Minimally invasive cardiac biopsy: An alternative to open-heart surgery

Thanks to innovation from UHN, patients needing diagnostic testing for unknown entities around the heart, such as growths, now have the option of a minimally invasive outpatient procedure instead of open-heart surgery.

UHN’s Peter Munk Cardiac Centre is a leading provider of a new outpatient testing procedure in Canada and one of the few centers worldwide. This innovative approach significantly shortens hospital stays and recovery times for certain patients.

The diagnosis and appropriate treatment of tumors rely on doctors’ dependence on biopsies. However, obtaining tissue samples from the heart poses significant challenges due to its continuous motion, which can lead to potentially life-threatening complications.

Dr. Patrik Rogalla, Division Head of Cardiovascular and Thoracic Imaging at the Joint Department of Medical Imaging, UHN, highlights the limited options available for patients in need of a cardiac or pericardial biopsy.

Until recently, open-heart surgery was the sole option for these patients, regardless of whether the entity was malignant or benign. This invasive procedure, purely for diagnostic purposes, subjected patients to significant discomfort and risks.

Dr. Robert Cusimano, a renowned cardiac surgeon and specialist in cardiac tumors at Peter Munk Cardiac Centre, handles some of the most intricate cardiac cases in the country. Patients diagnosed with cardiac or pericardial tumors are typically referred to Dr. Cusimano.

With the aim of providing improved care to these patients, Dr. Rogalla and his team have devised a novel procedure for biopsying masses located in and around the heart.

This procedure offers clear advantages by sparing the patient from surgery. It entails the manual synchronization of a computerized tomography (CT) scan and fluoroscopy with the electrocardiogram (ECG) to safely extract the sample. UHN biomedical engineer Ali Ursani provided support in developing the synchronization device.

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The typical cost for heart biopsy surgery is around $6,725. The recovery period varies based on the location of abnormal tissues and the extent of the operation needed to obtain a sample.

On average, patients undergoing this procedure stay in the hospital for seven days, with approximately one and a half days spent in the intensive care unit.

In contrast, the new testing procedure takes an average of 32 minutes, significantly shorter than traditional methods. After a two-hour recovery in the medical imaging day unit, patients can typically be discharged from the hospital.

Dr. Cusimano emphasizes the significant benefits of this minimally invasive cardiac or pericardial biopsy approach, stating, “It avoids the need for surgery, which brings obvious advantages for the patient.”

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