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Heart and Vessels

, Volume 34, Issue 5, pp 793–800 | Cite as

Impact of vascular access site on procedural time of endomyocardial biopsy

  • Kentaro Mukai
  • Yusuke Nakano
  • Tomofumi Mizuno
  • Toru Niwa
  • Hirokazu Wakabayashi
  • Akihiro Suzuki
  • Atsushi Watanabe
  • Hirohiko Ando
  • Kenta Murotani
  • Katsuhisa WasedaEmail author
  • Tetsuya Amano
Original Article
  • 54 Downloads

Abstract

Endomyocardial biopsy (EMB) is widely used for the diagnosis of unexplained ventricular dysfunction and for assessment of cardiac allograft rejection. But, the impact of vascular access site on procedural time of EMB is not well-known. From February 2014 to May 2016, consecutive patients requiring EMB were prospectively enrolled in this study. Vascular access, by either the jugular or femoral vein, was randomly assigned. EMB was randomly performed by 3 pre-identified physicians based on practical experience in EMB. Each case was required to obtain at least 3 samples. The primary endpoint was to compare the total time spent in acquiring EMB from the right ventricular septum between the jugular and femoral vein access groups. The secondary endpoints were evaluation of each set (1st to 3rd attempt) of EMB times and safety. In addition, factors affecting the EMB procedural times were evaluated. A total of 49 consecutive patients requiring EMB (3.9 attempts/patient) were enrolled (the jugular group: 23, the femoral group: 26), and 156 myocardial samples (3.2 samples/patient) were obtained. There were no significant differences in total biopsy procedural time between the 2 groups (16.3 ± 7.4 vs. 20.8 ± 9.9 min, p = 0.075). Independent predictors for longer procedural time of the 1st attempt included femoral access, non-expert operators, and larger right atrium according to multiple linear regression analysis. The complication rates were not significantly different between the 2 groups, except for catheter kinking as a technical factor. Total biopsy time was not significantly different between the jugular and femoral venous access groups. However, the 1st attempt EMB procedural time by non-expert operators was longer when using the femoral approach, especially in cases involving a larger right atrium diameter.

Keywords

Endomyocardial biopsy Access site Time Jugular Femoral 

Notes

Acknowledgements

The authors thank Heidi N. Bonneau, RN, MS, CCA, for her review of this manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

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Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  • Kentaro Mukai
    • 1
  • Yusuke Nakano
    • 1
  • Tomofumi Mizuno
    • 1
  • Toru Niwa
    • 1
  • Hirokazu Wakabayashi
    • 1
  • Akihiro Suzuki
    • 1
  • Atsushi Watanabe
    • 1
  • Hirohiko Ando
    • 1
  • Kenta Murotani
    • 2
  • Katsuhisa Waseda
    • 1
    • 3
    Email author
  • Tetsuya Amano
    • 1
  1. 1.Department of CardiologyAichi Medical UniversityNagakuteJapan
  2. 2.Division of Biostatistics, Clinical Research CenterAichi Medical UniversityNagakuteJapan
  3. 3.Medical Education CenterAichi Medical UniversityNagakuteJapan

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