A postmortem review of congenital cardiac malformations in a series of 180adults, over the age of 16 years, born between 1865 and 1980

The evolution of diagnosis and treatment of congenital heart malformations can be traced through patients surviving into adulthood. We reviewed the he art specimens from 180 patients aged 16 to 86 years and considered the morp hological features, the nature of any interventional procedures, and the ev ents leading to death. Based on the mode of clinical presentation, 33 cases were considered covert, and the remaining 147 cases were known or suspecte d to have a cardiac abnormality during life. Of the symptomatic cases, 60 h ad no surgical intervention, whereas 167 surgical procedures had been perfo rmed in the remaining 87 cases. Acquired heart disease was noted in 7 of th e covert cases and in 16 of the symptomatic cases. Overall, there were only 3 instances of errors in clinical identification of significant morphologi cal abnormalities, and 2 cases related to surgical procedures. This review emphasizes the value of autopsy examination for clinicopathologic correlati ons and the case for retention of cardiac specimens for teaching purposes. (C) 1999 by Elsevier Science Inc.