Shaddy R E, Bullock E A
Department of Pediatrics, University of Utah, Salt Lake City.
Pediatr Cardiol. 1993 Jan;14(1):5-8. doi: 10.1007/BF00794836.
Indications for endomyocardial biopsy (EMB) in pediatric patients include cardiomyopathy and postheart transplant rejection surveillance. There have been few reports of the use of the internal jugular venous approach for right ventricular EMB in pediatric patients. In this study, we report our experience with 100 consecutive EMBs in pediatric patients using this approach. Indications for EMB were cardiomyopathy of unknown etiology in four patients, adriamycin cardiomyopathy in three patients, postheart transplant rejection surveillance in five patients, right ventricular outflow tract tumors in one patient, and sustained ventricular tachycardia in one patient. Histologic diagnoses of biopsy specimens included interstitial fibrosis, vasculopathy, hypertrophy, anthracycline cardiotoxicity, and various degrees of allograft rejection. All EMBs were performed successfully and without complications. We conclude that right ventricular EMB using the right internal jugular venous approach can be performed safely and successfully in pediatric patients as young as 2 months of age and repeatedly in patients as young as 8 years old.
小儿心内膜心肌活检（EMB）的适应证包括心肌病和心脏移植术后排斥反应监测。关于小儿患者采用颈内静脉途径进行右心室EMB的报道很少。在本研究中，我们报告了连续100例采用该方法进行小儿EMB的经验。EMB的适应证包括4例病因不明的心肌病、3例阿霉素心肌病、5例心脏移植术后排斥反应监测、1例右心室流出道肿瘤和1例持续性室性心动过速。活检标本的组织学诊断包括间质纤维化、血管病变、肥大、蒽环类药物心脏毒性以及不同程度的同种异体移植排斥反应。所有EMB均成功完成且无并发症。我们得出结论，采用右颈内静脉途径进行右心室EMB在2个月大的小儿患者中可安全、成功地进行，在8岁的小儿患者中可重复进行。
