046 Safety of Endomyocardial Biopsy in Two Pediatric Non-Surgical Centers Using the New Atc Bioptome with Variable Flexibility

Abstract

BackgroundRight ventricular (RV) endomyocardial biopsy (EMB) is the “gold standard” for surveillance and acute detection of rejection following cardiac transplantation.Several bioptomes are in use. This study examined the safety of EMB in two pediatric non-surgical cardiac centers using the new Sparrowhawk bioptome with variable flexibility (ATC Technologies, Woburn, MA, USA).MethodsHealth records of all the EMB performed in two non-surgical Pediatric Cardiology Centers were reviewed: Variety Children's Heart Center, Winnipeg MB, and The Alberta Children's Hospital, Calgary AB. From October 2005 to January 2011, 79 RV EMB were performed in 33 children. The main indication for biopsy was routine surveillance for rejection following heart transplantation (n = 30) and the rest as part of cardiomyopathy work-up (n = 3). All procedures were performed under general anesthesia using custom pre-shaped guiding sheaths. The median age of the patients was 8 years (0.25-18 years) and median weight 22 kg (4.4-72.3Kg). Ten procedures were performed on children under 1 year of age. Femoral vein (FV) approach was used in most of our cases and internal jugular vein in bilateral FV occlusion. Four to five EMB specimens were obtained at each session, suitable for pathological examination.ResultsThere was no death, vascular damage or anesthetic complication. Only a small pericardial effusion in a 12 months old baby occured after the last biopsy. This complication did not require further intervention and it occurred during our early experience. There was no mechanical malfunction of the bioptome.ConclusionWe conclude that the EMB by using the new Sparrowhawk bioptome is safe in the infants & children and can be performed in cardiac non-surgical centers. BackgroundRight ventricular (RV) endomyocardial biopsy (EMB) is the “gold standard” for surveillance and acute detection of rejection following cardiac transplantation.Several bioptomes are in use. This study examined the safety of EMB in two pediatric non-surgical cardiac centers using the new Sparrowhawk bioptome with variable flexibility (ATC Technologies, Woburn, MA, USA). Right ventricular (RV) endomyocardial biopsy (EMB) is the “gold standard” for surveillance and acute detection of rejection following cardiac transplantation. Several bioptomes are in use. This study examined the safety of EMB in two pediatric non-surgical cardiac centers using the new Sparrowhawk bioptome with variable flexibility (ATC Technologies, Woburn, MA, USA). MethodsHealth records of all the EMB performed in two non-surgical Pediatric Cardiology Centers were reviewed: Variety Children's Heart Center, Winnipeg MB, and The Alberta Children's Hospital, Calgary AB. From October 2005 to January 2011, 79 RV EMB were performed in 33 children. The main indication for biopsy was routine surveillance for rejection following heart transplantation (n = 30) and the rest as part of cardiomyopathy work-up (n = 3). All procedures were performed under general anesthesia using custom pre-shaped guiding sheaths. The median age of the patients was 8 years (0.25-18 years) and median weight 22 kg (4.4-72.3Kg). Ten procedures were performed on children under 1 year of age. Femoral vein (FV) approach was used in most of our cases and internal jugular vein in bilateral FV occlusion. Four to five EMB specimens were obtained at each session, suitable for pathological examination. Health records of all the EMB performed in two non-surgical Pediatric Cardiology Centers were reviewed: Variety Children's Heart Center, Winnipeg MB, and The Alberta Children's Hospital, Calgary AB. From October 2005 to January 2011, 79 RV EMB were performed in 33 children. The main indication for biopsy was routine surveillance for rejection following heart transplantation (n = 30) and the rest as part of cardiomyopathy work-up (n = 3). All procedures were performed under general anesthesia using custom pre-shaped guiding sheaths. The median age of the patients was 8 years (0.25-18 years) and median weight 22 kg (4.4-72.3Kg). Ten procedures were performed on children under 1 year of age. Femoral vein (FV) approach was used in most of our cases and internal jugular vein in bilateral FV occlusion. Four to five EMB specimens were obtained at each session, suitable for pathological examination. ResultsThere was no death, vascular damage or anesthetic complication. Only a small pericardial effusion in a 12 months old baby occured after the last biopsy. This complication did not require further intervention and it occurred during our early experience. There was no mechanical malfunction of the bioptome. There was no death, vascular damage or anesthetic complication. Only a small pericardial effusion in a 12 months old baby occured after the last biopsy. This complication did not require further intervention and it occurred during our early experience. There was no mechanical malfunction of the bioptome. ConclusionWe conclude that the EMB by using the new Sparrowhawk bioptome is safe in the infants & children and can be performed in cardiac non-surgical centers. We conclude that the EMB by using the new Sparrowhawk bioptome is safe in the infants & children and can be performed in cardiac non-surgical centers.