A simplified method for postmortem coronary angiography using gastrograffin

Objective.-To assess the adequacy of perfusion of the heart at autopsy with a gastrograffin and dye mixture to obtain rapid postmortem angiograms whil e simultaneously documenting the vascular distribution of the myocardium. Background.-Postmortem coronary angiography is occasionally used in the eva luation of suspected cardiac deaths. Angiography provides legal documentati on and can serve to guide subsequent cardiac dissection. Multiple technique s have been suggested in the literature for coronary angiography using infu sion of radio-opaque silicone or gelatin. These techniques are cumbersome a nd require equipment generally not available in autopsy suites. Methods.-Following removal of the heart, a mixture of gastrograffin and col ored dyes is injected into each coronary artery via a syringe. The coronary arteries are ligated and radiographs are obtained. After fixation, the hea rt is dissected In the usual manner. Results.-Adequate postmortem coronary angiograms are routinely obtained wit h this method. The coronary arterial distribution within the myocardium is easily documented at both the gross and microscopic levels because of the p resence of differential coloration. Conclusions.-The aforementioned technique using a gastrograffin and dye mix ture provides a simplified approach to postmortem angiography. The novelty of the procedure stems from the low cost, ease of implementation, dual abil ity to assess vascular anatomy radiologically (gastrograffin), and gross di stribution and histologic findings of dependent tissue using the light micr oscope (colored dye). This technique is inexpensive, rapid, and easily used , making it more suitable for general hospital practice and medical examine rs' offices than previously described methods.