Real-time magnetic resonance imaging–guided transcatheter aortic valve replacement Justin G. Miller, MD, Ming Li, PhD, Dumitru Mazilu, PhD, Tim Hunt,

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Presentation transcript:

Real-time magnetic resonance imaging–guided transcatheter aortic valve replacement Justin G. Miller, MD, Ming Li, PhD, Dumitru Mazilu, PhD, Tim Hunt, BS, Keith A. Horvath, MD The Journal of Thoracic and Cardiovascular Surgery Volume 151, Issue 5, Pages 1269-1277 (May 2016) DOI: 10.1016/j.jtcvs.2015.11.024 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Medtronic CoreValve. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1269-1277DOI: (10.1016/j.jtcvs.2015.11.024) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Top and bottom right, Modified delivery catheter system. Bottom left, Valve deployment with active guide wire. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1269-1277DOI: (10.1016/j.jtcvs.2015.11.024) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Top, The delivery system and active guide wire. Bottom, The tip of the delivery system and the active guide wire, showing the handle of the delivery system and the RF connector. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1269-1277DOI: (10.1016/j.jtcvs.2015.11.024) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Long-axis view of rtMRI-guided valve deployment. A, Guide wire advanced across aortic valve. B, Delivery catheter system advanced over guide wire and into position. C, D, and E, Retracting capsule to deploy valve. F, Valve deployed. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1269-1277DOI: (10.1016/j.jtcvs.2015.11.024) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Postdeployment CINE (long-axis view) to confirm valve position. Top, diastole; bottom, systole. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1269-1277DOI: (10.1016/j.jtcvs.2015.11.024) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Postdeployment perfusion scan. Left column, apex; middle column, mid-wall; right column, base. Top row, arterial phase; bottom row, venous phase. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1269-1277DOI: (10.1016/j.jtcvs.2015.11.024) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 7 Necropsy results confirming the open coronary ostia. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1269-1277DOI: (10.1016/j.jtcvs.2015.11.024) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Postdeployment cine MRI to confirm valve position Postdeployment cine MRI to confirm valve position. Left, diastole; right, systole. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1269-1277DOI: (10.1016/j.jtcvs.2015.11.024) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions