Background .– Cardiac catheterization procedures are being increasingly performed in children with congenital heart disease for diagnostic and treatment purposes. Given children’s greater sensitivity to radiation and the longer life span during which radiation health effects can develop, the ALARA principle (irradiation As Low As Reasonably Achievable) is of peculiar importance. We report the radiation doses and related factors for children who underwent cardiac catheterization procedure in Toulouse children Hospital from January to April 2013.

Methods .– We prospectively included 60 children (mean age 4 years old, weight 2.350–59 kgs) undergoing a therapeutic ( n = 55, 91.7%) or diagnostic ( n = 5, 8.3%) cardiac catheterization procedures. We investigated the relationship between dose area product (DAP), fluoroscopic time (FT), pulsed fluoroscopic DAP, image acquisition DAP, age, morphological parameters and double products combining FT and weight or size or body mass index (BMI) or body surface area (BSA). BSA was calculated according to the Mosteller formula.

Results .– The mean DAP was 20,697 ± 29,342 mgycm ² . The mean total fluoroscopic time was 24.6 ± 19.7 min. DAP was not significantly different between diagnostic and therapeutic catheterization ( P = 0.98). Although image acquisition DAP accounted for only 4.4 ± 2.4% of FT, it represented 42.5 ± 19.6% of DAP. DAP was moderately although significantly correlated with FT ( r = 0.73, P < 0.0001), BSA ( r = 0.44, P = 0.0011), age ( r = 0.37, P = 0.0082), weight ( r = 0.43, P = 0.002) and size ( r = 0.38, P = 0.0052). DAP was strongly associated with FT × Weight ( r = 0.92, P < 0.0001), FT × BSA ( r = 0.93, P < 0.0001) and FT × Size ( r = 0.91, P < 0.0001). Linear regression analysis model involving FT × BSA to predict DAP was significant ( P < 0.0001). Approximately 90% of the variance of DSA was accounted for by this model.

Conclusion .– FT and morphological features (BSA, weight, size) are the key parameters associated with DAP. Peculiar attention to reduce FT and avoid unnecessary image acquisition may decrease irradiation during catheterization in children with congenital heart disease.