%0 Journal Article
%T Interventional cardiovascular magnetic resonance: still tantalizing
%A Kanishka Ratnayaka
%A Anthony Z Faranesh
%A Michael A Guttman
%A Ozgur Kocaturk
%A Christina E Saikus
%A Robert J Lederman
%J Journal of Cardiovascular Magnetic Resonance
%D 2008
%I BioMed Central
%R 10.1186/1532-429x-10-62
%X Surgical procedures afford direct exposure for visualization (optical imaging) of target tissue and access for mechanical intervention. This permits instant recognition of important complications like bleeding to allow immediate correction during the procedure. Unfortunately surgical exposure is morbid, meaning it produces physiological and geometric derangement, discomfort, immobilization, and risk.Catheter-based (i.e. endovascular) approaches have revolutionized the treatment of cardiovascular disease. X-ray fluoroscopy guides a wide range of minimally invasive procedures, including treatment of obstructive coronary artery disease, peripheral artery atherosclerosis and aneurysm, and structural or congenital heart disease. X-ray infrastructure is widely deployed, and versatile catheter devices are commercially available. X-ray fluoroscopy depicts soft tissue structures poorly and requires skilled operators to make assumptions about anatomic landmarks that may be inaccurate. X-ray exposes patient and operator to ionizing radiation that increases with procedure complexity, and significant career musculoskeletal injury to operators forced to wear protective lead aprons.While the actual risk of radiation injury remains controversial, even low-level exposure to ionizing radiation is thought to contribute to the long-term risk of malignancy [1,2]. Children are considered more sensitive to radiation and may live longer to experience radiation toxicity. Children requiring catheterization for congenital heart disease often require multiple procedures over time. Chromosomal damage was evident in the peripheral blood of children exposed to catheterization-related radiation [3].The great promise of iCMR is to provide some of the soft-tissue visualization afforded by direct surgical exposure with the reduced morbidity of X-ray catheter procedures. MR is attractive in the ability to display different blood and tissue contrasts, motion, flow, etc without ionizing radiation. This
%U http://jcmr-online.com/content/10/1/62