Tafamidis is a disease-modifying therapy recently approved for the treatment of transthyretin
amyloidosis cardiomyopathy (ATTR-CM). Eligibility criteria for public reimbursement
coverage in most Canadian provinces include the need for tissue biopsy confirmation
of amyloidosis deposits. Carpal tunnel syndrome (CTS) is highly prevalent in ATTR-CM,
and many patients require carpal tunnel release (CTR) surgery. We report our experience
performing simultaneous transverse carpal ligament and flexor tenosynovium biopsy
as potentially sparing endomyocardial biopsy for this indication. All patients undergoing
this approach demonstrated biopsy samples positive for amyloid deposits, facilitating
initiation of tafamidis therapy.
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References
- Canadian Cardiovascular Society/Canadian Heart Failure Society joint position statement on the evaluation and management of patients with cardiac amyloidosis.Can J Cardiol. 2020; 36: 322-334
- Tafamidis treatment for patients with transthyretin amyloid cardiomyopathy.N Engl J Med. 2018; 379: 1007-1016
- Canadian drug expert reimbursement recommendations: tafamidis meglumine.Canadian Agency for Drugs and Technology in Health, Ottawa, Ontario2020: 1-8
- The role of endomyocardial biopsy in the management of cardiovascular disease: a scientific statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology.Circulation. 2007; 116: 2216-2233
- Yield of noncardiac biopsy for the diagnosis of transthyretin cardiac amyloidosis.Am J Cardiol. 2014; 113: 1723-1727
Article Info
Publication History
Published online: June 22, 2022
Accepted:
June 9,
2022
Received:
February 11,
2022
Footnotes
See page 1645 for disclosure information.
Identification
Copyright
© 2022 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
