Safer diagnosis without X-rays. These are possible with Magnetic Resonance-guided Cardiac Catheterization, an innovative procedure for diagnosing heart defects in children. Performed for the first time in Italy at the Bambino Gesù Children’s Hospital, the new diagnostic method uses magnetic fields instead of radiations to obtain high-precision results. Benefits for children include a shorter and single anesthesia, a one-time procedure and no X-ray exposure. Bambino Gesù specialists consider at least 20 procedures of this type per year for the accurate diagnosis of patients affected by selected congenital heart diseases and / or pulmonary hypertension.
THE NEW DIAGNOSTIC
To define the most appropriate therapy in the event of heart abnormalities, it is necessary to measure with extreme precision the anatomy of the defect as well as a series of cardiovascular parameters (pressure, saturation, blood flow). In very complex situations, two different diagnostic tests may be required to collect these data: x-ray cardiac catheterization and magnetic resonance imaging. Both procedures often require anesthesia administered to the patient.
Traditionally, diagnostic cardiac catheterization is performed in the hemodynamic room using vascular catheters (flexible small tubes) that reach the patient’s heart through the blood vessels. During the maneuver, the team monitors the path of the catheter and records some information (anatomy of the heart defect, pressure, saturation) using X-ray imaging tools.
At a later stage, after 1 or 2 days, the patient is transferred to the MRI room to complete the investigation with the detailed data that can only be detected through this technology (eg blood flows). For some time, the specialists of the Holy See Hospital had optimized the procedure by scheduling the two exams in sequence on the same day and with a single anesthesia.
The new catheterization performed at the Bambino Gesù merges the two previous examinations into a single procedure, providing a series of advantages including, above all, the absence of X-rays. The examination, in fact, is performed in one place – the specially equipped MRI room – where the magnetic field imaging equipment guides the interventional cardiologist in catheterization maneuvers and, at the same time, measures all the cardiovascular parameters necessary for diagnosis with extreme precision.
The procedure involves a specially trained multidisciplinary team (interventional cardiologist, radiologist, anesthetist, nurse) and is coordinated by the specialists of the departments of Interventional Cardiology and Advanced Cardiovascular Radiology of the Bambino Gesù Children’s Hospital.
«Magnetic Resonance-guided Cardiac Catheterization is even safer and less invasive for children» underlines Dr. Gianfranco Butera, head of the Bambino Gesù Interventional Cardiology. «Without moving between rooms, the risk of altering important parameters is reduced; the procedure is shorter, the anesthesia times are reduced, and patients are not exposed to ionizing radiation».
«MRI provides very high precision hemodynamic data» adds Dr. Aurelio Secinaro, Head of Advanced Cardiovascular Radiology. «The results of the new procedure are much more accurate than those we may obtain through X-ray catheterization alone; therefore, we are able to make extremely precise diagnoses, based on which the most appropriate treatment plan can be identified».
THREE CASES IN ITALY
The first patients in Italy to undergo the new Magnetic Resonance-guided Cardiac Catheterization are two children aged 5 and 7 and a boy of 21 affected, respectively, by complex congenital heart disease, relapsing myocarditis, and univentricular heart. After the surgery, patients had a rapid recovery. Bambino Gesù is currently one of the few Centers in the world, both pediatric and for adults, capable of performing this type of procedure.
THE BAMBINO GESÙ PROJECT
The first Magnetic Resonance-guided Cardiac Catheterization is part of the project initiated by the Hospital to finetune increasingly less invasive diagnostic solutions for children. This innovative procedure – as underlined by the Bambino Gesù specialists – is applicable to most patients with congenital heart disease and / or pulmonary hypertension; according to forecasts, over 20 procedures of this type will be carried per year. With the development of imaging procedures, in the near future minimally invasive procedures can be carried out through the magnetic resonance imaging (therefore without X-rays) also for therapeutic purposes.