Beatrice Vogel1+2, Axel Heinemann1, Axel Gehl1, Iwao Hasegawa1, Wilhelm-Wolfgan Höpker, Chanasom Poodendaen1, Antonios Tzikas1, Helmut Gulbins2, Hermann Reichenspurner2, Klaus Püschel1, Hermann Vogel1

Post-mortem computed tomography (PMCT) and PMCT-angiography after transvascular cardiac interventions

1 Institute for Legal Medicine, University Medical Center Hamburg-Eppendorf

2 University Heart Center, Department of Cardiovascular Surgery, Hamburg

Background and Purpose: During the last years, Post Mortem Computed Tomography (PMCT) has become an integral part of the autopsy. PMCT-angiography may augment PMCT. Both exams have proven their value in visualizing complications after heart surgery. Therefore, they should also show complications after transvascular interventions. This assumption initiated our project: to evaluate the possibilities of PMCT and PMCT-angiography after transvascular cardiac interventions. Material and Methods: In our archives of characteristic and typical PMCT findings, we searched for observations on preceding transvascular cardiac interventions. Additionally, we reviewed our PMCTangiographies (N=140). Results: After transvascular cardiac interventions, PMCT and PMCT-angiography visualized bleeding, its amount and its origin, cardiac tamponade, free and covered perforations, transvascular implanted valves and their position, catheters and pacemakers with fractures, abnormal loops and bending. Bubbles in the coronary vessels (indicating air embolism) become visible. Conclusion: After transvascular cardiac interventions, PMCT and PMCT-angiography show complications and causes of death. They prove a correct interventional approach and also guide autopsy. In isolated cases, they may even replace autopsy.

Key words: PMCT, Angiography, Autopsy, Angioplasty, Heart, Transvascular Intervention
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