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A Retrospective Review of the Utility and Safety of Endomyocardial Biopsy
Description
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A1536 - A Retrospective Review of the Utility and Safety of Endomyocardial Biopsy
Author Block: K. Ryan1, H. Hall2, R. Mirza2, N. Barnes1, E. Shaw3, A. F. Madden2, B. Madden2; 1Cardiothoracic Medicine, St Georges University Hospital, London, United Kingdom, 2St Georges University Hospital, London, United Kingdom, 3Pulmonary Hypertension, St Georges University Hospital, London, United Kingdom.
Ryan K, Hall H, Mirza R, Barnes N, Shaw E, Madden AF, Madden BP.
Dept of Cardiothoracic Medicine, St Georges Hospital London.
Introduction
Cardiac involvement has important clinical, therapeutic and prognostic implications for non-cardiac transplant patients with multisystem diseases and is often associated with significant morbidity and mortality. Because of concerns regarding complications and lack of training in the technique of endomyocardial biopsy (EMB), the procedure is under-utilized when compared with biopsy of other organs. We wish to improve awareness of this important diagnostic modality amongst medical and nursing staff.
Method
Retrospective analysis of all patients who underwent EMB between December 2012-October 2017 was made. Procedure indications, histopathology results, complications and clinical outcome were reviewed. Three EMB were taken from the right ventricular septum via the right internal jugular vein under strict asepsis and 2D echocardiographic guidance in each patient. All patients had 2D echocardiography immediately after biopsy.
Results
79 patients aged 21-87 years of whom 68 were male, had EMB (table).
The most common indication was cardiac amyloidosis investigation (40 patients, 24 (60%) positive histology). 5 patients with respiratory disease had EMB to assess for associated cardiac involvement (4 positive; 1.lyme disease, 1.TB and amyloid, 2 sarcoid). 1 patient originally presented with eosinophilic pleural effusions and cardiac failure. EMB showed eosinophilic myocarditis. 10 patients had EMB for possible cardiac sarcoid and 4(40%) were positive. The median procedure time was 25 minutes. The only complication which occurred in one patient was ventricular tachycardia and was successfully cardioverted. When EMB were non diagnostic no change in therapeutic strategy was recommended.
Conclusion
Our experience shows that EMB in experienced hands is a safe, well tolerated and valuable addition to the management of selected patients with cardiothoracic pathology. It is hoped that further awareness and training in EMB will lead to an increase in its utilization.
Author Block: K. Ryan1, H. Hall2, R. Mirza2, N. Barnes1, E. Shaw3, A. F. Madden2, B. Madden2; 1Cardiothoracic Medicine, St Georges University Hospital, London, United Kingdom, 2St Georges University Hospital, London, United Kingdom, 3Pulmonary Hypertension, St Georges University Hospital, London, United Kingdom.
Ryan K, Hall H, Mirza R, Barnes N, Shaw E, Madden AF, Madden BP.
Dept of Cardiothoracic Medicine, St Georges Hospital London.
Introduction
Cardiac involvement has important clinical, therapeutic and prognostic implications for non-cardiac transplant patients with multisystem diseases and is often associated with significant morbidity and mortality. Because of concerns regarding complications and lack of training in the technique of endomyocardial biopsy (EMB), the procedure is under-utilized when compared with biopsy of other organs. We wish to improve awareness of this important diagnostic modality amongst medical and nursing staff.
Method
Retrospective analysis of all patients who underwent EMB between December 2012-October 2017 was made. Procedure indications, histopathology results, complications and clinical outcome were reviewed. Three EMB were taken from the right ventricular septum via the right internal jugular vein under strict asepsis and 2D echocardiographic guidance in each patient. All patients had 2D echocardiography immediately after biopsy.
Results
79 patients aged 21-87 years of whom 68 were male, had EMB (table).
The most common indication was cardiac amyloidosis investigation (40 patients, 24 (60%) positive histology). 5 patients with respiratory disease had EMB to assess for associated cardiac involvement (4 positive; 1.lyme disease, 1.TB and amyloid, 2 sarcoid). 1 patient originally presented with eosinophilic pleural effusions and cardiac failure. EMB showed eosinophilic myocarditis. 10 patients had EMB for possible cardiac sarcoid and 4(40%) were positive. The median procedure time was 25 minutes. The only complication which occurred in one patient was ventricular tachycardia and was successfully cardioverted. When EMB were non diagnostic no change in therapeutic strategy was recommended.
Conclusion
Our experience shows that EMB in experienced hands is a safe, well tolerated and valuable addition to the management of selected patients with cardiothoracic pathology. It is hoped that further awareness and training in EMB will lead to an increase in its utilization.
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