An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any disease or injury that may be present for research or educational purposes.
Between December 1992 and May 1999, IVUS examination was performed in 262 heart transplant recipients 30.9±13.2 days after transplantation. The donor population consisted of 116 women (44%) and 146 men (56%) with a mean age of 33.4±13.2 years. None of the patients had known coronary artery disease because potential donors were screened for heart disease before proceeding with transplantation. The hospital’s Institutional Review Board approved the study protocol. All participants provided info...
The method of IVUS imaging has been reported previously in detail.7After coronary angiography, patients received anticoagulation with heparin, and 100 to 200 μg nitroglycerin IC was administered. A 30-MHz, 3.5F monorail ultrasound catheter (Boston Scientific) was advanced over an angioplasty guidewire to a distal location in the coronary artery, and the position of the transducer was documented by angiography. Ultrasound images were displayed with a dedicated scanner (Hewlett-Packard Corp) an...
Offline IVUS Analysis
Images were reviewed on a video monitor in the IVUS core laboratory. Using an image-processing computer, a technician digitized full-motion IVUS sequences (30 frames per second) at a 640×480 pixel matrix with 24 bits per pixel. Images were considered suitable for analysis if they were free of ultrasound artifacts, such as extreme catheter angulation or nonuniform rotational distortion. For each segment, defined according to Coronary Artery Surgery Study (CASS) classification, the operator sel...
Patient Population and Extent of Imaging
All donors in the study were free of known heart disease, the mean age was 33±13.2 years, and 56% were male. Other donor characteristics are listed in the Table. In the 262 subjects, 574 major epicardial coronary arteries other than the left main trunk were imaged (2.2 arteries per patient). The left anterior descending coronary artery (LAD) was visualized in 238 patients (90% of the cohort), the left circumflex (LCx) in 180 (69%), and the right coronary artery (RCA) in 156 (56%). All 3 arter...
Intimal Thickness at the Normal Sites
Figure 1shows the frequency distribution of the normal site with least intimal thickness in each patient for different age cohorts. If the donor was <40 years of age, the smallest intimal thickness in each patient was always <0.3 mm. Even when the donor age was >40 years, the normal intimal thickness was always <0.5 mm. Therefore, in the present study, we used the threshold of 0.5 mm to define the presence of an atherosclerotic lesion and to determine the prevalence of atherosclerosis. We als...
Prevalence of Atherosclerosis
Of 262 individuals, 136 (51.9%) had ≥1 atherosclerotic site (intimal thickness >0.5 mm) (Figure 2). In these 136 subjects, the intimal thickness at the lesion was 1.08±0.48 mm, and percent stenosis averaged 32.7±15.9%. Figure 3 shows the frequency distribution of greatest intimal thickness in each patient for different age groups, demonstrating that intimal thickness increases progressively with advancing age. In all age groups, a portion of the cohort had ≥1 site with intimal thickness excee...
Atherosclerotic coronary disease is the leading cause of death and a major source of morbidity in developed countries, resulting in nearly 1 million deaths and $100 billion in annual costs in the United States alone.16 Necropsy studies have demonstrated that atherosclerosis begins at a very early stage in life. The present study provides unequivocal in vivo evidence of atherosclerosis in young asymptomatic individuals with no evidence of clinical coronary artery disease (Figure 3). This study is unique because it provides detailed, clinically relevant, quantitative, in vivo information on early atherosclerosis from an asymptomatic young population. Necropsy studies dating back to 1948 describe coronary atherosclerosis in a young population, but none have provided quantitative measures of disease severity.12345 In Korean and Vietnam war victims, the degree of obstruction was judged by gross inspection and microscopic examination performed without pressure fixation. Stary, in an elega...
- E. Murat Tuzcu, Samir R. Kapadia, Eralp Tutar, Khaled M. Ziada, Robert E. Hobbs, Patrick M. McCarthy...
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May 01, 2001 · The cause of death at necropsy cannot be ascertained unless there are prior ECG data. Genetic analysis reveals multiple abnormalities in genes related to both cardiac potassium and cardiac sodium channels. At present, important genotype—phenotype correlations and the identification of gene-specific arrhythmogenic triggers are slowly emerging.
- Cristina Basso, Fiorella Calabrese, Domenico Corrado, Gaetano Thiene
May 28, 1994 · EDITOR, - The definition of the sudden infant death syndrome was called into question at the second international conference on the syndrome, in February 1992. As no consensus could be reached it was decided to keep the 1969 Beckwith definition: “the death of an infant or young child, which is unexpected by history and in whom a thorough necropsy examination fails to reveal an adequate cause ...
- C Rambaud, C Guilleminault, P E Campbell
Aug 07, 2021 · (The cause of death from legal abortion during 1979-1985 was hemorrhage (22.2%); infection (13.9%); embolism (15.3%); anesthesia (29.2%) and other (19.4%). "Fatal Hemorrhage from Legal Abortion in the United States," D. Grimes, et al., Surgery, Gynecology and Obstetrics, 157: 461-6, November 1983.
May 01, 1987 · Thus, the definition of sudden death is an unexpected, witnessed death of natural causes with or without pre-existing disease that occurs within six hours of onset of symptoms. PATHOLOGY OF ATHEROSCLEROTIC CORONARY ARTERY DISEASE In the United States, the most frequent cause of sudden cardiac death is atherosclerotic coronary ar- tery disease.