PATHOLOGY OF THE STONE HEART SYNDROME - MASSIVE MYOCARDIAL-CONTRACTION BAND NECROSIS AND WIDELY PATENT CORONARY-ARTERIES

  • 1 January 1979
    • journal article
    • research article
    • Vol. 95  (3) , 745-752
Abstract
Of 201 patients who died some time after cardiac surgery employing cardiopulmonary bypass and who were studied at autopsy following postmortem coronary arteriography and fixation of the heart in a distended state, 4 (2%) had stone heart syndrome. All 4 had undergone aortic valve surgery for aortic stenosis employing hypothermic anoxic arrest. After uncomplicated operation the heart was firm, contracted, prone to fibrillate and could not sustain circulation. Pathological study showed widely patent coronary arteries and severe contraction band necrosis of the inner portions of both ventricular walls. Contraction band necrosis may be elicited by a brisk reflow phase following a potentiating phase of anoxic arrest of the myocardium. Stone heart syndrome appears to be simply the manifestations produced by massive contraction band necrosis in a severely hypertrophied heart.