Deckers J W, Hare J M, Baughman K L
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
J Am Coll Cardiol. 1992 Jan;19(1):43-7. doi: 10.1016/0735-1097(92)90049-s.
To determine the incidence, nature and subsequent management of complications occurring during right ventricular endomyocardial biopsy in patients with cardiomyopathy, all events occurring during 546 procedures in 464 consecutive patients were prospectively recorded. The internal jugular vein was the primary site of introduction in 96% of cases. A total of 33 complications (6%) occurred: 15 (2.7%) during catheter insertion including 12 arterial punctures (2%), 2 vasovagal reactions (0.4%) and 1 episode of prolonged bleeding (0.2%), all without sequelae; 18 (3.3%) during biopsy included 6 arrhythmias (1.1%), 5 conduction abnormalities (1%), 4 possible perforations (0.7%) and 3 definite perforations (0.5%) (pericardial fluid). Two (0.4%) of the three patients with a perforation died. There was no secular trend in the complication rate, nor were complications associated with specific clinical or hemodynamic characteristics. It is concluded that the overall rate of endomyocardial biopsy complications (6%) is low, but mortality may occur.
为了确定心肌病患者右心室心内膜心肌活检过程中并发症的发生率、性质及后续处理情况，前瞻性记录了464例连续患者546次活检过程中发生的所有事件。96%的病例以颈内静脉作为主要穿刺部位。共发生33例并发症（6%）：导管插入过程中发生15例（2.7%），包括12例动脉穿刺（2%）、2例血管迷走神经反应（0.4%）和1例出血时间延长（0.2%），均无后遗症；活检过程中发生18例（3.3%），包括6例心律失常（1.1%）、5例传导异常（1%）、4例可能的穿孔（0.7%）和3例明确的穿孔（0.5%）（心包积液）。3例穿孔患者中有2例（0.4%）死亡。并发症发生率无长期趋势，并发症也与特定的临床或血流动力学特征无关。结论是，心内膜心肌活检并发症的总体发生率（6%）较低，但可能发生死亡。
