Spectrum of post mortem autopsy findings in native and surgically corrected hearts with congenital malformations: A 10-year single center experience
Abstract
OBJECTIVES: We reviewed a spectrum of congenital heart defects (CHD) assessed in our center between 1/2010-4/2020, evaluated their gross anatomy, assessed the age distribution, evaluated performed surgical procedures and correlated gross and ultrasound findings. METHODS: All necroptic cases and explanted hearts that underwent specialized cardiac autopsy were included in this study.
Autopsy findings including gross description of CHD together with echocardiographic findings were retrospectively assessed. In surgically corrected hearts, the operation records were included as well.
All CHD and surgical procedures were sub-classified into main and additional category. RESULTS: The study included 92 necroptic cases of live-born children, 7 stillbirths, 2 cases of young adults, 50 induced abortions and 5 explanted hearts, with median age 36 weeks.
The most frequently encountered leading CHD were hypoplastic left heart syndrome, aortic stenosis, septal defects or persistent arterial trunk. 51 patients underwent surgical repair represented mainly by valvuloplasties, aortoplasty and procedures leading to univentricular circulation. In the native hearts, 4 postnatal and 16 abortion/stillbirth cases showed discordance between gross and sonographic findings, mainly attributed to missed ventricular septal defect.
Gestational age of the discordant group was significantly lower compared to the concordant group (p = 0.007). CONCLUSIONS: Autopsy continues to provide essential information about the morphology of CHD.
However, the encountered CHD were usually complex, often surgically corrected or evaluated as a result of induced abortion or still birth. Cardiac autopsy therefore places high demands on pathologists with regards to proper gross heart assessment.
It is also an invaluable part of quality control in prenatal cardiology.