD 100 [80, 135] milliliters, p = 0.042). Device success (LD 88.3% vs SD 91.3%, p = 0.25), and the composite end point (LD 8.1% vs SD 11.4%, p = 0.19) were similar. In multivariate analysis, the low-dose protocol was associated with a 19.8 Gy⋅cm2 reduction in procedural DAP (p <0.001). In conclusion, compared with standard imaging, a low-dose protocol for TAVI significantly reduced radiation dose without compromising outcomes.
- Journal title abbreviation:
- Am J Cardiol
- Year:
- 2021
- Journal volume:
- 139
- Pages contribution:
- 71-78
- Fulltext / DOI:
- doi:10.1016/j.amjcard.2020.10.035
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/33190811
- Print-ISSN:
- 0002-9149
- TUM Institution:
- Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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