The purpose of this case study was to form a well‐researched evaluation of the potential procedures and disease states of a donor from Western Michigan University during a cadaveric dissection program at Central Michigan University College of Medicine. The donor was an 83‐year‐old male with a primary cause of death of acute respiratory failure secondary to chronic obstructive pulmonary disease (COPD). Over 6 weeks, using a systematic dissection approach, we identified various surgical remnants and abnormalities within our donor’s body. Based on the surgical interventions and evidence of pathology, we formulated a retrospective diagnosis of the donor. We hypothesized the following procedures and disease states were present: bilateral percutaneous femoral‐popliteal bypass with a reverse saphenous vein anastomosis of the left leg, left carotid endarterectomy, and femorofemoral bypass with an aortobifemoral bypass graft, all of which were thought to be secondary to vascular disease, tobacco use, diabetes and hypertension, with the additional presence of knee arthroplasty and autosomal dominant polycystic kidney disease. At the end of the program, we compared our predictions to the donor's medical history, provided to us by Western Michigan University. Our methods included researching the surgical procedures as we discovered them and using these procedures to predict underlying disease states of our donor. Utilizing resources from PubMed and our program directors, we were able to narrow down the bilateral percutaneous femoral‐popliteal bypass, left carotid endarterectomy, and femorofemoral bypass with an aortobifemoral bypass graft. These vascular surgical interventions led us to believe our donor experienced symptoms of claudication due to underlying vascular disease including peripheral artery disease (PAD), aortoiliac occlusive disease (AIOD), and carotid artery disease (CAD). Common risk factors and causes for vascular disease include male sex, smoking, diabetes mellitus and hypertension; these are risk factors present in our donor that we later confirmed. Additionally, due to the age of our donor and the carotid endarterectomy, we predicted our donor likely experienced a cerebrovascular accident (CVA) during his lifetime. Our results, based on the provided medical history, revealed that we correctly predicted our donor's underlying vascular disease, our donor's risk factors of smoking, diabetes and hypertension, and our donor's surgical interventions including bilateral percutaneous femoral‐popliteal bypass, femorofemoral bypass with an aortobifemoral bypass graft, knee arthroplasty and left carotid endarterectomy. Additional procedures and disease states that we did not explicitly predict include spinal stenosis surgery, bilateral cataract extraction, coronary stent placement, deformity of the proximal femoral shaft, and myocardial infarction.
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Dec 31, 2023
Järvenpää Janne J + 2
