Intracardiac echocardiography‐guided biopsies for right‐sided intracardiac tumors: An optimized diagnostic algorithm and case illustrations

Intracardiac tumors, though uncommon, necessitate a swift and accurate diagnosis for personalized treatment and prognosis estimation. While multi‐modality imaging often determines the etiology of these cardiac masses, histological confirmation remains essential for definitive diagnosis and its speci...

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Published in:	Catheterization and cardiovascular interventions Vol. 104; no. 4; pp. 862 - 868
Main Authors:	Teske, Arco J., Jimenez‐Rodriguez, Gian‐Manuel, Kraaijeveld, Adriaan O., Broekhuizen, Lysette N., Osch, Dirk, Gort, Eelke H., Rhenen, Anna v, Harst, Pim vd, Voskuil, Michiel
Format:	Journal Article
Language:	English
Published:	United States Wiley Subscription Services, Inc 01-10-2024
Subjects:	Adult Aged Algorithms Biopsy Diagnosis Echocardiography endomyocardial biopsy (EMB) Female Heart Heart Neoplasms - diagnostic imaging Heart Neoplasms - pathology Humans Image-Guided Biopsy imaging intracardiac echocardiography (IICE) Male Middle Aged Predictive Value of Tests Sampling Tamponade Tumors tumors‐‐cardiac Ultrasonography, Interventional endomyocardial biopsy (EMB) imaging intracardiac echocardiography (IICE) tumors‐‐cardiac
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Summary:	Intracardiac tumors, though uncommon, necessitate a swift and accurate diagnosis for personalized treatment and prognosis estimation. While multi‐modality imaging often determines the etiology of these cardiac masses, histological confirmation remains essential for definitive diagnosis and its specific treatment. Since cardiac tumors are often found in high‐risk locations (ventricular free wall or atria), precision biopsy is paramount. The least invasive strategy would be to achieve this by means of endomyocardial biopsy (EMB); however real‐time additional imaging is essential to reduce the risk of perforation/tamponade and to minimize sampling error. Intracardiac echocardiography (ICE) emerges as an excellent tool to achieve this goal preventing procedural complications and reducing the likelihood of sampling errors obtaining a definitive histopathological diagnosis in all cases. This paper outlines our diagnostic algorithm for optimal patient selection, details three illustrative cases, and elucidates the steps to acquire histopathology via percutaneous transvenous biopsy with ICE guidance in patients with right‐sided cardiac tumors. Given the rarity of intracardiac tumors, we advocate these patients be managed by a dedicated multidisciplinary cardio‐oncology team including an interventional cardiologist.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Undefined-5 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1522-1946 1522-726X 1522-726X
DOI:	10.1002/ccd.31189