Magnetic resonance imaging of the cardiac venous system and magnetic resonance-guided intubation of the coronary sinus in swine: a feasibility study.
OBJECTIVE
To visualize the coronary sinus using magnetic resonance (MR), and to demonstrate the feasibility of MR-guided intubation of the cardiac venous system (CVS) in swine.


METHODS
A total of 6 pigs were investigated. All experiments were performed using an interventional 1.5-Tesla MRI system. The CVS was visualized using an inversion-recovery navigator-gated whole-heart steady-state free-precession sequence after administration of gadobenate dimeglumine contrast agent. The coronary sinus was then intubated under MR-guidance with a passive MR-compatible guidewire modified by incorporation of iron oxide markers for improved visualization and a nonbraided Cobra-catheter. MR-guided interventions were monitored using a steady-state free-precession real-time imaging sequence. Time needed was measured for MR-guided intubation of the CVS and compared with the time needed for fluoroscopy guided intubation of the CVS.


RESULTS
Visualization and intubation of the coronary sinus and its site branches was feasible in all cases. Time spent for MR-guided intubation of the CVS was comparable to time spent for fluoroscopy-guided intubation (8.2 +/- 2 minutes vs. 8.3 +/- 1.3 minutes; P = 0.85).


CONCLUSIONS
MR-visualization and MR-guided intubation of the coronary sinus and its side branches is feasible. The feasibility of MR-guided intubation of the CVS might have relevance for procedures like cardiac resynchronization therapy and percutaneous transcatheter mitral annuloplasty, requiring improved 3-dimensional knowledge about cardiac vein anatomy in the near future.
Department of Cardiology, Angiology and Pulmonology, University Hospital Düsseldorf, Düsseldorf, Germany.
Mirja
M
Neizel
Nils
N
Krämer
Adrian
A
Schütte
Bernhard
B
Schnackenburg
Sascha
S
Krüger
Malte
M
Kelm
Rolf W
RW
Günther
Harald P
HP
Kühl
Gabriele A
GA
Krombach
D000818:Animals; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods; D054326:Coronary Sinus / Q000033:anatomy & histology; D003331:Coronary Vessels / Q000033:anatomy & histology* / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy / Q000295:instrumentation / Q000379:methods; D021621:Imaging, Three-Dimensional; D007440:Intubation / Q000295:instrumentation / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008536:Meglumine / Q000031:analogs & derivatives; D009942:Organometallic Compounds; D013552:Swine; D013997:Time Factors
D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine