SPC365

Environmental impact of percutaneous aortic valve implants. Procedure assessment

Session: Sessão de Posters 47 - TAVI
Speaker: João Queiroz E Melo

Congress: CPC 2024
Topic: H. Interventional Cardiology and Cardiovascular Surgery
Theme: 25. Interventional Cardiology
Subtheme: 25.3 Non-coronary Cardiac Intervention
Session Type: Cartazes
FP Number: ---
Authors: João Queiroz E Melo; Henrique Figueiredo; Miguel Angelo Castro; Tiago Nolasco; João Brito; Silvio Leal; Luís Raposo; Pedro Gonçalves; Henrique Gabriel; Pedro Adragão; Rui Campante Teles; Manuel de Sousa Almeida

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">The contribute of modern cardiac care to the significant environmental impact of healthcare is seldom addressed. This study aims at getting an initial assessment of the direct environmental impact of uncomplicated percutaneous aortic valve implants. </span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Three consecutive standard routine cases were assessed in 2020. Data were collected from patient admission in the cath lab room until leaving it.</span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Personal protection goods, instruments and all materials used, as well as energy consumption &nbsp;and waste, were recorded. Energy was converted in CO2e using the conversion factor 0,144 kg.CO2/kWh and considering that 63% of the energy was originated from renewable energy.</span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Eleven people were in the room, using 5 gowns (single use), and 10 pair of gloves.</span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Energy consumption was 73,6 KW/h, on average. Out of these, 57% was due to heating, ventilation and air conditioning; the remaining was due to hemodynamic equipment (23%), anesthesia (18%), and lightning (2%).&nbsp; </span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">On average, this energy was responsible, for the emission of 3,8 kgs of CO2e. (4,3/ 2,8/ 4,3)</span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">All waste material was collected in bags according to its sorting category, according to our current outdated regulations, and each bag was weighted.</span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">A total of 14,8 kgs of waste were produced; out of these, potentially hazardous (67%), hazardous (5%), plastics (10%), and domestic (18%).</span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">The delay to leave the cath lab was on average 37 minutes (ranging from 10 nto 60 mimutes), thus generating unnecessary energy use of 31,9 KW.</span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Our study reinforces the concept that bottom-up analysis is critical to get the reality of each cath lab environmental impact, to get apropriate&nbsp; knowledge&nbsp;&nbsp;and implement measures to improve its healthcare CO2 footprint.</span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">This analysis showed that improving the planning of the procedures, and using reusable gowns, will decrease the environmental impact of VAP. Additional improvements can be obtained regarding the use of preformed packs, waste sorting and appropriate recycling. </span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">To achieve it, besides behavior changes, current Portuguese regulations regarding waste and circular economy need to be updated to the state of art. </span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:14.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">To get a complete knowledge of the impacts of the these procedures further studies are required, considering all its indirect inputs and outputs. </span></span></span></span></p>