Pediatric Cardiology

, Volume 37, Issue 8, pp 1429–1435 | Cite as

Radiation Exposure by Three-Dimensional Rotational Angiography (3DRA) During Trans-catheter Melody Pulmonary Valve Procedures (TMPV) in a Pediatric Cardiac Catheterization Laboratory

  • Hoang H. NguyenEmail author
  • David T. Balzer
  • Joshua J. Murphy
  • Ramzi Nicolas
  • Shabana Shahanavaz
Original Article


This retrospective study aims to evaluate radiation exposure by three-dimensional rotational angiography (3DRA) during trans-catheter Melody pulmonary valve (TMPV) procedures. 3DRA has been reported to have added value in the management of complex congenital heart disease aiding in the performance of interventional procedures albeit with concerns of higher radiation exposure. We test the hypothesis that 3DRA does not cause additional radiation exposure during TMPV procedures. We analyzed all 81 TMPV procedures performed at St. Louis Children’s Hospital, MO, USA, from January 1, 2011 to December 31, 2014. Dose-area product (DAP), DAP indexed to body weight (DAP/BW), fluoroscopy time (FT), and weight–fluoroscopy time product of each procedure were recorded. We reviewed each procedure’s images to determine whether additional interventions were performed (e.g., pulmonary artery angioplasty or treatment of conduit pseudo-aneurysm). 3DRA was used in 36 % of the procedures. 3DRA group had a higher number of additional procedures performed. The 3DRA group did not differ from the non-3DRA group in DAP, DAP/BW, and weight–fluoroscopy time product. 3DRA does not cause greater radiation exposure during TMPV procedures.


Tetralogy of Fallot Congenital heart disease Right ventricular outflow tract dysfunction 



The authors thank Dr. Toby Rockefeller for his critical reading of this manuscript.

Compliance with Ethical Standards

Conflict of interest

Dr. Balzer is a proctor for Medtronic. The remaining authors have no financial relationships relevant to this article to disclose. The authors have indicated they have no potential conflicts of interest to disclose.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Hoang H. Nguyen
    • 1
    • 2
    Email author
  • David T. Balzer
    • 1
  • Joshua J. Murphy
    • 1
    • 2
  • Ramzi Nicolas
    • 1
  • Shabana Shahanavaz
    • 1
  1. 1.Division of Cardiology, Department of PediatricsWashington University in St. Louis School of MedicineSt. LouisUSA
  2. 2.Division of Cardiology, Department of PediatricsRush University Medical CollegeChicagoUSA

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