Alternative approaches to right ventricular endomyocardial biopsy

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Transplantation

Background:

• Endomyocardial biopsy is increasingly performed, particularly post-cardiac transplantation.
• Conventional biopsy approaches may lead to complications and necessitate multiple procedures.
• There is a need for simpler, efficient biopsy techniques.

Purpose of the Study:

• To describe a novel, simple, and efficient technique for obtaining endomyocardial biopsy samples.
• To present an alternative to conventional venous approaches for cardiac biopsy.
• To detail a method facilitating multiple biopsies with reduced patient discomfort.

Main Methods:

• Utilized a 7 Fr 35 cm sheath and dilator system placed into the right ventricle over a balloon-tipped catheter.
• Employed right or left internal jugular or subclavian venous access, avoiding conventional right internal jugular or femoral routes.
• Allowed for multiple biopsy sample acquisition using standard bioptomes and sheath exchange for a triple-lumen catheter if needed.

Main Results:

• The described technique provides a simple and efficient method for endomyocardial biopsy.
• This approach allows for routine changes of central venous access lines within the catheterization laboratory.
• The method offers an important alternative to conventional biopsy techniques with potential for reduced patient discomfort.

Conclusions:

• The novel venous access technique for endomyocardial biopsy is a safe and effective alternative.
• This method simplifies the procedure, especially for patients requiring frequent biopsies like transplant recipients.
• The technique enhances patient comfort and procedural efficiency in the cardiac catheterization laboratory.