J Korean Med Sci.  2013 Sep;28(9):1323-1328. 10.3346/jkms.2013.28.9.1323.

Complication Rate of Transfemoral Endomyocardial Biopsy with Fluoroscopic and Two-dimensional Echocardiographic Guidance: A 10-Year Experience of 228 Consecutive Procedures

• Jang SY
• Cho Y
• Song JH
• Cheon SS
• Park SH
• Bae MH
• Lee JH
• Yang DH
• Park HS
• Chae SC

• KMID: 1793047
• DOI: http://doi.org/10.3346/jkms.2013.28.9.1323

Abstract

Endomyocardial biopsy (EMB) is one of the reliable methods for the diagnosis of various cardiac diseases. However, EMB can cause various complications. The purpose of this study is to evaluate the complication of transfemoral EMB with both fluoroscopic and two-dimensional (2-D) echocardiographic guidance. A total of 228 patients (148 men; 46.0+/-14.6 yr-old) who underwent EMB at Kyungpook National University Hospital from January 2002 to June 2012 were included. EMB was performed via the right femoral approach with the guidance of both echocardiography and fluoroscopy. Overall, EMB-related complications occurred in 21 patients (9.2%) including one case (0.4%) with cardiac tamponade requiring emergent pericardiocentesis, four cases (1.8%) with small pericardial effusion without pericardiocentesis, two cases (0.9%) with hemodynamically unstable ventricular tachycardia (VT), one case (0.4%) with nonsustained VT, one case (0.4%) with tricuspid regurgitation, twelve cases (5.3%) with right bundle branch block. There was no occurrence of either EMB-related death or cardiac surgery. Left ventricular ejection fraction was significantly lower (32.0+/-18.7% vs 42.0+/-19.1%, P=0.023) and left ventricular end-diastolic dimension was larger (60.0+/-10.0 mm vs 54.2+/-10.2 mm, P=0.013) in patients with EMB related complications than in those without. It is concluded that transfemoral EMB with fluoroscopic and 2-D echocardiographic guidance is a safe procedure with low complication rate.

Keyword

Endomyocardial Biopsy; Complication

MeSH Terms

Adult
Biopsy/*adverse effects
Cardiac Tamponade/etiology
Echocardiography/*adverse effects
Endocardium/*ultrasonography
Female
Fluoroscopy/*adverse effects
Heart Diseases/*pathology
Heart Ventricles/metabolism
Humans
Male
Middle Aged
Pericardial Effusion/etiology
Tachycardia, Ventricular/etiology
Ventricular Function

Figure

• 

  Fig. 1 Overall complication rate of endomyocardial biopsy according to etiology.

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