Diagnostic yield, safety and therapeutic consequences of myocardial biopsy in clinically suspected fulminant myocarditis unweanable from mechanical circulatory support
Authors' conclusion
In clinically suspected myocarditis unweanable from MCS, myocardial biopsy increased the rate of definite myocarditis but was associated with a low rate of treatment modification and a significant proportion of adverse events.
Study context
- Population
- Patients with fulminant clinically suspected myocarditis unweanable from mechanical circulatory support (MCS) undergoing in-ICU myocardial biopsy, French tertiary ICU, 2002–2019
- Participants
- 47 patients
- Exposure
- After biopsy vs Before biopsy
- Outcome
- Proportion of patients classified as definite myocarditis using Bonaca criteria before and after including myocardial biopsy results
Methodological detailssingle-centre, observational
- Single-centre
- Observational
Main finding
As reported in the abstract
Definite myocarditis (Bonaca classification)
P < 0.0001
Observational data: associations, not effects.
Further findings
Biopsy-related treatment modifications
- Rate of biopsy-related treatment modifications
- 13%
- Treatment modification leading to recovery
- 4%
Outcome at hospital discharge
- Died before hospital discharge
- 55%
- Bridged-to-recovery
- 34%
- Bridged-to-transplant
- 15%
Safety
- Tamponade requiring emergency pericardiocentesis after endomyocardial biopsy
- 29%
- Biopsy endomyocardial in 36%, surgical in 64%
Original publication
Diagnostic yield, safety and therapeutic consequences of myocardial biopsy in clinically suspected fulminant myocarditis unweanable from mechanical circulatory support. Ann Intensive Care. Published 31 August 2023. doi:10.
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