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Echo-guided endomyocardial biopsy in heterotopic heart transplantation. Case report
A M Grande1, G De Pieri, C Pederzolli
1Istituto di Chirurgia Generale e dei Trapianti d'Organo Divisione Cardiochirurgia, IRCCS Policlinico S. Matteo Universitá degli Studi di Pavia, Italy.
Insights
Echocardiographic guidance improves right ventricular endomyocardial biopsy in heterotopic heart transplant patients. This technique enhances safety by optimizing biopsy site selection and reducing perforation risks, minimizing radiation exposure for patients and operators.
Area of Science:
- Cardiology
- Medical Imaging
- Transplant Surgery
Background:
- Right ventricular endomyocardial biopsy is challenging post-heterotopic heart transplantation due to complex vascular anatomy.
- Current procedures typically rely on fluoroscopic guidance, posing risks of radiation exposure.
Observation:
- A case study details an echo-guided endomyocardial biopsy in a 59-year-old woman post-heterotopic heart transplant.
- The technique was applied to 11 additional heterotopic heart transplant patients.
Findings:
- Echocardiographic guidance facilitates superior selection of biopsy sites.
- The method significantly reduces the risk of right ventricular free wall perforation.
- Radiation exposure for both the patient and the medical operator is diminished.
Implications:
- Echocardiographic guidance offers a safer and more effective alternative for endomyocardial biopsies in heterotopic heart transplant recipients.
- This approach enhances procedural safety and reduces potential complications associated with radiation.
- Wider adoption could improve outcomes for patients undergoing heterotopic heart transplantation.
Abstract:
Right ventricular endomyocardial biopsy is difficult to perform in patients who underwent heterotopic heart transplantation because of the complex vascular anatomy. The procedure is usually performed under fluoroscopic control. We present a case of a 59-year-old woman that after heterotopic heart transplantation underwent echo-guided endomyocardial biopsy. We report the technique discussing data obtained in other 11 patients heart transplanted in the heterotopic way. In conclusion we believe that echocardiographic guidance during endomyocardial biopsy allows a better choice of bite sites, reduces the risk of free wall perforation. Moreover is diminished the risk of X-ray exposure to both patient and operator.