Percutaneous structural cardiology: are anaesthesiologists properly protected from ionising radiation?

Abstract

During transcatheter aortic valve implantations (TAVI) and other percutaneous structural procedures, some patients may need close anesthesiological care, thus exposing the anaesthesiologist to x-rays. This work aims to investigate the radiation dose received by anaesthesiologists during these specific procedures in order to improve their radiological protection. Occupational radiation doses were measured prospectively during percutaneous structural procedures in several health professionals using electronic dosimeters worn over the apron at chest level. A sample of 49 procedures were recorded, where the anaesthesiologists’ average dose per procedure resulted 13 times higher than that of interventional cardiologists. The average dose per procedure received over the protection apron during TAVIs by the anaesthesiologist was 0.13 mSv, with a maximum value of 0.69 mSv. Taking these figures as a conservative estimation of the eye lens dose, an anaesthesiologist could participate in around 150 procedures before reaching the regulatory annual dose limit for the lens of the eye in Europe (20 mSv). In those clinical procedures where patients need close anesthesiological care, the anaesthesiologists might receive high radiation doses increasing the risk for cataracts and the risk of stochastic radiation effects. The proper use of occupational dosimeters will help identify these situations. It is recommended to use a mobile shielding barrier to reduce radiation exposure to acceptable levels in these situations.