Department of Cardiology, University of Lorraine, University Hospital of Nancy, Nancy, France.
Department of Cardiology, University of Lorraine, University Hospital of Nancy, Nancy, France.
Am J Cardiol. 2022 Oct 15;181:25-31. doi: 10.1016/j.amjcard.2022.07.014. Epub 2022 Aug 13.
Reducing radiation exposure during cardiovascular catheterization is of paramount importance to ensure patient and staff safety. Our study aimed to assess the transferability of acquired skills from virtual reality to the real world, including radioprotection measures during mentored simulation training (ST) in coronary angiography. A total of 10 cardiology residents were evaluated during real-life cases in the catheterization laboratory before (group A) and after mentored ST. The educational effect of mentored simulator training on real-life case performance was evaluated at 2 different time points: within the first week (group B) and after 12 weeks (group C). Compared with group A, the total dose area product (DAP) (µGy•m) and total air kerma (mGy) were lower after ST: group A: 2,633 (1,723 to 3,617) versus group B: 1,618 (1,032 to 2,562), p <0.05 and 214 (136 to 297) versus 135 (84 to 222), p <0.05, respectively. Concerning operator radiation exposure (µSv), left finger dose: 1,090 (820 to 1,460) versus 635 (300 to 900), p = 0.028; left leg dose 80 (0 to 110) versus 0 (0 to 0), p = 0.027; left eye lens dose: 39 (24 to 69) versus 11 (8 to 20), p <0.0001; and chest dose outside the lead apron: 50 (34 to 88) versus 29 (21 to 50), p <0.003 were significantly lower in the group B than group A. A total of 12 weeks after ST, the total DAP and total air kerma remained stable along with operator exposure except left eye lens dose (µSv): group B: 11 (8 to 20) versus group C: 16 (12 to 27), p = 0.02. In addition, left eye lens dose, left wrist dose, and chest dose outside the lead apron were significantly correlated with total DAP (rs = 0.635, rs = 0.729, and rs = 0, 629, respectively) and total air kerma (rs = 0.488, rs = 0.514, and rs = 0.548, respectively) at 12 weeks. In conclusion, ST for coronary angiography may improve radioprotection learning and should be incorporated into training curricula.
在心血管导管插入术期间降低辐射暴露对于确保患者和工作人员的安全至关重要。我们的研究旨在评估从虚拟现实到真实世界的技能转移能力,包括在冠状动脉造影的有指导模拟培训(ST)期间的放射防护措施。在导管实验室的实际病例中,共有 10 名心脏病学住院医师在接受有指导的 ST 之前(A 组)和之后进行了评估。在两个不同的时间点评估了有指导的模拟器培训对实际病例表现的教育效果:第一周内(B 组)和 12 周后(C 组)。与 A 组相比,ST 后总剂量面积产物(DAP)(µGy•m)和总空气比释动能(mGy)降低:A 组:2,633(1,723 至 3,617)与 B 组:1,618(1,032 至 2,562),p<0.05 和 214(136 至 297)与 135(84 至 222),p<0.05。关于操作员的辐射暴露(µSv),左手手指剂量:1,090(820 至 1,460)与 635(300 至 900),p=0.028;左小腿剂量 80(0 至 110)与 0(0 至 0),p=0.027;左眼晶状体剂量:39(24 至 69)与 11(8 至 20),p<0.0001;铅围裙外胸部剂量:50(34 至 88)与 29(21 至 50),p<0.003 在 B 组明显低于 A 组。ST 后 12 周,除左眼晶状体剂量(µSv)外,总 DAP 和总空气比释动能以及操作员暴露均保持稳定:B 组:11(8 至 20)与 C 组:16(12 至 27),p=0.02。此外,左眼前晶状体剂量、左腕剂量和铅围裙外胸部剂量与总 DAP(rs=0.635,rs=0.729,rs=0,629)和总空气比释动能(rs=0.488,rs=0.514,rs=0.548)呈显著相关,分别在 12 周时。总之,冠状动脉造影的 ST 可能会改善放射防护学习,应纳入培训课程。