Magnetic Resonance-Guided Cardiac Interventions Using Magnetic Resonance-Compatible Devices A Preclinical Study and First-in-Man Congenital Interventions

Aphrodite Tzifa; Gabriele A. Krombach; Nils Kraemer; Sascha Krueger; Adrian Schuette; Matthias von Walter; Tobias Schaeffter; Shakeel Qureshi; Thomas Krasemann; Eric Rosenthal; Claudia A. Schwartz; Gopal Varma; Alexandra Buhl; Antonia Kohlmeier; Arno Buecker; Rolf W. Guenther; Reza Razavi

doi:10.1161/CIRCINTERVENTIONS.110.957209

Magnetic Resonance-Guided Cardiac Interventions Using Magnetic Resonance-Compatible Devices A Preclinical Study and First-in-Man Congenital Interventions

Aphrodite Tzifa, Gabriele A. Krombach, Nils Kraemer, Sascha Krueger, Adrian Schuette, Matthias von Walter, Tobias Schaeffter, Shakeel Qureshi, Thomas Krasemann, Eric Rosenthal, Claudia A. Schwartz, Gopal Varma, Alexandra Buhl, Antonia Kohlmeier, Arno Buecker, Rolf W. Guenther, Reza Razavi

Research output: Contribution to journal › Article › peer-review

67 Citations (Scopus)

Abstract

Background-Percutaneous cardiac interventions are currently performed under x-ray guidance. Magnetic resonance imaging (MRI) has been used to guide intravascular interventions in the past, but mainly in animals. Translation of MR-guided interventions into humans has been limited by the lack of MR-compatible and safe equipment, such as MR guide wires with mechanical characteristics similar to standard guide wires. The aim of the present study was to evaluate the safety and efficacy of a newly developed MR-safe and compatible passive guide wire in aiding MR-guided cardiac interventions in a swine model and describe the 2 first-in-man solely MR-guided interventions. Methods and Results-In the preclinical trial, the new MR-compatible wire aided the performance of 20 interventions in 5 swine. These consisted of balloon dilation of nondiseased pulmonary and aortic valves, aortic arch, and branch pulmonary arteries. After ethics and regulatory authority approval, the 2 first-in-man MR-guided interventions were performed in a child and an adult, both with elements of valvar pulmonary stenosis. Catheter manipulations were monitored with real-time MRI sequence with interactive modification of imaging plane and slice position. Temporal resolution was 11 to 12 frames/s. Catheterization procedure times were 110 and 80 minutes, respectively. Both patients had successful relief of the valvar stenosis and no procedural complications. Conclusions-The described preclinical study and case reports are encouraging that with the availability of the new MR-compatible and safe guide wire, certain percutaneous cardiac interventions will become feasible to perform solely under MR guidance in the future. A clinical trial is underway in our institution. (Circ Cardiovasc Interv. 2010;3:585-592.)

Original language	English
Pages (from-to)	585 - 592
Number of pages	8
Journal	Circulation-Cardiovascular Interventions
Volume	3
Issue number	6
DOIs	https://doi.org/10.1161/CIRCINTERVENTIONS.110.957209
Publication status	Published - Dec 2010

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10.1161/CIRCINTERVENTIONS.110.957209

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Tzifa, A., Krombach, G. A., Kraemer, N., Krueger, S., Schuette, A., von Walter, M., Schaeffter, T., Qureshi, S., Krasemann, T., Rosenthal, E., Schwartz, C. A., Varma, G., Buhl, A., Kohlmeier, A., Buecker, A., Guenther, R. W., & Razavi, R. (2010). Magnetic Resonance-Guided Cardiac Interventions Using Magnetic Resonance-Compatible Devices A Preclinical Study and First-in-Man Congenital Interventions. Circulation-Cardiovascular Interventions, 3(6), 585 - 592. https://doi.org/10.1161/CIRCINTERVENTIONS.110.957209

@article{87b0737fd70541289fbb92c624519f50,

title = "Magnetic Resonance-Guided Cardiac Interventions Using Magnetic Resonance-Compatible Devices A Preclinical Study and First-in-Man Congenital Interventions",

abstract = "Background-Percutaneous cardiac interventions are currently performed under x-ray guidance. Magnetic resonance imaging (MRI) has been used to guide intravascular interventions in the past, but mainly in animals. Translation of MR-guided interventions into humans has been limited by the lack of MR-compatible and safe equipment, such as MR guide wires with mechanical characteristics similar to standard guide wires. The aim of the present study was to evaluate the safety and efficacy of a newly developed MR-safe and compatible passive guide wire in aiding MR-guided cardiac interventions in a swine model and describe the 2 first-in-man solely MR-guided interventions. Methods and Results-In the preclinical trial, the new MR-compatible wire aided the performance of 20 interventions in 5 swine. These consisted of balloon dilation of nondiseased pulmonary and aortic valves, aortic arch, and branch pulmonary arteries. After ethics and regulatory authority approval, the 2 first-in-man MR-guided interventions were performed in a child and an adult, both with elements of valvar pulmonary stenosis. Catheter manipulations were monitored with real-time MRI sequence with interactive modification of imaging plane and slice position. Temporal resolution was 11 to 12 frames/s. Catheterization procedure times were 110 and 80 minutes, respectively. Both patients had successful relief of the valvar stenosis and no procedural complications. Conclusions-The described preclinical study and case reports are encouraging that with the availability of the new MR-compatible and safe guide wire, certain percutaneous cardiac interventions will become feasible to perform solely under MR guidance in the future. A clinical trial is underway in our institution. (Circ Cardiovasc Interv. 2010;3:585-592.)",

author = "Aphrodite Tzifa and Krombach, {Gabriele A.} and Nils Kraemer and Sascha Krueger and Adrian Schuette and {von Walter}, Matthias and Tobias Schaeffter and Shakeel Qureshi and Thomas Krasemann and Eric Rosenthal and Schwartz, {Claudia A.} and Gopal Varma and Alexandra Buhl and Antonia Kohlmeier and Arno Buecker and Guenther, {Rolf W.} and Reza Razavi",

year = "2010",

month = dec,

doi = "10.1161/CIRCINTERVENTIONS.110.957209",

language = "English",

volume = "3",

pages = "585 -- 592",

journal = "Circulation-Cardiovascular Interventions",

publisher = "LIPPINCOTT WILLIAMS & WILKINS",

number = "6",

}

Tzifa, A, Krombach, GA, Kraemer, N, Krueger, S, Schuette, A, von Walter, M, Schaeffter, T, Qureshi, S, Krasemann, T, Rosenthal, E, Schwartz, CA, Varma, G, Buhl, A, Kohlmeier, A, Buecker, A, Guenther, RW & Razavi, R 2010, 'Magnetic Resonance-Guided Cardiac Interventions Using Magnetic Resonance-Compatible Devices A Preclinical Study and First-in-Man Congenital Interventions', Circulation-Cardiovascular Interventions, vol. 3, no. 6, pp. 585 - 592. https://doi.org/10.1161/CIRCINTERVENTIONS.110.957209

Magnetic Resonance-Guided Cardiac Interventions Using Magnetic Resonance-Compatible Devices A Preclinical Study and First-in-Man Congenital Interventions. / Tzifa, Aphrodite; Krombach, Gabriele A.; Kraemer, Nils et al.
In: Circulation-Cardiovascular Interventions, Vol. 3, No. 6, 12.2010, p. 585 - 592.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Magnetic Resonance-Guided Cardiac Interventions Using Magnetic Resonance-Compatible Devices A Preclinical Study and First-in-Man Congenital Interventions

AU - Tzifa, Aphrodite

AU - Krombach, Gabriele A.

AU - Kraemer, Nils

AU - Krueger, Sascha

AU - Schuette, Adrian

AU - von Walter, Matthias

AU - Schaeffter, Tobias

AU - Qureshi, Shakeel

AU - Krasemann, Thomas

AU - Rosenthal, Eric

AU - Schwartz, Claudia A.

AU - Varma, Gopal

AU - Buhl, Alexandra

AU - Kohlmeier, Antonia

AU - Buecker, Arno

AU - Guenther, Rolf W.

AU - Razavi, Reza

PY - 2010/12

Y1 - 2010/12

N2 - Background-Percutaneous cardiac interventions are currently performed under x-ray guidance. Magnetic resonance imaging (MRI) has been used to guide intravascular interventions in the past, but mainly in animals. Translation of MR-guided interventions into humans has been limited by the lack of MR-compatible and safe equipment, such as MR guide wires with mechanical characteristics similar to standard guide wires. The aim of the present study was to evaluate the safety and efficacy of a newly developed MR-safe and compatible passive guide wire in aiding MR-guided cardiac interventions in a swine model and describe the 2 first-in-man solely MR-guided interventions. Methods and Results-In the preclinical trial, the new MR-compatible wire aided the performance of 20 interventions in 5 swine. These consisted of balloon dilation of nondiseased pulmonary and aortic valves, aortic arch, and branch pulmonary arteries. After ethics and regulatory authority approval, the 2 first-in-man MR-guided interventions were performed in a child and an adult, both with elements of valvar pulmonary stenosis. Catheter manipulations were monitored with real-time MRI sequence with interactive modification of imaging plane and slice position. Temporal resolution was 11 to 12 frames/s. Catheterization procedure times were 110 and 80 minutes, respectively. Both patients had successful relief of the valvar stenosis and no procedural complications. Conclusions-The described preclinical study and case reports are encouraging that with the availability of the new MR-compatible and safe guide wire, certain percutaneous cardiac interventions will become feasible to perform solely under MR guidance in the future. A clinical trial is underway in our institution. (Circ Cardiovasc Interv. 2010;3:585-592.)

AB - Background-Percutaneous cardiac interventions are currently performed under x-ray guidance. Magnetic resonance imaging (MRI) has been used to guide intravascular interventions in the past, but mainly in animals. Translation of MR-guided interventions into humans has been limited by the lack of MR-compatible and safe equipment, such as MR guide wires with mechanical characteristics similar to standard guide wires. The aim of the present study was to evaluate the safety and efficacy of a newly developed MR-safe and compatible passive guide wire in aiding MR-guided cardiac interventions in a swine model and describe the 2 first-in-man solely MR-guided interventions. Methods and Results-In the preclinical trial, the new MR-compatible wire aided the performance of 20 interventions in 5 swine. These consisted of balloon dilation of nondiseased pulmonary and aortic valves, aortic arch, and branch pulmonary arteries. After ethics and regulatory authority approval, the 2 first-in-man MR-guided interventions were performed in a child and an adult, both with elements of valvar pulmonary stenosis. Catheter manipulations were monitored with real-time MRI sequence with interactive modification of imaging plane and slice position. Temporal resolution was 11 to 12 frames/s. Catheterization procedure times were 110 and 80 minutes, respectively. Both patients had successful relief of the valvar stenosis and no procedural complications. Conclusions-The described preclinical study and case reports are encouraging that with the availability of the new MR-compatible and safe guide wire, certain percutaneous cardiac interventions will become feasible to perform solely under MR guidance in the future. A clinical trial is underway in our institution. (Circ Cardiovasc Interv. 2010;3:585-592.)

U2 - 10.1161/CIRCINTERVENTIONS.110.957209

DO - 10.1161/CIRCINTERVENTIONS.110.957209

M3 - Article

VL - 3

SP - 585

EP - 592

JO - Circulation-Cardiovascular Interventions

JF - Circulation-Cardiovascular Interventions

IS - 6

ER -

Magnetic Resonance-Guided Cardiac Interventions Using Magnetic Resonance-Compatible Devices A Preclinical Study and First-in-Man Congenital Interventions

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