OA221] The dose to the lens of the eye for the heart team performing transcatheter aortic valve implementation (TAVI): Is there any concern for cataract?

Abstract

Purpose To estimate and assess the lens doses to the heart team performing transcatheter aortic valve implementation (TAVI) from latest generation of interventional x-ray equipment and to establish correlations between the equivalent lens dose for each profession and the patient dose (dose-area product, DAP). Methods Thermoluminescence dosimeters (TLD) have been used to measure the lens dose without lead glasses, to the medical staff, in a cohort of 24 TAVI procedures. Detailed exam-specific dose-related data from radiation dose structured reports (RDSR) was used to analyze the components contributing to the operator’s eye lens dose. Results The mean annual dose (150 TAVI procedures) to the lens of the eye for the whole heart team (primary operator, secondary operator, anesthesiologist and the nurse) was 4.3 ± 1.5, 1.9 ± 0.68, 3.9 ± 1.4 and 1.1 ± 0.40 mSv. The mean DAP-value per procedure was 27 ± 19 Gycm2. The primary operator is exposed to the highest radiation dose with a conversion coefficient (equivalent dose to the lens/DAP) of 1.1 ± 0.27 μSv/Gycm2 of the left eye lens followed by the anesthesiologist, who was exposed for almost equally high lens doses but in both lenses, and the secondary operator with 0.48 ± 0.12 μSv/Gycm2 of the left eye lens. The nurse is located at a safe distance with the lowest conversion factor for the left eye lens (0.27 ± 0.069 μSv/Gycm2). Conclusions In modern interventional x-ray equipment, the TAVIs will contribute to radiation dose levels below the threshold value for cataract as long as a ceiling mounted shield is used. The information from the RDSR shows that the highest dose contribution to the primary operator’s lens is from the second half of the procedure due to the aortography section consisting of image acquisitions.