Abstract 14672: Blue Light During Pericardioscopy Improves the Diagnostic Yield of Epicardial and Pericardial Biopsy
Background: Epi- and pericardial biopsy guided by pericardioscopy has improved the diagnostic yield in patients(pts) with “idiopathic” pericarditis undergoing pericardiocentesis. Additional etiopathogenetic information can be expected from biopsies targeted to dark and white spots in pericardioscopy when the emission of blue light is used.
Patients: 32 male and 21 female pts, mean age 47.7+12.3 y, undergoing consecutive pericardiocenteses were biopsied prospectively at the dark sites of blue light imaging and compared to the white biopsy sites prospectively.
Methods: Under sedation with i.v. midazolam and analgesia with i.v. morphine the pericardial effusion was evacuated and a 16 F pericardioscope introduced to perform targeted epicardial biopsy. The biopsies from “dark” spots at blue light were compared with biopsies from “white” spots. This prospective group was compared with 50 consecutive pts, in whom no selection was made (“mixed”).
Results: In the comparative study biopsies from “white” areas during blue light emission could be attributed to fibrin and fibrosis in all cases. Infiltrates or neoplastic formations in these samples were extremely rare (2/53). Biopsies from “dark” spots could be characterized either as petechial bleeding (19/53), inflammatory infiltrates(26/53) or areas of tumor growth (20/50) thus summing up specific findings in 41/50 patients. The comparison between white and dark spots was for a diagnostic yield was significant (p<0.001). There was overlap between small bleeding and neoplastic sites in dark areas, in which both phenomena could be sometimes detected side to side.
Conclusion: A dramatically improved diagnostic yield can be attained by making use of the blue light mode for taking epicardial biopsies from dark spots in patients with pericardial effusions undergoing pericardiocentesis.
- © 2011 by American Heart Association, Inc.