Exposing the Cardiopulmonary Block

Abstract

The pathologist performing an autopsy on the body of an individual who had undergone open-heart surgery weeks to years previously needs to be aware that the heart may be adherent to the posterior surface of the chest plate. The chest plate should be removed without injuring the heart and then examined for clues regarding coronary artery reconstruction. Before removing the cardiopulmonary block from the body, any tubes exiting the heart and sewn to large vessels should be cut a few centimeters away from the anastomoses to facilitate isolation of the heart. When the organ block has been removed from the body, the heart should be isolated. If a coronary injection is planned, and particularly if there is one or more bypass grafts on the heart, no attempt should be made to remove a densely adherent parietal pericardium from the heart until after the injection is completed. Instead, the aorta should be prepared for the coronary injection.