To obtain endomyocardial biopsies, a catheter sheath is introduced into the right internal jugular vein with the patient under a local anesthetic, and a catheter bioptome is advanced under fluoroscopic control to the apex of the right ventricle. Adequate specimens are obtained for light and electron microscopy and for immunofluorescent studies. In 20 biopsy specimens obtained from ten patients following cardiac transplantation, the histologic information has been valuable in diagnosing acute rejection episodes. Serial percutaneous transvenous endomyocardial biopsy is now a part of our routine management of patients receiving heart transplants.
Caves PK, Stinson EB, Graham AF, Billingham ME, Grehl TM, Shumway NE. Percutaneous Transvenous Endomyocardial Biopsy. JAMA. 1973;225(3):288–291. doi:10.1001/jama.1973.03220300044010