Long Sheaths for Endomyocardial Biopsy via Femoral Approach

Background Endomyocardial biopsy has long been a useful tool to evaluate myocardial diseases. It is a gold standard in diagnosing cardiac rejection and certain types of myocarditis, but there is always a risk for related complications. We have assessed the safety and feasibility of applying long sheaths in endomyocardial biopsy via the femoral approach. Methods We performed endomyocardial biopsy in 63 patients via the femoral approach and used a long sheath to guide bioptome from the venous access to the interventricular septum and evaluate the procedure success and complications. Results Success rate (acceptable endomyocardial specimen) was 96%, and there were no complications (death, no death, urgent cardiac surgery, advanced cardiac life support, hemothorax, and pneumothorax). Conclusions Using long sheaths for the femoral approach seems to be safe and feasible; it confers an acceptable room to grab the endomyocardial samples while obviating the possibility of complications.