Real-time magnetic resonance imaging guidance in cardiac surgery

Real-time magnetic resonance imaging (rtMRI) techniques have been described for intravascular guidance and may be immediately applicable to provide vision in a beating heart with circulating blood to guide the surgeon in a minimally invasive cardiac surgery environment. Operative rtMRI guidance has stringent requirements for surgical instruments and devices. Typically, devices that are used during interventions, such as catheters and wires, are not designed to be magnetic resonance visible or compatible as they often contain ferromagnetic materials or long electrical conductors. This chapter illustrates the interactive rtMRI, MRI compatibility of the instruments and devices, and device tracking techniques. It also presents a promising example of MRI-guided cardiac surgery, specifically, transapical aortic valve replacement under rtMRI.