Minimizing scattered radiation dose in cardiac catheterization laboratory during interventional procedures using lead free drape – MILD study

Objective: RADPAD is a lead-free sterile drape that reduces scattered radiation during fluoroscopic procedures. We aimed to study the effect of using RADPAD on primary operator (PO) and secondary operator (SO) during coronary angiography (CAG) as well as percutaneous coronary intervention (PCI). Methods: 137 patients undergoing elective CAG and PCIwere randomized in a 1:1 pattern with or without the RADPAD. The ratio of PO received dose in mrem to total Air Kerma (AK) in mGy, Dose Area Product (DAP) in mGycm2 and Cine Adjusted Screening Time (CAST) in minute, at the end of the procedure with or without RADPAD were measured and designated as dose relative to AK, DAP and CAST. The exposure ratios were compared for both cohorts. Results: There was no significant difference in CAST, DAP and AK between the two patient cohorts. PO radiation dose relative to CAST was 0.15 ± 0.18 mrem/min for RADPAD cohort and 0.43 ± 0.31 mrem/min for No RADPAD cohort (p < 0.00001). PO dose relative to DAP was 0.00042 ± 0.00049 mrem/mGycm2 for RADPAD cohort and 0.0011 ± 0.0013 mrem/mGycm2 for No RADPAD cohort (p ¼ 0.000014). PO dose relative to AK was 0.0030 ± 0.0037 mrem/mGy for RADPAD cohort and 0.0071 ± 0.0049 mrem/mGy for No RADPAD cohort (p < 0.00001). All PO doses relative to CAST, DAP and AK were significantly reduced in the RADPAD cohort compared to the No RADPAD cohort. Similar findings were observed for the SO also. Conclusion: RADPAD significantly reduces radiation exposure to both PO and SO during CAG and PCI. © 2022 Published by Elsevier, a division of RELX India, Pvt. Ltd on behalf of Cardiological Society of India

Ruptured Sinus of a Valsalva Associated with Autosomal-Dominant Polycystic Kidney Disease in a young male

Autosomal-dominant polycystic kidney disease (ADPKD) is a systemic hereditary disorder characterized by localized cellular proliferation and extracellular matrix abnormalities resulting in both renal and extra renal manifestations, with multiple structural flaws such renal cysts, cerebral and aortic aneurysms, annulo-aortic ectasia, and valvular insufficiency states. Association between Autosomal-dominant polycystic kidney disease (ADPKD) and ruptured sinus of Valsalva aneurysm (SVA) has rarely been documented before. We herein report a case of Autosomal-dominant polycystic kidney disease (ADPKD) who presented with shortness of breath, was diagnosed as a case of ruptured sinus of Valsalva aneurysm (SVA) and defect was closed successfully.