Real-time MRI guided cardiovascular intervention

实时 MRI 引导心血管干预

• 批准号: 8939792
• 负责人: Robert J Lederman
• 金额: $ 144.51万
• 依托单位: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8939792
• 关键词: Adoption; Adult; Anatomy; Animals; Aorta; Arteries; Biological; Bypass; Cardiovascular system; Catheterization; Child; Child Care; Childhood; Clinical; Complex; Congenital Heart Defects; Development; Devices; Diagnostic radiologic examination; Heart; Human; Intervention; Leg; Lung; Magnetic Resonance Imaging; Mechanics; Medical center; Operative Surgical Procedures; Patients; Pericardiocentesis; Peripheral arterial disease; Procedures; Pulmonary Artery Catheterization; Radiation; Research; Shunt Device; Site; Testing; Time; Translating; United States; United States National Institutes of Health; Woman; Work; aortic valve replacement; base; clinical application; clinical practice; congenital heart disorder; heart function; novel; novel strategies; programs; repaired; tool

During the past year we have continued our work applying rapid MRI to guide simple and complex mechanical and biological interventions. We have introduced MRI catheterization into standard clinical practice at the NIH clinical center, based on our earlier careful pilot research comparison of conventional X-ray and wholly MRI guided transfemoral pulmonary artery catheterization in adults. We continue to enhance the capabilities of MRI catheterization to characterize heart function in patients. We continue to test MRI pericardiocentesis procedure in humans. We are developing new approaches to connect different heart chambers without surgery in patients with congenital heart disease. We also continue work towards direct repair of congenital heart defects on small children who otherwise might require open surgical access. We have completed a strategic project to accomplish non-surgical extra-anatomic bypass (a bidirectional Glenn superior cavo-pulmonary shunt) in animals, and expect to be able to translate this into the care of children in upcoming years. We are developing other novel catheterization tools, for example, to access the aorta without surgery in patients with small leg arteries (especially women) and patients with severe peripheral artery disease. This key advance has been translated into over 40 patients in its first year of clinical adoption at multiple sites across the United States, where it has proven lifesaving in many cases. We have now begun to sponsor a multi-center trial of this transcaval approach to transcatheter aortic valve replacement in patients without other good options. Simultaneously we are developing a purpose-built closure device for these caval-aortic access ports. We are helping other US medical centers develop their own interventional MRI programs. Overall we have successfully developed novel applications of real-time MRI for cardiovascular treatments, and we continue to work to clinical applications of these exciting new developments.

在过去的一年里，我们继续应用快速 MRI 来指导简单和复杂的机械和生物干预。 基于我们早期对成人常规 X 射线和全 MRI 引导经股肺动脉插管术的仔细试点研究比较，我们已将 MRI 插管术引入 NIH 临床中心的标准临床实践。 我们不断增强 MRI 导管插入术表征患者心脏功能的能力。 我们继续在人体中测试 MRI 心包穿刺术。 我们正在开发新方法，无需手术即可连接先天性心脏病患者的不同心室。我们还继续努力直接修复可能需要开放手术的幼儿先天性心脏缺陷。 我们已经完成了一个战略项目，以在动物身上实现非手术解剖外搭桥（双向格伦上腔静脉肺分流术），并期望能够在未来几年将其转化为儿童的护理。 我们正在开发其他新型导管插入工具，例如，无需手术即可进入小腿动脉患者（尤其是女性）和患有严重外周动脉疾病的患者的主动脉。 这一关键进步在美国多个地点进行临床应用的第一年就已转化为 40 多名患者，事实证明它在许多情况下可以挽救生命。 我们现在已经开始赞助一项多中心试验，针对没有其他良好选择的患者进行经导管主动脉瓣置换术。 同时，我们正在开发一种用于这些腔静脉主动脉通路的专用闭合装置。 我们正在帮助其他美国医疗中心开发自己的介入 MRI 项目。 总体而言，我们已经成功开发了用于心血管治疗的实时 MRI 的新颖应用，并且我们将继续致力于这些令人兴奋的新发展的临床应用。