What is the clinical evidence from this study?

Study design: Observational. Population: Cardiac pathologies requiring endomyocardial biopsy (n=90). Intervention: 2-D echocardiography guided transfemoral right ventricular endomyocardial biopsy. Primary outcome: Major complication rate.

What does this research mean for the field?

Two-dimensional echocardiography-guided transfemoral right ventricular endomyocardial biopsy is a relatively safe procedure, resulting in an overall major complication rate of 5.6% with no procedure-related mortality. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2006Open Access

Complications of 2-D Echocardiography Guided Transfemoral Right Ventricular Endomyocardial Biopsy

Key Result

Two-dimensional echocardiography guided transfemoral right ventricular endomyocardial biopsy resulted in an overall major complication rate of 5.6% with no procedure-related mortality.

Study Design

Type

Observational (n=90)

Multicenter

Structured PICO

Population

90 consecutive patients undergoing 2-D echocardiography guided transfemoral right ventricular endomyocardial biopsy. Mean age 42±13 years, 60 male. Clinical diagnoses included arrhythmogenic right ventricular dysplasia (n=54), dilated cardiomyopathy (n=19), Brugada syndrome (n=9), myocarditis (n=6), hypertrophic cardiomyopathy (n=1), and exercise-induced ventricular tachycardia (n=1).

Intervention

2-D echocardiography guided transfemoral right ventricular endomyocardial biopsy (EMBx)

Outcome

Incidence, nature, and subsequent management of major complications related to EMBx (categorized as complications related to venous cannulation, abnormalities of the heart rhythm, conduction abnormalities, and mechanical damage to the heart structures)safety

2-D echocardiography guided transfemoral right ventricular endomyocardial biopsy is a relatively safe procedure with a 5.6% major complication rate and no procedure-related mortality.

Limitations

Single center study
Sample size may not have been large enough to assess the risk of perforation according to the specific type of cardiac pathology

Abstract

Endomyocardial biopsy (EMBx) is a useful tool for diagnosing various cardiac pathologies. However, the routine use of EMBx has not gained widespread acceptance due to the possible complications related to the EMBx. Thus, not much information is available on the complications related to the EMBx. We prospectively evaluated 90 consecutive patients who underwent 2-D echocardiography guided transfemoral right ventricular EMBx at Kyungpook National University Hospital between March 2002 and November 2005 to determine the incidence, nature and subsequent management of complications related to EMBx. The clinical diagnoses before the EMBx were arrhythmogenic right ventricular dysplasia in 54, dilated cardiomyopathy in 19, Brugada syndrome in 9, myocarditis in 6 and miscellaneous in 2 patients. The overall major complication rate was 5.6% and no procedure-related mortality occurred. Myocardial perforation (n=3), which was the most frequent complication, did not progress to cardiac tamponade requiring pericardiocentesis in any patient. Hemodynamically unstable ventricular tachycardia occurred in 1 patient. New and persistent right bundle branch block occurred in another. Our findings suggest that 2-D echocardiography guided transfemoral right ventricular EMBx is a relatively safe procedure.

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