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Six-year-old boy undergoes world-first heart intervention using MRI Jack was born with the heart condition pulmonary valve stenosis, which obstructs the outflow of blood

from the right side of the heart, resulting in a reduction of blood flow to the lungs. After monitoring his condition since birth, it was decided Jack needed an intervention called valvuloplasty to widen the valve and allow more blood to flow. In this operation, a cardiac catheter is inserted into a blood vessel in the arm or groin and then guided through the body towards the heart. At the tip of the catheter is a balloon which is gently inflated to widen the narrowed heart valve. Traditionally, interventionalists would use x-ray imaging to track the progress of the catheter through the body. A new technique has been developed by a team, including clinicians and scientists from King's Health Partners Academic Health Sciences Centre, which uses MRI rather than x-ray. Performing the catheterisation under the guidance of an MRI scan means that patients are not exposed to radiation, something that is especially important for paediatric patients who are at an even higher risk from long-term side effects of the radiation from x-rays. The MRI scan also provides a clearer image that contains information about the different tissues in the body in real time throughout the surgery. This allows clinicians to more accurately assess the severity of the disease before the intervention and the degree of improvement afterwards. Previous to Jack's intervention, clinicians had been able to use MRI for diagnostic scans but it was not possible to use it for interventional treatment because the guide wires used for cardiac catheterisation were made of metal. Dr Aphrodite Tzifa is clinical research fellow at King's College London, part of King's Health Partners. She said: "We were faced with a problem because an MRI scanner uses a powerful magnetic field to construct images of the body. This magnetism not only caused the guide wire to move around inside the body, but also resulted in the tip of the wire heating up to temperatures of up to 70ºC. "We have been working for the last three years to develop a new guide wire that can be used with MRI and have come up with a fibreglass wire that has small iron markers along it that can be seen on the scan." Professor Reza Razavi is professor of imaging science at King's College London and consultant paediatric cardiologist at Guy's and St Thomas' NHS Foundation Trust, also part of King's Health Partners. He said: "We are delighted with the results of Jack's surgery. After years of research and development by a large team of scientists both here and in Germany, we have performed the procedure safely and successfully. "This work is the perfect example of translational research in action. Through collaboration with the hospital and university in our partnership, we have been able to transfer research from the laboratory to the bedside and ensure that patients benefit from developments as quickly as possible. We are very proud of this great achievement, which is an important milestone for both the scientists and clinicians and researchers working on the technique, as well as the many patients who will benefit." Jack's mum Kerry Warborn said: "At first I was unsure about allowing Jack to be the first person to have this operation, but once I had spoken to the doctors I felt much more at ease as I knew he was in safe hands. "His surgery was a great success and within an hour of coming out of theatre he was running around and back to being his lively self. I feel proud that Jack has helped to progress the surgery that will help other children in the future." The new technique has received approval by the King's College Hospital Research Ethics Committee and the new device used during catheterisation has been approved by the Medicines and Healthcare products Regulatory Agency (MHRA). The fibreglass device has been developed in partnership with Phillips Healthcare Research in Hamburg, the Fraunhofer Institute for Production Technology in Aachen, Hemoteg GmbH in Germany and the University Hospital of Aachen in Germany. COURTESY Guy's and St Thomas' NHS Foundation Trust.

  

  

  
     

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