Extended minimally invasive autopsy: Technical improvements for the investigation of cardiopulmonary events in COVID-19
OBJECTIVES: Ultrasound-guided minimally invasive autopsies (MIA-US) are an alternative to conventional autopsies and have been used in our institution to investigate the pathophysiology of COVID-19 since the beginning of the pandemic. Owing to the limitations of post-mortem biopsies for evaluating c...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier España
2021-11-01
|
| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100338&tlng=en |
| _version_ | 1818245829891194880 |
|---|---|
| author | Jair Theodoro-Filho Renata Aparecida de Almeida Monteiro Amaro Nunes Duarte-Neto Thais Mauad Luiz Fernando Ferraz da Silva Paulo Hilário Nascimento Saldiva Marisa Dolhnikoff |
| author_facet | Jair Theodoro-Filho Renata Aparecida de Almeida Monteiro Amaro Nunes Duarte-Neto Thais Mauad Luiz Fernando Ferraz da Silva Paulo Hilário Nascimento Saldiva Marisa Dolhnikoff |
| author_sort | Jair Theodoro-Filho |
| collection | DOAJ |
| description | OBJECTIVES: Ultrasound-guided minimally invasive autopsies (MIA-US) are an alternative to conventional autopsies and have been used in our institution to investigate the pathophysiology of COVID-19 since the beginning of the pandemic. Owing to the limitations of post-mortem biopsies for evaluating cardiopulmonary events involving large vessels, we continuously improved the technique during this period. Objectives: To demonstrate the usefulness of an extended MIA-US technique (EMIA-US) for the study of thoracic involvement in COVID-19. METHOD: US-guided percutaneous tissue sampling was combined with a small thoracic incision (≤5 cm), allowing for the sampling of larger tissue samples or even the entire organ (lungs and heart). RESULTS: EMIA-US was performed for eight patients who died of COVID-19 in 2021. We demonstrate cardiopulmonary events, mainly thromboembolism and myocardial infarction, that could be evaluated using EMIA-US. CONCLUSIONS: Minimally invasive image-guided post-mortem tissue sampling is a flexible and practical method to conduct post-mortem studies of human diseases, mainly in areas that do not have autopsy facilities or, alternatively, when autopsy is not possible owing to financial constraints, cultural and religious values, or for safety reasons, such as in the case of highly contagious infectious diseases. We present evidence that EMIA-US is feasible and can be used as an alternative to increase the accuracy of MIA-US in detecting cardiopulmonary events involving large vessels, which may not be assessed through post-mortem biopsies. |
| first_indexed | 2024-12-12T14:39:08Z |
| format | Article |
| id | doaj.art-ec38510d49244fa68f20c3b8d4efccc3 |
| institution | Directory Open Access Journal |
| issn | 1980-5322 |
| language | English |
| last_indexed | 2024-12-12T14:39:08Z |
| publishDate | 2021-11-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-ec38510d49244fa68f20c3b8d4efccc32022-12-22T00:21:19ZengElsevier EspañaClinics1980-53222021-11-017610.6061/clinics/2021/e3543Extended minimally invasive autopsy: Technical improvements for the investigation of cardiopulmonary events in COVID-19Jair Theodoro-Filhohttps://orcid.org/0000-0001-6876-6289Renata Aparecida de Almeida Monteirohttps://orcid.org/0000-0002-6709-5943Amaro Nunes Duarte-Netohttps://orcid.org/0000-0001-6659-7186Thais Mauadhttps://orcid.org/0000-0002-3354-1466Luiz Fernando Ferraz da Silvahttps://orcid.org/0000-0002-0181-6357Paulo Hilário Nascimento Saldivahttps://orcid.org/0000-0003-2005-8253Marisa Dolhnikoffhttps://orcid.org/0000-0002-9073-9989OBJECTIVES: Ultrasound-guided minimally invasive autopsies (MIA-US) are an alternative to conventional autopsies and have been used in our institution to investigate the pathophysiology of COVID-19 since the beginning of the pandemic. Owing to the limitations of post-mortem biopsies for evaluating cardiopulmonary events involving large vessels, we continuously improved the technique during this period. Objectives: To demonstrate the usefulness of an extended MIA-US technique (EMIA-US) for the study of thoracic involvement in COVID-19. METHOD: US-guided percutaneous tissue sampling was combined with a small thoracic incision (≤5 cm), allowing for the sampling of larger tissue samples or even the entire organ (lungs and heart). RESULTS: EMIA-US was performed for eight patients who died of COVID-19 in 2021. We demonstrate cardiopulmonary events, mainly thromboembolism and myocardial infarction, that could be evaluated using EMIA-US. CONCLUSIONS: Minimally invasive image-guided post-mortem tissue sampling is a flexible and practical method to conduct post-mortem studies of human diseases, mainly in areas that do not have autopsy facilities or, alternatively, when autopsy is not possible owing to financial constraints, cultural and religious values, or for safety reasons, such as in the case of highly contagious infectious diseases. We present evidence that EMIA-US is feasible and can be used as an alternative to increase the accuracy of MIA-US in detecting cardiopulmonary events involving large vessels, which may not be assessed through post-mortem biopsies.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100338&tlng=enAutopsyMinimally Invasive AutopsyCOVID-19 |
| spellingShingle | Jair Theodoro-Filho Renata Aparecida de Almeida Monteiro Amaro Nunes Duarte-Neto Thais Mauad Luiz Fernando Ferraz da Silva Paulo Hilário Nascimento Saldiva Marisa Dolhnikoff Extended minimally invasive autopsy: Technical improvements for the investigation of cardiopulmonary events in COVID-19 Clinics Autopsy Minimally Invasive Autopsy COVID-19 |
| title | Extended minimally invasive autopsy: Technical improvements for the investigation of cardiopulmonary events in COVID-19 |
| title_full | Extended minimally invasive autopsy: Technical improvements for the investigation of cardiopulmonary events in COVID-19 |
| title_fullStr | Extended minimally invasive autopsy: Technical improvements for the investigation of cardiopulmonary events in COVID-19 |
| title_full_unstemmed | Extended minimally invasive autopsy: Technical improvements for the investigation of cardiopulmonary events in COVID-19 |
| title_short | Extended minimally invasive autopsy: Technical improvements for the investigation of cardiopulmonary events in COVID-19 |
| title_sort | extended minimally invasive autopsy technical improvements for the investigation of cardiopulmonary events in covid 19 |
| topic | Autopsy Minimally Invasive Autopsy COVID-19 |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100338&tlng=en |
| work_keys_str_mv | AT jairtheodorofilho extendedminimallyinvasiveautopsytechnicalimprovementsfortheinvestigationofcardiopulmonaryeventsincovid19 AT renataaparecidadealmeidamonteiro extendedminimallyinvasiveautopsytechnicalimprovementsfortheinvestigationofcardiopulmonaryeventsincovid19 AT amaronunesduarteneto extendedminimallyinvasiveautopsytechnicalimprovementsfortheinvestigationofcardiopulmonaryeventsincovid19 AT thaismauad extendedminimallyinvasiveautopsytechnicalimprovementsfortheinvestigationofcardiopulmonaryeventsincovid19 AT luizfernandoferrazdasilva extendedminimallyinvasiveautopsytechnicalimprovementsfortheinvestigationofcardiopulmonaryeventsincovid19 AT paulohilarionascimentosaldiva extendedminimallyinvasiveautopsytechnicalimprovementsfortheinvestigationofcardiopulmonaryeventsincovid19 AT marisadolhnikoff extendedminimallyinvasiveautopsytechnicalimprovementsfortheinvestigationofcardiopulmonaryeventsincovid19 |