Post-mortem computed tomography (PMCT) and PMCT-angiography after cardiac surgery. Possibilities and limits

TY - JOUR

T1 - Post-mortem computed tomography (PMCT) and PMCT-angiography after cardiac surgery. Possibilities and limits

AU - Vogel, Beatrice

AU - Heinemann, Axel

AU - Tzikas, Antonios

AU - Poodendaen, Canasorn

AU - Gulbins, Helmut

AU - Reichenspurner, Hermann

AU - Püschel, Klaus

AU - Vogel, Hermann

PY - 2014

Y1 - 2014

N2 - BACKGROUND: PMCT is a well-known tool of the forensic pathologist. It is employed worldwide. PMCT-angiography offers additional insights. This paper intends to demonstrate possibilities of both methods after cardiac surgery.MATERIAL AND METHODS: Exemplary cases with typical findings were selected from our own collection. PMCT was performed as whole body CT (1mm slice, pitch 1.5, 130kV, 180-130mAs, 16 slice MDCT). In PMCT-angiography, contrast material (1.2 litres) is injected into the arteries (arterial phase, also documented with a whole body CT). Thereafter, contrast material is injected into the veins (venous phase, also documented with a whole body CT). The final CT is obtained after circulation has been provoked with a special pump (circulatory phase).RESULTS: PMCT visualised pseudoarthrosis and fractures of the sternum, implanted valves (TAVI) encroaching the ostia of the coronary arteries, bleeding and pericardial tamponade. PMCT-angiography showed the sources of the bleeding, vascular stenosis and obstruction and modified vascular supply. With respect to the postoperative care, malposition of tubes, drainages and complication of punctures could be seen.CONCLUSION: PMCT and PMCT-angiography can visualise complications and the cause of death. Such knowledge may allow for prevention of suffering and death. It may also aid in improving valve design and implantation procedures.

AB - BACKGROUND: PMCT is a well-known tool of the forensic pathologist. It is employed worldwide. PMCT-angiography offers additional insights. This paper intends to demonstrate possibilities of both methods after cardiac surgery.MATERIAL AND METHODS: Exemplary cases with typical findings were selected from our own collection. PMCT was performed as whole body CT (1mm slice, pitch 1.5, 130kV, 180-130mAs, 16 slice MDCT). In PMCT-angiography, contrast material (1.2 litres) is injected into the arteries (arterial phase, also documented with a whole body CT). Thereafter, contrast material is injected into the veins (venous phase, also documented with a whole body CT). The final CT is obtained after circulation has been provoked with a special pump (circulatory phase).RESULTS: PMCT visualised pseudoarthrosis and fractures of the sternum, implanted valves (TAVI) encroaching the ostia of the coronary arteries, bleeding and pericardial tamponade. PMCT-angiography showed the sources of the bleeding, vascular stenosis and obstruction and modified vascular supply. With respect to the postoperative care, malposition of tubes, drainages and complication of punctures could be seen.CONCLUSION: PMCT and PMCT-angiography can visualise complications and the cause of death. Such knowledge may allow for prevention of suffering and death. It may also aid in improving valve design and implantation procedures.

KW - Autopsy

KW - Cardiac Surgical Procedures

KW - Cause of Death

KW - Coronary Angiography

KW - Coronary Artery Bypass

KW - Coronary Artery Disease

KW - Forensic Pathology

KW - Germany

KW - Humans

KW - Image Processing, Computer-Assisted

KW - Postmortem Changes

KW - Postoperative Complications

KW - Postoperative Hemorrhage

KW - Pseudarthrosis

KW - Tomography, X-Ray Computed

M3 - SCORING: Journal article

C2 - 24672893

VL - 63

SP - 155

EP - 171

JO - Archiwum medycyny sa̧dowej i kryminologii

JF - Archiwum medycyny sa̧dowej i kryminologii

SN - 0324-8267

IS - 3

ER -