The results of left ventricular endomyocardial biopsy by means of a long sheath technique in 154 patients are reported. The risks of left ventricular biopsy are those of left heart catheterisation. In 30 of these patients the results of left and right ventricular biopsy were compared, and in further 10 patients the right ventricle only was biopsied. Biopsy from the left ventricle carries less risk of cardiac perforation, gives a higher incidence of successful biopsy, and with the exception of hypertrophic obstructive cardiomyopathy yields more diagnostic information.

We describe two patients with Starr-Edwards mitral valve replacements who underwent pregnancy on oral anticoagulants and who were successfully delivered of live babies. The literature on pregnancy with prosthetic heart valves is reviewed. It is suggested that properly controlled oral anticoagulation should be continued until the onset of labour; the anticoagulant effect should then be reversed by an intravenous infusion of fresh-frozen plasma and the patient maintained on intravenous heparin injections six-hourly. Oral anticoagulants should be restarted immediately after delivery and the heparin withdrawn only when their effect has been re-established.