Endomyocardial biopsy in infants and children: technique; indications and results

By modification of a miniaturized technique for transcatheter endomyocardial biopsy, it was possible to insert a bioptome through a 6 French catheter in 15 infants and children aged 40 days to 17 years and weighing 3.5 to 55kg. Eight right and 7 left ventricular biopsies were performed, and the specimens were examined by light and electron microscopy. In one child we failed to obtain a specimen. There were no complications. Diagnoses to be either proved or excluded were hypertrophic or dilated cardiomyopathy, endocardial fibroelastosis, glycogen and lipid storage disease, tumours and myocarditis. Morphological examination was diagnostic in 2 cases, helpful in 10 cases and of no help in 2 cases. by this technique it is possible to prove endomyocardial diseases with a high degree of reliability in infants and children without increasing risk or stress.