Initial application of transradial left ventricular endomyocardial biopsy in diagnosis of cardiomyopathy

Abstract

Objective To make an initial assessment of safety, efficacy and clinical significance of the application of transradial left ventricular endomyocardial biopsy(EMB)in the diagnosis of cardiomyopathy. Methods We performed a prospective observational study of 5 patients from December 2017 to February 2018 in Beijing Hospital.Full baseline data, and data of safety and efficacy of all the patients were obtained. Results This study included 3 males and 2 females.Mean age was 42 years(range 28-62 years), and the mean BMI of 28.8 kg/m2.According to the clinical indication, the operations encompassed the left ventricular angiography, coronary artery angiography(CAG)and EMB etc.The operation success rate was 100 %(5 of 5).3 patients were performed operations including left ventricular angiography, CAG and EMB consequently by the same transradial approach, and 2 patients received CAG first and EMB several days later.The The operation time was 34-68 min and the median duration of the invasive evaluation was 54 min.The mean amount of contrast media used was 123.4 ml per patient, ranging from 95.4 to 150.2 ml.The number of biopsy samples harvested ranged from 4 to 6, and 4.4 samples were obtained per patient in average.All biopsy samples harvested where graded as good quality by the pathologists involved.Biopsy sample diagnostic success rate was 100%.Overall mean fluoroscopy time was 15.3 min ranging from 10 to 22 min.The median dose area product was 26 433 cGy·cm2(range 17 323-30 574 cGy·cm2), with a median skin dose of 2 495 mGy(range 1 392-3 088 mGy). Immediate post-procedural ambulation could be achieved and no complications were observed in all patients. Conclusions The present article demonstrates an initial result of safety and efficacy of transradial left ventricular endomyocardial biopsy, which provides a potentially safer and effective novel technique for diagnosis of cardiomyopathy, improving patient comfort and making surgery easier and economical. Key words: Biopsy, needle; Endocardium; Myocardium; Radial artery; Cardiomyopathies