ArticleJACC. Advances2026
Occupational Pelvic and Chest-Level Radiation Exposure Among Interventional Echocardiographers During Percutaneous Structural Heart Interventions.
Article in JACC. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRapid expansion of transcatheter structural heart interventions has increased occupational radiation exposure for interventional echocardiographers (IEs).
objectivesThe authors aimed to quantify real-time underlead pelvic and chest-level radiation exposure to IEs during left atrial appendage occlusion (LAAO), transcatheter mitral valve intervention (TMVI), and transcatheter tricuspid valve intervention (TTVI); estimate implications for fetal safety; and identify independent predictors of higher chest dose.
methodsThis prospective, single-center study quantified radiation exposure during 118 LAAO, 59 TMVI, and 53 TTVI procedures from February 2025 to February 2026. Multivariable linear regression on log-transformed chest-level dose identified independent predictors. Comparisons used Kruskal-Wallis, Mann-Whitney U, and Spearman tests.
resultsPelvic dose was 0 μSv in 98.7% of cases; estimated dose for full pregnancy was ∼2.3 μSv, well below the recommended limit. Median raw chest-level exposure was 9.0 μSv (IQR: 3.2-21.0) for LAAO, 18.0 μSv (7.5-43.5) for TMVI, and 36.0 μSv (16-116) for TTVI (P < 0.001). IEs received 10- to 50-fold higher doses than sonographers (P < 0.001). Independent predictors of higher chest-level dose were higher log(dose-area product) (1.57; 95% CI: 1.29-1.91), head-of-bed positioning (2.17; 95% CI: 1.06-4.43), TMVI (2.27; 95% CI: 1.44-3.58), and TTVI (2.70; 95% CI: 1.35-5.40) vs LAAO, and half-shield-only use (3.78; 95% CI: 1.51-9.44) (all P ≤ 0.035).
conclusionsThe near absence of detectable under-lead pelvic radiation with standard lead apparel and shielding provides strong reassurance regarding reproductive safety. IEs sustain higher chest-level radiation exposure during TMVI and TTVI than LAAO. Head-of-bed positioning and half-shield-only use are key modifiable drivers, underscoring the need for standardized full-shielding protocols and positional awareness.
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