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Autopsy and Medicine
July 12, 1999

Case of the MonthOutcome Analysis and Quality Assessment

Allan T. Bennett, MD; Kim A. Collins, MD; Randy Hanzlick, MD; et al and the Autopsy Committee of the College of American Pathologists
Arch Intern Med. 1999;159(13):1399-1400. doi:10.1001/archinte.159.13.1399

A WHITE male infant was born at 37 weeks' gestation. Soon after delivery, hypoplastic left heart syndrome was diagnosed. A Norwood procedure was performed (a palliative procedure with anastomosis of the aorta to the right ventricle for systemic circulation and an atrial septectomy formed to avoid pulmonary venous hypertension). Reexploration was required for postoperative bleeding, which was controlled surgically. Urosepsis and disseminated intravascular coagulopathy complicated the clinical course and the infant died. The surgeons requested permission for autopsy from the family so that the surgical procedure could be reassessed, but the family declined and stated that the infant had been "cut on enough." However, when the option of a limited autopsy was discussed, the family consented to a postmortem examination limited to the heart and lungs.

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