• Aravind Arepally, Parag V Karmarkar, Clifford Weiss, E Rene Rodriguez, Robert J Lederman, and Ergin Atalar.
• The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA. aarepal@jhmi.edu
• J Magn Reson Imaging. 2005 Apr 1; 21 (4): 463-7.

PurposeTo test the feasibility of performing magnetic resonance (MR)-guided trans-septal punctures in the swine heart.Materials And MethodsAll procedures were performed in a 1.5-T MR scanner. A novel, active MR intravascular needle system was utilized for needle tracking and septal punctures. Trans-septal punctures were performed in five swine using electrocardiogram (ECG)-gated high resolution and non-ECG-gated, real-time MR imaging techniques. The intravascular needle was advanced over a guidewire from the femoral vein. Once the needle was in proper position, trans-septal punctures were made.ResultsActive tracking of the needle traversing the septum was possible. The location of the catheter tip was confirmed using real time gradient recalled echo (GRE). After a confirmatory ventriculogram with gadolinium-DTPA, a 0.014-inch guidewire was advanced into the left atrium and left ventricle. All punctures were made with no change in cardiac rhythm or rate; postmortem analysis was performed on all animals and demonstrated that 18/19 (95%) punctures were directly through the fossa ovalis.ConclusionUsing only MR guidance and a novel active intravascular needle system, we were able to repeatedly puncture the fossa ovalis in a swine heart from a transfemoral approach, with direct visualization of all components, including the needle, the atria, the fossa ovalis, and the surrounding vasculature.Copyright 2005 Wiley-Liss, Inc.

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