Generic Portal

TY - JOUR

T1 - Autopsy in adults with congenital heart disease (ACHD)

AU - On behalf of Association for European Cardiovascular Pathology (AECVP)

AU - Angelini, Annalisa

AU - di Gioia, Cira

AU - Doran, Helen

AU - Fedrigo, Marny

AU - Henriques de Gouveia, Rosa

AU - Ho, Siew Yen

AU - Leone, Ornella

AU - Sheppard, Mary N.

AU - Thiene, Gaetano

AU - Dimopoulos, Konstantinos

AU - Mulder, Barbara

AU - Padalino, Massimo

AU - van der Wal, Allard C.

PY - 2020/6/1

Y1 - 2020/6/1

N2 - The adult congenital heart diseases (ACHD) population is exceeding the pediatric congenital heart diseases (CHD) population and is progressively expanding each year, representing more than 90% of patients with CHD. Of these, about 75% have undergone surgical and/or percutaneous intervention for palliation or correction. Autopsy can be a very challenging procedure in ACHD patients. The approach and protocol to be used may vary depending on whether the pathologists are facing native disease without surgical or percutaneous interventions, but with various degrees of cardiac remodeling, or previously palliated or corrected CHD. Moreover, interventions for the same condition have evolved over the last decades, as has perioperative myocardial preservations and postoperative care, with different long-term sequelae depending on the era in which patients were operated on. Careful clinicopathological correlation is, thus, required to assist the pathologist in performing the autopsy and reaching a diagnosis regarding the cause of death. Due to the heterogeneity of the structural abnormalities, and the wide variety of surgical and interventional procedures, there are no standard methods for dissecting the heart at autopsy. In this paper, we describe the most common types of CHDs that a pathologist could encounter at autopsy, including the various types of surgical and percutaneous procedures and major pathological manifestations. We also propose a practical systematic approach to the autopsy of ACHD patients.

AB - The adult congenital heart diseases (ACHD) population is exceeding the pediatric congenital heart diseases (CHD) population and is progressively expanding each year, representing more than 90% of patients with CHD. Of these, about 75% have undergone surgical and/or percutaneous intervention for palliation or correction. Autopsy can be a very challenging procedure in ACHD patients. The approach and protocol to be used may vary depending on whether the pathologists are facing native disease without surgical or percutaneous interventions, but with various degrees of cardiac remodeling, or previously palliated or corrected CHD. Moreover, interventions for the same condition have evolved over the last decades, as has perioperative myocardial preservations and postoperative care, with different long-term sequelae depending on the era in which patients were operated on. Careful clinicopathological correlation is, thus, required to assist the pathologist in performing the autopsy and reaching a diagnosis regarding the cause of death. Due to the heterogeneity of the structural abnormalities, and the wide variety of surgical and interventional procedures, there are no standard methods for dissecting the heart at autopsy. In this paper, we describe the most common types of CHDs that a pathologist could encounter at autopsy, including the various types of surgical and percutaneous procedures and major pathological manifestations. We also propose a practical systematic approach to the autopsy of ACHD patients.

KW - Adult congenital heart diseases

KW - Autopsy

KW - Cardiovascular pathology

KW - Congenital heart diseases

KW - Protocol

UR - http://www.scopus.com/inward/record.url?scp=85083386220&partnerID=8YFLogxK

U2 - 10.1007/s00428-020-02779-8

DO - 10.1007/s00428-020-02779-8

M3 - Review article

C2 - 32266476

VL - 476

SP - 797

EP - 820

JO - Virchows Archiv

JF - Virchows Archiv

SN - 0945-6317

IS - 6

ER -