Physician Radiation Exposure During Endomyocardial Biopsy and Right Heart Catheterization

Loyaga‐Rendon, Renzo Y.; Lee, Sang-Jin; Dickinson, Michael G.; Grayburn, Ryan; Gonzalez, Matthew; Jani, Milena; Fermı́n, David J.; VanOosterhout, Stacie; Parker, Jessica; McNamara, David A.; Madder, Ryan D.

doi:10.1016/j.cardfail.2022.09.005

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…18 Right heart catheterization with EMB is also associated with high physician radiation doses due to fluoroscopic guidance. 19 Other limitations of EMB are its low diagnostic yield, particularly for patchy or isolated disease, and significant interobserver variability among pathologists interpreting rejection and cardiomyopathy. 7,20,21 Incorporating modern laboratory techniques, such as viral genome analysis and immunohistochemistry, has been shown to improve the diagnostic yield of EMB compared with histopathologic analysis alone.…”

Section: Discussionmentioning

confidence: 99%

“…Transplant recipients are exposed to 3.5 times greater doses of radiation per year 17 and are at increased risk of cancers such as post‐transplant lymphoproliferative disease 18 . Right heart catheterization with EMB is also associated with high physician radiation doses due to fluoroscopic guidance 19 . Other limitations of EMB are its low diagnostic yield, particularly for patchy or isolated disease, and significant interobserver variability among pathologists interpreting rejection and cardiomyopathy 7,20,21 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A phantom for targeted endomyocardial biopsy training

Contento,

Cleveland,

Ehtiati

et al. 2023

Cathet Cardio Intervent

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Endomyocardial biopsy (EMB) of the right ventricular (RV) septal surface during cardiac catheterization is the standard method to assess cardiac allograft rejection, heart failure, or inflammatory cardiomyopathies. We developed methodology using a three‐dimensional (3D) printed phantom to provide proof of concept for using biplane overlay technology for targeted EMB. A standard bioptome and steerable sheath were used to discern feasibility of biopsy for seven regions of the RV septum guided by 3D overlay. This novel biopsy phantom can help train operators in biopsy techniques, and biplane overlay technology has the potential to advance targeted EMB in transplant and cardiomyopathy populations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A phantom for targeted endomyocardial biopsy training

Contento,

Cleveland,

Ehtiati

et al. 2023

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…Until recently, physician radiation exposure during RHC and EMB was poorly understood. In a recent study, 31 investigators observed that head-level radiation doses during RHC were lower than those observed with DCoA or PCI; however, radiation doses during EMB were like DCoA. They observed that a physician performing an RHC or EMB would receive more radiation than a physician performing DCoA when normalized to dose area product.…”

Section: Advanced Heart Failure/transplant Cardiologymentioning

confidence: 98%