[114159656]
Patient presented for post heart transplant routine myocardial biopsies. Two endomyocardial biopsy specimens were removed with a sparrowhawk 5 fr 50 cm bioptome. On the third attempt a snap was reported to have been felt. The wire broke and jaws of the bioptome remained in the open position. The bioptome could not be pulled into the 5 fr long sheath and attempts to close the bioptome jaws using the actuator, wire and outside spring was unsuccessful. A tee confirmed that the open bioptome jaws were located at the anterior leaflet of the tricuspid valve or in the chordae right below the valve. Attempts to manipulate the bioptome in a rotational fashion did not change the position of the tip of the bioptome. With the bioptome in the valve there was moderate tricuspid regurg. Access was obtained over the 5 fr sheath. A 7 fr sheath was place and the bioptome was able to be pulled into the sheath and removed. Heparin was given during this process. There was clot along the bioptome after it was removed. Following removal of the bioptome a tee was performed. The tricuspid valve was reported to have good function with mild regur (unchanged from prior exams pre biopsy) there was no evidence of flail tricuspid valve. The right and left ventricular function was normal. No clot seen in the ra or rv. Manufacturer response for biopsy forcepts, sparrowhawk (per site reporter). Representative for the manufacturer was reported to by contact. I do not have access to the response at this writing.
Patient Sequence No: 1, Text Type: D, B5