Rt Heart Catheterization Alexander Sandy Dick MD Rebecca Thornhill PhD Sophie Chenier MRTRMR Summary iCMR NHLBI NHLBI HandsOn Workshop September 28 2016 Ratnayaka et al ID: 1026010
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1. Progress MRI Guided Adult Rt Heart CatheterizationAlexander (Sandy) Dick, MDRebecca Thornhill, PhDSophie Chenier, MRT(R,MR)
2. SummaryiCMR @ NHLBINHLBI Hands-On Workshop September 28, 2016Ratnayaka et al, Eur Hrt J 2012; Rogers et al, CHEST, 2014Progress to date OHIIRBEquipmentSafety
3. ChallengesJustificationCost/AccessLimited vendors in small marketStand alone busy clinical CMRSafety
4. Justification MRI Guided CatheterizationSimultaneous structural, functional and hemodynamic assessmentRV afterload, contractility and right ventricle-pulmonary artery couplingDiagnosis and prognosisFuture MRI guided procedures
5. Example of Post contrast T1, partition coefficient and ECV maps of a 68 year-old female with severe chronic thromboembolic pulmonary hypertension, with an mPAP=72 mmHg on right heart catheterization.Example of Post contrast T1, partition coefficient and ECV maps of a 68 year-old female with severe chronic thromboembolic pulmonary hypertension, with an mPAP=72 mmHg on right heart catheterization.Peña E... Mielniczuk L. SCMR 2016.
6. ItemMfrModelQtyCostTotalProjection SystemProjectorInFocusIN3120HD 2$1500$3000ScreenDa-Lite 1$700$700Video Matrix SwitchNTISM-16X16-DVI 1$3800$3800Fiber optic extenderNTIST-2FODVI-LC 4$600$2400Fiber CableNTIFIBER-2D-LCLC 4$170$680XFMPCDell 1$4000$4000Graphics cardNvidiaGTX970 1$600$600A/D cardNational InstrumentsNIUSB-6009 1$600$600PHYSIO-recordingInvivo and MACLAB$0$0Electronic FiltersIn House 1$3000$3000CommunicationWireless headsets (4)Innovere 1$35000$35000TOTAL$53780Interventional MRI Suite Equipment List
7. Wireless Communication
8. Hands free MRI noise cancelation communications systemIMROC™ Wireless: Complete Freedom and Flexibilityx 6Optoacoustics
9. R.F. Shielded Projector
10. The NIH Lab at Children’s National Medical CenterWashington, DC
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12. Control Room
13. Data Display NHLBI
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15. Safety (What keeps me up at night)Access in the roomDedicated removal of needle and wireMRI safe devices ArrhythmiasComplete Heart Block, Ventricular Tachycardia,Ventricular FibrillationDedicated observation monitor; arterial access
16. MR Safe Procedure Table
17. Patient Evacuation1st Operator2nd OperatorCath/MR TechCath RNSedation RN1Provide Instructions2Advance patient to scanner home positionOpen MR bay doorsSecure IV line3Remove Surface CoilRemove pt headsetSecure airway4Start chest compressionsTransfer patient from MR suiteAssist Cath RN5Restricts access to MR suiteDefibrillate/ Administer medications
18. SummaryiCMR @ NHLBIProgress to date OHIIRBEquipmentSafety