What We Do

A cardiac biopsy post-heart transplantation is a procedure done on patients who have had a heart transplant. It is the only reliable means of diagnosing rejection. It is performed on a regular schedule or when your team suspects you may have rejection.

Your doctor uses a small tube that's inserted into the vein in your neck or occasionally the groin. Under fluoroscopy (a special x-ray), a biopsy instrument is guided through the tube in your neck into the right ventricle in your heart where 4 to 5 pieces of tissue are taken.​

 Materials and Resources to Help You

The Patient & Family Education Program at UHN offers valuable resources to help you understand your condition.

Resources from the Patient & Family Education Program

Visit our Health Information section to find dedicated resources to help you understand your condition. Find the information you're looking for.​

 Your Procedure

How to Prepare

The transplant office will contact you using the Easy Call system regarding specific details about what to expect on the day of your biopsy. You will have blood tests on the day of your heart biopsy.

If you cannot go to your test, call the Easy Call system.

Bring with you any medications you normally take during the day.

Your procedure is in the morning you can have NOTHING to eat or drink from midnight the night before your procedure.

You will be contacted by the Easy Call system regarding instructions for the medications you are to take on the day of the procedure.

Checking In

Heart biopsies are performed in the Cardiovascular Investigations Unit at Toronto General Hospital. You will be provided specific instructions depending on the site where your biopsy will be performed. Please have the following ready:

  • Health card (OHIP card). If you do not have an OHIP card, please bring another form of government-issued photo ID (such as a driver's license, passport, or other provincial health card). Please arrive 15 minutes before your appointment.
  • Your name, address and birth date

Check-in at the reception desk at the Transplant Day Unit located on the 12th floor Munk Building.

Before the Cardiac Biopsy

When you check-in, we will give you a name band to wear. You will be asked to change into a hospital gown. When you have finished changing, a nurse will prepare you for the test. You will have blood work done and a physician will obtain your consent.

When it's time for your procedure, an attendant will take you to the Cardiovascular Investigations Unit on the 2nd floor.

During and After the Cardiac Biopsy

Cardiac biopsies are done in a lab. The lab is kept cool to keep the machines working properly, so you may feel cool as well. During the procedure, the nurses will monitor your heart rhythm and blood pressure. Sterile sheets will be put on you to keep the insertion site clean.

The doctor will give you an injection to numb the area. If you feel any pain or discomfort during the procedure, tell the doctor right away.

We then insert a biopsy instrument through a small puncture in the skin on the right side of your neck. Under fluoroscopy (a special x-ray), the instrument is guided through the jugular vein into your heart, and four or five small pieces of tissue are taken so that they can be examined and tested for rejection back in our lab.

Sometimes the jugular vein isn't accessible, so the instrument is inserted through the femoral vein in the groin. Afterward, you'll return to your bed, and a nurse will observe you for signs of bleeding. You'll be able to be discharged and go home after a couple of hours.

The Results of Your Cardiac Biopsy

You will be notified of the results of the cardiac biopsy the same week of your procedure. You will be notified using the Easy Call system. Medications will be adjusted according to the biopsy result.

How Long Will Your Appointment Be?

A Cardiac Biopsy usually takes about 30 minutes.

We do everything that we can to stay on time. Unfortunately, your appointment may be delayed by unforeseen circumstances. We recommend that you come prepared for delays.​

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