Percutaneous transcatheter biopsy for intracardiac mass diagnosis.

Authors:
Gautam Reddy
Gautam Reddy
University of Alabama at Birmingham
United States
Elad Maor
Elad Maor
Leviev Heart Center
Melanie C Bois
Melanie C Bois
Mayo Clinic
Dubai | United Arab Emirates
Charanjit S Rihal
Charanjit S Rihal
Mayo Clinic
Phoenix | United States
Rick A Nishimura
Rick A Nishimura
Mayo Clinic
United States
David R Holmes
David R Holmes
Mayo Clinic
Phoenix | United States
Guy S Reeder
Guy S Reeder
Mayo Clinic

EuroIntervention 2017 12 8;13(12):e1436-e1443. Epub 2017 Dec 8.

Mayo Clinic, Rochester, MN, USA.

Aims: The differential diagnosis of intracardiac masses (ICM) is wide. While imaging modalities can suggest a diagnosis, clinical decision making usually requires histopathologic diagnosis. The aim of this study was to describe the procedural technique, safety outcomes, diagnostic accuracy and clinical utility of percutaneous transcatheter biopsy (TCB) for histopathologic diagnosis of ICM. The records of all patients undergoing TCB of ICM at the Mayo Clinic catheterisation laboratories in Rochester, Minnesota, between 2002 and 2017 were retrieved and reviewed.

Methods And Results: TCB of ICM to establish histopathologic diagnosis was performed in 29 patients. Masses were located in the right-sided chambers in 93% of cases. Echocardiographic guidance was used. Ventricular arrhythmias requiring immediate cardioversion occurred in 7% of patients. No other complications were noted. The average number of samples retrieved per procedure was 7±3.6. A histopathologic diagnosis was made by TCB in 72% and altered clinical decision making in 52% of patients overall. Eleven patients (38%) who would otherwise have required excisional biopsy were able to avoid cardiovascular surgery. Each additional biopsy sample was associated with an increase in the likelihood of making a histopathologic diagnosis (OR 1.74, 95% CI: 1.05-2.87, p=0.032).

Conclusions: Echo-guided percutaneous TCB of ICM provides an accurate diagnosis and alters clinical management in the majority of cases. The procedural complication rate is low. An increase in the number of samples retrieved markedly improves the ability to render a diagnosis. TCB may therefore be considered as a first-line approach for the histopathologic diagnosis of ICM.

Download full-text PDF

Source
http://dx.doi.org/10.4244/EIJ-D-17-00707DOI Listing
December 2017
55 Reads

Article Mentions


Provided by Crossref Event Data
twitter
Twitter: McDamylouise
January 16, 2018, 4:52 am EST
twitter
Twitter: Doc_serg
January 11, 2018, 2:06 pm EST
twitter
Twitter: PCRonline
January 11, 2018, 9:33 am EST
twitter
Twitter: SeguraCardio
January 10, 2018, 4:32 pm EST
twitter
Twitter: Syllho
January 10, 2018, 11:54 am EST
twitter
Twitter: Chemaimagencv
January 10, 2018, 9:38 am EST
twitter
Twitter: Garconmiga
January 10, 2018, 6:19 am EST
twitter
Twitter: PCRonline
January 10, 2018, 6:03 am EST
twitter
Twitter: Sameergafoor
January 10, 2018, 4:05 am EST
twitter
Twitter: Farem
January 10, 2018, 2:32 am EST
twitter
Twitter: Fronimos1
January 10, 2018, 1:05 am EST
twitter
Twitter: Cardiotweets83
January 9, 2018, 9:01 pm EST
twitter
Twitter: Gopedernera
January 9, 2018, 8:37 pm EST
twitter
Twitter: Odremanr
January 9, 2018, 7:49 pm EST
twitter
Twitter: Wikimagen
January 9, 2018, 7:27 pm EST
twitter
Twitter: CGAM2016
January 9, 2018, 2:14 pm EST
twitter
Twitter: Odremanr
January 9, 2018, 11:35 am EST
twitter
Twitter: EuroInterventio
January 9, 2018, 11:15 am EST
twitter
Twitter: PCRonline
December 16, 2017, 6:33 am EST
twitter
Twitter: Barto2000
December 15, 2017, 5:40 pm EST
twitter
Twitter: Gopedernera
December 15, 2017, 11:30 am EST

Publication Analysis

Top Keywords

histopathologic diagnosis
24
tcb icm
12
diagnosis
11
number samples
8
samples retrieved
8
decision making
8
clinical decision
8
diagnosis icm
8
diagnosis tcb
8
transcatheter biopsy
8
percutaneous transcatheter
8
icm
6
tcb
6
histopathologic
6
patients
5
retrieved procedure
4
72% altered
4
altered clinical
4
patients 38%
4
38% required
4

Similar Publications