Endomyocardial biopsy--when and how?

Endomyocardial biopsy is a commonly performed useful procedure utilized for the evaluation of cardiac tissue. Biopsy may be used to monitor transplant rejection, but it has many other applications including the evaluation of myocarditis, cardiomyopathy, chest pain, arrhythmia, and secondary involvement by systemic diseases. Drug toxicity may be evaluated and neoplasms may be biopsied.

Cardiac tumors of adipocytes and cystic tumor of the atrioventricular node.

Lipomatous lesions of the heart and cystic tumor of the atrioventricular node are not common. A pathologist will only rarely encounter these entities, and in the case of the atrioventricular node tumor, only if they examine the conduction system. Most fatty lesions are not clinically significant; however, arrhythmias, blood flow obstruction, and valvular dysfunction may result from benign or malignant lipomatous tumors.

CD117-positive cells and mast cells in adult human cardiac valves--observations and implications for the creation of bioengineered grafts.

Background: There is no report to date of stem cells in human cardiac valves. We examined their possible presence, number, and distribution in valves removed at cardiac surgery from patients with a variety of underlying valve pathologies.

Methods: Grossly normal aortic and mitral valves were obtained from live heart transplant patients.

Innovations in cardiovascular pathology: anatomic and electrophysiologic determinants associated with ablation of atrial arrhythmias.

The pathologist is required to evaluate hearts and surgical specimens following innovative therapies to ablate arrhythmias. For the treatment or cure of atrial fibrillation, ablation of the pulmonary vein sleeves and left atrium is increasingly encountered. The recognized contribution of the right atrium, Bachmann's bundle and other sites such as the vein of Marshall and epicardial ganglia has given rise to specific procedures to target these areas.

The spectrum of intramyocardial small vessel disease associated with sudden death.

Intramyocardial small vessel abnormalities are not commonly recognized. The best known abnormality is fibromuscular dysplasia involving the sinoatrial or atrioventricular nodal arteries. Small vessel disease has been reported as an isolated cardiac anomaly in individuals with sudden death, and may also be associated with other cardiac conditions including hypertrophic cardiomyopathy and mitral valve prolapse.

Diagnostic endomyocardial biopsy pathology--general biopsy considerations, and its use for myocarditis and cardiomyopathy: a review.

Endomyocardial biopsy is a commonly performed procedure used for the evaluation of myocardial tissues. Biopsies may be used to monitor transplant rejection, but they have many other applications, such as the evaluation of myocarditis, cardiomyopathy, drug toxicity, chest pain, arrhythmia and cardiac involvement by systemic diseases or neoplasms. The present paper discusses practical suggestions for biopsy interpretation, and the clinicopathological considerations for biopsies from patients with myocarditis and cardiomyopathies.

Focal and patchy cardiac valve lesions: a clinicopathological review.

Pathologists and surgeons often encounter cardiac valves with focal or patchy abnormalities either at postmortem examination or during the assessment of a valve removed at surgery. Many health professionals including nurses, cardiologists, echocardiographers, sonographers and radiologists may be called upon to assess these lesions. With the development of increasingly more sophisticated and sensitive imaging techniques, including transesophageal echocardiography and magnetic resonance imaging, more valve lesions are being discovered.