Postmortem coronary CT angiography

Abstract

In the past few decades, the medical autopsy rate has markedly decreased owing to several factors such as the family’s refusal to provide consent, complexity of a time-consuming procedure, and fear of litigation in case of a missed diagnosis. On the other hand, CT and MR scans have increased the accuracy of diagnostic procedures and reduced the need for autopsy. However, medical autopsy remains of interest in the case of unexplained sudden death. Recently, postmortem computed tomography (CT) has emerged as an appealing alternative and compared favourably with conventional autopsy [1]. However, because of blood flow cessation, confirmation of diagnosis based on vascular opacification remains difficult. Recent advances in forensic medicine have prompted implementation of new protocols and use of a modified heart lung machine which temporarily restores blood flow and allows diagnosis of vascular pathologies. However, this requires surgical cannulation of the femoral vessels and might be difficult to implement on a routine basis [2, 3].