Rentabilidad diagnóstica y seguridad de la biopsia endomiocárdica en corazón nativo en un centro español de referencia

  1. Eusebio García-Izquierdo Jaén 1
  2. Juan F. Oteo Domínguez 1
  3. Marta Jiménez Blanco 1
  4. Cristina Aguilera Agudo 1
  5. Fernando Domínguez Rodríguez 1
  6. Jorge Toquero Ramos 1
  7. Javier Segovia Cubero 1
  8. Clara Salas Antón 2
  9. Arturo García Touchard 1
  10. José Antonio Fernández Díaz 1
  11. Rodrigo Estévez Loureiro 1
  12. Javier Goicolea Ruigómez 1
  13. Luis Alonso Pulpón Rivera 1
  1. 1 Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
  2. 2 Servicio de Anatomía Patológica, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
Journal:
REC: Interventional Cardiology

ISSN: 2604-7276,  2604-7306

Year of publication: 2019

Volume: 1

Issue: 2

Pages: 99-107

Type: Article

DOI: 10.24875/RECIC.M19000027 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

More publications in: REC: Interventional Cardiology

Sustainable development goals

Abstract

Introduction and objectives: Endomyocardial biopsy (EMB) is an established diagnostic tool in myocardial disease. However, this technique may carry major complications. We present the diagnostic and safety results of our experience in EMB in the non-transplant setting. We also present the results after the implementation of a technical and safety protocol developed at our center. Methods: We retrospectively analyzed the data of all EMBs conducted in non-transplant patients from September 2004 through July 2018. We compared the diagnostic yield and rate of major complications of EMB in two different periods: before and after implementing the protocol. Results: We included 204 EMBs performed in 190 patients. The most frequent indications were the evaluation of ventricular dysfunction or suspected myocarditis (51.5%) and the evaluation of restrictive cardiomyopathy or suspected infiltrative disease (44.6%). One hundred and seventy-two EMBs were performed in the right cardiac chambers (84.3%) and 30 EMBs in the left cardiac chambers (14.7%). The samples were taken from both ventricles on 2 cases only. Definite diagnosis was reached in 52% of the cases. After the implementation of the protocol, the diagnostic yield significantly improved (42.5% vs 58.1%; P = .030) and the rate of major complications decreased (from 7.5% to 3.2%; P = .167), with a statistically significant lower rate of cardiac perforation (6.3% vs 0.8%; P = .025). Conclusions: The EMB is a diagnostic tool with a great potential in patients with suspected cardiomyopathy. Our experience shows that a technical and safety protocol can help decrease the rate of complications and improve the diagnostic yield of EMB.

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