<html> <head> <meta http-equiv=Content-Type content="text/html; charset=unicode"> <meta name=Generator content="Microsoft Word 15 (filtered)"> <title>Lederman Lab - NHLBI Cardiovascular Intervention Program</title> <style> <!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4;} @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4;} @font-face {font-family:"Calibri Light"; panose-1:2 15 3 2 2 2 4 3 2 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in; margin-bottom:.0001pt; font-size:12.0pt; font-family:"Times New Roman",serif;} h2 {mso-style-link:"Heading 2 Char"; margin-right:0in; margin-left:0in; font-size:18.0pt; font-family:"Times New Roman",serif; font-weight:bold;} h3 {mso-style-link:"Heading 3 Char"; margin-right:0in; margin-left:0in; font-size:13.5pt; font-family:"Times New Roman",serif; font-weight:bold;} p.MsoCaption, li.MsoCaption, div.MsoCaption {margin-top:0in; margin-right:0in; margin-bottom:10.0pt; margin-left:0in; font-size:9.0pt; font-family:"Times New Roman",serif; color:#44546A; font-style:italic;} p.MsoBodyText, li.MsoBodyText, div.MsoBodyText {mso-style-link:"Body Text Char"; margin-top:0in; margin-right:0in; margin-bottom:6.0pt; margin-left:0in; font-size:12.0pt; font-family:"Times New Roman",serif;} a:link, span.MsoHyperlink {color:blue; text-decoration:underline;} a:visited, span.MsoHyperlinkFollowed {color:red; text-decoration:underline;} p {margin-right:0in; margin-left:0in; font-size:12.0pt; font-family:"Times New Roman",serif;} p.MsoListParagraph, li.MsoListParagraph, div.MsoListParagraph {margin-top:0in; margin-right:0in; margin-bottom:0in; margin-left:.5in; margin-bottom:.0001pt; font-size:12.0pt; font-family:"Times New Roman",serif;} span.Heading2Char {mso-style-name:"Heading 2 Char"; mso-style-link:"Heading 2"; font-family:"Calibri Light",sans-serif; color:#2E74B5;} span.Heading3Char {mso-style-name:"Heading 3 Char"; mso-style-link:"Heading 3"; font-family:"Calibri Light",sans-serif; color:#1F4D78;} p.msonormal0, li.msonormal0, div.msonormal0 {mso-style-name:msonormal; margin-right:0in; margin-left:0in; font-size:12.0pt; font-family:"Times New Roman",serif;} span.BodyTextChar {mso-style-name:"Body Text Char"; mso-style-link:"Body Text"; font-family:"Times New Roman",serif;} p.msolistparagraphcxspfirst, li.msolistparagraphcxspfirst, div.msolistparagraphcxspfirst {mso-style-name:msolistparagraphcxspfirst; margin-top:0in; margin-right:0in; margin-bottom:0in; margin-left:.5in; margin-bottom:.0001pt; font-size:12.0pt; font-family:"Times New Roman",serif;} p.msolistparagraphcxspmiddle, li.msolistparagraphcxspmiddle, div.msolistparagraphcxspmiddle {mso-style-name:msolistparagraphcxspmiddle; margin-top:0in; margin-right:0in; margin-bottom:0in; margin-left:.5in; margin-bottom:.0001pt; font-size:12.0pt; font-family:"Times New Roman",serif;} p.msolistparagraphcxsplast, li.msolistparagraphcxsplast, div.msolistparagraphcxsplast {mso-style-name:msolistparagraphcxsplast; margin-top:0in; margin-right:0in; margin-bottom:0in; margin-left:.5in; margin-bottom:.0001pt; font-size:12.0pt; font-family:"Times New Roman",serif;} p.msochpdefault, li.msochpdefault, div.msochpdefault {mso-style-name:msochpdefault; margin-right:0in; margin-left:0in; font-size:10.0pt; font-family:"Times New Roman",serif;} .MsoChpDefault {font-size:10.0pt;} @page WordSection1 {size:11.0in 8.5in; margin:1.0in 1.0in 1.0in 1.0in;} div.WordSection1 {page:WordSection1;} /* List Definitions */ ol {margin-bottom:0in;} ul {margin-bottom:0in;} --> </style> </head> <body lang=EN-US link=blue vlink=red> <div class=WordSection1> <div align=center> <table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 width="80%" style='width:80.0%'> <tr> <td style='padding:18.75pt 18.75pt 18.75pt 18.75pt'> <h2><span style='font-family:"Calibri",sans-serif;color:#2E75B6'>NHLBI Cardiovascular Intervention Program<br> Robert J. Lederman, MD </span></h2> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif; color:#333333'>We create new catheter based treatments and devices for structural heart disease and introduce them into medical practice.</span></p> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif; color:#333333'>We are a multidisciplinary team of cardiologists (adult and pediatric), imaging scientists, and catheter engineers. We have close collaborations with luminary cardiologists across the USA and the world.</span></p> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif; color:#333333'>We have a growing list of techniques and devices that we have invented and helped to use in humans for the first time. Many more are in advanced development.</span></p> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 style='border-collapse:collapse'> <tr> <td width=296 valign=top style='width:222.05pt;border:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><b><span style='font-family:"Calibri",sans-serif;color:#333333'>Treatment</span></b></p> </td> <td width=311 valign=top style='width:233.55pt;border:solid windowtext 1.0pt; border-left:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><b><span style='font-family:"Calibri",sans-serif;color:#333333'>First human use</span></b></p> </td> </tr> <tr> <td width=296 valign=top style='width:222.05pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>Transcaval access for transcatheter aortic valve replacement TAVR</span></p> </td> <td width=311 valign=top style='width:233.55pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>July 2013 (<a href="https://www.henryford.com/physician-directory/g/greenbaum-adam">Dr Adam B. Greenbaum, Henry Ford Hospital, Detroit</a>) </span></p> </td> </tr> <tr> <td width=296 valign=top style='width:222.05pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>Intentional right atrial exit to access the otherwise empty pericardial space</span></p> </td> <td width=311 valign=top style='width:233.55pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>June 2014 (<a href="https://www.henryford.com/physician-directory/g/greenbaum-adam">Dr Adam B. Greenbaum, Henry Ford Hospital, Detroit</a>)</span></p> </td> </tr> <tr> <td width=296 valign=top style='width:222.05pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>Transcatheter mitral valve cerclage annuloplasty</span></p> </td> <td width=311 valign=top style='width:233.55pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>July 2015 (Dr June-Hong Kim, Pusan National University Yangsan Hospital, Korea)</span></p> </td> </tr> <tr> <td width=296 valign=top style='width:222.05pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>Transcatheter bidirectional superior cavo-pulmonary bypass (Glenn Shunt)</span></p> </td> <td width=311 valign=top style='width:233.55pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>December 2016 (<a href="https://www.rchsd.org/doctors/kanishka-ratnayaka-md/">Dr Kanishka Ratnayaka, UCSD Rady Childrens Hospital, San Diego</a>)</span></p> </td> </tr> <tr> <td width=296 valign=top style='width:222.05pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>LAMPOON (Intentional <u>L</u>aceration of the <u>A</u>nterior <u>M</u>itral leaflet to <u>P</u>revent left ventricular <u>O</u>utflow <u>O</u>bstructio<u>N</u> during transcatheter mitral valve replacement TMVR)</span></p> </td> <td width=311 valign=top style='width:233.55pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>May 2016 (<a href="http://medicine.emory.edu/cardiology/faculty-directory/babaliaros-vasilis.html">Dr Vasilis C Babaliaros, Emory University Hospital, Atlanta</a>)</span></p> </td> </tr> <tr> <td width=296 valign=top style='width:222.05pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><u><span style='font-family:"Calibri",sans-serif;color:#333333'>B</span></u><span style='font-family:"Calibri",sans-serif;color:#333333'>ioprosthetic <u>A</u>ortic <u>S</u>callop <u>I</u>ntentional <u>L</u>aceration to prevent <u>I</u>atrogenic <u>C</u>oronary <u>A</u>rtery obstruction</span></p> </td> <td width=311 valign=top style='width:233.55pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>July 2017 (Dr Danny Dvir, University of Washington, Seattle)</span></p> </td> </tr> <tr> <td width=296 valign=top style='width:222.05pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>MRI catheterization using a passive commercial nitinol guidewire in patients</span></p> </td> <td width=311 valign=top style='width:233.55pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>August 2017 (Dr Toby Rogers and Dr Adrienne Campbell, NHLBI, Bethesda)</span></p> </td> </tr> <tr> <td width=296 style='width:222.05pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><u><span style='font-family:"Calibri",sans-serif;color:#333333'>E</span></u><span style='font-family:"Calibri",sans-serif;color:#333333'>lectrosurgical <u>L</u>aceration of <u>A</u>lfieri <u>STIC</u>h to enable transcatheter mitral valve replacement (ELASTIC)</span></p> </td> <td width=311 style='width:233.55pt;border-top:none;border-left:none; border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>October 2017 (<a href="http://medicine.emory.edu/cardiology/faculty-directory/babaliaros-vasilis.html">Dr Vasilis C Babaliaros, Emory University Hospital, Atlanta</a>)</span></p> </td> </tr> <tr> <td width=296 style='width:222.05pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>Closure of transcaval access ports using Transmural Systems dedicated Transcaval Closure Device, developed at NHLBI</span></p> </td> <td width=311 style='width:233.55pt;border-top:none;border-left:none; border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoBodyText style='margin-bottom:0in;margin-bottom:.0001pt'><span style='font-family:"Calibri",sans-serif;color:#333333'>February 2018 (<a href="https://www.medstarhealth.org/doctor/dr-toby-rogers-md/">Dr Toby Rogers, Medstar Washington Hospital Center, Washington DC</a> and <a href="https://www.henryford.com/physician-directory/g/greenbaum-adam">Dr Adam B. Greenbaum, Henry Ford Hospital, Detroit</a>)</span></p> </td> </tr> </table> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif; color:#333333'>We also have a significant effort towards using MRI to guide radiation-free heart catheterization (see below).</span></p> <h2><span style='font-family:"Calibri",sans-serif;color:#333333'>Hospital, University, and Industry Key Collaborators</span></h2> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 style='border-collapse:collapse'> <tr> <td width=111 style='width:83.55pt;padding:0in 1.45pt 0in 1.45pt'> <p class=MsoBodyText align=center style='margin-bottom:0in;margin-bottom: .0001pt;text-align:center'><a href="https://www.emoryhealthcare.org/physicians/b/babaliaros-vasilis.html"><span style='color:windowtext;text-decoration:none'><img border=0 width=140 height=49 src="index_files/image003.gif" alt=Emory></span></a></p> </td> <td width=111 style='width:83.55pt;padding:0in 1.45pt 0in 1.45pt'> <p class=MsoBodyText align=center style='margin-bottom:0in;margin-bottom: .0001pt;text-align:center'><a href="https://www.rchsd.org/doctors/kanishka-ratnayaka-md/"><span style='color:windowtext;text-decoration:none'><img border=0 width=142 height=83 src="index_files/image002.jpg" alt="RCHSD - UCSD logos"></span></a></p> </td> <td width=111 style='width:83.55pt;padding:0in 1.45pt 0in 1.45pt'> <p class=MsoBodyText align=center style='margin-bottom:0in;margin-bottom: .0001pt;text-align:center'><a href="https://www.pusan.ac.kr/"><span style='color:windowtext;text-decoration:none'><img border=0 width=145 height=32 src="index_files/image008.gif" alt="Title: Pusan National University Yangsan Hospital Logo"></span></a></p> </td> <td width=111 style='width:83.6pt;padding:0in 1.45pt 0in 1.45pt'></td> </tr> <tr> <td width=111 style='width:83.55pt;padding:0in 1.45pt 0in 1.45pt'> <p class=MsoBodyText align=center style='margin-bottom:0in;margin-bottom: .0001pt;text-align:center'><a href="https://www.transmuralsystems.com/"><span style='color:windowtext;text-decoration:none'><img border=0 width=145 height=26 src="index_files/image010.gif" alt="Title: Transmural Systems Logo"></span></a></p> </td> <td width=111 style='width:83.55pt;padding:0in 1.45pt 0in 1.45pt'> <p class=MsoBodyText align=center style='margin-bottom:0in;margin-bottom: .0001pt;text-align:center'><a href="https://www.cookmedical.com/"><span style='color:windowtext;text-decoration:none'><img border=0 width=145 height=95 src="index_files/image012.gif" alt="Title: Cook Medical Logo"></span></a></p> </td> <td width=111 style='width:83.55pt;padding:0in 1.45pt 0in 1.45pt'> <p class=MsoBodyText align=center style='margin-bottom:0in;margin-bottom: .0001pt;text-align:center'><a href="https://usa.healthcare.siemens.com/magnetic-resonance-imaging/mri-guided-therapy/cardiovascular-interventions"><span style='color:windowtext;text-decoration:none'><img border=0 width=145 height=36 src="index_files/image014.gif" alt="Title: Siemens Logo"></span></a></p> </td> <td width=111 style='width:83.6pt;padding:0in 1.45pt 0in 1.45pt'> <p class=MsoBodyText align=center style='margin-bottom:0in;margin-bottom: .0001pt;text-align:center'>&nbsp;<a href="https://www.medstarhealth.org/doctor/dr-toby-rogers-md/"><span style='color:windowtext;text-decoration:none'><img border=0 width=133 height=43 src="index_files/image004.gif" alt=Logo></span></a></p> </td> </tr> </table> <p class=MsoBodyText>&nbsp;</p> <h2 style='page-break-after:avoid'><span style='font-family:"Calibri",sans-serif; color:#333333'>Transcaval access to the aorta for transcatheter aortic valve replacement</span></h2> <h3 style='page-break-after:avoid'><span style='font-family:"Calibri",sans-serif; color:#333333'>Summary</span></h3> <p><img width=254 height=252 src="index_files/image016.gif" align=right hspace=12 alt="Title: An illustration of the transcaval technique"><span style='font-family:"Calibri",sans-serif;color:#333333'> Transcaval access is an alternative to standard transfemoral artery access for transcatheter aortic valve replacement ( TAVR ) and other non-surgical procedures that require large-bore catheter access. It has been performed in over 500 patients so far.</span> </p> <p><span style='font-family:"Calibri",sans-serif;color:#333333'>Transcaval TAVR involves introducing a sheath (catheter) from the femoral vein across the inferior vena cava into the abdominal aorta. After TAVR the hole is closed with an occluder device. The safety and success of transcaval TAVR relies on the counter-intuitive observation that bleeding from the hole in the abdominal aorta is tolerated as long as there is simultaneous decompression into the matching hole in the nearby vena cava. </span></p> <p><span style='font-family:"Calibri",sans-serif;color:#333333'>Transcaval TAVR was developed at the NHLBI Cardiovascular Intervention Program and applied to patient care in collaboration with Dr. Adam Greenbaum at Henry Ford Hospital. We have introduced the technique to over 70 hospitals on 3 continents using 5 different TAVR valves. It has proven lifesaving in patients who have no other good access options for aortic valve disease, and increasingly it is the preferred approach when transfemoral artery access is not suitable. </span></p> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Manuscripts and Presentations about transcaval TAVR</span></h3> <p class=MsoNormal style='margin-left:.25in;text-indent:-.25in'><span style='font-family:"Calibri",sans-serif;color:#333333'>1.</span><span style='font-size:7.0pt;color:#333333'> </span><span style='font-family:"Calibri",sans-serif; color:#333333'>Aortic access from the vena cava for large caliber transcatheter cardiovascular interventions: pre-clinical validation. Halabi M, Ratnayaka K, Faranesh AZ, Chen MY, Schenke WH, Lederman RJ. J Am Coll Cardiol. 2013 Apr 23;61(16):1745-6. Pubmed ID <a href="http://www.ncbi.nlm.nih.gov/pubmed/23500317" target="_blank">23500317<br> </a>" This is the first description of the technique as conceived and performed in animals.</span></p> <p class=MsoNormal style='margin-left:.25in;text-indent:-.25in'><span style='font-family:"Calibri",sans-serif;color:#333333'>2.</span><span style='font-size:7.0pt;color:#333333'> </span><span style='font-family:"Calibri",sans-serif; color:#333333'>Caval-aortic access to allow transcatheter aortic valve replacement in otherwise ineligible patients: initial human experience. Greenbaum AB, O'Neill WW, Paone G, Guerrero ME, Wyman JF, Cooper RL, Lederman RJ. J Am Coll Cardiol. 2014 Jul 1;63(25 Pt A):2795-804. Pubmed ID <a href="http://www.ncbi.nlm.nih.gov/pubmed/24814495" target="_blank">24814495</a>.<br> " This details how the procedure was first performed the patients, including the first 19.</span></p> <p class=MsoNormal style='margin-left:.25in;text-indent:-.25in'><span style='font-family:"Calibri",sans-serif;color:#333333'>3.</span><span style='font-size:7.0pt;color:#333333'> </span><span style='font-family:"Calibri",sans-serif; color:#333333'>How to perform transcaval access and closure for transcatheter aortic valve implantation, Lederman RJ, Babalarios VC, Greenbaum AB. Catheter Cardiovasc Interv, 2015;86:1242. Pubmed ID <a href="https://www.ncbi.nlm.nih.gov/pubmed/26356244">26356244</a></span></p> <p class=MsoNormal style='margin-left:.25in;text-indent:-.25in'><span style='font-family:"Calibri",sans-serif;color:#333333'>4.</span><span style='font-size:7.0pt;color:#333333'> </span><span style='font-family:"Calibri",sans-serif; color:#333333'>Anatomic Suitability for Transcaval Access Based on Computed Tomography. Lederman RJ, Greenbaum AB, Rogers T, Khan JM, Fusari M, Chen MY. JACC Cardiovasc Interv, 2017;10(1):1. Pubmed ID <a href="http://pubmed.gov/28057275">28057275</a><br> " This teaches how to plan a transcaval procedure based on CT.</span></p> <p class=MsoNormal style='margin-left:.25in;text-indent:-.25in'><span style='font-family:"Calibri",sans-serif;color:#333333'>5.</span><span style='font-size:7.0pt;color:#333333'> </span><span style='font-family:"Calibri",sans-serif; color:#333333'>Transcaval Access and Closure for Transcatheter Aortic Valve Replacement: A Prospective Investigation. Greenbaum AB, Babaliaros VC, Chen MY, Stine AM, Rogers T, O'Neill WW, Paone G, Thourani VH, Muhammad KI, Leonardi RA, Ramee S, Troendle JF, Lederman RJ. J Am Coll Cardiol, 2017;69(5):511. Pubmed ID <a href="http://pubmed.gov/27989885">27989885</a><br> " These are the results of an independently-adjudicated multicenter investigation of the transcaval technique using Amplatzer closure devices.</span></p> <p class=MsoNormal style='margin-left:.25in;text-indent:-.25in'><span style='font-family:"Calibri",sans-serif;color:#333333'>6.</span><span style='font-size:7.0pt;color:#333333'> </span><span style='font-family:"Calibri",sans-serif; color:#333333'>Lecture: Transcaval Access Technique Step-by-Step, CRT 2015 Conference, February 2015. Video posted for download <a href="../../../../AppData/Roaming/Microsoft/Word/CRT2015_LedermanRobert_Transcaval.mp4" target="_blank">here.</a></span></p> <p class=MsoNormal style='margin-left:.25in;text-indent:-.25in'><span style='font-family:"Calibri",sans-serif;color:#333333'>7.</span><span style='font-size:7.0pt;color:#333333'> </span><span style='font-family:"Calibri",sans-serif; color:#333333'>Lecture: Transcaval case example, SCAI Conference, May 2015. Video posted <a href="https://www.youtube.com/watch?v=U3rDAz7PTsY&amp;t=509s">here</a>.</span></p> <p class=MsoNormal style='margin-left:.25in;text-indent:-.25in'><span style='font-family:"Calibri",sans-serif;color:#333333'>8.</span><span style='font-size:7.0pt;color:#333333'> </span><span style='font-family:"Calibri",sans-serif; color:#333333'>Live transcaval case transmission, TCT conference, October 2016. Video posted <a href="https://youtu.be/UbYccQsI02U">here</a>.</span></p> <h3 style='page-break-after:avoid'><span style='font-family:"Calibri",sans-serif; color:#333333'>Physician training for transcaval access</span></h3> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif; color:#333333'>Physician training courses about the transcaval technique are periodically held by our luminary partners, Dr Adam Greenbaum at Henry Ford Hospital (Detroit), Dr Vasilis Babaliaros at Emory University (Atlanta), Dr Toby Rogers at Medstar Washington Hospital Center (Washington DC). Physician proctorship is offered by at least one valve manufacturer (Edwards Lifesciences).</span></p> <h3 style='page-break-after:avoid'><span style='font-family:"Calibri",sans-serif; color:#333333'>Inventing medical devices to enhance transcaval closure</span></h3> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif'>Our NHLBI laboratory is collaborating with Transmural Systems (Andover MA) to co-develop purpose-built closure devices for transcaval TAVR. Testing in patients is planned in early 2018.<span style='color:#333333'> </span></span></p> <p class=MsoBodyText>&nbsp;</p> <h2 style='page-break-after:avoid'><span style='font-family:"Calibri",sans-serif; color:#333333'>LAMPOON: Catheter-based splitting of the anterior mitral valve leaflet to prevent LV outflow tract obstruction during transcatheter mitral valve replacement</span></h2> <h3><img width=211 height=376 src="index_files/image001.gif" align=right hspace=12 vspace=5 alt=" "><span style='font-family:"Calibri",sans-serif; color:#333333'>Summary</span></h3> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif'>About half of patients are turned away from non-surgical catheter-based mitral valve implantation procedures today, out of concern that the valve implant will block blood outflow from the left ventricle. Dr Jaffar Khan in our NHLBI laboratory, in collaboration with Dr Vasilis Babaliaros at Emory University Atlanta and Dr Adam Greenbaum at Henry Ford Hospital Detroit have developed the LAMPOON technique in animals and applied it to a small number of patients. </span></p> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif'>This procedure resembles a technique that otherwise requires open heart surgery.</span> </p> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif'>We have begun a prospective multicenter trial of the LAMPOON technique. More information can be found on <a href="https://clinicaltrials.gov/ct2/show/NCT03015194">clinicaltrials.gov</a>.</span></p> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Manuscripts and Presentations about LAMPOON</span></h3> <p class=MsoNormal style='margin-left:.25in;text-indent:-.25in'><span style='font-family:"Calibri",sans-serif;color:#333333'>1.</span><span style='font-size:7.0pt;color:#333333'> </span><span style='font-family:"Calibri",sans-serif; color:#333333'>Intentional Laceration of the Anterior Mitral Valve Leaflet to Prevent Left Ventricular Outflow Tract Obstruction During Transcatheter Mitral Valve Replacement: Pre-Clinical Findings. Khan JM, Rogers T, Schenke WH, Mazal JR, Faranesh AZ, Greenbaum AB, Babaliaros VC, Chen MY, Lederman RJ. JACC Cardiovasc Interv, 2016;9(17):1835. Pubmed ID <a href="http://pubmed.gov/27609260">27609260</a></span></p> <p class=MsoNormal style='margin-left:.25in;text-indent:-.25in'><span style='font-family:"Calibri",sans-serif;color:#333333'>2.</span><span style='font-size:7.0pt;color:#333333'> </span><span style='font-family:"Calibri",sans-serif; color:#333333'>Live case demonstration at TCT October 2016. Video posted <a href="https://www.google.com/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=3&amp;cad=rja&amp;uact=8&amp;ved=0ahUKEwidsaTApqvSAhWESSYKHSq_C9kQtwIIMDAC&amp;url=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3Dd2nGDa513Bs&amp;usg=AFQjCNEksUR1eZ5vDcR1GqLPmmgxVcOMLw&amp;sig2=I4JRiE-ke0NHAQ1Q9qlITw">here</a>. </span></p> <p class=MsoNormal style='margin-left:.25in;text-indent:-.25in'><span style='font-family:"Calibri",sans-serif;color:#333333'>3.</span><span style='font-size:7.0pt;color:#333333'> </span><span style='font-family:"Calibri",sans-serif'>Intentional <u>L</u>aceration of the <u>A</u>nterior <u>M</u>itral leaflet to <u>P</u>revent <u>O</u>utflow <u>O</u>bstructio<u>N</u> (LAMPOON) during TMVR: first-in-human experience, Babaliaros VC, Greenbaum AB, Khan JM, Rogers T, Wang DD, Eng MH, O Neill WW, Paone G, Thourani VH, Lerakis S, Kim DW, Lederman RJ. Journal of the American College of Cardiology Interventions, 2017. Pubmed ID <a href="https://www.ncbi.nlm.nih.gov/pubmed/28427597">28427597</a>.</span></p> <h2><span style='font-family:"Calibri",sans-serif;color:#333333'>TRAIPTA: Trans-Atrial Intra-Pericardial Tricuspid Annuloplasty to treat secondary tricuspid valve regurgitation </span></h2> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Summary</span></h3> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif; color:#333333'>TRAIPTA is a catheter-based repair for secondary tricuspid valve regurgitation, which causes right-sided heart failure and for which there is no satisfactory non-surgical option. TRAIPTA restores tricuspid valve function by installing a simple extracardiac appliance. The TRAIPTA technique uses a catheter to exit the heart, from inside out, to enter the pericardial space surrounding the heart. Once inside the pericardial space, the TRAIPTA device surrounds the valve annulus and introduces circumferential compression to restore tricuspid valve function, while protecting other vital structures from compression. The right atrial exit port is then closed with a simple occluder device. Dr Toby Rogers developed the technique has been demonstrated in animals with </span><img width=241 height=272 src="index_files/image018.gif" align=right hspace=12 alt="Title: An illustration of the TRAIPTA procedure - Description: An illustration of the TRAIPTA procedure."><span style='font-family:"Calibri",sans-serif;color:#333333'>&nbsp;tricuspid valve regurgitation but has not yet been tested in patients. </span></p> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Manuscripts and Presentations related to TRAIPTA</span></h3> <ol style='margin-top:0in' start=1 type=1> <li class=MsoNormal style='color:#333333'><span style='font-family:"Calibri",sans-serif'>Trans-auricular intra-pericardial tricuspid annuloplasty. Rogers T, Ratnayaka K, Sonmez M, Franson DN, Schenke WH, Mazal JR, Kocaturk O, Chen MY, Faranesh AZ, Lederman RJ, JACC Cardiovascular Interventions 2015 Mar;8(3):483-91. Pubmed ID: <a href="http://www.ncbi.nlm.nih.gov/pubmed/25703872">25703872</a>. <br> " This describes the technique of TRAIPTA as initially tested in animals, including improvement of secondary tricuspid valve regurgitation.</span></li> <li class=MsoNormal style='color:#333333'><span style='font-family:"Calibri",sans-serif'>Intentional right atrial exit for microcatheter infusion of pericardial carbon dioxide or iodinated contrast to facilitate sub-xiphoid access. Rogers T, Ratnayaka K, Schenke WH, Faranesh AZ, Mazal JR, O'Neill WW, Greenbaum AB, Lederman RJ. Catheter Cardiovasc Interv. 2014 Oct 14. doi: 10.1002/ccd.25698. Pubmed ID: <a href="http://www.ncbi.nlm.nih.gov/pubmed/25315516">25315516</a>.<br> " This tests the safety of intentional right atrial exit, which is an important first step in TRAIPTA.</span></li> </ol> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Inventing Medical Devices Designed to Perform TRAIPTA Tricuspid Annuloplasty</span></h3> <p><span style='font-family:"Calibri",sans-serif;color:#333333'>Our NHLBI laboratory has designed and is testing purpose-built devices for TRAIPTA. We have applied for several patents for these devices so that they can be commercialized, and we have reversed tricuspid regurgitation using these prototypes in live animals. NHLBI is collaborating with Cook Medical to test TRAIPTA in patients. </span></p> <h2><span style='font-family:"Calibri",sans-serif;color:#333333'>Transcatheter Mitral Cerclage Annuloplasty to Treat Secondary Mitral Valve Regurgitation.</span></h2> <h3><img width=239 height=287 src="index_files/image020.gif" align=right hspace=12 alt="Title: Illustration of the cerclage technique - Description: The cerclage trajectory through the coronary sinus, basal septal perforator vein, septal myocardial tunnel, reentering into the right ventricle, and crossing the tricuspid septal commissure into the right atrium."><span style='font-family:"Calibri",sans-serif;color:#333333'>Summary</span></h3> <p><span style='font-family:"Calibri",sans-serif;color:#333333'>Mitral cerclage annuloplasty is a completely new treatment for secondary ( functional ) mitral valve regurgitation, a common contributor to heart failure. This technique connects natural cavities via a non-anatomic device trajectory. Cerclage establishes circumferential tension around the mitral annulus through a pathway that includes the coronary sinus, a basal septal perforator vein, a short trans-myocardial tunnel through the interventricular septum, and the right ventricle In applying circumferential tension, cerclage is unique among percutaneous mitral regurgitation annuloplasty strategies.</span></p> <p><span style='font-family:"Calibri",sans-serif;color:#333333'>Cerclage has been tested successfully in a small number of patients by Dr June-Hong Kim at Pusan National University Yongsang Hospital in Busan, Korea.</span></p> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif; color:#333333'>NHLBI is collaborating with Transmural Systems (Andover MA) on a refined catheter system to accomplish mitral cerclage annuloplasty. First human tests are planned for 2018.</span></p> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Manuscripts and Presentations about Mitral Cerclage Annuloplasty</span></h3> <ol style='margin-top:0in' start=3 type=1> <li class=MsoNormal style='color:#333333'><span style='font-family:"Calibri",sans-serif'>Mitral cerclage annuloplasty, a novel transcatheter treatment for secondary mitral valve regurgitation: initial results in swine. Kim JH, Kocaturk O, Ozturk C, Faranesh AZ, Sonmez M, Sampath S, Saikus CE, Kim AH, Raman VK, Derbyshire JA, Schenke WH, Wright VJ, Berry C, McVeigh ER, Lederman RJ. J Am Coll Cardiol. 2009 Aug 11;54(7):638-51. Pubmed ID <a href="http://www.ncbi.nlm.nih.gov/pubmed/19660696">19660696</a></span></li> <li class=MsoNormal style='color:#333333'><span style='font-family:"Calibri",sans-serif'>This describes cerclage as conceived and performed in animals.</span></li> <li class=MsoNormal style='color:#333333'><span style='font-family:"Calibri",sans-serif'>Mitral Loop Cerclage Annuloplasty for Secondary Mitral Regurgitation. First Human Results. </span><span style='font-family:"Calibri",sans-serif; color:windowtext'>Park YH, Chon MK, Lederman RJ, Sung SC, Je H, Choo KS, Lee SH, Shin ES, Kim JS, Lee SY, Chon KJ, Kim JH. J Am Coll Cardiol Cardiovascular Interventions. 2017;10(6):597-610. Pubmed ID <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=28335897">28335897</a></span></li> </ol> <p class=MsoListParagraph style='text-indent:-.25in'><span style='font-family: Symbol;color:#333333'></span><span style='font-size:7.0pt;color:#333333'> </span><span style='font-family:"Calibri",sans-serif;color:#333333'>This describes the first human mitral cerclage annuloplasty.</span></p> <h2 style='page-break-after:avoid'><img width=184 height=356 src="index_files/image001.gif" align=right hspace=12 vspace=5 alt=" "><span style='font-family:"Calibri",sans-serif;color:#333333'>BASILICA: <u>B</u>ioprosthetic <u>A</u>ortic <u>S</u>callop <u>I</u>ntentional <u>L</u>aceration to prevent <u>I</u>atrogenic <u>C</u>oronary <u>A</u>rtery obstruction</span></h2> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Summary</span></h3> <p class=MsoNormal><span style='font-family:"Calibri",sans-serif;color:#333333'>Patients needing TAVR, whether for bioprosthetic or native aortic valve failure, sometimes risk acute coronary obstruction created when the TAVR device pushes the diseased aortic valve leaflets outwards. BASILICA is a simple catheter approach, performed immediately before TAVR, to reduce this risk. BASILICA splits the threatening aortic leaflet using techniques similar to LAMPOON. It has shown promise in a small number of patients. BASILICA may also prove important for patients with bicuspid aortic valve disease ( BiSILICA ), which is more common in Asia.</span></p> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Clinical Protocol</span></h3> <p class=MsoNormal><span style='font-family:"Calibri",sans-serif;color:#333333'>NHLBI has begun a multi-center prospective investigation of BASILICA (<a href="https://clinicaltrials.gov/ct2/show/NCT03381989">NCT03381989</a>) </span></p> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Manuscripts and Presentations about BASILICA</span></h3> <ol style='margin-top:0in' start=1 type=1> <li class=MsoNormal style='margin-top:6.0pt;margin-bottom:6.0pt;text-align: justify'><span style='font-family:"Calibri",sans-serif'>Khan JM*, Dvir D*, Greenbaum AB, Babaliaros VC, Rogers T, Aldea G, Reisman M, Mackensen GB, Eng MH, Paone G, Wang DD, Guyton RA, Devireddy CM, Schenke WH, <u>Lederman RJ</u>,  Transcatheter laceration of aortic leaflets to prevent coronary obstruction during transcatheter aortic valve implantation: concept to first-in-human aka <u>BASILICA</u>, Journal of the American College of Cardiology Cardiovascular Interventions, 2018;11(7):677 89. (Pubmed ID <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=29622147">29622147</a>)</span></li> <li class=MsoNormal style='margin-top:6.0pt;margin-bottom:6.0pt;text-align: justify'><span style='font-family:"Calibri",sans-serif;color:#333333'>A BASILICA procedure was demonstrated by Drs Adam Greenbaum and Danny Dvir at the 2017 Transcatheter Therapeutics conference in Denver, broadcast from Henry Ford Hospital in Detroit. Video posted <a href="https://www.google.com/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=1&amp;cad=rja&amp;uact=8&amp;ved=0ahUKEwiI1LKhitLXAhUFxYMKHWnWDXwQtwIIKDAA&amp;url=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DTLYg4NaiWHU&amp;usg=AOvVaw0xHLPgfBdRp8kX6Z6rzomy" title="Link to youtube video of BASILICA demonstration">here</a>.</span></li> <li class=MsoNormal style='margin-top:6.0pt;margin-bottom:6.0pt;text-align: justify'><span style='font-family:"Calibri",sans-serif;color:#333333'>TCTMD news story about BASILICA <a href="https://www.tctmd.com/news/delayed-coronary-obstruction-after-tavr-prevalence-causes-and-solution-explored-deadly">here</a>.</span></li> <li class=MsoNormal style='margin-top:6.0pt;margin-bottom:6.0pt;text-align: justify'><span style='font-family:"Calibri",sans-serif;color:#333333'>NIH press release about BASILICA <a href="https://www.nhlbi.nih.gov/news/2018/new-technique-makes-heart-valve-replacement-safer">here</a>.</span></li> </ol> <h2 style='page-break-after:avoid'><img width=337 height=109 src="index_files/image002.gif" align=right hspace=12 vspace=5 alt=" "><span style='font-family:"Calibri",sans-serif;color:#333333'>PASTA</span></h2> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Summary</span></h3> <p class=MsoNormal><span style='font-family:"Calibri",sans-serif;color:#333333'>Pledget assisted tricuspid annuloplasty (PASTA) is the world s first transcatheter suturing technique using off-the shelf components. PASTA creates a double orifice tricuspid valve to reduce tricuspid regurgitation (leakage) when the right heart chambers are massively dilated. PASTA employs double-bite suture pledgets, a novel  septal bite to serve as an intracardiac anchor, and a simple technique to exchange electrosurgical traversing wires for sutures. </span></p> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Manuscripts about PASTA</span></h3> <ol style='margin-top:0in' start=1 type=1> <li class=MsoNormal style='margin-top:6.0pt;margin-bottom:6.0pt;text-align: justify'><span style='font-family:"Calibri",sans-serif'>Khan JM, Rogers T, Schenke WH, Greenbaum AB, Babaliaros VC, Paone G, Ramasawmy R, Chen MY, Herzka DA, Lederman RJ,  Transcatheter Pledget-Assisted Suture Tricuspid Annuloplasty (PASTA), Catheterization and Cardiovascular Interventions, 2018 Feb 6. (Pubmed ID <a href="https://www.ncbi.nlm.nih.gov/pubmed/29405564">29405564</a>)</span></li> </ol> <h2 style='page-break-after:avoid'><img width=239 height=307 src="index_files/image022.gif" align=right hspace=12 alt="Title: Image of MRI catheterization in a patient - Description: MRI catheterization in a patient. The catheter tip is visible as a white gadolinium-filled balloon in the inferior vena cava (A), superior vena cava (B), right ventricle (C), and right pulmonary artery (D)."><span style='font-family:"Calibri",sans-serif;color:#333333'>MRI Catheterization</span></h2> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Why MRI Catheterization? </span></h3> <p><span style='font-family:"Calibri",sans-serif;color:#333333'>Unlike X-ray, which depicts only shadows of the heart, MRI clearly depicts soft tissue and blood spaces. Advances in MRI allow real-time MRI at frame rates of 5-15 per second. Compared with X-ray, these pictures have fewer pixels but more information. MRI catheterization allows radiation-free catheterization, for example in children or in protracted procedures, and allows guidance of newer and more complex non-surgical procedures. </span></p> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Routine MRI Catheterization in Patients</span></h3> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif; color:#333333'>At the NIH Clinical Center, we now perform MRI catheterization as our standard clinical approach. Not only does it avoid radiation entirely, it provides the most accurate measurement of blood flow, and it allows us to study heart function both at rest and after pharmacologic provocation.</span></p> <h3><img width=241 height=231 src="index_files/image024.gif" align=right hspace=12 alt="Title: Image of MRI catheterization lab during a proceduret. - Description: MRI catheterization at NHLBI. The suite is configured to resemble an interventional X-ray lab."><span style='font-family:"Calibri",sans-serif;color:#333333'>Bringing MRI Catheterization to Practice at Your Medical Center</span></h3> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif; color:#333333'>NHLBI offers to help you begin the practice and investigation of MRI catheterization at your medical center. We also offer <a href="http://www.cc.nih.gov/training/gme/programs/imageguided_cardio.html">training</a> for fellows with expertise and interest in interventional and image-guided intervention. For information, contact <a href="mailto:lederman@nih.gov?subject=MRI%20Catheterization%20Inquiry%20From%20NHLBI%20Web%20Site">Dr. Robert Lederman</a>. </span></p> <h3><span style='font-family:"Calibri",sans-serif;color:#333333'>Recent publications about MRI catheterization</span></h3> <ol style='margin-top:0in' start=1 type=1> <li class=MsoNormal style='color:#333333'><span style='font-family:"Calibri",sans-serif'>MRI catheterization in cardiopulmonary disease. Rogers T, Ratnayaka K, Lederman RJ. Chest. 2014 Jan;145(1):30-6. Pubmed ID <a href="http://www.ncbi.nlm.nih.gov/pubmed/24394821">24394821</a></span></li> <li class=MsoNormal style='margin-top:6.0pt;margin-bottom:6.0pt;text-align: justify'><span style='font-family:"Calibri",sans-serif'>CMR fluoroscopy right heart catheterization for cardiac output and pulmonary vascular resistance: results in 102 patients. Rogers T, Ratnayaka K, Khan JM, Stine AM, Schenke WH, Grant LP, Mazal JR, Grant EK, Campbell-Washburn A, Hansen MS, Ramasawmy R, Herzka DA, Xue H, Faranesh AZ, Kellman P, Lederman RJ, Journal of Cardiovascular Magnetic Resonance, 2017;19:54. Pubmed ID <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=28750642">28750642</a></span></li> </ol> <p class=MsoListParagraph style='text-indent:-.25in'><span style='font-family: "Calibri",sans-serif'>4.</span><span style='font-size:7.0pt'> </span><span style='font-family:"Calibri",sans-serif'>Radiation-Free MRI Diagnostic Heart Catheterization in Children. Ratnayaka K, Kanter JP, Faranesh AZ, Grant EK, Olivieri LJ, Cross RR, Cronin I, Hamann KS, Campbell-Washburn AE, O Brien KJ, Rogers T, Hansen MS, Lederman RJ, Journal of Cardiovascular Magnetic Resonance, 2017 Sep 6;19(1):65. Pubmed ID <a href="https://www.ncbi.nlm.nih.gov/pubmed/28874164">28874164</a></span></p> <ol style='margin-top:0in' start=5 type=1> <li class=MsoNormal style='margin-top:6.0pt;margin-bottom:6.0pt;text-align: justify'><span style='font-family:"Calibri",sans-serif'>More information about iCMR is available at <a href="https://icmr.nhlbi.nih.gov">https://icmr.nhlbi.nih.gov</a> </span></li> </ol> <h3 style='page-break-after:avoid'><span style='font-family:"Calibri",sans-serif; color:#333333'>Inventing and Cultivating Development of Medical Devices for MRI Catheterization</span></h3> <p class=MsoBodyText><span style='font-family:"Calibri",sans-serif; color:#333333'>MRI catheterization is not yet popular because there are not a large number of MRI-safe catheter tools; companies do not wish to invest in the development of MRI-safe catheter tools because MRI catheterization is not yet popular. That is why NHLBI is developing custom MRI-safe catheter tools, along with a team of scientists, engineers, physicists, and clinicians, to  jump-start the chicken-egg problem with industry, and to bring MRI catheterization into wider clinical practice. NHLBI issues periodic solicitations for Small Business Innovation Research contract to develop MRI-safe catheter devices, and our lab offers to (and often does) collaborate with the contract awardees. These include a MRI safe hemodynamic recording system, a MRI myocardial bioptome, and MRI myocardial injection catheters.</span></p> <p><span style='font-family:"Calibri",sans-serif;color:#333333'>Our laboratory continues to work on a range of pre-clinical applications for MRI catheterization devices. Internally, we have developed unique passive MRI guidewires, and are working to help commercialize it for general use in patients.</span></p> <p><b><span style='font-size:13.5pt;font-family:"Calibri",sans-serif; color:#333333'><a href="repository/index.htm">NHLBI Cardiovascular Intervention Structural Heart Image Data Repository</a></span></b></p> <p class=MsoNormal><span style='font-family:"Calibri",sans-serif;color:#333333'>Representative cardiovascular medical images (such as CT) are posted from patients with specific conditions of interest to researchers worldwide. These can be downloaded and used freely from <a href="repository/index.htm">this link</a>.</span></p> <p><b><span style='font-size:13.5pt;font-family:"Calibri",sans-serif; color:#333333'>Uploading files to Lederman lab</span></b></p> <p><span style='font-family:"Calibri",sans-serif;color:#333333'>Use <a href="https://nhlbi.app.box.com/upload-widget/preview?folderID=50415601034&amp;title=Upload%20DICOM%20files%20to%20Lederman%20Lab&amp;instructions=Please%20arrange%20in%20advance%20with%20Dr%20Lederman.%20Only%20transmit%20ZIP%20or%20ISO%20files%20of%20DICOM%20studies.%20%20Anonymized%20or%20de-identified%20studies%20will%20not%20be%20accepted.%20%20&amp;isDescriptionFieldShown=1&amp;isEmailRequired=1&amp;width=385&amp;height=420&amp;token=e25xmmqdsf3of5ip5mmfrog7lqe7l6jb">this link</a> to upload files to the lab.</span></p> <p>&nbsp;</p> <p class=MsoNormal><span style='font-family:"Calibri",sans-serif;color:#333333'>Updated 7/9/2018</span></p> </td> </tr> </table> </div> <p>&nbsp;</p> </div> </body> </html>