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Radiation Risk Categories in Cardiac Catheterization for Congenital Heart Disease: A Tool to Aid in the Evaluation of Radiation Outcomes

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Abstract

To stratify diverse procedure types into categories with similar radiation exposure in cardiac catheterization for congenital heart disease. Radiation exposures for a comprehensive list of specific procedure types and stratification of outcomes based on radiation risk are not currently available. Data between January 2014 and December 2015 were collected on all cases performed at sites participating in C3PO-QI (Congenital Cardiac Catheterization Outcomes Project-Quality Improvement Initiative) and 9 centers were included. Using expert consensus, 40 unique procedure types were defined by diagnostic characteristics or the intervention(s) performed, and dose area product (DAP) per kilogram of body weight (µGy × m2/kg) was summarized. Using empiric and consensus methods, three radiation risk categories were created. A total of 11,735 cases were included for analysis. Thirteen (n = 7918) procedure types with median DAP/kg < 100 were categorized in the low radiation exposure category (median DAP/kg 39). The medium exposure category (n = 1807) consisted of 16 procedure types with median DAP/kg values ranging 100 to < 200 (overall median DAP/kg 131). Finally, the high radiation exposure category (n = 1073) consisted of 11 procedure types with median DAP/kg ≥ 200 (overall median DAP/kg of 231). The radiation exposure risk categories created in this multi-center dataset are a critical step towards the development of a robust risk adjustment methodology for radiation exposure in catheterization for congenital heart disease.

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Acknowledgements

We appreciate support by a grant from The Children’s Heart Foundation.

Author information

Authors and Affiliations

  1. Department of Cardiology, Boston Children’s Hospital, Bader 2, 300 Longwood Avenue, Boston, MA, 02115, USA

    Brian P. Quinn, Ryan Callahan, Andrea S. Goodman & Lisa Bergersen

  2. The Heart Center, Nationwide Children’s Hospital, Columbus, OH, USA

    Aimee K. Armstrong

  3. Division of Pediatric Cardiology, Children’s Healthcare of Atlanta Sibley Heart Center, Atlanta, GA, USA

    Holly D. Bauser-Heaton & Christopher J. Petit

  4. Division of Cardiology, Rady Children’s Hospital, San Diego, CA, USA

    Howaida G. El-Said

  5. Division of Cardiology, Children’s Hospital of Wisconsin, Milwaukee, WI, USA

    Susan R. Foerster & Todd M. Gudausky

  6. Department of Cardiology, Cincinnati Children’s Hospital, Cincinnati, OH, USA

    Bryan H. Goldstein

  7. Division of Cardiology, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA

    Jacqueline N. Kreutzer & Sara M. Trucco

  8. Division of Cardiology, Norton Children’s Hospital, Louisville, KY, USA

    Ryan A. Leahy

  9. Division of Pediatric Cardiology, St. Louis Children’s Hospital, St. Louis, MO, USA

    Toby A. Rockefeller & Shabana Shahanavaz

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  1. Brian P. Quinn
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  2. Aimee K. Armstrong
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  3. Holly D. Bauser-Heaton
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  4. Ryan Callahan
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  5. Howaida G. El-Said
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  6. Susan R. Foerster
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  7. Bryan H. Goldstein
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  8. Andrea S. Goodman
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  9. Todd M. Gudausky
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  10. Jacqueline N. Kreutzer
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  11. Ryan A. Leahy
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  12. Christopher J. Petit
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  13. Toby A. Rockefeller
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  14. Shabana Shahanavaz
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  15. Sara M. Trucco
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  16. Lisa Bergersen
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The Congenital Cardiac Catheterization Project on Outcomes-Quality Improvement (C3PO-QI)

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All authors have read, reviewed, and approved of the manuscript.

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Correspondence to Brian P. Quinn.

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All authors declare that they have no conflicts of interest to disclose.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Quinn, B.P., Armstrong, A.K., Bauser-Heaton, H.D. et al. Radiation Risk Categories in Cardiac Catheterization for Congenital Heart Disease: A Tool to Aid in the Evaluation of Radiation Outcomes. Pediatr Cardiol 40, 445–453 (2019). https://doi.org/10.1007/s00246-018-2024-3

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  • DOI: https://doi.org/10.1007/s00246-018-2024-3

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