Trans-Septal Myocardial Biopsy in Hypertrophic Cardiomyopathy Using the Liwen Procedure: An Introduction of a Novel Technique

Author:

Han Chao12,Zhou Mengyao1,Hu Rui1,Wang Bo1,Zuo Lei1,Li Jing1,Ta Shengjun1,Hsi David H.3ORCID,Liu Jiani1,Wei Lichun2ORCID,Liu Liwen1ORCID

Affiliation:

1. Department of Ultrasound, Xijing Hypertrophic Cardiomyopathy Center, Xijing Hospital, Fourth Military Medical University, Xi’an, Shannxi, China

2. Department of Radiation Oncology, Xijing Hypertrophic Cardiomyopathy Center, Xijing Hospital, Fourth Military Medical University, Xi’an, Shannxi, China

3. Heart & Vascular Institute, Stamford Hospital, Stamford, CT, USA

Abstract

Objective. The purpose of this study was to evaluate the feasibility and safety of myocardial biopsy using a new approach, the Liwen procedure. Background. Myocardial biopsy is essential when other methods could not differentiate other etiologies from hypertrophic obstructive cardiomyopathy (HOCM). Our previous work using intramyocardial radiofrequency ablation for hypertrophic obstructive cardiomyopathy (Liwen procedure) may provide another approach to obtain the myocardial samples. Method. Seventeen patients with HOCM were enrolled for biopsies through percutaneously accessed intramyocardial septum and evaluated possible complications. Results. We obtained 31 specimens from 17 patients with a success rate of sample acquisition 100.0%. The number of myocardial samples taken per patient was 1.8 ± 0.8, and the average length of all samples was 16.7 ± 5.6 mm which could be used for pathological diagnosis. The complications included pericardial effusion with and without tamponade in one patient (5.9%), and no incidence of nonsustained and sustained ventricular tachycardia, conduction abnormity, perforation, stroke, and pneumothorax. The inhospital and 30-day mortality was 0%. Conclusion. This study has shown that myocardial biopsy of the Liwen procedure is relatively safe and technically feasible with adequate tissue sampling, which may help pathological diagnosis and further research of HOCM of diverse etiologies. This trial is registered with NCT04355260.

Funder

Disciplinary Boost Program of Xijing Hospital

Publisher

Hindawi Limited

Subject

Cardiology and Cardiovascular Medicine,Radiology Nuclear Medicine and imaging

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