TY - JOUR
T1 - Is the internal jugular vein or femoral vein a better approach site for endomyocardial biopsy in heart transplant recipients?
AU - Imamura, Teruhiko
AU - Kinugawa, Koichiro
AU - Nitta, Daisuke
AU - Fujino, Takeo
AU - Inaba, Toshiro
AU - Maki, Hisataka
AU - Hatano, Masaru
AU - Kinoshita, Osamu
AU - Nawata, Kan
AU - Yao, Atsushi
AU - Kyo, Shunei
AU - Ono, Minoru
N1 - Publisher Copyright:
© 2015, International Heart Journal Association. All rights reserved.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2015
Y1 - 2015
N2 - Scheduled serial endomyocardial biopsies are executed by an internal jugular vein (IJV) or femoral vein (FV) approach to survey acute rejection after heart transplantation (HTx). However, a better approach site is needed. A total of 379 sessions consisting of 329 IJV approaches and 50 FV approaches in 48 HTx recipients executed at 75 ±127 days (4-1182 days) after HTx between September 2007 and April 2014 at University of Tokyo Hospital were retrospectively analyzed. The IJV approach had shorter operation and radiation exposure times, and a lower dose of radiation exposure and lower usage of contrast agents than the FV approach (all P < 0.001). There were no fatal complications requiring surgical management or resulting in death during all sessions. The IJV approach had less complications than the FV approach (2.7% versus 10.0%, P = 0.011). Among the complications, atrial tachyarrhythmia occurred only with the IJV approach (0.9%), whereas transient ventricular tachyarrhythmia and bundle branch block were more frequently observed in the FV approach (8.0% versus 0.9%, P = 0.042). In conclusion, endomyocardial biopsy from the IJV approach was safer and less invasive than that of the FV approach if we only consider the incidence of atrial tachyarrhythmia.
AB - Scheduled serial endomyocardial biopsies are executed by an internal jugular vein (IJV) or femoral vein (FV) approach to survey acute rejection after heart transplantation (HTx). However, a better approach site is needed. A total of 379 sessions consisting of 329 IJV approaches and 50 FV approaches in 48 HTx recipients executed at 75 ±127 days (4-1182 days) after HTx between September 2007 and April 2014 at University of Tokyo Hospital were retrospectively analyzed. The IJV approach had shorter operation and radiation exposure times, and a lower dose of radiation exposure and lower usage of contrast agents than the FV approach (all P < 0.001). There were no fatal complications requiring surgical management or resulting in death during all sessions. The IJV approach had less complications than the FV approach (2.7% versus 10.0%, P = 0.011). Among the complications, atrial tachyarrhythmia occurred only with the IJV approach (0.9%), whereas transient ventricular tachyarrhythmia and bundle branch block were more frequently observed in the FV approach (8.0% versus 0.9%, P = 0.042). In conclusion, endomyocardial biopsy from the IJV approach was safer and less invasive than that of the FV approach if we only consider the incidence of atrial tachyarrhythmia.
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U2 - 10.1536/ihj.14-156
DO - 10.1536/ihj.14-156
M3 - Article
C2 - 25503653
AN - SCOPUS:84921853683
VL - 56
SP - 67
EP - 72
JO - International Heart Journal
JF - International Heart Journal
SN - 1349-2365
IS - 1
ER -