Endomyocardial biopsy
Enrico Fabris1,2, Aldostefano Porcari2,3, Rossana Bussani4
1Interventional Cardiology Unit, Cardiothoracovascular Department, University of Trieste, Trieste, Italy.
Summary
Endomyocardial biopsy (EMB) is a crucial diagnostic tool for heart conditions like myocarditis and cardiomyopathies. Careful patient selection and expert performance are essential to ensure safety and optimize the risk/benefit profile.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Pathology
Background:
- Endomyocardial biopsy (EMB) has transitioned from monitoring heart transplant rejection to a gold-standard for diagnosing cardiac disorders.
- It is vital for unexplained acute heart failure with hemodynamic compromise.
- EMB offers interventional cardiologists a bridge between invasive diagnostics and personalized patient care.
Purpose of the Study:
- To review the contemporary use of EMB from an interventional cardiologist's viewpoint.
- To provide a practical resource for clinical practice regarding EMB.
- To clarify the indications and techniques for performing right and left ventricular EMB.
Main Methods:
- Review of current clinical practices and literature on endomyocardial biopsy.
- Focus on the interventional cardiologist's perspective.
- Examination of safety considerations and risk/benefit profiles.
Main Results:
- EMB is fundamental for diagnosing myocarditis, cardiomyopathies, and unexplained heart failure.
- Technological advancements are enhancing EMB's integration with non-invasive methods for precise cardiac condition management.
- Major complications, though rare (1-5%), underscore the need for correct indications and expertise.
Conclusions:
- EMB remains a critical tool for definitive etiological diagnosis in various cardiac conditions.
- Optimizing the risk/benefit ratio of EMB relies on appropriate patient selection and procedural expertise.
- This review serves as a guide for interventional cardiologists on the contemporary application of EMB.
