Application of postmortem computed tomography angiography to settle a medical dispute after aortic dissection surgery: a forensic case report
Abstract Background In the present case, we applied postmortem computed tomography angiography (PMCTA) in a medical dispute involving sudden death after cardiovascular surgery. Case presentation A 39-year-old man underwent aortic arch replacement combined with stented elephant trunk implantation sur...
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Format: | Article |
Language: | English |
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BMC
2023-08-01
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Series: | Journal of Cardiothoracic Surgery |
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Online Access: | https://doi.org/10.1186/s13019-023-02353-8 |
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author | Wang Zhuoqun Tian Zhiling Wan Lei Dong Hewen Zou Donghua Zhang Jianhua Liu Ningguo |
author_facet | Wang Zhuoqun Tian Zhiling Wan Lei Dong Hewen Zou Donghua Zhang Jianhua Liu Ningguo |
author_sort | Wang Zhuoqun |
collection | DOAJ |
description | Abstract Background In the present case, we applied postmortem computed tomography angiography (PMCTA) in a medical dispute involving sudden death after cardiovascular surgery. Case presentation A 39-year-old man underwent aortic arch replacement combined with stented elephant trunk implantation surgery under extracorporeal circulation. All vital signs were stable and he was arranged for discharge seven days after surgery. Several days later, the patient was sent back to the hospital for chest pain and poor appetite. Unfortunately, his condition worsened and he ultimately died. PMCT scanning detect pericardial effusion. Family members suspected that the surgical sutures were not dense enough, causing the patient’s postoperative bleeding and resulting in cardiac tamponade and death. PMCTA was performed before autopsy, which showed pericardial effusion. However, postmortem angiography with simulated blood pressure showed no leakage of contrast agent, which guided the subsequent autopsy and histological examinations. Conclusions While many previous postmortem imaging case reports have shown positive results that provided evidence of medical malpractice, the current case excludes the possibility of physician negligence and reasonably settles the medical dispute from another perspective. In short, the PMCTA approach we describe here was an effective tool that can be applied to certain medical-related forensic cases. |
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format | Article |
id | doaj.art-f5aef032c7694abba01c6bae58535bb7 |
institution | Directory Open Access Journal |
issn | 1749-8090 |
language | English |
last_indexed | 2024-03-10T17:04:26Z |
publishDate | 2023-08-01 |
publisher | BMC |
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series | Journal of Cardiothoracic Surgery |
spelling | doaj.art-f5aef032c7694abba01c6bae58535bb72023-11-20T10:52:55ZengBMCJournal of Cardiothoracic Surgery1749-80902023-08-011811810.1186/s13019-023-02353-8Application of postmortem computed tomography angiography to settle a medical dispute after aortic dissection surgery: a forensic case reportWang Zhuoqun0Tian Zhiling1Wan Lei2Dong Hewen3Zou Donghua4Zhang Jianhua5Liu Ningguo6Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of JusticeShanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of JusticeShanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of JusticeShanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of JusticeShanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of JusticeShanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of JusticeShanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of JusticeAbstract Background In the present case, we applied postmortem computed tomography angiography (PMCTA) in a medical dispute involving sudden death after cardiovascular surgery. Case presentation A 39-year-old man underwent aortic arch replacement combined with stented elephant trunk implantation surgery under extracorporeal circulation. All vital signs were stable and he was arranged for discharge seven days after surgery. Several days later, the patient was sent back to the hospital for chest pain and poor appetite. Unfortunately, his condition worsened and he ultimately died. PMCT scanning detect pericardial effusion. Family members suspected that the surgical sutures were not dense enough, causing the patient’s postoperative bleeding and resulting in cardiac tamponade and death. PMCTA was performed before autopsy, which showed pericardial effusion. However, postmortem angiography with simulated blood pressure showed no leakage of contrast agent, which guided the subsequent autopsy and histological examinations. Conclusions While many previous postmortem imaging case reports have shown positive results that provided evidence of medical malpractice, the current case excludes the possibility of physician negligence and reasonably settles the medical dispute from another perspective. In short, the PMCTA approach we describe here was an effective tool that can be applied to certain medical-related forensic cases.https://doi.org/10.1186/s13019-023-02353-8Postmortem computed tomography angiographyCardiac surgeryAortic dissectionMedical disputeForensic pathology |
spellingShingle | Wang Zhuoqun Tian Zhiling Wan Lei Dong Hewen Zou Donghua Zhang Jianhua Liu Ningguo Application of postmortem computed tomography angiography to settle a medical dispute after aortic dissection surgery: a forensic case report Journal of Cardiothoracic Surgery Postmortem computed tomography angiography Cardiac surgery Aortic dissection Medical dispute Forensic pathology |
title | Application of postmortem computed tomography angiography to settle a medical dispute after aortic dissection surgery: a forensic case report |
title_full | Application of postmortem computed tomography angiography to settle a medical dispute after aortic dissection surgery: a forensic case report |
title_fullStr | Application of postmortem computed tomography angiography to settle a medical dispute after aortic dissection surgery: a forensic case report |
title_full_unstemmed | Application of postmortem computed tomography angiography to settle a medical dispute after aortic dissection surgery: a forensic case report |
title_short | Application of postmortem computed tomography angiography to settle a medical dispute after aortic dissection surgery: a forensic case report |
title_sort | application of postmortem computed tomography angiography to settle a medical dispute after aortic dissection surgery a forensic case report |
topic | Postmortem computed tomography angiography Cardiac surgery Aortic dissection Medical dispute Forensic pathology |
url | https://doi.org/10.1186/s13019-023-02353-8 |
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