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KMID : 0357820050290020146
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Korean Journal of Legal Medicine
2005 Volume.29 No. 2 p.146 ~ p.151
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Forensic Consideration of Myocardial Reperfusion Injury Associated with Cardiac Valves Replacement and Coronary Artery Bypass Graft: A Case Report
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Eom Min-Seob
Choi Yoo-Duk
Kang Gu-Hyun
Min Byeong-Woo
Kim Dong-Hoon
Kim Youn-Shin
Lee Han-Young
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Abstract
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The most effective ways to salvage ischemic myocardium threatened by infarction is to restore tissue perfusion as rapidly as possible. These are best accomplished by restoration of coronary flow(reperfusion) by thrombolysis, percutaneous transluminal conronary angioplasty(PTCA), coronary arterial bypass graft (CABG), or cardiac transplantation. Reperfusion of an ischemic area may result however, in paradoxical cardiomyocytes dysfunction, a phenomenon termed" reperfusion injury". Reperfusion injury has been observed in each of above situations. The myocardium can tolerate brief periods (up to 15 minutes) of severe and even total myocardial ischemia without resultant myocardial death. With increasing duration and severity of ischemia, greater cardiomyocytes damage develop with spectrum of reperfusionassociated pathologies, collectively called reperfusion injury. Here, we report a case of a sixty two-yearold female woman who was suffered cardiac surgery(bivalvular replacement and CABG) and died soon after. Post-mortem examination have revealed typical cardiac reperfusion injury in the background of diffuse myocardial infarction. So, authors report this case with literatures reviews, because we think that this is very good case of cardiac reperfusion injury, confirmed histologically by post-mortem examination.
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KEYWORD
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Reperfusion injury, Heart, Ischemia, Autopsy
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