Interventional vascular MRI: moving forward

This editorial refers to ‘Real-time MRI-guided right heart catheterization in adults using passive catheters’[†][1], by K. Ratnayaka et al. , on page 380 The article by Ratnayaka et al. is an exclamation mark for the clinical feasibility of cardiovascular interventional magnetic resonance imaging (MRI).1 The team has done a remarkable job by comparing X-ray fluoroscopy with MRI-only guidance of the right heart and pulmonary artery catheterization in 16 patients. MRI intervention has been a fascinating theme ever since interventional vascular MRI was described by Godart et al. 2 and Omary et al. 3 in 2000. The benefits of interventional MRI fluoroscopy are obvious: lack of ionizing radiation, freedom to choose any imaging plane at your disposal, the ability to look beyond the mere lumen of the vessel or cardiac chamber, and the instantaneous characterizion of cardiac function as well as myocardial properties such as focal fibrosis, oedema,4 and temperature.5 Interventional vascular MRI has been used as guidance to close atrial or ventricular6 septal defects. Several groups have used MRI for atrial electrophysiological ablation therapies,4 pulmonary balloon valvuloplasty,7 interventional valve placement, or dilatation of aortic coarctation.8 Although most of these procedures have been performed in animal models, an increasing number of diagnostic and therapeutic vascular MRI interventions are performed in humans, as can be seen from the various reports published within the last 24 months. Catheter steering and visualization, patient safety, and spatial resolution of … [1]: #fn-2