Transradial left ventricular endomyocardial biopsy was non-inferior to transfemoral LV and RV biopsy, with an overall major complication rate of 1.5% and no significant differences between groups.
Cohort (n=514)
No
Does transradial left ventricular endomyocardial biopsy have a similar safety profile compared to transfemoral left or right ventricular biopsy in patients with heart failure of unknown etiology?
Transradial left ventricular endomyocardial biopsy is a safe alternative to transfemoral approaches, with a low overall major complication rate of 1.5% and no significant differences between access routes.
AIMS: With the present study, we sought to determine the safety of three different endomyocardial biopsy (EMB) access routes in 514 patients admitted for diagnostic workup of heart failure of unknown aetiology. METHODS AND RESULTS: In this retrospective monocentric cohort study, we analysed 514 consecutive patients with heart failure without evidence of significant coronary artery disease or valvular disease undergoing EMB between November 2013 and December 2018, stratified in three access route groups: transradial arterial left ventricular (LV-)EMB (323 patients), transfemoral LV-EMB (138 patients), and transfemoral right ventricular (RV-)EMB (53 patients). Patients undergoing selective transradial LV-EMB were older compared with patients undergoing selective transfemoral LV-EMB or RV-EMB transradial LV-EMB: 56.0 (45.0/64.0) vs. transfemoral LV-EMB: 53 (42.5/64.5), P = 0.455; transradial LV-EMB: 56 (45.0/64.0) vs. RV-EMB: 53 (42.5/64), P = 0.695 and presented more often in New York Heart Association-functional class III and IV. A total of eight major complications including permanent atrioventricular block requiring pacemaker implantation, pericardial tamponade necessitating pericardiocentesis, stroke and transient cerebral ischaemic attack as well as severe valvular damage, vascular access site complications, and ventricular fibrillation were documented with no significant differences between the groups (8/514, 1.5%). Minor complications such as transient chest pain, non-sustained electrocardiogram abnormalities, and transient atrioventricular block were rare and equally distributed between groups. CONCLUSIONS: Transradial LV-EMB is a safe procedure for experienced radial operators and non-inferior compared with transfemoral LV-EMB and RV-EMB. An accurate peri-procedural and post-procedural monitoring and follow-up care should be recommended for all patients undergoing this procedure in order to identify potential complications.
Göbel et al. (Sat,) conducted a cohort in Heart failure of unknown aetiology (n=514). Transradial left ventricular endomyocardial biopsy vs. Transfemoral left ventricular and right ventricular endomyocardial biopsy was evaluated on Major complications. Transradial left ventricular endomyocardial biopsy was non-inferior to transfemoral LV and RV biopsy, with an overall major complication rate of 1.5% and no significant differences between groups.
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