The skin around the jugular vein in the neck was anesthetized. Access was obtained through insertion of a needle and a guidewire. The guidewire was advanced through the right internal jugular vein and into the right brachiocephalic vein. It entered the superior vena cava, was passed along the posterior wall of the atrium, and entered the superior aspect of the inferior vena cava. A catheter was inserted over the wire and directed into the right hepatic vein. Using a series of dilators, the hole was enlarged and a biopsy needle was placed over the wire and into the right hepatic vein. The liver was biopsied through the right hepatic vein and the biopsy sample was removed. A simple suture was used to close the internal jugular vein in the neck, and minor compression stemmed any blood flow.