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[Endomyocardial biopsy in childhood--experiences in 60 pediatric patients]
A A Schmaltz1, J Apitz, W Hort
1Abteilung für Pädiatrische Kardiologie der Universitäts-Kinderklinik Tübingen.
Insights
Endomyocardial biopsy in pediatric patients provides valuable diagnostic insights into myocardial diseases, aiding in understanding the cause and development of heart conditions in children.
Area of Science:
- Pediatric Cardiology
- Cardiac Pathology
- Diagnostic Imaging
Context:
- Endomyocardial biopsy is an invasive procedure used to diagnose heart conditions.
- Pediatric heart diseases require accurate etiological and pathogenetic understanding for effective management.
Purpose:
- To evaluate the diagnostic utility and safety of transvascular endomyocardial biopsy in pediatric patients.
- To assess the contribution of endomyocardial biopsy to the diagnosis of various pediatric myocardial diseases.
Summary:
- Transvascular endomyocardial biopsy was performed in 60 pediatric patients (1 month to 22 years) for indications including poorly functioning left ventricles, left ventricular hypertrophy, and unclear myocardial damage.
- Specimens were analyzed using light and electron microscopy, with additional immune serological and histological examinations in subsets of patients.
- The procedure was found to be diagnostic in 11.7% and helpful in 71.7% of cases, with no serious complications reported, indicating its value in pediatric cardiology.
Impact:
- Endomyocardial biopsy serves as a crucial diagnostic tool in pediatric cardiology, offering essential information on the etiology and pathogenesis of myocardial diseases.
- The findings support the continued use of endomyocardial biopsy in childhood for diagnosing complex cardiac conditions.
- This diagnostic approach can guide treatment strategies and improve patient outcomes in pediatric heart disease.
Abstract:
In 60 pediatric patients, aged from 1 month to 22 years (median 3.54) and a bodyweight of 3 to 67 kg (median 12.6 kg) transvascular endomyocardial biopsy was performed from the right (35 patients) or left ventricle (30 patients). The specimens were investigated by light and electron microscopy. Immune serological investigations were performed in 22 patients, immune histological examinations in eight. There were three indications for biopsy: a. 29 children had a poorly functioning, dilated left ventricle. Of these, seven suffered from endocardial fibroelastosis, 16 from dilated cardiomyopathy, six (plus one control-biopsy) from healing/healed or chronic myocarditis. b. 17 children showed inadequate left ventricular hypertrophy. Of these, ten suffered from HCM, four from secondary hypertrophy, three from storage diseases. c. Various questions were answered in eight children - four with hypoxic, two with cytotoxic myocardial damage. There were five misindications, retrospectively. We observed no serious complications. Evaluation of biopsy revealed diagnostic findings in 11.7%, was helpful in 71.7% and of no help in 16.6%. Hence, even in childhood, endomyocardial biopsy is a diagnostic tool which can contribute useful information on the etiology or pathogenesis of the underlying myocardial disease.