The Feed and Sleep method: how to perform a cardiac MRI in the 1st year of life without the need for General Anesthesia
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POSTER PRESENTATION
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The Feed and Sleep method: how to perform a cardiac MRI in the 1st year of life without the need for General Anesthesia Jonathan D Windram*, Lars Grosse-Wortmann, Masoud Shariat, Mary-Louise Greer, Shi-Joon Yoo From 2011 SCMR/Euro CMR Joint Scientific Sessions Nice, France. 3-6 February 2011 Introduction MRI in small children as a general rule necessitates the use of general anesthesia. We describe our initial results with a new technique which we name the feed and sleep method whereby an infant can undergo a Cardiac MRI without the need for general anesthesia or sedation. Methods The infant is starved for 4 hours prior to the scan and is then fed by his mother prior to the scan. He is then swaddled with 1 to 2 infant sheets before placed within a vacuum-bag immobilizer. As air is removed from the bag, the immobilizer becomes a rigid cradle that fits the infant’s body. We prioritize the sequences to target
the area of importance first according to the purposes of the study and in the order of clinical importance.
Results Between Jan and July 2010 a total of 12 infants median age 14 days (minimum 2 days maximum 150 days ) have undergone CMR studies via this method. All were performed successfully with no distress to the infant. The average scan time was 45.5 min (minimum 24, maximum 65 min). All had complex congenital heart defects (Table 1) and all planned sequences were able to be acquired ensuring the scans were of sufficient quality to allow accurate diagnosis and to plan appropriate future surgery.
Table 1 Pt Diagnosis
Time of scan (min)
Age (days)
1
Right atrial isomerism, Atrioventricular Septal Defect with total anomalous pulmonary venous drainage
37
2
2
Left ventricular hypoplasia
48
12
3
Right atrial isomerism, Atrioventricular Septal Defect with total anomalous pulmonary venous drainage
65
60
4 5
Total anomalous pulmonary venous drainage Hypoplastic Left heart syndrome, Blalock Taussig Shunt, Left pulmonary artery stenosis.
46 33
150 15
6
Arteriovenous malformation
57
14
7
Supracardiac total anomalous pulmonary venous drainage, left atrial isomerism with interrupted IVC
57
12
8
Tetralogy of Fallot
59
4
9
Aortic coarctation
24
30
10 Congenital Correction of Transposition of the Great Arteries, Atrial Septal Defect, Ventricular Septal Defect, central shunt
58
35
11 Double Outlet Right Ventricle, sub-pulmonary VSD, Interupted Aortic Arch (type A)
39
4
12 Absent right pulmonary artery
27
14
The Hospital for Sick Children, Toronto, ON, Canada
© 2011 Windram et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Windram et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P224 http://jcmr-online.com/content/13/S1/P224
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Conclusion Using this technique
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