1
|
Tamirisa KP, Alasnag M, Calvert P, Islam S, Bhardwaj A, Pakanati K, Zieroth S, Razminia M, Dalal AS, Mamas M, Russo AM, Kort S. Radiation Exposure, Training, and Safety in Cardiology. JACC. ADVANCES 2024; 3:100863. [PMID: 38939686 PMCID: PMC11198606 DOI: 10.1016/j.jacadv.2024.100863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/19/2023] [Accepted: 01/04/2024] [Indexed: 06/29/2024]
Abstract
Exposure to ionizing radiation is an inherent occupational health hazard in clinical cardiology. Health risks have been reported previously, including predilection to cancer. In addition, orthopedic injury due to prolonged wearing of heavy protective lead aprons, which are mandatory to reduce radiation risk, have been extensively documented. Cardiology as a specialty has grown with rising volumes of increasingly complex procedures. This includes electrophysiological, coronary, and structural intervention, advanced heart failure/transplant management, and diagnostic imaging. Both the operator as well imaging specialists are exposed to radiation, particularly in structural interventions where interventional cardiologists and structural imagers work closely. Increasingly, women interested in cardiology may deselect the field due to radiation concerns. This expert document highlights the risks of radiation exposure in cardiology, including practical tips within various subspecialty fields such as interventional/structural cardiology, electrophysiology, imaging, advanced heart failure, and pediatric cardiology.
Collapse
Affiliation(s)
| | - Mirvat Alasnag
- Cardiac Center, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Peter Calvert
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Sabrina Islam
- Section of Cardiology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Anju Bhardwaj
- Advanced Cardiopulmonary Therapies and Transplantation, University of Texas/McGovern Medical School, Texas Medical Center, Houston, Texas, USA
| | - Keerthana Pakanati
- Center for Cardiovascular Health, Virginia Mason Franciscan Health, Seattle, Washington, USA
| | - Shelley Zieroth
- Department of Cardiology, St. Boniface Hospital, Winnipeg, Manitoba, Canada
| | | | - Aarti S. Dalal
- Division of Cardiology, Department of Pediatrics, Vanderbilt Medical Center, Nashville, Tennessee, USA
| | - Mamas Mamas
- Keele Cardiovascular Research Group, Keele University, Stoke on Trent, UK
| | - Andrea M. Russo
- Division of Cardiology, Cooper University Hospital, Camden, New Jersey, USA
| | - Smadar Kort
- Department of Cardiology, Stony Brook Heart Institute, Stony Brook, New York, USA
| | - ACC Women in Cardiology Advocacy Work Group
- Texas Cardiac Arrhythmia Institute, Austin, Texas, USA
- Cardiac Center, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Section of Cardiology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
- Advanced Cardiopulmonary Therapies and Transplantation, University of Texas/McGovern Medical School, Texas Medical Center, Houston, Texas, USA
- Center for Cardiovascular Health, Virginia Mason Franciscan Health, Seattle, Washington, USA
- Department of Cardiology, St. Boniface Hospital, Winnipeg, Manitoba, Canada
- Amita St. Joseph Hospital, Elgin, Illinois, USA
- Division of Cardiology, Department of Pediatrics, Vanderbilt Medical Center, Nashville, Tennessee, USA
- Keele Cardiovascular Research Group, Keele University, Stoke on Trent, UK
- Division of Cardiology, Cooper University Hospital, Camden, New Jersey, USA
- Department of Cardiology, Stony Brook Heart Institute, Stony Brook, New York, USA
| |
Collapse
|
3
|
Contento J, Cleveland V, Ehtiati T, Olivieri L, Kanter J. A phantom for targeted endomyocardial biopsy training. Catheter Cardiovasc Interv 2023; 102:1109-1113. [PMID: 37855199 PMCID: PMC10842507 DOI: 10.1002/ccd.30862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/21/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023]
Abstract
Endomyocardial biopsy (EMB) of the right ventricular (RV) septal surface during cardiac catheterization is the standard method to assess cardiac allograft rejection, heart failure, or inflammatory cardiomyopathies. We developed methodology using a three-dimensional (3D) printed phantom to provide proof of concept for using biplane overlay technology for targeted EMB. A standard bioptome and steerable sheath were used to discern feasibility of biopsy for seven regions of the RV septum guided by 3D overlay. This novel biopsy phantom can help train operators in biopsy techniques, and biplane overlay technology has the potential to advance targeted EMB in transplant and cardiomyopathy populations.
Collapse
Affiliation(s)
| | - Vincent Cleveland
- Division of Cardiology, Children’s National Hospital, Washington, DC
| | - Tina Ehtiati
- Siemens Medical Solutions USA, Inc., Malvern, PA
| | - Laura Olivieri
- Division of Pediatric Cardiology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Joshua Kanter
- Division of Cardiology, Children’s National Hospital, Washington, DC
| |
Collapse
|
4
|
Goswami R, Ruiz J, Nativi J, Yip D, Leoni J, Lyle M, Patel P. Letter to the Editor. J Card Fail 2023; 29:119. [PMID: 36400175 DOI: 10.1016/j.cardfail.2022.10.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Rohan Goswami
- Division of Heart Failure and Transplant,Mayo Clinic in Florida, Jacksonville, Florida
| | - Jose Ruiz
- Division of Heart Failure and Transplant,Mayo Clinic in Florida, Jacksonville, Florida
| | - Jose Nativi
- Division of Heart Failure and Transplant,Mayo Clinic in Florida, Jacksonville, Florida
| | - Daniel Yip
- Division of Heart Failure and Transplant,Mayo Clinic in Florida, Jacksonville, Florida
| | - Juan Leoni
- Division of Heart Failure and Transplant,Mayo Clinic in Florida, Jacksonville, Florida
| | - Melissa Lyle
- Division of Heart Failure and Transplant,Mayo Clinic in Florida, Jacksonville, Florida
| | - Parag Patel
- Division of Heart Failure and Transplant,Mayo Clinic in Florida, Jacksonville, Florida
| |
Collapse
|