Transesophageal Echocardiography‐Guided Transvenous Biopsy of an Intracardiac Tumor

Abstract

Transesophageal echocardiography with simultaneous fluoroscopic guidance during a transvenous biopsy of an intracardiac tumor is a valuable technique. We present the case of a 67‐year‐old man with a metastasis in the right atrium from which histological examination of the tumor was indicated. The inaccessible location of the primary tumor in the liver and impaired hemostasis due to cirrhosis necessitated a transvenous biopsy of the metastasis. The procedure and the associated techniques are discussed in this case.

Transjugular biopsy case report of inferior vena cava hepatocellular carcinoma with intracardiac extension

“…This method of transvenous sampling is not limited to the vascular system. Intracardiac neoplasms have been biopsied in this way with a variety of imaging-guidance including transoesophageal echocardiography, fluoroscopy and intracardiac echocardiography [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] . Renal biopsies have also been performed safely on a large series of patients using the internal jugular vein, as have hepatic biopsies [33] , [34] .…”

Intracardiac Echocardiography to Guide Biopsy for Two Cases of Intracardiac Masses

“…Because the fluoroscopy is inadequate to target the mass lesion, especially in patients with cardiac tumors, many researchers use TTE or TEE to guide the prompt site for biopsy. 4) 5) However, TTE gives less clear cardiac images than TEE, especially for the posterior wall mass and the patient with poor echo window, 6) and TEE requires general anesthesia during the procedure.…”

Diffuse Large B-cell Lymphoma Diagnosed by Intracardiac Echocardiography-guided Cardiac Tumor Biopsy

“…Previous reports demonstrate that a transvenous EMB procedure under fluoroscopic guidance is safe when performed by experienced technicians, the overall rate of complications is between 1% and 3%, the risk of cardiac perforation with tapenade is less than 0.05% (12,13). A transvenous EMB procedure under TEE guidance is a useful, simple and safe method (14)(15)(16)(17)(18)(19). However, it causes patient discomfort and sometimes requires general anesthesia in addition to local pharyngeal anesthesia.…”