Magnetic resonance image-guided trans-septal puncture in a swine heart

Aravind Arepally, Parag V. Karmarkar, Clifford Weiss, E. Rene Rodriguez, Robert J. Lederman, Ergin Atalar

Research output: Contribution to journalArticlepeer-review


Purpose: To test the feasibility of performing magnetic resonance (MR)-guided trans-septal punctures in the swine heart. Materials and Methods: All 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, transseptal punctures were made. Results: Active 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. Conclusion: : Using 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.

Original languageEnglish (US)
Pages (from-to)463-467
Number of pages5
JournalJournal of Magnetic Resonance Imaging
Issue number4
StatePublished - Apr 2005


  • Cardiac
  • Interventional
  • MR guided
  • Magnetic resonance Imaging
  • Trans-septal catheterization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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