Diagnostic Tools: Cardiac MRI for Structural Heart Disease and Catheter-Based Cardiovascular Interventions
Cardiovascular magnetic resonance imaging has enhanced noninvasive evaluation and management of patients with several forms of cardiovascular disease. The role is increasing due to its improved soft tissue contrast, capacity to perform multiplanar reconstructions, and ability to visualize and quantify cardiac function without the use of ionizing radiation. Phase contrast imaging allows for velocity and flow assessment, as well as gradient estimation, providing important diagnostic information for structural and valvular disorders. Catheter-based interventions under magnetic resonance rather than fluoroscopic guidance are currently under investigation. As percutaneous cardiovascular intervention becomes more complex, the need for enhanced soft tissue visualization without ionizing radiation will allow for the expansion of magnetic resonance–guided intervention.
The authors would like to give special appreciation to Dr. Robert Lederman and his team at the National Heart, Lung, and Blood Institute, National Institutes of Health, for their work and instructional assistance in real-time MRI guidance for catheter-based intervention.
- 2.Bellenger NG, Burgess MI, Ray SG, Lahiri A, Coats AJ, Cleland JG, et al. Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, radionuclide ventriculography and cardiovascular magnetic resonance; are they interchangeable? Eur Heart J. 2000;21(16):1387–96.CrossRefPubMedGoogle Scholar
- 10.American College of Cardiology Foundation Task Force on Expert, Consensus D, Hundley WG, Bluemke DA, Finn JP, Flamm SD, Fogel MA, et al. ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. Circulation. 2010;121(22):2462–508.CrossRefGoogle Scholar
- 14.Park J, Chang HJ, Choi JH, Yang PS, Lee SE, Heo R, et al. Late gadolinium enhancement in cardiac MRI in patients with severe aortic stenosis and preserved left ventricular systolic function is related to attenuated improvement of left ventricular geometry and filling pressure after aortic valve replacement. Korean Circ J. 2014;44(5):312–9.CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Hartlage GR, Babaliaros VC, Thourani VH, Hayek S, Chrysohoou C, Ghasemzadeh N, et al. The role of cardiovascular magnetic resonance in stratifying paravalvular leak severity after transcatheter aortic valve replacement: an observational outcome study. J Cardiovasc Magn Reson. 2014;16:93.CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(23):e521–643.CrossRefPubMedGoogle Scholar
- 20.Steinmetz M, Preuss HC, Lotz J. Non-invasive imaging for congenital heart disease—recent progress in cardiac MRI. J Clin Exper Cardiol. 2012;15:2012.Google Scholar
- 24.Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Adults with Congenital Heart Disease). Circulation. 2008;118(23):2395–451.CrossRefPubMedGoogle Scholar
- 30.Calkins H, Kuck KH, Cappato R, Brugada J, Camm AJ, Chen SA, et al. 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC) and the European Cardiac Arrhythmia Society (ECAS); and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). Endorsed by the governing bodies of the American College of Cardiology Foundation, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, the Asia Pacific Heart Rhythm Society, and the Heart Rhythm Society. Heart Rhythm. 2012;9(4):632–96. e21CrossRefPubMedPubMedCentralGoogle Scholar
- 37.Halabi M, Ratnayaka K, Faranesh AZ, Hansen MS, Barbash IM, Eckhaus MA, et al. Transthoracic delivery of large devices into the left ventricle through the right ventricle and interventricular septum: preclinical feasibility. J Cardiovasc Magn Reson. 2013;15:10.CrossRefPubMedPubMedCentralGoogle Scholar
- 38.Ganesan AN, Selvanayagam JB, Mahajan R, Grover S, Nayyar S, Brooks AG, et al. Mapping and ablation of the pulmonary veins and cavo-tricuspid isthmus with a magnetic resonance imaging-compatible externally irrigated ablation catheter and integrated electrophysiology system. Circ Arrhythm Electrophysiol. 2012;5(6):1136–42.CrossRefPubMedGoogle Scholar