Real-time MRI-guided right heart catheterization in adults using passive catheters.

Abstract:

AIMS:Real-time MRI creates images with superb tissue contrast that may enable radiation-free catheterization. Simple procedures are the first step towards novel interventional procedures. We aim to perform comprehensive transfemoral diagnostic right heart catheterization in an unselected cohort of patients entirely using MRI guidance. METHODS AND RESULTS:We performed X-ray and MRI-guided transfemoral right heart catheterization in consecutive patients undergoing clinical cardiac catheterization. We sampled both cavae and both pulmonary arteries. We compared success rate, time to perform key steps, and catheter visibility among X-ray and MRI procedures using air-filled or gadolinium-filled balloon-tipped catheters. Sixteen subjects (four with shunt, nine with coronary artery disease, three with other) underwent paired X-ray and MRI catheterization. Complete guidewire-free catheterization was possible in 15 of 16 under both. MRI using gadolinium-filled balloons was at least as successful as X-ray in all procedure steps, more successful than MRI using air-filled balloons, and better than both in entering the left pulmonary artery. Total catheterization time and individual procedure steps required approximately the same amount of time irrespective of image guidance modality. Catheter conspicuity was best under X-ray and next-best using gadolinium-filled MRI balloons. CONCLUSION:In this early experience, comprehensive transfemoral right heart catheterization appears feasible using only MRI for imaging guidance. Gadolinium-filled balloon catheters were more conspicuous than air-filled ones. Further workflow and device enhancement are necessary for clinical adoption.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Ratnayaka K,Faranesh AZ,Hansen MS,Stine AM,Halabi M,Barbash IM,Schenke WH,Wright VJ,Grant LP,Kellman P,Kocaturk O,Lederman RJ

doi

10.1093/eurheartj/ehs189

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

380-9

issue

5

eissn

0195-668X

issn

1522-9645

pii

ehs189

journal_volume

34

pub_type

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