Abstract
Endomyocardial biopsy is an essential procedure for the diagnosis and grading of rejection in heart transplant patients. Direct control of the bioptome positioning has classically been obtained by fluoroscopy. Starting in June 1988, at our institution an alternative approach involving the use of two-dimensional echocardiography was introduced in clinical practice. In 125 patients 1591 biopsies have been performed: 445 under echographic control and 1146 under fluoroscopic control with 3.6 and 4.5 samples/biopsy, respectively. The percentages of inadequate samples caused by biopsy site sampling were 0.4% and 1.3%, respectively, in the two groups. Cardiac perforation has occurred twice in the fluoroscopic group; it has not been observed in the echographic group. One case of iatrogenic tricuspid regurgitation was detected in each group. We now consider echocardiography the method of choice to guide the bioptome. We prefer it to fluoroscopy because it eliminates the risks of x-ray exposure, increases the number of sampling sites in case of echocardiographic evidence of rejection, can be easily performed as a bedside procedure, allows choice and variation of sampling sites, and permits monitoring of cardiac complications during and after the procedure. A randomized clinical trial is probably needed to assess with statistical significance the superiority of the echographic-controlled biopsy.
| Original language | English |
|---|---|
| Pages (from-to) | 538-542 |
| Number of pages | 5 |
| Journal | Journal of Heart Transplantation |
| Volume | 9 |
| Issue number | 5 |
| Publication status | Published - 1990 |
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ASJC Scopus subject areas
- Transplantation
Cite this
Echo-controlled endomyocardial biopsy. / Ragni, T.; Martinelli, L.; Goggi, C.; Speziali, G.; Rinaldi, M.; Roda, G.; Pederzolli, C.; Intili, P. A A; Raisaro, A.; Vigano, M.
In: Journal of Heart Transplantation, Vol. 9, No. 5, 1990, p. 538-542.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Echo-controlled endomyocardial biopsy
AU - Ragni, T.
AU - Martinelli, L.
AU - Goggi, C.
AU - Speziali, G.
AU - Rinaldi, M.
AU - Roda, G.
AU - Pederzolli, C.
AU - Intili, P. A A
AU - Raisaro, A.
AU - Vigano, M.
PY - 1990
Y1 - 1990
N2 - Endomyocardial biopsy is an essential procedure for the diagnosis and grading of rejection in heart transplant patients. Direct control of the bioptome positioning has classically been obtained by fluoroscopy. Starting in June 1988, at our institution an alternative approach involving the use of two-dimensional echocardiography was introduced in clinical practice. In 125 patients 1591 biopsies have been performed: 445 under echographic control and 1146 under fluoroscopic control with 3.6 and 4.5 samples/biopsy, respectively. The percentages of inadequate samples caused by biopsy site sampling were 0.4% and 1.3%, respectively, in the two groups. Cardiac perforation has occurred twice in the fluoroscopic group; it has not been observed in the echographic group. One case of iatrogenic tricuspid regurgitation was detected in each group. We now consider echocardiography the method of choice to guide the bioptome. We prefer it to fluoroscopy because it eliminates the risks of x-ray exposure, increases the number of sampling sites in case of echocardiographic evidence of rejection, can be easily performed as a bedside procedure, allows choice and variation of sampling sites, and permits monitoring of cardiac complications during and after the procedure. A randomized clinical trial is probably needed to assess with statistical significance the superiority of the echographic-controlled biopsy.
AB - Endomyocardial biopsy is an essential procedure for the diagnosis and grading of rejection in heart transplant patients. Direct control of the bioptome positioning has classically been obtained by fluoroscopy. Starting in June 1988, at our institution an alternative approach involving the use of two-dimensional echocardiography was introduced in clinical practice. In 125 patients 1591 biopsies have been performed: 445 under echographic control and 1146 under fluoroscopic control with 3.6 and 4.5 samples/biopsy, respectively. The percentages of inadequate samples caused by biopsy site sampling were 0.4% and 1.3%, respectively, in the two groups. Cardiac perforation has occurred twice in the fluoroscopic group; it has not been observed in the echographic group. One case of iatrogenic tricuspid regurgitation was detected in each group. We now consider echocardiography the method of choice to guide the bioptome. We prefer it to fluoroscopy because it eliminates the risks of x-ray exposure, increases the number of sampling sites in case of echocardiographic evidence of rejection, can be easily performed as a bedside procedure, allows choice and variation of sampling sites, and permits monitoring of cardiac complications during and after the procedure. A randomized clinical trial is probably needed to assess with statistical significance the superiority of the echographic-controlled biopsy.
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UR - http://www.scopus.com/inward/citedby.url?scp=0025123353&partnerID=8YFLogxK
M3 - Article
C2 - 2231092
AN - SCOPUS:0025123353
VL - 9
SP - 538
EP - 542
JO - Journal of Heart Transplantation
JF - Journal of Heart Transplantation
SN - 0887-2570
IS - 5
ER -