Endomyocardial biopsy guided by intracardiac echocardiography as a key step in intracardiac mass diagnosis

BMC Cardiovasc Disord. 2018 Jan 30;18(1):15. doi: 10.1186/s12872-018-0749-9.


Background: Based on a plenty of different applications, intracardiac echocardiography (ICE) is now a well-established technology in complex electrophysiological procedures. Recently, ICE has become the most widely used ultrasound-based imaging tool to guide diagnostic endomyocardial biopsy (EMB). EMB of cardiac mass guided by ICE is an interesting application of ICE. Allowing a correct positioning of the bioptome, ICE reduce the procedure-related risks and the need of a diagnostic open-chest procedure reserving the more invasive approach to selected cases.

Case presentation: Hereby we report a case series of right ventricular masses in which the EMB was safely and effectively performed under ICE guidance giving essential information for planning the therapeutic strategy.

Conclusions: The diagnosis of both metastatic and primary cardiac tumors relies on the histopathological analyses. The endomyocardial biopsy is a valuable tool for preoperative diagnosis and surgical planning of intracardiac masses suspected for tumors. In our experience, the use of ICE for right ventricle EMB of an intracardiac mass is an attractive modality thanks to the precise localization of the cardiac structures and the ability to guide bioptic withdrawal in the target area.

Keywords: Endomyocardial biopsy; Intracardiac echocardiography; Intracardiac mass; Right ventricle.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Aged
  • Echocardiography*
  • Female
  • Heart Neoplasms / diagnostic imaging
  • Heart Neoplasms / pathology*
  • Heart Neoplasms / secondary
  • Heart Neoplasms / therapy
  • Humans
  • Image-Guided Biopsy / methods*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Myocardium / pathology*
  • Predictive Value of Tests
  • Prognosis