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.

在过去的一年中，我们继续使用快速MRI来指导简单而复杂的机械和生物学干预措施。 根据我们较早的仔细的试点研究比较，我们对NIH临床中心的标准临床实践进行了MRI导管插入术，对成年人的常规X射线和全面MRI引导的转际肺动脉导管的比较。 我们继续增强MRI导管插入术的能力，以表征患者心脏功能。 我们继续测试人类中的MRI心脏穿刺术程序。 我们正在开发新的方法来连接不同的心脏腔室，而无需手术，患有先天性心脏病的患者。我们还继续致力于直接修复先天性心脏缺陷，否则可能需要开放手术。 我们已经完成了一个战略项目，以完成动物的非手术外旁路旁路（双向Glenn Superior Cavo-pulonary Enct），并希望能够将其转化为即将到来的几年的儿童照顾。 我们正在开发其他新型导管插入工具，例如，在小动脉（尤其是女性）和严重的外周动脉疾病的患者中，无需手术即可进入主动脉。 在美国各个地点采用临床领养的第一年，该关键进步已被转化为40多名患者，在许多情况下，它已证明其救生已被证明。 现在，我们已经开始赞助这种经诊断方法的多中心试验，以替换经导管主动脉瓣替代患者，而没有其他好选择。 同时，我们正在为这些Caval-Aortic访问端口开发专门构建的闭合设备。 我们正在帮助其他美国医疗中心制定自己的介入MRI计划。 总体而言，我们成功地开发了实时MRI的新型应用在心血管治疗中，并且我们继续致力于这些令人兴奋的新发展的临床应用。