Document Detail

Real-time interactive MRI-guided cardiac surgery: aortic valve replacement using a direct apical approach.
MedLine Citation:
PMID:  17036300     Owner:  NLM     Status:  MEDLINE    
Minimally invasive cardiac surgery requires arresting and emptying of the heart, which compromises visualization of the surgical field. In this feasibility study a novel surgical procedure is demonstrated in which real-time MRI is used to guide the placement of a prosthetic aortic valve in the beating heart via direct apical access in eight porcine hearts. A clinical stentless bioprosthetic valve affixed to a platinum stent was compressed onto a balloon-tipped catheter. This was fed through a 15-18-mm delivery port inserted into the left ventricular (LV) apex via a minimally invasive subxyphoid incision. Using interactive real-time MRI, the surgeon implanted the prosthetic valve in the correct location at the aortic annulus within 90 s. In four of the animals immediately after implantation, ventricular function, blood flow through the valve, and myocardial perfusion were evaluated with MRI. MRI-guided beating-heart surgery may provide patients with a less morbid and more durable solution to structural heart disease.
Elliot R McVeigh; Michael A Guttman; Robert J Lederman; Ming Li; Ozgur Kocaturk; Timothy Hunt; Shawn Kozlov; Keith A Horvath
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Magnetic resonance in medicine : official journal of the Society of Magnetic Resonance in Medicine / Society of Magnetic Resonance in Medicine     Volume:  56     ISSN:  0740-3194     ISO Abbreviation:  Magn Reson Med     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-26     Completed Date:  2007-01-30     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  8505245     Medline TA:  Magn Reson Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  958-64     Citation Subset:  IM    
Copyright Information:
Published 2006 Wiley-Liss, Inc.
Laboratory of Cardiac Energetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892-1061, USA.
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MeSH Terms
Aortic Valve / anatomy & histology*,  surgery*
Computer Systems
Equipment Design
Equipment Failure Analysis
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / instrumentation*,  methods
Magnetic Resonance Imaging / instrumentation*,  methods
Surgery, Computer-Assisted / instrumentation*,  methods
User-Computer Interface
Grant Support
Z01 HL004608-08/HL/NHLBI NIH HHS

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