Key result
ICE safely guides EMB for accurate histopathological diagnosis in 3 patients with RV masses.
Case Report (n=3)
No
ICE-guided endomyocardial biopsy is a safe and effective technique for the precise localization and histological diagnosis of right ventricular masses, potentially avoiding the need for open-chest diagnostic procedures.
ICE-guided EMB may safely aid cardiac mass diagnosis; leaves open need for prospective validation before wider use.
BACKGROUND: Based on a plenty of different applications, intracardiac echocardiography (ICE) is now a well-established technology in complex electrophysiological procedures. Recently, ICE has become the most widely used ultrasound-based imaging tool to guide diagnostic endomyocardial biopsy (EMB). EMB of cardiac mass guided by ICE is an interesting application of ICE. Allowing a correct positioning of the bioptome, ICE reduce the procedure-related risks and the need of a diagnostic open-chest procedure reserving the more invasive approach to selected cases. CASE PRESENTATION: Hereby we report a case series of right ventricular masses in which the EMB was safely and effectively performed under ICE guidance giving essential information for planning the therapeutic strategy. CONCLUSIONS: The diagnosis of both metastatic and primary cardiac tumors relies on the histopathological analyses. The endomyocardial biopsy is a valuable tool for preoperative diagnosis and surgical planning of intracardiac masses suspected for tumors. In our experience, the use of ICE for right ventricle EMB of an intracardiac mass is an attractive modality thanks to the precise localization of the cardiac structures and the ability to guide bioptic withdrawal in the target area.
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Zanobini et al. (2018) conducted a case report in Right ventricular intracardiac mass (n=3). Intracardiac echocardiography (ICE) guided endomyocardial biopsy was evaluated on Successful histopathological diagnosis and procedural safety. Intracardiac echocardiography safely and effectively guided endomyocardial biopsy in three patients with right ventricular masses, allowing for accurate histopathological diagnosis.
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