Organ and effective doses detriment to paediatric patients undergoing multiple interventional cardiology procedures

Abstract

The aims of the present study were to present the frequency of multiple interventional cardiac procedures for a certain group of patients obtained at one of the largest paediatric hospitals in Chile. In addition it has been analysed cumulative kerma area product (KAP) and cumulative air kerma (CAK), and calculated organ doses for the patient groups undergoing 2, 3 and ≥ 4 procedures, using Monte Carlo software. Effective doses were also estimated for epidemiological purposes and to permit comparison with other imaging procedures. The sample used corresponds to the last 9 years and refers to a total of 1521 paediatric patients and 1824 interventional cardiac procedures. The results for frequency were: 13.7% of patients underwent 2 procedures, 4.1% underwent 3 procedures and 1.4% underwent 4 or more procedures. The median KAP and CAK values measured for the cumulative procedures in these three groups of patients were 3.7, 5.4 and 10.8 Gy·cm² and 59.9, 83.2 and 147.6 mGy, respectively. In terms of the most irradiated organs during interventional cardiac procedures, the highest median values (for the group of ≥4 procedures) were: active bone marrow 5.0 mGy, lungs 23.5 mGy, oesophagus 15.2 mGy, thyroid 7.8 mGy and breast 11.0 mGy. Median dose value to the heart (for the group of ≥4 procedures) was 12.7 mGy. Median values in terms of calculated effective dose for the three patient groups (with 2, 3 and ≥4 procedures) were 3.4, 5.9 and 8.7 mSv, respectively.

Keywords: Effective dose; Interventional cardiology; Organ dose; Paediatrics.