Purpose or Case Report: The purpose of this educational presentation is to review the feed and wrap method, also known as feed and sleep, swaddle, or bundle, as an alternative to deep sedation or general anesthesia through a pictorial review of cardiac magnetic resonance (MR) studies performed using this method. The feed and wrap technique in which feeding and warmth are used to induce sleep and swaddling is used to reduce motion is described. Indications and contraindications as well risks and benefits of this method versus general anesthesia and deep sedation are discussed. Multiple examples of congenital heart disease including atrial and ventricular septal defects, atrioventricular canal defects, and double outlet right ventricle are provided, with sequences used, length of scan, and diagnostic quality also summarized. The example shown in Figures 1-3 is a 12-day-old female. The scan was completed in 12 minutes without intravenous contrast. Figure 1 is the scout image showing situs inversus. Figure 2 is a gated axial steady state free procession (SSFP) image showing a membranous ventricular septal defect (yellow arrow), an atrial septal defect (yellow arrowhead), and atrial inversion. Figure 3 is a 4D flow reconstruction showing the superior and inferior vena cava entering anatomic right atrium on the left, a right aortic arch with mirror branch pattern, and relationship to the main pulmonary artery (MPA).
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Conclusions: After reviewing this educational exhibit, the reader will be able to implement the feed and wrap method as an alternative to general anesthesia or sedation in CT and MRI scans of infants. Examples are provided in cardiovascular imaging, of particular interest because the risk of adverse events under general anesthesia is higher in congenital heart disease patients and because of the complexity of disease being evaluated.