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The Heart at Autopsy, Including Radiological Autopsy of the Heart

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Cardiac Pathology

Abstract

The autopsy examination of cardiac tissues is described in detail with stepwise consideration of the individual components of the heart. The approach to common pathological processes is provided. There is a stepwise photographic illustration of the dissection technique together with discussion of the appropriate histological investigations, special stains, ultrastructural histology and ancillary tests. The method for cardiac conduction system assessment is demonstrated and an approach to various cardiac devices is discussed. The value of post-mortem radiology (PM-CT) scanning of cardiac disease is described, along with examples of radiology images.

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References

  1. Basso C, Aguilera B, Banner J, et al. Guidelines for autopsy investigation of sudden cardiac death: 2017 update from the Association for European Cardiovascular Pathology. Virchows Arch. https://doi.org/10.1007/s00428-017-2221-0.

    Article  Google Scholar 

  2. Suvarna SK. National guidelines for adult autopsy cardiac dissection: are they achievable? Histopathology. 2008;53:97–112.

    Article  CAS  Google Scholar 

  3. Suvarna SK. External examination. In: Atlas of adult autopsy. New York, NY: Springer; 2016. p. 13–46.

    Chapter  Google Scholar 

  4. Burton J, Saunders S, Hamilton S. Atlas of adult autopsy pathology. Boca Raton, FL: CRC Press; 2015.

    Book  Google Scholar 

  5. Rutty GN, Burton JL. The evisceration. In: Burton JL, Rutty GN, editors. The hospital autopsy. 3rd ed. London: Arnold; 2010. p. 115–35.

    Chapter  Google Scholar 

  6. Suvarna SK, Coe MS. Evisceration & thorax. In: Suvarna SK, editor. Atlas of adult autopsy. A guide to modern practice. New York, NY: Springer; 2016. p. 47–160.

    Chapter  Google Scholar 

  7. Farrer-Brown G. A colour atlas of cardiac pathology. London: Wolfe Medical Publications Ltd; 1977. p. 88–91.

    Google Scholar 

  8. Rutty GN, Burton JL. Dissection of the internal organs. In: Burton JL, Rutty GN, editors. The hospital autopsy. 3rd ed. London: Arnold; 2010. p. 136–58.

    Google Scholar 

  9. Edwards WD. Cardiovascular system. In: Ludwig J, editor. Autopsy practice. 3rd ed. Toronto, WA: Humana; 2002. p. 21–43.

    Chapter  Google Scholar 

  10. Becker AE, Anderson RH. Cardiac adaptation and its sequelae. In: Cardiac pathology. An integrated text and color atlas, vol. 1. Edinburgh: Churchill Livingstone; 1982. p. 2–1.8.

    Google Scholar 

  11. Silver MM, Silver MD. Examination of the heart and cardiovascular specimens in surgical pathology. In: Silver MD, Gotlieb AI, Schoen FJ, editors. Cardiovascular pathology. 3rd ed. New York, NY: Churchill Livingstone; 2001. p. 1–29.

    Google Scholar 

  12. Burke AP, Aubrey M-C, Malezewski JJ, Alexiev B, Tavora FR. Practical thoracic pathology. Diseases of the lung, heart and thymus. Philadelphia, PA: Wolters-Kluwer; 2017. p. 573–887.

    Google Scholar 

  13. Kitson DW, Scholz DG, Hagen PT, Ilstrup DM, Edwards WD. Age-related changes in normal human heart during the first ten decades of life. Part II. Maturity: a quantitative anatomical study of 765 specimens from subjects 20–99 years old. Mayo Clin Proc. 1988;63:137–46.

    Article  Google Scholar 

  14. Lucas SL. Derivation of new reference tables for human heart weights in light of increasing body mass index. J Clin Pathol. 2011;64:279–80.

    Article  Google Scholar 

  15. Gaitskell K, Perera R, Soilleux EJ. Derivation of new reference tables for human heart weights in light of increasing body mass index. J Clin Pathol. 2011;64:358–62.

    Article  Google Scholar 

  16. Bradshaw SH, Kennedy L, Dexter DF, Veinot JP. A practical method to rapidly dissolve metallic stents. Cardiovasc Pathol. 2009;18(3):127–33. https://doi.org/10.1016/j.carpath.2009.01.001.

    Article  CAS  PubMed  Google Scholar 

  17. Palmerini T, Biondii-Zoccai G, Dela-Riva D, et al. Clinical outcomes with bioabsorbable polymer- versus durable polymer-based drug-eluting and bare-metal stents. Evidence from a comprehensive network meta-analysis. J Am Coll Cardiol. 2014;63(4):299–307.

    Article  CAS  Google Scholar 

  18. Waksman R, Pakala R. Biodegradable and bioabsorbable stents. Curr Pharm Des. 2010;16(36):4041–51.

    Article  CAS  Google Scholar 

  19. Anderson RH, Becker AE. Normal cardiac anatomy. In: Anderson RH, Becker AE, Roberts WB, editors. The cardiovascular system. Part A: general considerations and congenital malformations. Edinburgh: Churchill Livingstone; 1993. p. 3–26.

    Google Scholar 

  20. Raasch F. Pacemaker post-mortem. In: Legal medicine annual. Boston, MA: Butterworth; 1997. p. 97–100.

    Google Scholar 

  21. Suvarna SK, Start RD, Tayler DI. A prospective audit of pacemaker function, implant lifetime and patient cause of death. J Clin Pathol. 1999;52:677–80.

    Article  CAS  Google Scholar 

  22. Prahlow JA, Guilleyardo JM, Barnard JJ. The implantable cardioverter defibrillator. A potential hazard for autopsy pathologists. Arch Pathol Lab Med. 1997;121:1076–80.

    CAS  PubMed  Google Scholar 

  23. Fulton RM, Hutchinson EC, Morgan Jones A. Ventricular weight in cardiac hypertrophy. Br Heart J. 1952;14:413–20. https://doi.org/10.1136/hrt.14.3.413.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Schoen FJ. Approach to the analysis of cardiac valve prostheses as surgical pathology or autopsy specimens. Cardiovasc Pathol. 1995;4:241–55.

    Article  CAS  Google Scholar 

  25. Luk A, Rao V, Cusimano RJ, David TE, Butany J. CorMatrix extracellular matrix used for valve repair in the adult: is there de novo valvular tissue seen? Ann Thorac Surg. 2015;99:2205–7.

    Article  Google Scholar 

  26. Chand M, Lamagni T, Kranzer K, et al. Insidious risk of severe Mycobacterium chimaera infection in cardiac surgery patients. Clin Infect Dis. 2017;64(3):335–42.

    Article  Google Scholar 

  27. The Royal College of Pathologists. Tissue pathways for cardiovascular pathology. www.rcpath.org/.

  28. The Royal College of Pathologists. Guidelines on autopsy practice: scenario 1: sudden death with likely cardiac pathology. www.rcpath.org/.

  29. Tester DJ, Ackerman MJ. The role of molecular autopsy in unexplained sudden cardiac death. Curr Opin Cardiol. 2006;21:166–72.

    Article  Google Scholar 

  30. Thali M, Dirhofer R, Vock P, editors. The virtopsy approach: 3D optical and radiological scanning and reconstruction in forensic medicine. Boca Raton, FL: CRC Press; 2009.

    Google Scholar 

  31. Grabherr S, Grimm JM, Heinemann A. Atlas of postmortem angiography. New York, NY: Springer; 2016.

    Book  Google Scholar 

  32. Roberts ISD, Traill ZC. The radiological autopsy. In: Suvarna SK, editor. Atlas of adult autopsy: a guide to current practice. London: Springer; 2016.

    Google Scholar 

  33. der Bijl N, Joemai RMS, Gelejnes J, et al. Assessment of Agatston coronary artery calcium score using contrast-enhanced CT coronary angiography. Am J Roentgen. 2010;195:1299–305.

    Article  Google Scholar 

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Acknowledgements

Grateful thanks are expressed to Mr. B. Wagner, Senior Electron Microscopist, Sheffield Teaching Hospitals for his expertise and photography of ultrastructural histology in this chapter.

Especial thanks are given to iGene Digital Autopsy services, UK, who have ably assisted and guided me and my interaction with autopsy radiology (PM-CT). They have been generous in making images available for this chapter. Their interaction with Sheffield autopsy services has been ground-breaking in my opinion.

I am also grateful to the Forensic Pathology unit in Lausanne, Switzerland for the opportunity to see the Virtopsy practice.

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Authors and Affiliations

  1. Sheffield Teaching Hospitals, Royal Hallamshire Hospital Sheffield Teaching Hospitals Sheffield, South Yorkshire, UK

    S. Kim Suvarna

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  1. S. Kim Suvarna
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Correspondence to S. Kim Suvarna .

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Editors and Affiliations

  1. Sheffield Teaching Hospitals, Royal Hallamshire Hospital Sheffield Teaching Hospitals, Sheffield, South Yorkshire, UK

    S. Kim Suvarna

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Suvarna, S.K. (2019). The Heart at Autopsy, Including Radiological Autopsy of the Heart. In: Suvarna, S. (eds) Cardiac Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-24560-3_5

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  • DOI: https://doi.org/10.1007/978-3-030-24560-3_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24559-7

  • Online ISBN: 978-3-030-24560-3

  • eBook Packages: MedicineMedicine (R0)

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