title: Post-mortem computed tomography and post-mortem computed tomography angiography following transcatheter aortic valve implantation†.
abstract: OBJECTIVE
  At present, transcatheter aortic valve implantation (TAVI) is widely used. As with any interventional treatment, however, TAVI may also be accompanied by complications and may result in periprocedural mortality. This study aims to evaluate such complications and causes of death after TAVI.
  
  
  METHODS
  The study included 32 deceased (59.4% female, n = 19, median age: 82 years) patients with TAVI, since 2008, in whom post-mortem computed tomography (PMCT) and PMCT angiography were performed with the intention of identifying complications.
  
  
  RESULTS
  Altogether, we registered bleeding (28.1%, 9/32), perforation and rupture (25%, 8/32), cerebral infarction (18.8%, 6/32), injury of the conduction system (3.1%, 1/32), insufficiency of the aortic (12.5%, 4/32) and the mitral valve (9.4%, 3/32) and of valve-in-valve procedures (9.4%, 3/32). Furthermore, there were findings due to cardiopulmonary resuscitation and intensive care. PMCT and PMCT angiography has advantages over autopsy. The demonstration of bleeding vessels, ruptures, the position of the implanted aortic valve and its effects on the mitral valve and its suspensions were more easily accessible by computed tomography-imaging display than by customary autopsy photo-documentation.
  
  
  CONCLUSIONS
  After TAVI, PMCT and PMCT angiography successfully demonstrated the complications leading to death. PMCT and PMCT angiography contribute to the post-mortem analysis of causes of periprocedural death.
authors.affiliation: Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany b.vogel@uke.de.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Vogel
authors.affiliation: Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Heinemann
authors.affiliation: Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Gulbins
authors.affiliation: Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Treede
authors.affiliation: Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Reichenspurner
authors.affiliation: Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Püschel
authors.affiliation: Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Vogel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001344:Autopsy; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000401:mortality*; D014057:Tomography, X-Ray Computed; D065467:Transcatheter Aortic Valve Replacement / Q000401:mortality*
keywords: Complications; Multiphase PMCT angiography; Post-mortem computed tomography; Transcatheter aortic valve implantation