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For procedures with multiple components, cumulative dose area product (DAP) was proportionally allocated using weight-adjusted (DAP\/BW) median values from single-intervention cases. ED was estimated in silico in randomly selected examinations using Monte Carlo simulation. Dose conversion factors between DAP and ED were derived. Additionally, a structured review of the literature on recently published data on radiation doses was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 3683 procedures in 2494 patients (median age 3.8\u00a0years) were included. Body weight showed a stronger association with DAP than age. Median DAP\/BW was 11.7\u00a0cGy\u00b7cm\n                      <jats:sup>2<\/jats:sup>\n                      \/kg for diagnostic and 9.7\u00a0cGy\u00b7cm\n                      <jats:sup>2<\/jats:sup>\n                      \/kg for interventional procedures. For most procedure types, DAP\/BW was substantially lower than previously published benchmarks. Simulated conversion factors declined logarithmically with increasing body weight and differed only slightly between posterior\u2013anterior and lateral projections. Only 0.9% of patients exceeded a cumulative ED of 30\u00a0mSv.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Radiation exposure in contemporary pediatric cardiac catheterization is markedly lower than in earlier reports, with procedure complexity being the primary determinant of effective dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-026-02907-5","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T13:31:07Z","timestamp":1775568667000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Decreasing radiation exposure in interventional pediatric cardiology: a 10-year European single-center analysis of 3683 procedures"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3246-2045","authenticated-orcid":false,"given":"Florentine","family":"Gr\u00e4fe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Teske","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5830-0549","authenticated-orcid":false,"given":"Frank-Thomas","family":"Riede","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2773-689X","authenticated-orcid":false,"given":"Ingo","family":"D\u00e4hnert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3204-748X","authenticated-orcid":false,"given":"Maciej","family":"Rosolowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7680-0990","authenticated-orcid":false,"given":"Daniel","family":"Gr\u00e4fe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"2907_CR1","unstructured":"World Health Organization (2016) Communicating radiation risks in paediatric imaging: information to support health care discussions about benefit and risk. 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