Spectrum Health Study Determines Higher Level of Radiation for Interventional Echocardiographers

Radiation doses exceed those measured in interventional cardiologists and sonographers

GRAND RAPIDS, Mich., July 18, 2022 – Spectrum Health researchers have determined that interventional echocardiographers receive significantly greater head-level radiation doses than interventional cardiologists during two commonly performed structural heart cases.

Interventional echocardiography is a rapidly evolving field requiring imaging expertise. An increasing number of structural heart interventions now require real-time imaging guidance for device placement and immediate functional evaluation.

“These comparatively higher radiation doses indicate a previously underappreciated occupational risk faced by interventional echocardiographers,” said first author David McNamara, MD, MPH. “These findings have implications for the rapidly expanding field of structural heart procedures.”

Two heart procedures – transesophageal echocardiography during percutaneous left atrial appendage closure (LAAO) and transcatheter edge-to-edge mitral valve repair (TEER) – require an interventional echocardiographer to stand near a radiation source and patient. Despite previous work demonstrating high radiation exposure for interventional cardiologists performing percutaneous coronary and structural heart interventions, similar data for interventional echocardiographers are lacking.

In this single-center cross-sectional study of 60 structural heart procedures, researchers determined that interventional echocardiographers experienced higher head-level radiation doses than interventional cardiologists and sonographers.

Radiation doses were collected from interventional echocardiographers, interventional cardiologists, and sonographers at a quaternary care center during 30 sequential LAAO and 30 sequential TEER procedures from July 1, 2016, to January 31, 2018.

“Spectrum Health has a strong national reputation in radiation exposure work led by Dr. Ryan Madder from our cardiology group,” McNamara said. “This has focused predominantly on radiation exposure during heart catheterizations for coronary artery disease work. The current study builds upon the foundation from prior published studies to expand into the growing field of interventional echocardiography and structural heart interventions.”

McNamara said that future studies are planned to further target interventions to reduce these radiation doses.

Results of the study were published July 7, 2022 in JAMA Network Open.

This work was funded by the Frederik Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, Michigan, and by Corindus, A Siemens Healthineers Company.

In addition to Dr. McNamara, Ryan Madder, MD, served as senior author. Additional authors include Rajus Chopra, MD, Jeffrey Decker, MD, Michael McNamara, MD, Stacie VanOosterhout, MEd, Duane Berkompas, MD, Musa I. Dahu, MD, Mohamad Kenaan, MD, Wassim Jawad, MD, William Merhi, DO, and Jessica Parker, MS.

All authors are affiliated with Frederik Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, Michigan.


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Tim Hawkins
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