Radiation Exposure During Transcatheter Valve Replacement: What Cardiac Surgeons Need to Know

The Washington University group compared operator radiation exposure during transcatheter valve implantation when performed via a transfemoral versus an alternative access approach, when performed in a catheterization lab versus a hybrid operating room (OR), and investigated the potential benefit of disposable shielding.
They found that procedures performed in the hybrid OR were associated with higher operator radiation exposure. In comparison to the transfemoral approach, alternative access cases had the highest levels of operator radiation. This is particularly important in cases of transcatheter mitral valve replacement that can only be done via an alternative access approach. The use of disposable radiation shielding in this series did not attenuate operator radiation exposure. The authors conclude that radiation shielding within hybrid ORs should be scrutinized in an effort to remain on par with that found within catheterization labs.