Endomyocardial biopsy | |
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Purpose | Surveillance of rejection following heart transplantation |
Endomyocardial biopsy (EMB) is an invasive procedure used routinely to obtain small samples of heart muscle, primarily for detecting rejection of a donor heart following heart transplantation. It is also used as a diagnostic tool in some heart diseases.[1]
A bioptome is used to gain access to the heart via a sheath inserted into the right internal jugular or less commonly the femoral vein.[1] Monitoring during the procedure consists of performing ECGs and blood pressures.[1] Guidance and confirmation of correct positioning of the bioptome is made by echocardiography or fluoroscopy.[1]
The risk of complications is less than 1% when performed by an experienced physician in a specialist centre.[1] Serious complications include perforation of the heart with pericardial tamponade, haemopericardium, AV block, tricuspid regurgitation and pneumothorax.[2]
EMB, sampling myocardium was first pioneered in Japan by S. Sakakibra and S. Konno in 1962.[1][3]