Pathological examination of 50 young patients with unexpected sudden perioperative death revealed unsuspected cardiac lesions in 47 cases, most commonly arrhythmogenic right ventricular cardiomyopathy.
Observational (n=50)
Unsuspected cardiac lesions, particularly arrhythmogenic right ventricular cardiomyopathy and coronary artery disease, are frequent underlying causes of sudden unexpected perioperative death in young, otherwise healthy patients.
The retrospective analysis of 1700 forensic autopsies over 17 years (1981-97) following unexpected sudden cardiac death revealed a group of 50 cases that could have been related to surgery and/or anaesthesia. Patients were young with no history of cardiac disease. Surgery was performed for uncomplicated disorders, all classified as ASA 1. Cardiac arrest took place at induction of anaesthesia in 16% of cases, during surgery in 64% and at the end of surgery in 20%. Investigation and expertise reports ordered by the public prosecutor revealed none of the typical causes of death usually associated with surgery or anaesthesia. Pathological examination showed cardiac lesions in 47 cases: arrhythmogenic right ventricular cardiomyopathy in 18 cases, coronary artery disease in 10 cases, cardiomyopathy in eight cases, structural abnormalities of the His bundle in nine cases, mitral valve prolapse in one case, and acute myocarditis in one case. Identification of the cause of death of patients at low risk may provide major relief to the family of the patient and the medical staff.
Tabib et al. (Sat,) conducted a observational in Unexpected sudden perioperative death (n=50). Unsuspected cardiac lesions was evaluated on Presence of cardiac lesions on pathological examination. Pathological examination of 50 young patients with unexpected sudden perioperative death revealed unsuspected cardiac lesions in 47 cases, most commonly arrhythmogenic right ventricular cardiomyopathy.