Tyler Zaccharie, Guttmann Oliver P, Savvatis Konstantinos, Jones Daniel, O'Mahony Constantinos
St Bartholomew's Hospital London, UK.
UCL Centre for Heart Muscle Disease, Institute of Cardiovascular Science, University College London London, UK.
Interv Cardiol. 2021 Oct 18;16:e29. doi: 10.15420/icr.2021.20. eCollection 2021 Apr.
Left ventricular endomyocardial biopsy (EMB) is an essential tool in the management of myocarditis and is conventionally performed via transfemoral access (TFA). Transradial access EMB (TRA-EMB) is a novel alternative and the authors sought to determine its safety and feasibility by conducting a systematic review of the literature. Medline was searched in 2020, and cohort demographics, procedural details and complications were extracted from selected studies. Four observational studies with a combined total of 496 procedures were included. TRA-EMB was most frequently performed with a sheathless MP1 guide catheter via the right radial artery. The most common complication was pericardial effusion (up to 11% in one study), but pericardial drainage for tamponade was rare (one reported case). Death and mitral valve damage have not been reported. TRA-EMB was successful in obtaining samples in 99% of reported procedures. The authors concluded that TRA-EMB is a safe and feasible alternative to TFA-EMB and the most common complication is uncomplicated pericardial effusion.
左心室心内膜心肌活检（EMB）是心肌炎治疗中的一项重要手段，传统上通过经股动脉途径（TFA）进行。经桡动脉途径心内膜心肌活检（TRA-EMB）是一种新的替代方法，作者试图通过对文献进行系统评价来确定其安全性和可行性。2020年检索了Medline，并从选定的研究中提取了队列人口统计学、操作细节和并发症信息。纳入了四项观察性研究，共计496例操作。TRA-EMB最常通过无鞘MP1引导导管经右桡动脉进行。最常见的并发症是心包积液（一项研究中发生率高达11%），但因心包填塞进行心包引流的情况很少见（有一例报告）。未报告死亡和二尖瓣损伤情况。在99%的报告操作中，TRA-EMB成功获取了样本。作者得出结论，TRA-EMB是TFA-EMB的一种安全可行的替代方法，最常见的并发症是无并发症的心包积液。
