Abstract
Purpose
Radiation exposure in interventional cardiology is an important consideration, due to risk of cancer and other morbidity to the patient and clinical staff. Cardiac catheterizations rely heavily on fluoroscopic imaging exposing both patient and clinician to ionizing radiation. An image-guided surgery system capable of facilitating cardiac catheterizations was developed and tested to evaluate dose reduction.
Methods
Several electromagnetically tracked tools were constructed specifically a 7-Fr catheter with five 5-degree-of-freedom magnetic seeds. Catheter guidance was accomplished using our image guidance system Kit for Navigation by Image-Focused Exploration and fluoroscopy alone. A cardiac phantom was designed and 3D printed to validate the image guidance procedure. In mock procedures, an expert clinician guided and deployed an occluder across the septal defect of the phantom heart.
Results
The image guidance method resulted in a dose of 1.26 mSv of radiation dose per procedure, while traditional guidance resulted in a dose of 3.33 mSv. Average overall dose savings for the image-guided method was nearly 2.07 mSv or 62 %.
Conclusion
The work showed significant (\(p<0.001\)) decrease in radiation dose with use of image guidance methods at the expense of a modest increase in procedure time. This study lays the groundwork for further exploration of image guidance applications in pediatric cardiology.
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Acknowledgments
The authors would like to thank the Medical University of South Carolina’s Department Pediatric Cardiology for assistance and use of equipment. The authors would also like to thank the CU-MUSC program for providing space and time for students and faculty members while visiting the MUSC campus.
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Kwartowitz, D.M., Mefleh, F.N. & Baker, G.H. Toward computer-assisted image-guided congenital heart defect repair: an initial phantom analysis. Int J CARS 12, 1839–1844 (2017). https://doi.org/10.1007/s11548-016-1440-1
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DOI: https://doi.org/10.1007/s11548-016-1440-1