General anesthesia (GA), while not always required, is frequently necessary in infants and children undergoing cardiac magnetic resonance imaging (CMR) based on risk-benefit of breath-hold under GA v/s diagnostic value of the images. Primarily, requirement of breath-hold for cine imaging to evaluate ventricular volumes and function, a key prognostic measure in spectrum of congenital heart diseases, governs the administration of anesthesia. Our experience demonstrates that completely free-breathing-CMR studies including CArdio-REspiratory Synchronized cine imaging allow elimination of anesthesia or minimization in depth of sedation while providing diagnostic morphologic, functional, and pathophysiologic evaluation in young children, and adolescents considered high-risk for anesthesia.
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