Section  on  Cardiac  Magnetic  ResonanceThe  Children’s  Hospital  of  Philadelphia,  Division  of  CardiologyPerelman  School  of  Medicine  at  the  University  of  Pennsylvania

Philadelphia,  PA  USA  19004

Founded: 1988  by  Paul  Weinberg  &  Alvin  ChinFirst  Director: Paul  Weinberg  1989-­‐2002Current  physician  team:• Mark  Fogel,  Director  (2002-­‐present)• Matthew  Harris,  Kevin  Whitehead,  Sara  Partington,  

David  BikoCMR  technologists: Justin  Wilson,  Shaun  Hoffacker,  George  Englehardt,  Brian  Brazinski,  Kathy  DiazNursing  Staff: Traci  Sullivan,  Denise  VirdenAnesthesia  staff: Susan  Nicolson  (lead),  James  StevenAdministration: Robert  Shaddy,  Kasa Darge,  Chris  Harris

Pediatric/Congenital  CMR  Patient  Volume  Growth

Evolution  of  CMR  at  CHOP

Partnered/Affiliated  Groups:  Past  &  Present

Selected  Influential  Pediatric/Congenital  CMR  Manuscripts

Georgia  Institute  of  TechnologyEmory  University/Sibley  Heart  Institute

Hospital  for  Sick  Kids  – TorontoChildren’s  National  Medical  CenterUniversity  of  California  – Los  AngelesNational  Institutes  of  Health  (NIH)

Clinical  Focus: All  aspects  of  pediatric  and  congenital  heart  diseaseResearch  Focus: 1)  Ventricular  function,  blood  flow  and  tissue  characterizaton,  2)  CMR  application  to  pediatrics  and  congenital  heart  disease  and  3)  new  CMR  techniques

Single  Ventricle© Fogel MA,  et  al.  Neurologic  Injury  and  Cerebral  Blood  Flow  in  Single  Ventricles  Throughout  Staged  

Surgical  Reconstruction.  Circulation.  2016© Whitehead  KK,  et  al.  Status  of  Systemic  To  Pulmonary  Arterial  Collateral  Flow  After  the  Fontan  

Procedure.  Am  J  Cardiol.  2015© Khiabani RH,  et  al.  Exercise  Capacity  in  Single  Ventricle  Patients  after  Fontan  Correlates  with  

Hemodynamic  Energy  Loss  in  TCPC.  Heart.  2015  © Fogel  MA,  et  al.  Cardiac  magnetic  resonance  and  the  need  for  routine  cardiac  catheterization  in  

single  ventricle  patients  prior  to  Fontan.  A  comparison  of  3  groups.  J  Am  Coll  Cardiol.  2012© Whitehead  KK  et  al.  Noninvasive  Quantification  of  Systemic  To  Pulmonary  Collateral  Flow:  A  Major  

Source  of  Inefficiency  in  Patients  w/  Superior  Cavopulmonary Connections.  Circ CV  Imaging.  2009  © Harris  MA,  et  al.  Pre-­‐Fontan  Cardiac  Magnetic  Resonance  Predicts  Post-­‐Fontan  Length  of  Stay  and  

Avoids  Ionizing  Radiation.  J  Thorac Cardiovasc  Surg.  2009© Sundareswaran  K,  et  al.  Correction  Of  Pulmonary  Arteriovenous  Malformation  Using  Image  Based  

Surgical  Planning.  JACC  Cardiovascular  Imaging,  2009© Sundareswaran  K,  et  al.  Impaired  Power  Output  and  Cardiac  Index  with  Hypoplastic Left  Heart  

Syndrome  -­‐ A  Magnetic  Resonance  Imaging  Study.  Ann  Thorac Surg.  2006  © Fogel  MA  et  el.  Brain  versus  lung:  Hierarchy  of  feedback  loops  in  single  ventricle  patients  with  

superior  cavopulmonary connection.  Circulation.  2004© Fogel  MA  et  al.  The  nature  of  flow  in  the  systemic  venous  pathway  measured  by  magnetic  

resonance  blood  tagging  in  Fontan  patients.  J  Thorac Cardiovasc  Surg.  1997  © Fogel  MA    et  al.  A  Study  in  ventricular  -­‐ ventricular  interaction:  Single  right  ventricles  compared  

with  systemic  right  ventricles  in  a  dual  chambered  circulation.  Circulation.  1995  © Fogel  MA  et  al.  Magnetic  resonance  imaging  of  constant  total  heart  volume  and  center  of  mass  

before  and  after  staged  Fontan  procedure.  Am  J  Cardiol.  1993  Coronary  Imaging© Harris  MA,  et  al.  Identifying  Abnormal  Ostial  Morphology  in  Anomalous  Aortic  Origin  of  a  

Coronary  Artery.  Ann  Thorac Surg.  2015Tetralogy  of  Fallot© Fogel MA  et  al.  Power  loss  and  right  ventricular  efficiency  in  patients  after  tetralogy  of  Fallot

repair  with  pulmonary  insufficiency:  Clinical  implications.  J  Thorac Cardiovasc  Surg.  2012© Harris  MA  et  al.    Differential  Branch  PA  Regurgitant Fraction  Is  a  Function  of  Differential  

Pulmonary  Arterial  Anatomy  and  Pulmonary  Vascular  Resistance.  JACC  Cardiovasc  Imaging.  2011  New  CMR  Techniques  or  Applications© Dori  Y,  et  al.  Magnetic  Resonance  Imaging  of  Lymphatic  Abnormalities  After  Functional  Single  

Ventricle  Palliation  Surgery.  Am  J  Roentgenol.  2014  © Fogel  MA  et  al.  Comparison  and  usefulness  of  CMR  versus  CT  in  infants  six  months  of  age  or  

younger  with  aortic  arch  anomalies  without  deep  sedation  or  anesthesia.  Am  J  Cardiol.  2011  © Harris  MA  et  al.  Delayed  Enhancement  Cardiovascular  Magnetic  Resonance  Identifies  Fibrous  

Tissue  In  Children  After  Congenital  Heart  Surgery.  J  Thorac Cardiovasc  Surg.  2007© Fogel  MA  et  al.  A  New  Method  Of  Functional  Assessment  Of  The  Fetal  Heart  Using  A  Novel  

Application  Of  “Real  Time”  Cardiac  Magnetic  Resonance  Imaging.  Fetal  Diagn Ther.  2005  © Fogel  MA  et  al.  Caval Contribution  to  Flow  in  Fontan  Branch  Pulmonary  Arteries  Using  A  Novel  

Application  of  Magnetic  Resonance  Presaturation Pulse.  Circulation.  1999  

Involvement  with  SCMRMark  Fogel• Past  Board  of  Trustees  member• Chair/founder  of    Pediatric  /  

Congenital  working  group• SCMR  rep  numerous  times• Numerous  committees

1253