Application of postmortem computed tomography angiography to settle a medical dispute after aortic dissection surgery: a forensic case report

Author:

Zhuoqun Wang,Zhiling Tian,Lei Wan,Hewen Dong,Donghua Zou,Jianhua Zhang,Ningguo Liu

Abstract

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.

Funder

National Key Research and Development Program of China

Council of National Science Foundation of China

Council of National Science Foundation of Shanghai

Key Laboratory of judicial expertise of Ministry of Justice and Shanghai Key Laboratory of Forensic Medicine

Shanghai Forensic Service Platform

Central Research Institute Public Project

Shanghai Key Laboratory of Forensic Medicine, Key Lab of Forensic Science, Ministry of Justice

Publisher

Springer Science and Business Media LLC

Subject

Cardiology and Cardiovascular Medicine,General Medicine,Surgery,Pulmonary and Respiratory Medicine

Reference23 articles.

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