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Endomyocardial Biopsy

Published byRafe Adrian Dorsey Modified over 9 years ago

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Presentation on theme: "Endomyocardial Biopsy"— Presentation transcript:

1 Endomyocardial Biopsy
2009 Pediatric and Congenital/Structural Fellows Course Endomyocardial Biopsy Thomas K. Jones, MD Professor, Pediatrics and Medicine University of Washington School of Medicine Director, Cardiac Catheterization Laboratories Seattle Children’s Hospital

2 Disclosures None related to this presentation
2009 Pediatric and Congenital/Structural Fellows Course Disclosures None related to this presentation

3 Indications Evaluation of Cardiomyopathy
Myocarditis Anthracycline cardiotoxicity Unexplained myocardial hypertrophy Storage diseases Mitochondrial disorders Cardiac Tumors Unexplained arrhythmias Monitoring Allograft Rejection

4 How To Femoral vs. jugular venous approach Importance of long sheath
Bioptome size Number of samples Location for sampling Imaging

5 How to Meticulous care in positioning sheath, first opening then advancing jaws, gentle counterforce with sheath when withdrawing bioptome Do not close then reopen jaws inside body

6 Tampa Bay Guiding Catheter
Useful for femoral approach 8 F short sheath 6 F guide Introduced into RV with balloon wedge catheter Not a Tampa Bay Catheter Canedo M. Tampa bay catheter: A new guiding catheter for endomyocardial biopsy via femoral approach. Cath Cardiovasc Diag 1992;25:71-75

7 Adverse events Safety of endomyocardial biopsy in children
Cowley CG, et al. Cardiol Young 2003;13: Complications of endomyocardial biopsy in children Pophal SG, et al. J Am Coll Cardiol 1999;34:

8 Adverse events Bophal paper Cowley paper 1987-1996 1986-2002
1000 procedures in 194 patients IJ approach (57%) 64 < 1yr 85% rejection surv. 1.9% SAE (9 perfs) One death (from perf) Increased risk in younger patients, myocarditis and FV approach Cowley paper 1051 procedures in 135 patients IJ approach 68% 48 < 1yr 92% rejection surv. 1% SAE (no perfs) No deaths Increased risk in younger patients

9 Thanks A special ‘Thumbs-Up” to Ziyad

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