Contrast-enhanced coronary artery and coronary artery bypass graft imaging using an aortic root catheter injection with either magnetic resonance angiography or computed tomographic angiography

Abstract

A three-dimensional method of imaging the coronary arteries and coronary artery bypass grafts using a catheter contrast enhanced technique. The method involves the percutaneous placement of a catheter via the lower or upper extremity arterial circulation and engaging the distal end of the catheter into the aortic root with subsequent injection of a magnetic resonance imaging (MRI) or iodinated contrast agent and performing rapid first pass imaging with either magnetic resonance angiography (MRA) or computed tomographic angiography (CTA) techniques, respectively. Furthermore, a three dimensional catheter is used which includes a plurality of small distal round openings which are situated at the immediate distal end of the catheter near the small end-hole opening. The immediate distal end of the catheter is pre-formed having a memory and a three-dimensional, instead of a two-dimensional, curve to enhance the delivery of contrast to the aortic root for subsequent delivery of contrast to the coronary arteries. The distal three-dimensional curve is coiled or spirally shaped like a bell. The distal end-hole of the catheter has a smaller inner diameter than the inner diameter of the catheter and accepts a guidewire. This design helps to decrease the amount of contrast exiting the end-hole and subsequently reduces catheter recoil and enhances contrast flow through the plurality of small distal round openings in the catheter. Alternatively, the distal end-hole can be designed with valves. Finally, a means of delivering contrast is presented which employs an external interface for ECG-triggered, diastolic phase, injection of contrast agent.