- Oral presentation
- Open Access
Transcatheter bidirectional Glenn shunt guided by real-time MRI
© Ratnayaka et al; licensee BioMed Central Ltd. 2015
- Published: 3 February 2015
- Superior Vena Cava
- Branch Pulmonary Artery
- Single Ventricle Physiology
- Glenn Shunt
- Pulmonary Artery Flow
Children with single ventricle physiology require multiple open heart surgeries for palliation, including sternotomies and cardiopulmonary bypass. The reduced morbidity of a catheter-based approach is attractive. We hypothesize real-time multiplanar MRI guidance enables closed-chest percutaneous bidirectional Glenn shunt because of arbitrary-plane imaging capability.
Ten swine underwent transcatheter bidirectional Glenn procedures under MRI at 1.5T. An MRI antenna-needle was advanced from the superior vena cava (SVC) into the target pulmonary artery (PA) bifurcation using real-time MRI guidance. A caval-pulmonary sheath introduced endografts. Balloon-expansion secured a proximal end-to-end caval anastomosis that also occluded the azygos, and a distal end-to-side pulmonary anastomosis that preserved blood flow to both branch pulmonary arteries.
MRI guidance enabled a complex closed-chest beating heart pediatric transcatheter structural heart procedure that otherwise requires open surgery and cardiopulmonary bypass. In this study, MRI alone guided a wholly percutaneous Glenn shunt that preserved bidirectional pulmonary artery flow. Clinical translation would require minor refinement of catheter tools.
Z01-HL005062 (NHLBI/NIH DIVISION OF INTRAMURAL RESEARCH).
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