Retrospective analysis of forensic sectional examinations after a coronary bypass surgery

Background: In the case of sudden or violent death, occurring in the rehabilitation period after a previously performed coronary bypass surgery, a forensic medical examination is usually prescribed. In recent years, the number of such forensic examinations has increased. At the same time, problems were revealed related to the lack of guidelines for the study of coronary shunts and recommendations on the structure of forensic diagnosis. Aims: This study aimed to summarize significant differences and features of coronary shunt research methods and give examples of diagnosis in cases of forensic examinations of corpses of patients who underwent coronary bypass surgery. Conclusions (acts) of forensic medical examinations (studies) of corpses performed at the bureau of forensic medical examination of the city of Moscow for the five-year period in 2012–2016 were studied. Cases of forensic examinations in patients who had previously undergone coronary bypass surgery were identified, original technical methods for sectional study of postoperative shunts are summarized, and options for constructing and substantiating sectional diagnoses were developed. In the analysis of 135, 446 conclusions (acts), 56 cases of forensic examinations of corpses of persons with signs of previously performed coronary bypass surgery were selected. Distinctive features of original methods for the study of shunts, tasks resolved during the study of native and prosthetic heart vessels, and examples of the design of forensic protocols are described. Examples of construction and substantiation of forensic diagnoses are also provided. Conclusion: This study revealed original technical methods for the study of coronary shunts during the concealment of corpses and examples of protocols of identified changes, and options for the formulation of forensic medical diagnoses in cases of forensic examinations of corpses of persons with a previously performed coronary bypass surgery are given.