Comparative Analysis of the Complications of 5347 Endomyocardial Biopsies Applied to Patients After Heart Transplantation and With Cardiomyopathies: A Single-center Study

Fiorelli, Alfredo Inácio; Benvenuti, Luiz Alberto; Aielo, V.; Coelho, Augusto Quaresma; Palazzo, J.F.; Rossener, Rebecca; Barreto, Alessandra Costa; Mady, Charles; Bacal, Fernando; Bocchi, E.A.; Stolf, Noedir Antônio Groppo

doi:10.1016/j.transproceed.2012.07.023

Cited by 21 publications

(22 citation statements)

References 22 publications

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“…Reported complications of EMB include pneumothorax, hemothorax, ventricular perforation, arrhythmia, coronary fistulae, and tricuspid valve regurgitation . These risks are magnified in smaller patients , supporting minimization of EMB use in the infant population. In addition to these risks, frequent EMB increases patient stress, which could negatively impact quality of life .…”

Section: Discussionmentioning

confidence: 99%

Variation in the use of surveillance endomyocardial biopsy among pediatric heart transplant centers over time

Godown

Harris

Burger

et al. 2015

Pediatric Transplantation

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EMB is widely utilized for graft surveillance after HTx; however, there is significant variation in the frequency of surveillance EMB use during the first year post-HTx. The aim of this study was to assess changes in the utilization of surveillance EMB over time among member institutions of PHTS. A survey of PHTS centers assessing the frequency of surveillance EMB use during the first year post-HTx was conducted in 2006. The same survey was repeated in 2014 to assess changes in practice over time. The number of EMB in infants ranged from 0 to 9 and in adolescents 0 to 16. The number of EMB decreased or remained unchanged in the majority of centers. Fewer EMB are performed in infants compared to adolescents and this practice did not change over time. There was a significant decrease in surveillance EMB use in adolescents (p = 0.012). International centers perform significantly fewer EMB in adolescents when compared to centers within the United States (p = 0.006). There continues to be significant variation in the utilization of surveillance EMB, with a shift toward less reliance on EMB for adolescents in the current era. Further research is necessary to determine the optimal frequency of invasive monitoring that reduces costs without compromising outcomes.

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Section: Discussionmentioning

confidence: 99%

Variation in the use of surveillance endomyocardial biopsy among pediatric heart transplant centers over time

Godown

Harris

Burger

et al. 2015

Pediatric Transplantation

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“…Due to the accumulation of a large number of cases to date, globally diagnosis can be made in the same way according to these diagnostic criteria, and reflected in treatment . EMB is a rather invasive modality compared to other tests such as echocardiography and MRI . However, it is still the most important examination, being the ‘gold standard’ to monitor acute rejection .…”

Section: Discussionmentioning

confidence: 99%

“…19 EMB is a rather invasive modality compared to other tests such as echocardiography and MRI. 20 However, it is still the most important examination, being the 'gold standard' to monitor acute rejection. 21 In our study population, 23 patients (46%) experienced mild and moderate ACR, and three patients (6%) had AMR within the first year.…”

Section: Discussionmentioning

confidence: 99%

The pathological implications of heart transplantation: Experience with 50 cases in a single center

Ishibashi‐Ueda

Ikeda

Matsuyama

et al. 2014

Pathology International

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Heart transplantation started in Japan in 1999. Since then, 50 transplants have been performed at our center. We performed histopathological analyses of the 50 explanted hearts and the post-transplant biopsy specimens. The median age of recipients was 39 years. The primary diseases before transplant were idiopathic dilated cardiomyopathy in 33 patients (66%), hypertrophic cardiomyopathy in seven (14%), restrictive cardiomyopathy in one, arrhythmogenic right ventricular cardiomyopathy in one, and secondary cardiomyopathy in eight (16%). Before transplantation, 47 patients (94%) had left ventricular assist devices. No severe cardiovascular failure due to allograft rejection occurred. The post-transplant survival rate was 97.6% at 1 year and 93.1% at 10 years. One recipient was lost to sepsis from myelodysplastic syndrome in the fourth year, one died of multiple organ failure and peritonitis 8 months after transplant. Another patient died of recurrent posttransplant lymphoproliferative disorders (PTLD). Mild cardiac dysfunction occurred in seven recipients in the early postoperative period. Moderate acute cellular rejection occurred in six patients (12%), and antibody-mediated rejection occurred in three (6%). The number of heart transplants performed in Japan is very small. However, the outstanding 10-year survival rate is due to donor evaluation and posttransplant care resulting in low grade rejection. Pathological evaluation has also greatly contributed to the results.

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“…The right ventricular access is widely accepted and has a low incidence of complications. The mortality ranges between 0% and 0.4% [3]. In combination with left heart catheterization, left heart biopsy appears reasonable.…”

Section: Discussionmentioning

confidence: 99%

“…Percutaneous transvenous EMB from the right ventricle remains the gold standard. However, it is an invasive procedure with potential morbidity of ventricular perforation, pneumothorax, and tricuspid valve injury [3]. In combination with coronary catheterization for detection of allograft vasculopathy, left heart biopsy appears as a reasonable procedure.…”

Section: Introductionmentioning

confidence: 99%

Mitral Valve Regurgitation: A Severe Complication following Left Ventricular Biopsy 15 Years after Heart Transplantation

Vollroth

Kiefer

Garbade

et al. 2013

Case Reports in Transplantation

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A 71-year-old male patient underwent orthotopic heart transplantation in 1995. Due to left heart catheterization 15 years later, biopsy from the left ventricular apex was performed for rejection screening. Two days later, echocardiography revealed severe mitral valve regurgitation requiring mitral valve replacement. This is a very rare case showing that left heart biopsy may lead to severe hemodynamic complications with the need for surgical intervention.

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Comparative Analysis of the Complications of 5347 Endomyocardial Biopsies Applied to Patients After Heart Transplantation and With Cardiomyopathies: A Single-center Study

Cited by 21 publications

References 22 publications

Variation in the use of surveillance endomyocardial biopsy among pediatric heart transplant centers over time

Variation in the use of surveillance endomyocardial biopsy among pediatric heart transplant centers over time

The pathological implications of heart transplantation: Experience with 50 cases in a single center

Mitral Valve Regurgitation: A Severe Complication following Left Ventricular Biopsy 15 Years after Heart Transplantation

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