title: Echo-guided endomyocardial biopsy in heart transplant recipients.
abstract: After heart transplantation the effect of immunosuppression is monitored by histopathology of endomyocardial biopsy (EMB). EMB is usually carried out under X-ray guidance. Between January 1998 and March 2003, 1,262 biopsies were collected under echo-guidance in 156 patients. The biopsy access was gained through the internal jugular vein, by the standard catheterization technique. The average time of the procedure was 17 min. Four or five specimens were obtained from each patient, with a success rate of 96%. Complications involved two episodes of partial pneumothorax in one patient, atrial flutter in another and ventricular fibrillation in three patients. Conversion from echo to X-ray guidance was indicated in 11 patients. No case of significant tricuspid regurgitation related to the EMB procedure was recorded. The echo-guided endomyocardial biopsy appears to be a prospective alternative to the conventional approach under X-ray guidance. Its duration is comparable, it eliminates X-ray exposure, enables continuous echocardiographic monitoring and can be performed at the bedside.
authors.affiliation: Centre of Cardiovascular and Transplant Surgery, Pekarska 52, 656 91 Brno, Czech Republic. helena.bedanova@cktch.cz
authors.forename: Helena
authors.initials: H
authors.lastname: Bedanova
authors.forename: Josef
authors.initials: J
authors.lastname: Necas
authors.forename: Erik
authors.initials: E
authors.lastname: Petrikovits
authors.forename: Petr
authors.initials: P
authors.lastname: Pokorny
authors.forename: Sylva
authors.initials: S
authors.lastname: Kovalova
authors.forename: Petr
authors.initials: P
authors.lastname: Malik
authors.forename: Jiri
authors.initials: J
authors.lastname: Ondrasek
authors.forename: Jan
authors.initials: J
authors.lastname: Cerny
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001282:Atrial Flutter / Q000209:etiology; D001706:Biopsy / Q000009:adverse effects / Q000379:methods; D004452:Echocardiography / Q000592:standards; D004699:Endocardium / Q000473:pathology*; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology; D011182:Postoperative Care; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000592:standards; D014693:Ventricular Fibrillation / Q000209:etiology