Morphological evaluation of endomyocardial biopsy.
Endomyocardial biopsy (EMB) has evolved as a simple and safe procedure with minimal morbidity and mortality. It is performed via the transvascular approach and can be done either as an individual procedure or, more commonly, at the time of routine cardiac catheterization. Sequential biopsies can be performed without ill-effects. Conventionally, the right ventricle is biopsied through the transvenous approach. It has been shown that biopsies from the right side are adequately representative if the disease is biventricular. The left ventricle can be biopsied in disease states affecting that chamber, viz. left ventricular tumour or predominant involvement of the left ventricle in endomyocardial fibrosis. For proper evaluation, biopsy pieces need to be handled and processed carefully. A large amount of valuable information can be retrieved from routinely processed tissue-a process which can be done in all laboratories. Important indications for EMB include diagnosis and monitoring of cardiac allograft rejection, adriamycin toxicity and diagnosis and follow up of myocarditis. Pathologists need to be aware of inherent artefacts of the biopsy procedure and should interpret these with caution. Thus, EMB provides useful information for diagnosis, follow up, monitoring of therapy and studying the evolution of several cardiac disorders.
Chopra
P
P
Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Talwar
K K
KK
D001706:Biopsy / Q000009:adverse effects; D006801:Humans; D009206:Myocardium / Q000473:pathology*