结构性心脏病经皮治疗期间的辐射剂量。
Radiation dose during percutaneous treatment of structural heart disease.
作者信息
Boland John E, Wang Louis W, Love Bernard J, Wynne Dylan G, Muller David W M
机构信息
Cardiac Catheterisation Laboratories, St Vincent's Public and Private Hospitals, Sydney, Australia.
Cardiac Catheterisation Laboratories, St Vincent's Public and Private Hospitals, Sydney, Australia.
出版信息
Heart Lung Circ. 2014 Nov;23(11):1075-83. doi: 10.1016/j.hlc.2014.04.258. Epub 2014 Jun 5.
BACKGROUND
With the increased application of structural heart intervention techniques, there is concern over increasing radiation dose, especially during lengthy procedures.
METHODS
We compared data from 91 consecutive single-vessel percutaneous coronary interventions, 69 patent foramen ovale closures, 25 atrial septal defect closures, 49 percutaneous transluminal mitral valvuloplasties, 57 balloon aortic valvuloplasties, 53 trans-catheter aortic valve implantations (TAVI), 21 left atrial appendage occlusions and 7 MitraClip procedures.
RESULTS
The following fluoroscopy times and dose-area product (median, interquartile range) were recorded: patent foramen ovale closure (7.8, 5.3-10.9 minutes; 16.9, 7.5-30.6 Gycm(2)), atrial septal defect closure (10.1, 7.3-13 minutes; 15.5, 11.6-30.5 Gycm(2)), percutaneous transluminal mitral valvuloplasty (14.3, 11.4-24.2 minutes; 37.4, 19.8-87.0 Gycm(2)), balloon aortic valvuloplasty (8.4, 5.2-13.2 minutes; 19.8, 10.2-30.0 Gycm(2)), Edwards Sapien TAVI (24.0, 19.3-34.4 minutes; 86.4, 64.0-111.4 Gycm(2)), Medtronic CoreValve TAVI (19.4, 15.0-26.0 minutes; 101.9, 52.6-143.2 Gycm(2)), left atrial appendage occlusion (18.5, 15.7-29.1 minutes; 84.1, 36.4-140.0 Gycm(2)), Mitraclip procedures (37.2, 14.2-59.9 minutes; 89.1, 26.2-118.7 Gycm(2)), coronary angiography and single vessel percutaneous coronary intervention (6.6, 5.1-11.0 minutes; 62.5, 37.0-95.8 Gycm(2)).
CONCLUSION
For structural heart interventions, dose-area product was not significantly greater than for coronary angiography with single-vessel percutaneous coronary artery intervention. This should be reassuring to patients and staff attending prolonged structural heart interventions.
背景
随着结构性心脏介入技术应用的增加，人们对辐射剂量的增加感到担忧，尤其是在长时间手术过程中。
方法
我们比较了91例连续单支血管经皮冠状动脉介入治疗、69例卵圆孔未闭封堵术、25例房间隔缺损封堵术、49例经皮腔内二尖瓣成形术、57例球囊主动脉瓣成形术、53例经导管主动脉瓣植入术（TAVI）、21例左心耳封堵术和7例MitraClip手术的数据。
结果
记录了以下透视时间和剂量面积乘积（中位数，四分位间距）：卵圆孔未闭封堵术（7.8，5.3 - 10.9分钟；16.9，7.5 - 30.6 Gycm²），房间隔缺损封堵术（10.1，7.3 - 13分钟；15.5，11.6 - 30.5 Gycm²），经皮腔内二尖瓣成形术（14.3，11.4 - 24.2分钟；37.4，19.8 - 87.0 Gycm²），球囊主动脉瓣成形术（8.4，5.2 - 13.2分钟；19.8，10.2 - 30.0 Gycm²），爱德华兹Sapien TAVI（24.0，19.3 - 34.4分钟；86.4，64.0 - 111.4 Gycm²），美敦力CoreValve TAVI（19.4，15.0 - 26.0分钟；101.9，52.6 - 143.2 Gycm²），左心耳封堵术（18.5，15.7 - 29.1分钟；84.1，36.4 - 140.0 Gycm²），MitraClip手术（37.2，14.2 - 59.9分钟；89.1，26.2 - 118.7 Gycm²），冠状动脉造影和单支血管经皮冠状动脉介入治疗（6.6，5.1 - 11.0分钟；62.5，37.0 - 95.8 Gycm²）。
结论
对于结构性心脏介入治疗，剂量面积乘积并不显著高于单支血管经皮冠状动脉介入治疗的冠状动脉造影。这应该会让接受长时间结构性心脏介入治疗的患者和工作人员放心。
Zotero 插件