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Utility of screening echocardiogram after endomyocardial biopsy for identification of cardiac perforation or tricuspid valve injury
Author(s) -
Peng David M.,
Kipps Alaina K.,
Palmon Michal,
Tacy Theresa A.,
Peng Lynn F.,
Hollander Seth A.,
McElhinney Doff B.
Publication year - 2018
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13275
Subject(s) - medicine , transesophageal echocardiogram , pericardiocentesis , transthoracic echocardiogram , hemopericardium , pericardial effusion , complication , perforation , surgery , cardiac tamponade , tricuspid valve , incidence (geometry) , cardiology , radiology , punching , materials science , physics , optics , metallurgy
Per protocol, our institution obtains echocardiograms immediately after each EMB to rule out procedural complication. We sought to determine the incidence of echocardiogram‐detected cardiac perforation and TV injury and to evaluate the utility of routine screening echocardiogram after each EMB in the current era. At a single center, 99% (1917/1942) EMB performed in 162 patients were immediately followed by an echocardiogram per protocol. There were five newly diagnosed pericardial effusions, and only one required pericardiocentesis. In the three echocardiograms demonstrating new flail TV, only one patient underwent surgical repair 2 months later. This study demonstrates the very low incidence of significant hemopericardium and TV injury after EMB in pediatric heart transplant recipients and argues against the utility of post‐EMB echocardiograms to screen solely for procedural complications.