Background The use of three-dimensional rotational angiography (3D-RA) to assess patients
with congenital heart diseases appears to be a promising technique despite the
scarce literature available. Objectives The objective of this study was to describe our initial experience with 3D-RA and
to compare its radiation dose to that of standard two-dimensional angiography
(2D-SA). Methods Between September 2011 and April 2012, 18 patients underwent simultaneous 3D-RA
and 2D-SA during diagnostic cardiac catheterization. Radiation dose was assessed
using the dose-area-product (DAP). Results The median patient age and weight were 12.5 years and 47.5 Kg, respectively. The
median DAP of each 3D-RA acquisition was
1093µGy.m2 and
190µGy.m2 for each 2D-SA acquisition
(p<0.01). In patients weighing more than 45Kg (n=7), this difference was
attenuated but still significant (1525 µGy.m2
vs.413µGy.m2, p=0.01). No difference
was found between one 3D-RA and three 2D-SA
(1525µGy.m2 vs.1238
µGy.m2, p = 0.575) in this population. This
difference was significantly higher in patients weighing less than 45Kg (n=9)
(713µGy.m2
vs.81µGy.m2, P = 0.008), even when comparing
one 3D-RA with three 2D-SA (242µGy.m2,
respectively, p<0.008). 3D-RA was extremely useful for the assessment of
conduits of univentricular hearts, tortuous branches of the pulmonary artery, and
aorta relative to 2D-SA acquisitions. Conclusions The radiation dose of 3D-RA used in our institution was higher than those
previously reported in the literature and this difference was more evident in
children. This type of assessment is of paramount importance when starting to
perform 3D-RA.