Craven C M, Allred T, Garry S L, Pickrell J, Buys S S
Department of Pathology, University of Utah, Salt Lake City 84132.
Arch Pathol Lab Med. 1990 Aug;114(8):836-9.
Three patients had perforation of the ventricular free wall and fatal cardiac tamponade following endocardial biopsy to evaluate congestive heart failure. The number of endocardial biopsies at this institution at the time of the third death was 2372, resulting in an overall mortality rate of 0.13%. Of the 2372 biopsies, 2136 (90%) were performed to evaluate cardiac graft rejection and 236 (10%) were performed for other reasons. All the patients who died belonged to the latter group. None of the cardiac transplant patients have had fatal ventricular perforation--a significant difference. At our institution, the frequency of mortality following endocardial biopsy in the noncardiac transplant patients is 1.3%. Patients who have ventricular endocardial biopsy of native hearts rather than transplanted hearts may be at increased risk for fatal perforation.
三名患者在接受心内膜活检以评估充血性心力衰竭后发生心室游离壁穿孔并导致致命性心脏压塞。在第三次死亡发生时，该机构的心内膜活检数量为2372例，总体死亡率为0.13%。在这2372例活检中，2136例（90%）是为评估心脏移植排斥反应而进行的，236例（10%）是因其他原因进行的。所有死亡患者均属于后一组。心脏移植患者中无一例发生致命性心室穿孔——这是一个显著差异。在我们机构，非心脏移植患者心内膜活检后的死亡率为1.3%。接受天然心脏而非移植心脏的心室内膜活检的患者可能发生致命穿孔的风险更高。
