Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 30.
doi: 10.1002/ccd.70064. Online ahead of print.

Feasibility and Safety of a Three-Dimensional Sheath for Right Ventricular Septal Endomyocardial Biopsy

Francesco Notaristefano  1 , Francesco Catania  2 , Marco Del Papa  2 , Manuel Freschini  1 , Giovanni Russo  2 , Alberto Barengo  3 , Matteo D'Ammando  1 , Salvatore Notaristefano  1 , Stefano Sforna  1 , Monica De Gaspari  4 , Stefania Rizzo  4 , Gianluca Zingarini  1 , Paolo Verdecchia  1 , Claudio Cavallini  1 , Cristina Basso  4 , Erberto Carluccio  2 , Rocco Sclafani  1
Affiliations

Feasibility and Safety of a Three-Dimensional Sheath for Right Ventricular Septal Endomyocardial Biopsy

Francesco Notaristefano et al. Catheter Cardiovasc Interv. .

Abstract

Background: Endomyocardial biopsy (EMB) is a complementary invasive procedure for the diagnosis of several cardiac diseases. New technical developments are needed to increase the safety of the procedure even in low-volume centers.

Methods: We retrospectively enrolled patients who underwent EMB in our institution, which is a non-heart transplant tertiary care center. Patients were divided into two groups according to the use of a standard long sheath (S-T) or a three-dimensional sheath (3D-T). The latter was originally designed for conduction system pacing.

Results: There were 30 patients in the S-T group and 16 in the 3D-T group. Patients in the 3D-T group were older (65 ± 19 vs. 52 ± 20, p = 0.049) and more likely to have ischaemic heart disease (25% vs. 0%, p = 0.011). Indications for EMB were similar in both groups except for a higher proportion of amyloidosis in the 3D-T group (56% vs. 17%, p = 0.005). The total number of collected samples (10 ± 2 vs. 11 ± 3), their dimensions (1.3 ± 0.6 mm x 1 ± 0.3 mm vs. 1.7 ± 0.6 mm x 1.2 ± 0.4 mm) and the proportion of specimens meeting the quality standard to be analyzed (76% ± 26% vs. 83% ± 25%) didn't differ between 3D-T and S-T (all p = ns). Pericardial effusion or cardiac tamponade was more frequent in the S-T group compared to the 3D-T group (23% vs. 0%, p = 0.078). There were five cardiac tamponades in the S-T group and none in the 3D-T group.

Conclusion: The use of a 3D sheath for EMB of the right ventricular septum was feasible and safe with similar diagnostic accuracy compared to the standard long sheath technique.

PubMed Disclaimer

References

    1. O. Leone, J. P. Veinot, A. Angelini, et al., “2011 Consensus Statement on Endomyocardial Biopsy From the Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology,” Cardiovascular Pathology 21 (2012): 245–274.
    1. C. Basso, “Ultrastructural Evidence of Intercalated Disc Remodelling in Arrhythmogenic Right Ventricular Cardiomyopathy: An Electron Microscopy Investigation on Endomyocardial Biopsies,” European Heart Journal 27 (August 2006): 1847–1854.
    1. T. Isogai, H. Yasunaga, H. Matsui, et al., “Hospital Volume and Cardiac Complications of Endomyocardial Biopsy: A Retrospective Cohort Study of 9508 Adult Patients Using a Nationwide Inpatient Database in Japan,” Clinical Cardiology 38 (March 2015): 164–170.
    1. C. Chimenti and A. Frustaci, “Contribution and Risks of Left Ventricular Endomyocardial Biopsy in Patients With Cardiomyopathies: A Retrospective Study over a 28‐year Period,” Circulation 128 (October 2013): 1531–1541.
    1. R. Bagur, O. F. Bertrand, P. Béliveau, et al., “Feasibility of Using a Sheathless Guiding Catheter for Left Ventricular Endomyocardial Biopsy Performed by Transradial Approach,” The Journal of Invasive Cardiology 26 (2014): 161–163.

LinkOut - more resources