Biopsia endomiocárdica por vía venosa braquial.Descripción de la técnica y experiencia en 12 años de 2 centros

  1. María Tamargo 2
  2. Enrique Gutiérrez Ibañes 2
  3. Juan Francisco Oteo Domínguez 1
  4. Felipe Díez 2
  5. Ebrey León Aliz 1
  6. Ricardo Sanz Ruiz 2
  7. Francisco José Hernández Pérez 1
  8. María Eugenia Vázquez Alvarez 2
  9. Javier Segovia Cubero 1
  10. Allan Rivera Juárez 2
  11. Eduardo Zatarain 2
  12. Javier Goicolea Ruigómez 1
  13. Javier Soriano Triguero 2
  14. E. Pérez Pereira 1
  15. Jorge García Carreño 2
  16. Arturo García Touchard 1
  17. Lilian Grigorian Shamagian 2
  18. José Antonio Fernández Díaz 1
  19. Jaime Elízaga Corrales 2
  20. Luis Alonso Pulpón Rivera 1
  21. F. Fernández Avilés 2
  1. 1 Departamento de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
  2. 2 Departamento de Cardiología Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Instituto de Salud Carlos III, Madrid, España
Journal:
REC: Interventional Cardiology

ISSN: 2604-7276,  2604-7306

Year of publication: 2020

Volume: 2

Issue: 4

Pages: 264-271

Type: Article

DOI: 10.24875/RECIC.M20000107 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

More publications in: REC: Interventional Cardiology

Sustainable development goals

Abstract

ABSTRACT Introduction and objectives: Recipients of a heart transplant need to receive serial endomyocardial biopsies (EMB) to discard rejection, a procedure that is usually performed through the femoral or jugular vein. Over the last few years, we have developed a technique to perform EMBs using the brachial venous access that we have implemented as the preferential access route. In this article, we describe the technique and the initial clinical experience of 2 different centers. Methods: Between 2004 and 2016, we developed and implemented a brachial venous access technique. We registered the main clinical and procedural variables of all the brachial biopsies performed in both centers and compared them with a retrospective series of femoral and jugular procedures. Results: Brachial EMBs were successfully performed 544 of the time with no major complications. The number of brachial procedures per patient rose from 1 to 14. Over the same period of time 1054 femoral and 686 jugular procedures were performed. The total procedural time was similar with different access routes (mean for brachial/femoral/jugular access: 28/26/29 min., P = .31) while fluoroscopy time was shorter in jugular procedures (mean 5/5/3 min. respectively; P < .001). The brachial procedure was recalled as the least painful procedure of all compared to the jugular or femoral ones (2/8/9 score on a scale from 1 to 10; P = .001) with an overall patient preference towards the brachial access. Conclusions: The venous brachial access route is a good alternative to the central venous one to perform EMBs and is the route of choice in our centers. Also, it has high feasibility and safety and brings additional comfort to patients.

Bibliographic References

  • 1. Cooper LT, Baughman KL, Feldman AM, et al. The role of endomyocardial biopsy in the management of cardiovascular disease:A Scientific Statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology Endorsed by the Heart Failure Society of America and the Heart Failure Association of the European Society of Cardiology. Eur Heart J. 2007;28:3076-3093.
  • 2. AM, Maleszewski JJ, Rihal CS. Current Status of Endomyocardial Biopsy. Mayo Clin Proc. 2011;86:1095-1102.
  • 3. Kern MJ. Endomyocardial biopsy in cardiac transplant recipients using the femoral venous approach. Am J Cardiol. 1991;67(4):324.
  • 4. Esplugas E, Jara F, Sabaté X, et al. Right ventricular endomyocardial biopsy. Description of the percutaneous femoral vein technic. Rev Esp Cardiol. 1987;40:410-414.
  • 5. Schäufele TG, Spittler R, Karagianni A, et al. Transradial left ventricular endomyocardial biopsy:assessment of safety and efficacy. Clin Res Cardiol. 2015;104:773-781.
  • 6. García-Izquierdo Jaén E, Oteo Domínguez JF, Jiménez Blanco M, et al. Diagnostic yield and safety profile of endomyocardial biopsy in the nontransplant setting at a Spanish referral center.REC:interventional cardiology. REC Interv Cardiol. 2019;2:99-107.
  • 7. Practice Guidelines for Central Venous Access:A Report by the American Society of Anesthesiologists Task Force on Central Venous Access. Anesthesiology. 2012;116:539-573.
  • 8. Harwani N, Chukwu E, Alvarez M, Thohan V. Comparison of Brachial Vein Versus Internal Jugular Vein Approach for Access to the Right Side of the Heart With or Without Myocardial Biopsy. Am J Cardiol. 2015;116:740-743.
  • 9. Bielsa I, España J, Perez Quesada J, Pacheco A. Biopsia cardiaca y cateterismo derecho a través de la vena basílica. Metas Enf. 2006;9:22-26.
  • 10. D'Amario D, Burzotta F, Leone AM, et al. Feasibility and Safety of Right and Left Heart Catheterization Via an Antecubital Fossa Vein and the Radial Artery in Patients With Heart Failure. J Inv Cardiol. 2017;29:301-308.
  • 11. Imamura T, Kinugawa K, Nitta D, et al. Is the Internal Jugular Vein ornFemoral Vein a Better Approach Site for Endomyocardial Biopsy in Heart Transplant Recipients?Int Heart J. 2015;56:67-72.
  • 12. Yang C-H, Guo GB-F, Yip H-K, et al. Bilateral Cardiac Catheterizations. Int Heart J. 2006;47:21-27.
  • 13. Speiser B, Pearson K, Xie H, Shroff AR, Vidovich MI. Compared to femoral venous access, upper extremity right heart catheterization reduces time to ambulation:A single center experience:Arm Access for RHC and Ambulation Times. Catheter Cardiovasc Int. 2017;89:658-664.
  • 14. Bennett MK, Gilotra NA, Harrington C, et al. Evaluation of the Role of Endomyocardial Biopsy in 851 Patients With Unexplained Heart Failure From 2000-2009. Circ:Heart Failure. 2013;6:676-684.
Data source: Dialnet