Perspective:

Patients with CHD often undergo multiple diagnostic and therapeutic procedures that involve exposure to ionizing radiation. This is the first large population to document the association between radiation exposure as related to cardiac procedures and cancer later in life. Prospective studies will be important to confirm these findings. This finding is particularly important with the increasing use of prolonged complex interventional catheterization procedures such as transcatheter pulmonary valve implantation, which can involve significant radiation exposure, particularly when done in conjunction with additional interventions on the pulmonary arteries. Physicians involved with cardiac imaging should be sensitive to the issue and use the lowest reasonable radiation dose. Physicians involved in the longitudinal care of patients with CHD should also be sensitive to the cumulative lifetime radiation exposure of ACHD patients.