Magnetic resonance image-guided trans-septal puncture in a swine heart
Magnetic resonance image-guided trans-septal puncture in a swine heart
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DOI：
10.1002/jmri.20262
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发表时间：
2005-04-01
影响因子：
4.4
通讯作者：
Atalar, E
中科院分区：
文献类型：
--
作者：
Arepally, A;Karmarkar, PV;Atalar, E
目的：探讨磁共振引导下在猪心脏中隔穿刺的可行性。材料和方法：所有手术均在1.5 t MR扫描仪上进行。一种新颖的，主动磁共振血管内针系统用于针跟踪和间隔穿刺。使用心电图门控的高分辨率和非心电图门控的实时磁共振成像技术对5头猪进行了跨隔膜穿刺。血管内针从股静脉穿过导丝推进。针就位后，进行跨间隔穿刺。结果：主动跟踪针穿过鼻中隔是可能的。采用实时梯度回忆回声（GRE）确定导管尖端位置。经钆- dtpa确认心室造影后，将一根0.014英寸导丝推进左心房和左心室。所有穿刺均未见心律或心率变化；对所有动物进行尸检分析，结果显示18/19（95%）的穿刺直接穿过卵状窝。结论：仅使用MR引导和一种新型的主动血管内针系统，我们就能从经股入路反复穿刺猪心脏的卵圆窝，并能直接看到所有组成部分，包括针、心房、卵圆窝和周围的血管。
Purpose: To test the feasibility of performing magnetic resonance M-guided bans septal punctures in the swine heart.Materials and Methods: All procedures were performed in a 1.5-T MR scanner. A novel, active MR intravascular needle system was utilized for needle tracking and septal punctures. Trans-septal punctures were performed in five swine using electrocardiogram (ECG)-gated high resolution and non-ECG-gated, real-time MR imaging techniques. The intravascular needle was advanced over a guidewire from the femoral vein. Once the needle was in proper position, trans-septal punctures were made.Results: Active tracking of the needle traversing the septum was possible. The location of the catheter tip was confirmed using real time gradient recalled echo (GRE). After a confirmatory ventriculogram with gadolinium-DTPA, a 0.014-inch guidewire was advanced into the left atrium and left ventricle. All punctures were made with no change in cardiac rhythm or rate; postmortem analysis was performed on all animals and demonstrated that 18/19 (95%) punctures were directly through the fossa ovalis.Conclusion: : Using only MR guidance and a novel active intravascular needle system, we were able to repeatedly puncture the fossa ovalis in a swine heart from a trans-femoral approach, with direct visualization of all components, including the needle, the atria, the fossa ovalis, and the surrounding vasculature.