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First your most important question, does it hurt?
What is a heart biopsy for?
As you can see there are three staff members involved, the doctor, E.C.G. technician and a radiograph operator. You lay on your back and then turn your head to the left, the doctor then gives you a local anesthetic in the neck (small injection). He then makes a small incision in your neck, then has to thread a small wire down your vein to the heart. He removes a small piece of the heart with the end of the wire (in total he needs four small pieces). When the wire is removed, he presses on the incision to make sure it doesn't bleed (for about one minute). Puts a plaster on it and that's it off you go 15/20min later.
The small pieces of heart are then sent to the laboratory to be tested for rejection, you normally get the result within 24 hours.
This procedure is first done two weeks after transplant, then once a week for six weeks. All being well and no rejection being found you then have your biopsies every two weeks for the next three months. Then once a month, then once every two months until your first year is up. Then you go in for your first M.O.T. (full check up)
The cardiac, or heart, biopsy is a diagnostic test to detect rejection done frequently on an outpatient basis after heart transplantation. Having an episode of rejection is not uncommon and does not mean that the patient will lose his or her new heart. Rejection will present itself if medications need adjusting and very often the patient may have no symptoms. This is why cardiac biopsies are an important part of routine care after transplantation.
Typical Cardiac Biopsy Schedule (Additional appointments are added as needed): First month following transplant: Every visit Second month following transplant: Every biweekly visit Following four months: Every monthly visit Months 6 to 12 after transplant: Every other month Months 12 to 18 after transplant: Every 3-month visit Months 18 - 24 after transplant Every 3 to 6 months Annual maintenance schedule: Visit every 6 to 12 months as needed.
During the biopsy, a small piece of heart muscle is removed for microscopic examination to detect rejection. The biopsy is performed through a vein located either in the right side of your neck or in your groin, using a bioptome, a long, thin tube with a tiny cutting edge. The entire procedure takes about 1/2 hour and will be performed either in the Transplant Clinic. The biopsy results are available from 24 to 48 hours after the procedure. If your biopsy indicates rejection is present, we will immediately treat you by changing your medication regimen. You may require intravenous or additional oral medications. It may be beneficial to have you admitted to the Hospital. But don’t panic. Remember that rejection can recur at any time, and rejection is treatable.
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