Practical aspects of endomyocardial left ventricular biopsy – own experience

Introduction
Left ventricular endomyocardial biopsy (LV-EMB) is the only procedure that allows a direct assessment of the left ventricular myocardium, thus enabling the diagnosis of myocarditis or other myocardial diseases.

Aim
To describe the characteristics of a population that underwent LV-EMB, as well as to address the periprocedural and technical aspects of the LV-EMB.

Material and methods
Since its initiation in our center in 2016, a total of 43 patients have undergone LV-EMB. In the manuscript, the indications for LV-EMB and the detailed technical aspects of its safe performance, including the equipment used, are described. A large part of the text is also devoted to the possible complications of LV-EMB.

Results
The results of the initial population that underwent LV-EMB in our center are presented. The patients who were qualified for LV-EMB were predominantly male (85.7%), with a mean age of 38.8 years. Of those, 38 (88.3%) had acute heart failure. The mean left ventricular ejection fraction was 19.6%. The primary indications for LV-EMB were unexplained heart failure with a left ventricular ejection fraction < 35% and (1) hemodynamic abnormalities or electrical instability of the heart and/or (2) recent worsening of heart failure (NYHA class II, III, or IV) with no response to standard therapy for 2 weeks. The mean fluoroscopy time was 5.4 min, and the mean radiation dose was 87 mGy. No periprocedural complications were found.

Conclusions
The results of the analysis indicate that LV-EMB can be performed safely by skilled physicians in an experienced center.