Vázquez de Prada J A
Servicio de Cardiología, Hospital Marqués de Valdecilla, Santander.
Rev Esp Cardiol. 1995;48 Suppl 7:86-91.
Endomyocardial biopsy is still considered the most reliable means for the detection of acute cardiac rejection after heart transplantation. However, this technique has several limitations that might not have been sufficiently underscored. In this review, some of the limitations of endomyocardial biopsy are discussed. In order to overcome these problems, the possibility of using this technique in a more selective and oriented manner is suggested. A combined approach is proposed, using serial echocardiographic studies to monitor rejection episodes and to selectively indicate the need for endomyocardial biopsy. In this way, the total number of biopsies might be reduced along with a more individualized therapy for the rejection episodes. The experience with this new approach in the Heart Transplantation Program of the Hospital Universitario Marqués de Valdecilla, Santander, Spain, is presented.
心内膜心肌活检仍被认为是检测心脏移植后急性心脏排斥反应最可靠的方法。然而，这项技术存在一些局限性，可能尚未得到充分强调。在本综述中，将讨论心内膜心肌活检的一些局限性。为了克服这些问题，建议以更具选择性和针对性的方式使用该技术。提出了一种联合方法，即使用系列超声心动图研究来监测排斥反应发作，并选择性地表明心内膜心肌活检的必要性。通过这种方式，活检总数可能会减少，同时对排斥反应发作进行更个体化的治疗。本文介绍了西班牙桑坦德瓦尔迪西利亚侯爵大学医院心脏移植项目中这种新方法的经验。
