Cardiac Catheterization for Children

According to a study in the September 2005 issue of Catheterization and Cardiovascular Interventions: Journal of the Society for Cardiovascular Angiography and Interventions, more detailed images, quicker scan times, more powerful magnets, and open scanners that provide clinicians access to patients during interventional procedures are all making real-time, MRI-guided cardiac catheterization a reality.

"MRI is on the verge of changing the way both diagnostic and interventional catheterization is done in children with congenital heart disease,” said Dr. Phillip Moore, a professor of clinical pediatrics and director of the Congenital Cardiac Catheterization Laboratory at the University of California, San Francisco (USA).

MRI cardiac catheterization is catching the attention of interventional cardiologists because it can do what conventional x-ray angiography cannot. Whereas x-ray angiography visualizes the inside of the blood vessels and heart chambers in two dimensions and the remainder of the heart as a mass of gray, MRI provides a detailed three-dimensional image of the heart. This enables the interventional cardiologist to visualize blood vessels inside and out, to effectively measure the size and volume of heart chambers and the thickness of the heart muscle, and to see the heart valves and other structures in relation to one another from any angle.

It is now possible for MRI not only to image the heart in great definition but to do so while the heart is beating and display those images in real time. This enables the interventional cardiologist to monitor a MRI-compatible catheter as it winds it way through the heart and to make fine adjustments when implanting therapeutic devices, such as stents.

Most of the studies into MRI cardiac catheterization have been done with laboratory animals, but the application is now expanding to humans. The researchers have combined MRI and conventional angiography in diagnosing congenital heart disease in children. They expect to soon begin utilizing MRI cardiac catheterization in treatment procedures, positioning stents to open constrictions in the aorta and pulmonary artery.





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