Superior accuracy of anatomic positioning with echocardiographic‐ over fluoroscopic‐guided endomyocardial biopsy

Bell, Calvin; Kern, Morton J.; Aguirre, Frank V.; Donohue, Thomas J.; Bach, Richard G.; Wolford, Thomas; Penick, Danny; Ofili, Elizabeth; Miller, Leslie A.; Labovitz, Arthur J.; Anthonis, Dennis; Vrain, Jan St.

doi:10.1002/ccd.1810280405

Cited by 14 publications

(4 citation statements)

References 7 publications

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“…In small animals and man, endomyocardial biopsy is generally guided by fluoroscopy, as this provides accurate information about the course of the forceps and the biopsy site . In contrast, other studies in human medicine revealed greater accuracy of bioptome positioning and greater tissue sample sizes with an echocardiography‐guided technique . A comparative study in grizzly bears demonstrated that forceps positioning by fluoroscopy often does not correspond to the location by echocardiography .…”

Section: Discussionmentioning

confidence: 91%

Right atrial and right ventricular ultrasound‐guided biopsy technique in standing horses

Decloedt

Clercq

Ven

et al. 2015

Equine Veterinary Journal

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Endomyocardial biopsy of the right atrium and right ventricle could be performed in standing horses using a percutaneous approach through the jugular vein and was not associated with complications other than temporary arrhythmias. This technique may be useful for research purposes or as a diagnostic tool, although further research is needed to establish the safety of the technique in clinical patients with myocardial disease.

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Section: Discussionmentioning

confidence: 91%

Right atrial and right ventricular ultrasound‐guided biopsy technique in standing horses

Decloedt

Clercq

Ven

et al. 2015

Equine Veterinary Journal

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“…Depending upon the test needed from the biopsy sample obtained, greater tissue volume may provide better samples for muscle mechanical studies and histopathologic evaluation. Comparisons in humans have also revealed increased accuracy of bioptome positioning and greater tissue sample sizes with the echo‐guided technique 10–12 …”

Section: Discussionmentioning

confidence: 99%

Comparison of Echocardiography‐guided and Fluoroscopy‐guided Endomyocardial Biopsy Techniques

Nelson

Robbins

2005

Vet Radiology Ultrasound

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The accuracy of bioptome placement for endomyocardial biopsy was evaluated using standard fluoroscopic guidance and compared simultaneously with two-dimensional echocardiography in six healthy subadult grizzly bears (Ursus arctos horribilis). Despite perceived adequate positioning of the bioptome toward the septum when judged using fluoroscopy, only one out of the six placements were actually positioned in the right ventricular apex toward the septum when evaluated using two-dimensional echocardiography. The bioptome was readily relocated to the right ventricular apex/septal location by echocardiography. The forceps were easily visualized at all times and the open cups were readily directed into the desired location for biopsy. Based on a subjective score for tissue quantity from 1 to 4 (poor to excellent), biopsies collected by echocardiographic-guided technique had a mean score of 3.4, while biopsies collected by fluoroscopic-guided technique had a mean score of 1.8. In summary, this study suggests that endomyocardial biopsy locations can be accurately positioned using two-dimensional echocardiography with the advantages of less radiation, lower procedural costs, and direct visualization of the sampling site. Clear definition of endocardial surface as afforded by echocardiography may enhance tissue sample quality and lower potential complications from this procedure.

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“…Echocardiography is increasingly being adopted in this context because of several advantages: it avoids repeated X-ray exposure and may be performed at patients’ bedside when required. Echocardiographic monitoring permits adequately following the movement of the catheter in the RV and selecting the site of the biopsy, usually the apical segment of the right side of the interventricular septum [ 98 , 99 ]. It also affords the possibility of avoiding damage to the tricuspid valve, chordae and papillary muscles and promptly identifying the occurrence of complications like pericardial effusion [ 24 , 99 , 100 ].…”

Section: Echocardiography During Endomyocardial Biopsymentioning

confidence: 99%

A Comprehensive Excursus of the Roles of Echocardiography in Heart Transplantation Follow-Up

Bacich,

Tessari,

Ciccarelli

et al. 2024

JCM

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Current guidelines for the care of heart transplantation recipients recommend routine endomyocardial biopsy and invasive coronary angiography as the cornerstones in the surveillance for acute rejection (AR) and coronary allograft vasculopathy (CAV). Non-invasive tools, including coronary computed tomography angiography and cardiac magnetic resonance, have been introduced into guidelines without roles of their own as gold standards. These techniques also carry the risk of contrast-related kidney injury. There is a need to explore non-invasive approaches providing valuable information while minimizing risks and allowing their application independently of patient comorbidities. Echocardiographic examination can be performed at bedside, serially repeated, and does not carry the burden of contrast-related kidney injury and procedure-related risk. It provides comprehensive assessment of cardiac morphology and function. Advanced echocardiography techniques, including Doppler tissue imaging and strain imaging, may be sensitive tools for the detection of minor myocardial dysfunction, thus providing insight into early detection of AR and CAV. Stress echocardiography may offer a valuable tool in the detection of CAV, while the assessment of coronary flow reserve can unravel coronary microvascular impairment and add prognostic value to conventional stress echocardiography. The review highlights the role of Doppler echocardiography in heart transplantation follow-up, weighting advantages and limitations of the different techniques.

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Superior accuracy of anatomic positioning with echocardiographic‐ over fluoroscopic‐guided endomyocardial biopsy

Cited by 14 publications

References 7 publications

Right atrial and right ventricular ultrasound‐guided biopsy technique in standing horses

Right atrial and right ventricular ultrasound‐guided biopsy technique in standing horses

Comparison of Echocardiography‐guided and Fluoroscopy‐guided Endomyocardial Biopsy Techniques

A Comprehensive Excursus of the Roles of Echocardiography in Heart Transplantation Follow-Up

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