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Left ventricle transradial endomyocardial biopsy: initial experience of a tertiary center
Session:
Sessão de Comunicações Orais - Doenças do Miocárdio
Speaker:
Tiago Graça Rodrigues
Congress:
CPC 2020
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.3 Myocardial Disease – Diagnostic Methods
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Tiago Graça Rodrigues; Miguel Nobre Menezes; Rafael Santos; Nelson P. Cunha; Afonso Nunes Ferreira; Joana Rigueira; Inês Aguiar Ricardo; Pedro Silvério António; Pedro Morais; Sara Couto Pereira; Fausto José Pinto; Pedro Canas Da Silva
Abstract
<p><strong>Introduction and objectives</strong>: over the last decade, several studies have suggested that left ventricle endomyocardial biopsy is safer and has a higher diagnostic yield that transvenous right ventricle biopsy. In addition, recent publications suggest the transradial approach is a feasible and safe alternative to the transfemoral approach, for sampling the left ventricle. We aim to report our initial experience with transradial endomyocardial biopsy with regards to feasibility, safety and usefulness.</p> <p> </p> <p><strong>Methods</strong>: Single center registry of consecutive patients undergoing intended transradial left endomyocardial biopsy. Clinical and technical data were prospectively collected, with a particular focus on success rate and complications.</p> <p> </p> <p><strong>Results</strong>: Thirty-four (34) patients were screened for left ventricle biopsy. Thirty-two (32) were selected for intended transradial approach (mean age 52 ± 18 years old, 26 male). Success rate was 100% with no crossover to femoral approach (28 right radial artery and 4 left radial artery). There were no major complications. Two patients experienced mild radial spasm. Two of them also had a run of non-sustained ventricular tachycardia.</p> <p>The indication for the biopsy was either myocarditis or cardiomyopathy of unknown etiology. The final diagnosis was acute lymphocytic myocarditis in 6 patients, chronic myocarditis in 1 patient, AL amyloidosis in 7 patients and ATTR amyloidosis in 10 patients. Myocarditis was ruled out in 8 patients and amyloidosis in 1 patient. The last patient samples are still undergoing histopathology analysis.</p> <p> </p> <p><strong>Conclusions</strong>: transradial left ventricle endomyocardial biopsy is a very safe and feasible method of sampling myocardium for histopathological analysis, with a good diagnostic yield and clinically meaningful results in well selected patients.</p>
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