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Echocardiography-guided endomyocardial biopsy. A 5-year experience
L W Miller1, A J Labovitz, L A McBride
1Department of Internal Medicine, St. Louis University School of Medicine, Missouri.
Circulation
|November 1, 1988
Summary
Echocardiography offers a safer, more flexible alternative to fluoroscopy for guiding cardiac transplant biopsies. This method reduces radiation exposure and complications, improving patient care during rejection monitoring.
Area of Science:
- Cardiology
- Medical Imaging
- Transplantation Medicine
Background:
- Cardiac transplantation is increasing, requiring frequent endomyocardial biopsies for rejection monitoring.
- Cyclosporine therapy often masks rejection symptoms, necessitating routine biopsies.
- Traditional fluoroscopy-guided biopsies have drawbacks like radiation exposure and limited access.
Purpose of the Study:
- To evaluate echocardiography as an alternative or adjunct to fluoroscopy for guiding endomyocardial biopsies.
- To assess the safety and efficacy of echocardiography-guided biopsies in cardiac transplant patients.
Main Methods:
- Over 4,700 echocardiography-guided endomyocardial biopsies were performed in 58 cardiac transplant patients.
- Echocardiography was used to guide biopsies, replacing the need for fluoroscopy.
- Biopsies were performed to evaluate allograft rejection.
Main Results:
- No fluoroscopy was required for any of the echocardiography-guided biopsies.
- Only two complications occurred across 4,700 biopsies, demonstrating a high safety profile.
- Echocardiography allowed safe biopsy of various right ventricular areas.
Conclusions:
- Echocardiography is a safe and effective alternative or adjunct to fluoroscopy for guiding endomyocardial biopsies.
- The technique offers advantages in portability, flexibility, and elimination of radiation exposure.
- Echocardiography-guided biopsy is easily learned and can improve rejection monitoring in cardiac transplant recipients.