Right atrial and right ventricular ultrasound-guided biopsy technique in standing horses.
Authors: Decloedt A, de Clercq D, Ven S, van der Vekens N, Chiers K, van Loon G
Journal: Equine veterinary journal
Summary
# Right atrial and right ventricular ultrasound-guided biopsy technique in standing horses Myocardial disease in horses remains substantially underdiagnosed due to limited diagnostic tools, yet endomyocardial biopsy could provide definitive histological assessment of cardiac pathology. Decloedt and colleagues developed and validated a percutaneous technique for obtaining serial biopsies from both the right atrium and right ventricle in standing, sedated horses via jugular vein catheterisation under real-time echocardiographic guidance. All 10 healthy horses yielded successful tissue samples (three biopsies from each chamber), with histology confirming myocardial origin; whilst all animals developed transient atrial and ventricular premature depolarisations during the procedure, arrhythmias resolved within minutes in nine cases and within 8 hours in one, with no other adverse effects observed. Though this technique demonstrates feasibility and safety in healthy subjects, practitioners should recognise it as a potentially valuable research and diagnostic tool for investigating suspected myocarditis, cardiomyopathy and other infiltrative or degenerative cardiac conditions—however, validation in symptomatic clinical patients with existing myocardial disease is essential before widespread adoption in practice.
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Practical Takeaways
- •This minimally invasive endomyocardial biopsy technique offers a safe diagnostic option for investigating suspected myocardial disease in standing horses, which may be underdiagnosed due to lack of specific diagnostic tools
- •Expect transient arrhythmias during and immediately after the procedure; monitor with continuous ECG and allow time for resolution before assuming complications
- •The technique is currently validated for research and diagnostic purposes in healthy horses, but safety in clinical patients with active myocardial disease requires further investigation
Key Findings
- •Right atrial and right ventricular endomyocardial biopsies were successfully obtained in all 10 standing horses via percutaneous jugular vein approach with ultrasound guidance
- •All horses developed atrial and ventricular premature depolarisations during biopsy acquisition, with arrhythmias resolving within 8 hours in all cases
- •No complications beyond temporary arrhythmias were observed, with histology confirming myocardial tissue in all samples
- •The technique enabled serial sampling from the right ventricular apex and dorsal right atrial wall near the tuberculum intervenosum