National Taiwan University Hospital is introducing new approaches to cardiac surgery that reduce reliance on X-rays. For cardiac fibrillation patients, that means eliminating the need for hundreds of X-rays, in favor of using ultrasounds. Because ultrasounds show heart structures in real time, this technique also enables the early detection of complications.

The April 3 earthquake in Hualien affected many businesses and institutions, including NTU Hospital. Two X-ray machines in its cath lab were damaged, making cardiac catheterization procedures a challenge. Appointments were canceled for all but one patient who required the procedure that day.

Yu Chih-chieh
Doctor
I had never done it without an X-ray machine at hand. The consideration was that the patient was feeling very unwell. She trusted me, and I’m very grateful for that trust.

The patient was a woman between 30 and 40 years of age. Her case is NTU Hospital’s first successful cardiac catheterization without X-ray support. Another success story achieved without X-rays is that of a 75-year-old man surnamed Chuang, who underwent heart surgery assisted by ultrasound to prevent radiation exposure.

Mr. Chuang
Patient
For simpler cases of atrial fibrillation, you may have to get 300 or 400 chest X-rays. It’s a significant amount of exposure. For more complicated cases like mine, you may require up to 1,000.

Operations to treat atrial fibrillation traditionally employ X-ray fluoroscopy. But modern medical treatment has embraced the use of intracardiac ultrasounds, which reduce dependence on X-rays and enable the early detection of complications. Since 2021, NTU Hospital has used this method on more than 50 patients.

Kao Hsien-li
NTU Hospital Cardiovascular Center
Using the traditional approach with X-rays, you only find out the patient’s condition is unstable after it has destabilized. But using ultrasound allows you to see the structure of the heart in real-time. It’s not like X-ray, which is just an image. So the approach allows us to avoid touching certain structures during the procedure.

Doctors are finding ways to reduce radiation exposure during surgery. Future medical development will target zero-radiation techniques that ensure surgery effectiveness and patient safety, even if machines fail during an earthquake.

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