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Valvular & structural heart diseaseCohort study

Occupational Pelvic and Chest-Level Radiation Exposure Among Interventional Echocardiographers During Percutaneous Structural Heart Interventions

JACC AdvPublished

  • prospective, single-center study
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Authors' conclusion

The 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.

Study context

Population
Interventional echocardiographers (IEs) during left atrial appendage occlusion (LAAO), transcatheter mitral valve intervention (TMVI), and transcatheter tricuspid valve intervention (TTVI), February 2025 to February 2026procedures · LAAO 118 · TMVI 59 · TTVI 53
Participants
118 / 59 / 53
Exposure
Chest-level radiation exposure across LAAO, TMVI and TTVI procedures
  • LAAOn = 118
  • TMVIn = 59
  • TTVIn = 53

Main finding

As reported in the abstract

Pelvic dose

Pelvic dose was 0 μSv in cases

98.7%

estimated dose for full pregnancy, well below the recommended limit

∼2.3 μSv

Observational data: associations, not effects.

Further findings

Median raw chest-level exposure

OutcomeEstimate
Independent predictors of higher chest-level dose — higher log(dose-area product)1.57 (95% CI 1.29–1.91)
Independent predictors of higher chest-level dose — head-of-bed positioning2.17 (95% CI 1.06–4.43)
Independent predictors of higher chest-level dose — TMVI vs LAAO · TMVI vs LAAO2.27 (95% CI 1.44–3.58)
Independent predictors of higher chest-level dose — TTVI vs LAAO · TTVI vs LAAO2.70 (95% CI 1.35–5.40)
Independent predictors of higher chest-level dose — half-shield-only use3.78 (95% CI 1.51–9.44)
  • Median raw chest-level exposure: P < 0.001
  • Independent predictors of higher chest-level dose: all P ≤ 0.035
  • Independent predictors of higher chest-level dose: Multivariable linear regression on log-transformed chest-level dose

Dose, IEs vs sonographers

IEs received 10- to 50-fold higher doses than sonographers
P < 0.001

Original publication

Occupational Pelvic and Chest-Level Radiation Exposure Among Interventional Echocardiographers During Percutaneous Structural Heart Interventions. JACC Adv. Published 26 June 2026. doi:10.1016/j.jacadv.2026.102959
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Summarised from the published abstract; every number is checked against it