Abstract 16814: Procedural Time in Echocardiogram versus Fluoroscopic Guided Endomyocardial Biopsies: Debunking the Myth

Autor: Geoffrey T. Jao, Barbara A. Pisani, Mahesh Chandrasekhar, Thomas J. O’Neill, Diego Malaver
Rok vydání: 2020
Předmět:
Zdroj: Circulation. 142
ISSN: 1524-4539
0009-7322
Popis: Introduction: Fluoroscopic-guided endomyocardial biopsy (FGEB) of the right ventricle is the most common method for rejection surveillance among heart transplant recipients. Echocardiogram guided endomyocardial biopsy (EGEB) has been shown to be a safe alternative, but not widely adopted, in part due to perceived longer procedural time. Hypothesis: EGEB is has comparable total procedural and biopsy time compared to FGEB and significantly lowers radiation exposure. Methods: A single center retrospective study was performed on patients who underwent biopsy via right internal jugular vein approach from 1/1/15 to 2/1/19. Biopsy time was time of bioptome insertion to sheath removal. Total procedure time was from physician entrance to exit into procedure lab. Results: 100, patients, 487 biopsies. The mean biopsy time of EGEB was similar to FGEB; 30.0 ± 10.2 min (95% CI: 27.9-32.1 min) to 29.7 ± 9.91 min (95% CI: 28.7 - 30.7 min) respectively, p = 0.73. The mean total procedural time of the EGEB was similar to FGEB; 70.3 ± 18.9 min (95% CI: 34-125 min) to 73.4 ± 18.5 min (95% CI: 21 - 129 min), p = 0.102. Mean fluoroscopy time for EGEB was lower than FGEB; 1.78 min (95% CI: 1.4-2.2 min) vs 5.53 min (95% CI: 5.22-5.83 min) p < 0.0001. A mixed model analysis of mean fluoroscopy time was performed to account for the same patients receiving multiple endomyocardial biopsies, sometimes by different guidance, showed a difference of 1.89 mins less with EGEB than FGEB (p < 0.0001). Conclusions: EGEB has similar biopsy and total procedural time but significantly reduced fluoroscopy time. EGEB should be routinely considered in patients for endomyocardial biopsy.
Databáze: OpenAIRE
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