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.
Bennett AT, Collins KA, Hanzlick R, and the Autopsy Committee of the College of American Pathologists. Case of the Month: Outcome Analysis and Quality Assessment. Arch Intern Med. 1999;159(13):1399–1400. doi:10.1001/archinte.159.13.1399
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