Deep sedation for cardiac magnetic resonance imaging: A comparison with cardiac anesthesia

Objective To test the hypothesis that safety, efficacy, and image quality in pediatric patients who undergo deep sedation for cardiac magnetic resonance imaging (CMR) for congenital heart disease (CHD) is similar to general anesthesia (GA). Study design Retrospective review of all CMR records from 1997-2006. Six hundred sixty patients underwent deep sedation (DS) and 161 underwent GA. Statistics included analysis of variance, chi(2) analysis, and the coefficient of variation. Results Diagnoses included a broad spectrum of CHD. No serious adverse events (A-E) including mortalities and hospitalizations occurred because of DS. There were 18 (2.8%) self-limited events in the DS group with a success rate of 97.9%. The AE rate for patients undergoing GA was 3.9% (n = 6), including 2 overnight hospital stays with a success rate of 100%. AE and success rates did not differ between the 2 groups. Observers blinded to the patient's group found no difference in image quality. Even in young infants, excellent image quality was obtained. Conclusions Sedation of appropriately screened pediatric patients with CHD undergoing CMR is safe and well tolerated and yields high-quality images similar to GA. GA should be considered for patients with CHD with hemodynamic or airway compromise, in whom sedation has failed, or who have special circumstances.