A new technique for endomyocardial biopsy in infants and small children.
Endomyocardial biopsy (EMB) is usually performed from the femoral veins in infants and small children. This requires the use of a long vascular sheath to direct a bioptome to the ventricular septum. We describe a technique of EMB in this population that obviates the need for the use of a long vascular sheath. A 5 Fr 0.038" internal diameter, no-sideholes Cobra catheter (Cook, Bloomington, IN) introduced via a 5 Fr short sheath was used to direct a 3 Fr, 60-cm-length Cook bioptome to the ventricular septum. From January 1998 to August 1999, this technique was used 22 times in seven patients for EMB (median, age 13 months; range, 1-72 months). Indications for EMB in this group were posttransplantation surveillance (21 times) and evaluation for cardiomyopathy/myocarditis (1). Median number of EMB specimens obtained per procedure was 6 (range, 5-9). There was one pneumopericardium seen post-EMB with this technique without hemodynamic embarrassment. EMB in infants and small children can be performed successfully, safely, and repeatedly from the femoral veins without the need for a long sheath.
Pediatric Interventional Cardiology Service, Division of Pediatric Cardiology, Babies and Children's Hospital of New York, New York Presbyterian Hospital, Columbia University, New York, NY 10032, USA. pediheart@aol.com
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D001706:Biopsy / Q000295:instrumentation*; D006328:Cardiac Catheterization; D009202:Cardiomyopathies / Q000473:pathology* / Q000601:surgery; D002675:Child, Preschool; D004867:Equipment Design; D004869:Equipment Safety; D016027:Heart Transplantation / Q000473:pathology; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009206:Myocardium / Q000473:pathology*; D012189:Retrospective Studies