心肌活检

定义

心肌活检 is the removal of a small piece of heart muscle for examination.

选择的名字

Heart biopsy; Biopsy - heart

How the Test is Performed

心肌活检 is done through a catheter that is threaded into your heart (cardiac catheterization). The procedure will take place in a hospital radiology department, special procedures room, or cardiac diagnostics laboratory.

做手术:

• You may be given medicine to help you relax (sedative) before the procedure. 然而, you will remain awake and able to follow instructions during the test.
• You will lie flat on a stretcher or table while the test is being done.
• The skin is scrubbed and a local numbing medicine (anesthetic) is given.
• A surgical cut will be made your arm, neck, or groin.
• The health care provider inserts a thin tube (catheter) through a vein or artery, depending on whether tissue will be taken from the right or left side of the heart.
• If the biopsy is done without another procedure, the catheter is most often placed through a vein in the neck and then carefully threaded into the heart. The doctor will use moving x射线 images (fluoroscopy) or echocardiography (ultrasound) to guide the catheter to the correct area.
• Once the catheter is in position, a special device with small jaws on the tip is used to remove small pieces of tissue from the heart muscle.
• The procedure may last 1 or more hours.

How to Prepare for the Test

You will be told not to eat or drink anything for 6 to 8 hours before the test. The procedure takes place in the hospital. 最常, you will be admitted the morning of the procedure, 但在某些情况下, you may need to be admitted the night before.

A provider will explain the procedure and its risks. You must sign a consent form.

考试的感觉如何

You may feel some pressure at the biopsy site. You may have some discomfort due to lying still for a long period of time.

Why the Test is Performed

This procedure is routinely done after heart transplantation to watch for signs of rejection.

Your provider may also order this procedure if you have signs of:

• Alcoholic cardiomyopathy
• 心脏淀粉样变性
• 心肌病
• Hypertrophic cardiomyopathy
• Idiopathic cardiomyopathy
• Ischemic cardiomyopathy
• 心肌炎
• Peripartum cardiomyopathy
• Restrictive cardiomyopathy

正常的结果

A normal result means no abnormal heart muscle tissue was discovered. 然而, it does not necessarily mean your heart is normal because sometimes the biopsy can miss abnormal tissue.

What Abnormal Results Mean

An abnormal result means abnormal tissue was found. This test may reveal the cause of cardiomyopathy. Abnormal tissue may be due to:

• 淀粉样变
• 心肌炎
• 结节病
• Transplant (heart) rejection

风险

风险 are moderate and include:

• 血凝块
• Bleeding from the biopsy site
• 心脏 心律失常
• 感染
• Injury to the recurrent laryngeal nerve
• Injury to the vein or artery
• 气胸
• Rupture of the heart (very rare)
• Tricuspid regurgitation

参考文献。

Kliger CA, Sorajja P. 特殊的技术. In: Sorajja P, Lim MJ, Kern MJ, eds. Kern's 心脏 Catheterization Handbook. 7日艾德. Philadelphia, PA: Elsevier; 2020:chap 9.

米勒DV. 心血管系统. In: Goldblum JR, Lamps LW, McKenney JK, Myers JL, eds. Rosai and Ackerman's Surgical Pathology. 11日艾德. Philadelphia, PA: Elsevier; 2018:chap 42.

罗杰斯JG，奥康纳CM. Heart failure: pathophysiology and diagnosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil医学. 26日艾德. Philadelphia, PA: Elsevier; 2020:chap 52.