Interventional Cardiology

From cathlab to MRI

Doing hemodynamic, diagnostic procedures in the MRI (CMR) has a tremendous advantage over cathlab procedures especially in congenital heart diseases (CHD) and pulmonary hypertension (PH).

Cardiac catheterization using MRI guidance allows for simultaneous and accurate measurement of pressures, and pulmonary and systemic blood flows needed for accurate calculation of the pulmonary vascular resistance. Some CHD patients undergo a cardiac MRI for further delineation of anatomy prior to transcatheter or surgical intervention. The combined MRI guided cardiac cath procedure is increasingly being used for such patients where both anatomical and hemodynamic information is obtained in one setting under the same anesthetic procedure. Furthermore, if patient is deemed to have a lesion that is amenable for transcatheter intervention, the patient is transferred to the adjacent cath lab for the said intervention making this a one stop imaging, diagnostic, and interventional procedure.
The MRI approach in cardiology is innovative, eliminates radiation exposure during vulnerable patient treatment, and combines gold-standard flow and volume measurement with invasive blood pressure. In addition, our studies (Kalms consulting, 2017) show that reimbursement is usually not an issue due to considerable savings in cathlab time or overnight stay between two procedures.

What does it take?
This question is best answered by our current users, and usually contains 4 elements:
1) A cardiac Cath-MRI platform and dedicated team with appropriate training
2) Supplementary equipment within the MRI suite – hemodynamic, visualization and communication systems.
3) MRI compatible catheters and guide wires
4) Internal clinical approval

To learn more details please watch a presentation from Dr Suren Reddy( lecture at CMR2018) entitled Lessons from year One. Reddy -Barcelona-CMR 2018

Case1-website. A 4 year old with hypoplastic left heart syndrome, status post-Glenn palliation.

Case2-website. 5 year old patient with suspected transverse arch hypoplasia and severe long segment coarctation

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