Cardiac magnetic resonance perfusion imaging and the effects of single intravenous cannulation with the Octopus bionector

Background CMR perfusion (CMRP) imaging using adenosine traditionally requires bilateral arm cannulation. Patients with multiple comorbidities often have difficult venous access and dual cannulation often proves impossible. We used a standard two-way adapter (Octopus Vygon with no-reflow valve) to administer adenosine at a standard rate of 140 mcg/kg/minute over 3 minutes for maximum coronary vasodilatation following a bolus injection of gadolinium. High flow bolus injection may cause sinus arrest caused by a flush of residual adenosine in the same arm vein. We acquired 50 sequential R-wave triggered image frames to assess first pass myocardial perfusion and assessed the effect of significant sinus pauses on image acquisition.