RISK OF ENDOMYOCARDIAL BIOPSY IN IMMUNOSUPPRESSED PATIENTS AFTER CARDIAC TRANSPLANTATION

Objectives: Central venous puncture is required for endomyocardial bio psy to identify rejection after cardiac transplantation. We evaluated our use of the Seldinger technique to determine the safety of this inv asive method. Methods: In 42 immunosuppressed patients central venous puncture was performed after cardiac transplantation using the Selding er technique for right heart biopsy. Together with physical examinatio ns, chest X-ray and cardiac ultrasonography were performed during the inhospital follow-up. Outpatient follow-up continues and all reported adverse effects were evaluated by the attending cardiologist. Results: There were a total of 620 central venous punctures, most via the righ t internal jugular vein (77.9%). The planned puncture could not be per formed in 3.2% of the cases and an alternative site was used. The femo ral approach was associated with the longest radiation time. No severe adverse effects were observed and no complications (infection, large haematoma, pneumothorax, severe rhythm disorders) were recorded. Concl usion: Even in immunosuppressed patients frequently requiring central venous puncture, right heart endomyocardial biopsy can be safetly perf ormed to evaluate rejection.