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[Right ventricular endomyocardial biopsy from the femoral vein]
M Zuguchi1, S Takahashi, K Sakamoto
1Department of Radiology, Tohoku University, School of Medicine.
Insights
This study presents a modified femoral venous approach for percutaneous right ventricular endomyocardial biopsy. The technique uses a reshaped biotome and sheath, achieving adequate tissue samples without complications in 14 patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biopsy Techniques
Context:
- Percutaneous endomyocardial biopsy is crucial for diagnosing cardiac conditions.
- Existing methods like subclavian, internal jugular, and femoral venous approaches have limitations.
- The femoral venous approach, while common, carries a risk of right bundle branch block due to high ventricular sampling.
Purpose:
- To describe a modified femoral venous approach for percutaneous right ventricular endomyocardial biopsy.
- To enhance the safety and efficacy of tissue sampling from the right ventricle.
- To overcome the limitations of standard femoral venous biopsy techniques.
Summary:
- A modified femoral venous approach was developed using King's biotome and a reshaped Cordis sheath.
- The biotome tip was reformed into an inverted S-shape, and the sheath tip into a J-shape.
- This technique facilitated easier introduction and safer biopsy, yielding adequate specimens in 14 cases without complications.
Impact:
- Provides a safer and more effective method for percutaneous right ventricular endomyocardial biopsy.
- Reduces the risk of complications associated with traditional femoral venous approaches.
- Offers a valuable technique for routine cardiac catheterization and tissue diagnosis.
Abstract:
Several methods are used for percutaneous right ventricular endomyocardial biopsy, including the subclavian venous approach, internal jugular venous approach and femoral venous approach. The femoral venous approach is the most suitable for routine cardiac catheterization, but the risk of right bundle branch block may be increased because the specimens often must be taken from a high position in the right ventricle. We modified the femoral venous approach using King's biotome, and obtained adequate tissue specimens in 14 cases without any complications. We reformed the tip of the biotome into an inverted S shape by scrubbing with the thumb, and we reformed the tip of the long sheath (Cordis) into a J shape by warming with steam, for easy introduction of the biotome and safe biopsy. We describe here the methodological details of our technique.