Catheterization is a minimally invasive approach to treating cardiovascular disease, and uses increasingly sophisticated combinations of catheter tools to maneuver in the vasculature and of imaging technologies to track them. Dr. Lederman’s goal is to enhance and expand the capabilities, safety, and effectiveness of catheterization by using real-time magnetic resonance imaging (MRI) to enable non-surgical catheter-based treatments for adults and children.
Unlike currently available X-ray technologies, MRI visualize soft tissues and does not use harmful radiation, an especially important consideration for procedures in children or for very complicated procedures. The laboratory uses MRI to reduce radiation in conventional X-ray procedures (by combining MRI pictures with X-ray during catheterization) and to avoid radiation altogether (by performing whole procedures using MRI guidance alone).In one of the few facilities in the world equipped with real-time MRI for clinical interventions, Dr. Lederman works with a talented interdisciplinary team of scientists, clinicians, and engineers to develop the hardware, software, and clinical solutions required to perform safe cardiovascular interventions. Working in an MRI environment can be challenging. For example catheter tools need to be redesigned to be safe and visible during MRI. Dr Lederman’s team has a catheter fabrication facility to invent, design, and test fundamental catheter tools, such as MRI guidewire antennas, to deliver simple catheters and more complex treatment devices.
Dr. Lederman and his colleagues work in animal models to develop advanced procedures, for example to repair complex congenital heart defects, aneurysm, cross total arterial occlusions, and cross tissue boundaries. They have developed the capability to deliver very large devices directly through the chest and heart walls without surgery, for example, to replace the mitral valve or to close holes the heart under MRI guidance, and they are preparing to translate this innovative technology into patients.
Dr Lederman’s team has developed and tested radiation-free heart catheterization in adults, and is preparing to expand this service. NHLBI has opened a new MRI catheterization laboratory at Children’s National Medical Center to begin testing radiation-free catheterization in children.
Working with advanced imaging tools has allowed the Dr Lederman’s laboratory to develop innovative catheterization techniques that can be applied with normal X-ray guidance. His group has recently developed a novel non-surgical catheter-based approach to repair leaky mitral valves in the heart known as “cerclage annuloplasty,” and is working to partner with industry to bring this into broader testing. His group also is applying other innovative approaches to other valve disease, such as tricuspid valve regurgitation.
Dr Lederman’s Cardiovascular Intervention Program offers consultation and clinical treatment to patients with heart, valve, and vascular disease, and also invites patients to participate in clinical research protocols.
Please click on ledermanlab.nhlbi.nih.gov for more information on projects and collaborations.