Background
Methods
Study Design
Research subjects
Real-time CMR fluoroscopy guided catheterization procedure
CMR room
CMR fluoroscopy imaging protocols: catheter guidance
CMR imaging protocols: diagnostic imaging
Performance measures and data analysis
Results
Feasibility
Procedure success and subject characteristics
Characteristic | Finding |
---|---|
Age | 12.7 ± 4.7 |
Gender | 51% Female |
Height | 146.3 ± 23.7 |
Weight | 48.8 ± 26.5 |
Body surface area | 1.4 ± 0.5 |
CMR RHC indication | |
Transplant (%) | 33 |
Shunt (%) | 28 |
Pulmonary hypertension (%) | 18 |
Cardiomyopathy (%) | 15 |
Valvular heart disease (%) | 3 |
Other (%) | 3 |
History | |
Prior cardiac surgery (%) | 44 |
Prior cardiac catheterization (%) | 59 |
1 previous (%) | 8 |
multiple previous (%) | 51 |
if multiple, how many? | 5.5 ± 5 |
Retained thoracic surgical or catheter device (%) | 36 |
Continuous intravenous vasopressor (%) | 5 |
Oral Medication (%) | 72 |
Procedure time and characteristics
Procedural detail | Finding |
---|---|
CMR RHC procedure time: 1 condition (min; n = 40) | 12 ± 5 |
CMR RHC procedure time: 2 conditions (min; n = 10) | 31 ± 10 |
Total CMR scanner time (min) | 50 ± 14 |
Additional research CMR imaging (%) | 66 |
Additional clinical CMR imaging (%) | 15 |
CMR RHC body temperature Δ (Celsius) | 0.3 ± 0.4 |
CMR RHC catheters | |
Medtronic (%) | 50 |
Edwards "T" tip (%) | 40 |
Arrow (%) | 20 |
Edwards (%) | 8 |
Edwards "S" tip (%) | 2 |
Cook (%) | 0 |
Vascor (%) | 0 |
X-Ray procedure | |
X-Ray procedure performed (%) | 80 |
Fluoroscopy time (min) | 3.8 ± 3.8 |
Dose Area Product (Gy∙cm2) | 1295.7 ± 2363 |
Endomyocardial biopsy | 23 |
Left heart catheterization | 9 |
Shunt device closure | 10 |
Coronary angiography | 11 |
Thermodilution | 1 |
Other | 3 |
Safety (adverse events, heating)
Invasive and imaging data
Fick versus Phase Contrast in catheterizations without shunt (n = 34) | |
Fick pulmonary blood flow (Qp, L/min/m2) | 3.3 ± 0.7 |
Fick systemic blood flow (Qs, L/min/m2) | 3.3 ± 0.7 |
Fick pulmonary: systemic blood flow (Qp:Qs) | 1 ± 0.1 |
Fick pulmonary vascular resistance (indexed Woods units) | 2.4 ± 1.9 |
Phase Contrast Main Pulmonary Artery indexed (Qp, L/min/m2) | 2.9 ± 0.6* |
Phase Contrast Aorta indexed (Qs, L/min/m2) | 2.8 ± 0.6* |
Phase Contrast pulmonary: systemic blood flow (Qp:Qs) | 1 ± 0.1 |
Phase Contrast pulmonary vascular resistance (indexed Woods units) | 2.5 ± 2.1 |
Fick versus Phase Contrast in catheterizations with shunt (n = 11) | |
Fick pulmonary blood flow (Qp, L/min/m2) | 5.6 ± 2.1 |
Fick systemic blood flow (Qs, L/min/m2) | 3.4 ± 0.8 |
Fick pulmonary: systemic blood flow (Qp:Qs) | 1.8 ± 0.9 |
Fick pulmonary vascular resistance (indexed Woods units) | 1.9 ± 1.6 |
Phase Contrast Main Pulmonary Artery indexed (Qp, L/min/m2) | 5.1 ± 2.1 |
Phase Contrast Aorta indexed (Qs, L/min/m2) | 2.8 ± 0.7* |
Phase Contrast pulmonary: systemic blood flow (Qp:Qs) | 2 ± 0.9* |
Phase Contrast pulmonary vascular resistance (indexed Woods units) | 2.1 ± 2 |
Subject number | Age (yr) | CMR RHC indication | # previous X-Ray Caths | Retained thoracic implant | CMR RHC time (min) |
---|---|---|---|---|---|
Subject 1 | 14.8 | Valvular heart disease | none | sternal wires | 19 |
Subject 2 | 21.1 | Transplant | 15 | sternal wires | 13 |
Subject 3 | 12.8 | Transplant | 14 | sternal wires | 19 |
Subject 4 | 13.3 | Transplant | 13 | sternal wires | 12 |
Subject 5 | 17.1 | Cardiomyopathyb
| 2 | none | 48a
|
Subject 6 | 12.2 | Other | none | surgical clips, sternal wires | 29 |
Subject 7 | 14.9 | Shunt (Atrial Septal Defect) | none | none | 18 |
Subject 8 | 10 | Transplant | 2 | sternal wires | 6 |
Subject 9 | 5.4 | Cardiomyopathyb
| none | none | 12 |
Subject 10 | 13.8 | Transplant | none | sternal wires | 8 |
Subject 11 | 9.6 | Shunt (Atrial Septal Defect) | none | none | 11 |
Subject 12 | 10.1 | Transplant | 2 | sternal wires | 12 |
Subject 13 | 13.1 | Pulmonary hypertension | none | none | 45a
|
Subject 14 | 6.3 | Transplant | 8 | surgical clips, sternal wires, pulmonary artery stents, embolization coils | 18 |
Subject 15 | 10.2 | Shunt (Atrioventricular Canal Defect) | 2 | none | 16 |
Subject 16 | 18.8 | Shunt (Patent Ductus Arteriosus) | none | none | 9 |
Subject 17 | 15.3 | Transplant | 2 | sternal wires | 18 |
Subject 18 | 18.2 | Cardiomyopathy | none | none | 17 |
Subject 19 | 15.2 | Transplant | 2 | sternal wires | 11 |
Subject 20 | 4.4 | Shunt (Atrial Septal Defect) | none | none | 16 |
Subject 21 | 16.6 | Transplant | 12 | sternal wires | 15 |
Subject 22 | 15.8 | Cardiomyopathy | 3 | none | 15 |
Subject 23 | 9.2 | Cardiomyopathy | 1 | none | 23a
|
Subject 24 | 17.3 | Transplant | 13 | sternal wires, temporary pacing wire | 9 |
Subject 25 | 6.3 | Shunt (Patent Ductus Arteriosus) | none | none | 14 |
Subject 26 | 12.5 | Shunt (Atrial Septal Defect) | none | none | 8 |
Subject 27 | 17.5 | Transplant | 4 | surgical clips, sternal wires | 13 |
Subject 28 | 13.9 | Shunt (Patent Ductus Arteriosus) | none | sternal wires | 16 |
Subject 29 | 5 | Transplant | 5 | none | 10 |
Subject 30 | 20.7 | Shunt (Atrial Septal Defect) | none | none | 15 |
Subject 31 | 6.1 | Pulmonary hypertension | 3 | none | 27a
|
Subject 32 | 4.6 | Pulmonary hypertension | 2 | none | 25a
|
Subject 33 | 18 | Shunt (Atrial Septal Defect) | none | none | 9 |
Subject 34 | 16 | Shunt (Atrial Septal Defect) | none | none | 11 |
Subject 35 | 9.3 | Pulmonary hypertension | 5 | sternal wires | 21a
|
Subject 36 | 17.3 | Pulmonary hypertension | 1 | none | 25a
|
Subject 37 | 5.7 | Cardiomyopathy | 4 | none | 22a
|
Subject 38 | 14.9 | Pulmonary hypertension | 0 | none | 40a
|
Subject 39 | 13.1 | Pulmonary hypertension | 5 | none | 39a
|