Complication Rate of Transfemoral Endomyocardial Biopsy with Fluoroscopic and Two-dimensional Echocardiographic Guidance: A 10-Year Experience of 228 Consecutive Procedures

• Published in: Journal of Korean medical science Vol. 28; no. 9; pp. 1323 - 1328
• Main Authors: Jang, Se Yong, Cho, Yongkeun, Song, Joon Hyuck, Cheon, Sang Soo, Park, Sun Hee, Bae, Myung Hwan, Lee, Jang Hoon, Yang, Dong Heon, Park, Hun Sik, Chae, Shung Chull
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.09.2013; 대한의학회
• Subjects: Adult; Biopsy - adverse effects; Cardiac Tamponade - etiology; Echocardiography - adverse effects; Endocardium - diagnostic imaging; Female; Fluoroscopy - adverse effects; Heart Diseases - pathology; Heart Ventricles - metabolism; Humans; Male; Middle Aged; Original; Pericardial Effusion - etiology; Tachycardia, Ventricular - etiology; Ventricular Function; 의학일반; Complication; Endomyocardial Biopsy
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2013.28.9.1323

Endomyocardial biopsy (EMB) is one of the reliable methods for the diagnosis of various cardiac diseases. However, EMB can cause various complications. The purpose of this study is to evaluate the complication of transfemoral EMB with both fluoroscopic and two-dimensional (2-D) echocardiographic guidance. A total of 228 patients (148 men; 46.0±14.6 yr-old) who underwent EMB at Kyungpook National University Hospital from January 2002 to June 2012 were included. EMB was performed via the right femoral approach with the guidance of both echocardiography and fluoroscopy. Overall, EMB-related complications occurred in 21 patients (9.2%) including one case (0.4%) with cardiac tamponade requiring emergent pericardiocentesis, four cases (1.8%) with small pericardial effusion without pericardiocentesis, two cases (0.9%) with hemodynamically unstable ventricular tachycardia (VT), one case (0.4%) with nonsustained VT, one case (0.4%) with tricuspid regurgitation, twelve cases (5.3%) with right bundle branch block. There was no occurrence of either EMB-related death or cardiac surgery. Left ventricular ejection fraction was significantly lower (32.0±18.7% vs 42.0±19.1%, P=0.023) and left ventricular end-diastolic dimension was larger (60.0±10.0 mm vs 54.2±10.2 mm, P=0.013) in patients with EMB related complications than in those without. It is concluded that transfemoral EMB with fluoroscopic and 2-D echocardiographic guidance is a safe procedure with low complication rate.