Heart biopsy: Uses and risks

Heart biopsy or myocardial biopsy is a procedure during which the doctor takes a piece of the heart muscle tissue. The tissue is then sent to a laboratory for analysis.

It is preformed with the bioptome, a device which has jaws on the tip, used for obtaining small pieces of the heart muscle tissue.

USES

It is used to watch for signs of rejection, after heart transplant surgery. However, it can also be used to diagnose:

  • Inflammation of the heart muscle (Myocarditis)
  • Different types of cardiomyopathy
  • Cardiac amyloidosis

RISKS

Since myocardial biopsy is an invasive procedure, there is some risk involved:

  • Bleeding from the biopsy site (minor bleeding is to be expected)
  • Blood clots or infection
  • Cardiac arrhythmias
  • Collection of the air between the lung and the chest wall
  • Injury to the nerve, vein or artery
  • Tricuspid valve malfunction
  • Rupture of the heart (very unlikely)

HOW TO PREPARE FOR HEART BIOPSY

You shouldn't eat or drink anything for 6-8 hours before the test. However, you should consult with your doctor, regarding the medication and supplements you take or allergies you may have that can affect the test. Jewelry and non essential items is best to leave at home.

Bring someone with you to drive you home, after the test, since you may be groggy due to sedatives. Although you will be received to the hospital, usually in the morning at the day of the test, in some cases, you may be required to come the night before.

WHAT TO EXPECT DURING HEART BIOPSY

After you change into a hospital gown and lie on a special table, face pointing toward ceiling, where large camera and TV monitors should be placed, you will be given a sedative through the intravenous (IV) line in your arm. The sedative will help you relax but you will be awake during the test.

The doctor will use local anesthetic to numb the area, where he will preform the small incision through which plastic introducer sheath is inserted. Incision is usually done on the veins in the neck. Plastic introducer sheath serves as a doorway for catheter and a bioptome which is used to obtain samples of the heart muscle.

Special X-ray's are used to position the bioptome while obtaining small amounts of the heart tissue. Although the procedure last from 30 to 60 minutes, preparation and especially the recovery add several hours since the area where the sheath was inserted may bleed, after it has been removed.

WHAT TO EXPECT AFTER HEART BIOPSY

After the test is finished, you will be free to go home. The doctor which has done the procedure will explain you how to take care of the wound, when can you expect it to heal as well as when will you be able to return to your regular activities.

Results of the test are sent to your doctor which will discuss about them with you.





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