The evolution in device optimization and technique modification to the endomyocardial biopsy (EMB) procedure over many decades has resulted in a relatively easy, straightforward, safe, and effective tool for pathological evaluation. ( , 2 King's endomyocardial bioptome. ) Early techniques obtaining myocardial biopsies - including percutaneous needle biopsy of the left ventricle, catheter needle biopsy of the interventricular septum, and open thoracotomy - are now simplified to percutaneous biopsies via the right internal jugular vein to the right ventricle under local anesthesia.