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Endomyocardial biopsy in infants and children: experience in 60 patients
A A Schmaltz1, J Apitz, W Hort
1Department of Pediatric Cardiology, University's Children's Hospital Tübingen, FRG.
Insights
Endomyocardial biopsy (EMB) in children is a valuable diagnostic tool for identifying the causes of heart muscle diseases. This procedure provided helpful or diagnostic information in most cases, aiding in understanding pediatric myocardial conditions.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Pathology
- Diagnostic Imaging
Background:
- Endomyocardial biopsy (EMB) is an invasive procedure used to diagnose myocardial diseases.
- Its utility and safety in pediatric populations require further elucidation.
- Understanding the etiology and pathogenesis of pediatric heart conditions is crucial for effective management.
Purpose of the Study:
- To evaluate the diagnostic yield and safety of transvascular endomyocardial biopsy in children.
- To assess the indications and outcomes of EMB in pediatric patients with various cardiac conditions.
Main Methods:
- Sixty children underwent transvascular endomyocardial biopsy (EMB) from either the right or left ventricle.
- Biopsied specimens were analyzed using light and electron microscopy.
- Indications included poorly functioning left ventricles, unexplained hypertrophy, and specific diagnostic questions.
Main Results:
- No serious complications were reported during or after the procedures.
- Biopsies were diagnostic in 11.7% and helpful in 71.7% of cases.
- The study identified various conditions including dilated cardiomyopathy, hypertrophic cardiomyopathy, and myocarditis.
Conclusions:
- Endomyocardial biopsy (EMB) is a safe and useful diagnostic tool in pediatric cardiology.
- It provides valuable etiological and pathogenetic information for a wide range of myocardial diseases in children.
- EMB can significantly contribute to the diagnosis and management of pediatric heart conditions.
Abstract:
In 60 children, aged between 1 month and 22 years (median 3.54 years) and with a body weight of 3-67 kg (median 12.6 kg), transvascular endomyocardial biopsy (EMB) was performed from the right (35 children) or left ventricle (30 children). The specimens were investigated by light and electron microscopy. There were three indications for biopsy: (1) poorly functioning, dilated left ventricle (seven patients with endocardial fibroelastosis, 16 with dilated cardiomyopathy, six from healing/healed or chronic myocarditis); (2) unexplained left ventricular hypertrophy (10 with hypertrophic cardiomyopathy, four with secondary hypertrophy, three with storage diseases); (3) to answer certain questions in eight children (four with hypoxic and two with cytoxic myocardial damage). Retrospectively, there were five nonindicated biopsies. There were no serious complications. Biopsies were diagnostic in 11.7% of cases, helpful in 71.7%, and of no help in 16.6%. Thus even in childhood endomyocardial biopsy is a diagnostic tool which can add useful information on the etiology or pathogenesis of an underlying myocardial disease.