Effectiveness of a radiation protective device for anesthesiologists and transesophageal echocardiography operators in structural heart disease interventions

In structural heart disease (SHD) interventions, the exposure of staff other than the first operator such as anesthesiologists and transesophageal echocardiography (TEE) operators to the radiation can also pose the risks of cancer and cataracts in the long term. This study was conducted to test our new radiation protective device (RPD) for anesthesiologists and TEE operators in SHD interventions. The RPD, which consists of a head side shield and a cradle shield, was mounted on a 0.25 mm Pb-equivalent unleaded radiation protection sheet on a self-made J-shaped acrylic table, and it was placed on the head side and cradle on the operating table. A CT human body phantom was placed on the operating table, and the C-arm was set in five directions: posteroanterior, right anterior oblique 30°, left anterior oblique 30°, caudal 30°, and cranial 30°. The ambient dose equivalent rate at the usual positions of the anesthesiologist and TEE operator were measured under a fluoroscopic sequence with and without the RPD, and the dose reduction rate was obtained. The height of each measurement point was set to 100, 130 or 160 cm. The reduction rates at the positions of the anesthesiologist and the TEE operator were 82.6–86.4% and 77.9–89.5% at the height of 100 cm, 48.5–68.4% and 83.3–91.0% at 130 cm, and 23.6–62.9% and 72.9–86.1% at 160 cm, respectively. The newly developed RPD can thus effectively reduce the radiation exposure of anesthesiologists and TEE operators during SHD interventions.