Endomyocardial Biopsy Technique

Abstract

Endomyocardial biopsy is now an established technique for obtaining samples of myocardium, including endocardium, from patients with suspected primary or secondary myocardial disease. The wider application of catheter biopsy has resulted from the development of newer forms of bioptome [1, 5, 13, 18] and since multiple samples can be taken with reasonable ease and safety, this technique has now displaced other forms of heart biopsy. Prior to the development of the catheter biopsy forceps, percutaneous techniques using a variety of specially adapted needles [2, 19] and even exploratory mediastinotomy and thoracotomy [12] were occasionally employed. The first development of the catheter biotome and the description of the technique of use was by Konno in 1962 [17]. Subsequently further reports of its use were made [6, 7, 8] but some limitations were encountered with the original Konno bioptome [14] and modified forms of instrument were described [13a]. The introduction of a smaller diameter of biotome facilitated percutaneous introduction into either a vein or artery allowing right and left ventricular biopsy to be performed [4, 14a, 15] either separately or at the same time.