ABSTRACT
In the early 1970s, Caves made a series of modifications to the Konno biopsy forceps to allow percutaneous biopsy through the right internal jugular vein with only local anesthesia and rapid serial tissue sampling through a preformed sheath (7,8). Pioneered at Stanford University, the Stanford-Caves-Schulz bioptome became central to monitoring cardiac transplant patients for rejection and served as the standard device for endomyocardial biopsy from 1975 to 1995. The biopsy forceps were more flexible and had features allowing the operator to adjust the force applied to the forceps using a surgery-like clamp. The Stanford-Caves-Schulz device was also reusable. This led to the requirement for frequent retooling and resharpening, along with concerns about protecting patients from infection and pyrogen reaction. Richardson in 1974 and Kawai in 1977 added special features to the bioptome for right or left ventricular sampling by increasing sheath flexibility, electrocardiographic monitoring, and intracardiac maneuverability (9,10).
