title: Autopsy after transcatheter aortic valve implantation.
abstract: Autopsy after transcatheter aortic valve implantation (TAVI) is a new field of interest in cardiovascular pathology. To identify the cause of death, it is important to be familiar with specific findings related to the time interval between the procedure and death. We aimed to provide an overview of the autopsy findings in patients with TAVI in their medical history divided by the timing of death with specific interest in the added value of autopsy over a solely clinically determined cause of death. In 8 European centres, 72 cases with autopsy reports were available. Autopsies were divided according to the time interval of death and reports were analysed. In 32 patients who died ≤72 h postprocedure, mortality resulted from cardiogenic or haemorrhagic shock in 62.5 and 34.4%, respectively. In 31 patients with mortality >72 h to ≤30 days, cardiogenic shock was the cause of death in 51.6% followed by sepsis (22.6%) and respiratory failure (9.7%). Of the nine patients with death >30 days, 88.9% died of sepsis, caused by infective endocarditis in half of them. At total of 12 patients revealed cerebrovascular complications. Autopsy revealed unexpected findings in 61.1% and resulted in a partly or completely different cause of death as was clinically determined. Autopsy on patients who underwent TAVI reveals specific patterns of cardiovascular pathology that clearly relate to the time interval between TAVI and death and significantly adds to the clinical diagnosis. Our data support the role of autopsy including investigation of the cerebrum in the quickly evolving era of cardiac device technology.
authors.affiliation: Heart Centre, Academic Medical Centre, Amsterdam, The Netherlands.|Department of Radiology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: van Kesteren
authors.affiliation: Heart Centre, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: E M A
authors.initials: EM
authors.lastname: Wiegerinck
authors.affiliation: Department of Cardiac, Thoracic, and Vascular Sciences, Cardiovascular Pathology Unit, University of Padua, Padua, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Rizzo
authors.affiliation: Heart Centre, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Baan
authors.affiliation: Department of Radiology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: R N
authors.initials: RN
authors.lastname: Planken
authors.affiliation: Department of Pathology, Erasmus Medical Centre, University of Rotterdam, Rotterdam, The Netherlands.
authors.forename: J H
authors.initials: JH
authors.lastname: von der Thüsen
authors.affiliation: Department of Pathology and Cardiac Surgery, ICaR-VU, VU Medical Centre, Amsterdam, The Netherlands.
authors.forename: H W M
authors.initials: HW
authors.lastname: Niessen
authors.affiliation: Department of Pathology, Sint Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: M F M
authors.initials: MF
authors.lastname: van Oosterhout
authors.affiliation: Department of Pathology, Pisa University Hospital, Pisa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pucci
authors.affiliation: Department of Cardiac, Thoracic, and Vascular Sciences, Cardiovascular Pathology Unit, University of Padua, Padua, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Thiene
authors.affiliation: Department of Cardiac, Thoracic, and Vascular Sciences, Cardiovascular Pathology Unit, University of Padua, Padua, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Basso
authors.affiliation: Department of Pathology, St George Medical School, University of London, London, UK.
authors.forename: M N
authors.initials: MN
authors.lastname: Sheppard
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Cardiac Pathology Unit, Deutsches Herzzentrum Berlin, Berlin, Germany.|Department of Pathology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Wassilew
authors.affiliation: Department of Pathology, Academic Medical Centre-University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands. a.c.vanderwal@amc.nl.
authors.forename: A C
authors.initials: AC
authors.lastname: van der Wal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000401:mortality*
keywords: Autopsy; Cause of death; Pathology; TAVI; TAVR