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An endomyocardial biopsy is a biopsy of the heart tissue inside the heart. This is done in most cases as a follow up for heart transplantation. UofL Health Cardiology Associates has been involved in the heart transplantation program at UofL Health - Jewish Hospital in Louisville, Kentucky since its inception. We follow many patients who have had cardiac transplantation and these patients are followed with endomyocardial biopsies as a means to adjust their anti-rejection medicines following their heart transplantation. The procedure involves placement of a catheter through a vein in either the neck or groin area. The area is scrubbed with a cleaning solution and a drape is placed. A plastic tube is placed and through this tube a biopsy catheter is placed and positioned inside the heart with the aid of x-ray. Samples of the heart tissue are removed and examined for evidence of rejection or evidence of abnormalities that could cause a weakening of the heart muscle. This weakening is called cardiomyopathy. The procedure takes 15 minutes and is associated with little or no discomfort. There may be a pushing sensation in the neck or groin with manipulation of the catheter and there may be some perception of extra heart beats when the biopsy samples are taken. At the completion of the test, the catheter is removed and pressure is held to stop bleeding. This takes ten minutes or less and the patient is allowed to ambulate immediately if the procedure is done through the neck and after 1-2 hours if the procedure is done through the groin. The patient is allowed to go home on the same day of the procedure. There are no limitations following the procedure. UofL Health Cardiology Associates performs approximately 100 endomyocardial biopsies per year and these are performed primarily by two of the twelve physicians in the group.