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Feasibility, safety and diagnostic yield of interventional cardiac magnetic resonance for routine right heart catheterization in adults. | LitMetric

Feasibility, safety and diagnostic yield of interventional cardiac magnetic resonance for routine right heart catheterization in adults.

Arch Cardiovasc Dis

Cardiovascular Magnetic Resonance Laboratory, Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques-Cartier, Ramsay Santé, 6, avenue du Noyer-Lambert, 91300 Massy, France. Electronic address:

Published: April 2024

AI Article Synopsis

  • Real-time cardiac magnetic resonance (CMR) allows for detailed imaging of the heart without using contrast agents or X-rays, and CMR-guided right heart catheterization (CMR-RHC) merges this technology with traditional catheterization methods.
  • This study evaluated the feasibility and safety of CMR-RHC in 35 patients needing right heart catheterization from December 2018 to May 2021, finding a high success rate of 91% in obtaining necessary measurements and no adverse effects reported.
  • The procedures averaged 29 minutes for CMR-RHC and 62 minutes total, with good overall comfort reported by both patients and physicians, highlighting the technique's potential for improving cardiac diagnostics.*

Article Abstract

Background: Real-time cardiac magnetic resonance generates spatially and temporally resolved images of cardiac anatomy and function, without the need for contrast agent or X-ray exposure. Cardiac magnetic resonance-guided right heart catheterization (CMR-RHC) combines the benefits of cardiac magnetic resonance and invasive cardiac catheterization. The clinical adoption of CMR-RHC represents the first step towards the development of cardiac magnetic resonance-guided therapeutic procedures.

Aim: To describe the feasibility, safety and diagnostic yield of CMR-RHC in consecutive all-comer patients with clinical indications for right heart catheterization.

Methods: From December 2018 to May 2021, 35 consecutive patients with prespecified indications for right heart catheterization were scheduled for CMR-RHC via the femoral route under local anaesthesia in a 1.5T cardiac magnetic resonance suite equipped for interventional cardiac magnetic resonance. The duration of various procedural components and safety data were recorded. Success rate (defined by the ability to record all prespecified haemodynamic measurements and imaging metrics), adverse events and patient/physician perprocedural comfort were assessed.

Results: One patient withdrew his consent before the study, and scanner troubleshooting occurred in one case. Among the 33 remaining patients, prespecified cardiac magnetic resonance imaging metrics were obtained in all patients, whereas full CMR-RHC measurements were obtained in 30 patients (91%). A dedicated cardiac magnetic resonance-compatible wire was used in 25/33 procedures. CMR-RHC was completed in 29±16minutes, and the total duration of the procedure, including conventional cardiac magnetic resonance imaging, was 62±20minutes. There were no adverse events and no femoral haematomas. Procedural comfort was deemed good by the patients and operators for all procedures. CMR-RHC significantly impacted diagnosis or patient management in 28/33 patients (85%).

Conclusions: CMR-RHC seems to be a feasible and safe procedure that can be used in routine daily practice in consecutive adults with an impactful clinical yield.

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Source
http://dx.doi.org/10.1016/j.acvd.2024.01.004DOI Listing

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