Rapid Fire Session

Session: Rapid Fire Session 4: Interventional MRI (Devices & Methods) (Monitor 2)

Use of CMR / Catheterization Combination Cases to Start an Interventional CMR Program for Patients with Congenital Heart Disease

Friday, February 6, 2026

4:06 PM - 4:13 PM

Location: Galapagos / Aruba / Ilhabela (2nd Lower Level)

Presenting Author(s)

Neil Tailor, MD

Pediatric Interventional Cardiologist
Le Bonheur Children's Hospital
Memphis, Tennessee, United States

Co-Author(s)

Anthony Merlocco, MD, FSCMR

Associate Professor, Pediatric Cardiology, University of Tennessee Health Science Center
Le Bonheur Children's Hospital
Memphis, Tennessee, United States
Garrett C. McFadden, BSc

Medical Student
University of Tennessee Health Science Center
Germantown, Tennessee, United States
JA

John Adams, MD, MBA

Associate Professor
University of Tennessee Health Science Center / Le Bonheur Children's Hospital, United States
SS

Shyam Sathanandam, MD

Chief, Pediatric Cardiology
Nicklaus Children's Hospital, United States
SH

Siyuan Hu, PhD

Clinical Research Scientist
GE Healthcare
Memphis, Tennessee, United States
AS

Alex Smith, PhD

Clinical Research Scientist
GE Healthcare
Nashville, Tennessee, United States
RP

Ranjit Philip, MD

Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Tennessee, United States
Ronak Naik, MD

Associate Professor
Le Bonheur Children's Hospital, University of Tennessee Health Science Center
Memphis, Tennessee, United States
NP

Nirbhay Parashar, MD

Pediatric Cardiology
Le Bonheur Children's Hospital
Jackson, Tennessee, United States
AM

Ashley Molloy, MD

Assistant Professor
University of Tennessee Health Science Center / Le Bonheur Children's Hospital, United States

Primary Author(s)

Jason N. Johnson, MD

Chief, Pediatric Cardiology
Le Bonheur Children's Hospital
Memphis, Tennessee, United States

Background: Cardiac catheterization with x-ray fluoroscopy has been the gold standard modality for obtaining hemodynamic data in patients with congenital heart disease (CHD). Interventional cardiovascular magnetic resonance (iCMR) represents the convergence of CMR imaging capabilities with catheterization procedures. This study describes the stepwise approach of starting an iCMR program for pediatric patients with CHD.

Methods: A retrospective cohort study of all CMR and catheterization procedures under the same anesthesia (CMR/cath combo) from May 2025 to July 2026. Patient demographics, CHD details, surgical history, and CMR/cath combo details obtained. iCMR defined as moving catheters in vessels by CMR guidance (Figure 1) by real time balanced steady state free precession / fast gradient recalled echo based interactive imaging framework (iDrive) on 1.5T SIGNA Artist, GE HealthCare. Patient transfers (cath – CMR – cath), magnet sterile draping, vascular sheath secured in CMR, and complications collected for each CMR/cath combo. Success for the study defined by predetermined goals (transfer, draping, sheath, or iCMR) for each CMR/cath combo case.

Results: Twenty-two patients had a CMR/cath combo with patient characteristics in Table 1. The most common CHD diagnosis was hypoplastic left heart syndrome (n=8, 36%) and almost all patients had some form of single ventricle (n=21, 95%). Most of the patients had a history of at least one surgery for CHD (n=19, 86%). The first 11 CMR/cath combo did not undergo iCMR, as patient transfer, magnet sterile draping, and vascular sheath security were the goals. Of the final 11 CMR/cath combo, 8 (73%) had planned iCMR. Almost all the CMR/cath combo and iCMR cases were successful (21, 95%). One (5%) iCMR case was unsuccessful due to the sheath not being within the vasculature requiring repositioning in the cath lab. One (5%) complication occurred during iCMR when the sheath was pulled out at the end of the case during patient transfer adequately recognized with minimal blood loss.

Conclusion: CMR/cath combo cases support program development, feasibility and safety providing valuable learning experience towards establishing a comprehensive iCMR program.

Table 1. Patient characteristics at time of cardiovascular magnetic resonance catheterization combination.

Median (Range) or N (%)	CMR/cath combo, n=22	iCMR, n=8 (36%)
Male	11 (50%)	4 (50%)
Race
White	11 (50%)	4 (50%)
Black	11 (50%)	3 (38%)
Hispanic	1 (5%)	0 (0%)
Asian	1 (5%)	1 (13%)
Age, years	5.3 (0.4 – 12.4)	8.3 (2.5 – 12.4)
Weight, kg	17.9 (5.5 – 94.4)	21.5 (14.0 – 94.4)
Height, cm	114.5 (57.0 – 160.0)	123.5 (98.0 – 160.0)
BSA, m2	0.78 (0.28 – 1.97)	0.87 (0.61 – 1.97)
CHD Diagnosis
HLHS	8 (36%)	3 (38%)
Tricuspid atresia	3 (14%)	2 (25%)
DORV / MA	3 (14%)	1 (13%)
Heterotaxy / PA	3 (14%)	1 (13%)
Single Ventricle	21 (95%)	8 (100%)
CHD Surgery, Yes	19 (86%)	7 (88%)
Cath Intervention*, Yes	12 (54%)	3 (38%)

*On day of CMR/cath combo; BSA = body surface area; Cath = catheterization; CMR/cath combo = cardiovascular magnetic resonance catheterization combination; CHD = congenital heart disease; DORV = double outlet right ventricle; HLHS = hypoplastic left heart syndrome; iCMR = interventional cardiovascular magnetic resonance; MA = mitral atresia; PA = pulmonary atresia.Figure 1. Real time imaging with interactive framework (iDrive) to guide interventional cardiovascular magnetic resonance (iCMR) catheter movement. Balanced steady state free precession (A-D) and fast gradient recalled echo (E, F) images of a patient with single ventricle physiology status post Fontan. Images in a sagittal (A, B) and coronal (C-E) projection. The balloon tip catheter with diluted gadolinium solution (white arrows) appears hyperintense within the Fontan.