Micro-CT to study and reconstruct fetal and infant coronary arteries: a pilot study on a novel post-mortem technique

For a significant part of infant and fetal deaths, specific pathophysiologic processes cannot be recognized. Thus, the scientific community is called to identify novel post-mortem diagnostic tools. This manuscript proposes the results of a pilot study which reports a novel post-mortem technique to study and reconstruct fetal/ infant coronary arteries. The study included human fetuses characterized by the absence of macroscopic cardiac abnormalities at post-mortem in situ examination. For the study of fetal hearts, it was used a curing radiopaque silicone rubber compound (which solidified after injection in the coronary arteries) and an X-Ray microtomography (micro-CT). After micro -CT scans, coronary arteries' branches were reconstructed throughout a specific software. At injection, it was possible to macroscopically evaluate coronary arteries' perfusion. The analysis of the three-dimensional reconstructions highlighted that the aforementioned compound reached deep branches too. This approach can be considered a novel post-mortem technique for fetal/infant hearts. Nevertheless, the manuscript also discussed the following limitations: in some spots, coronary arteries' reconstruction appeared interrupted; the compound also perfused parts of internal cardiac chambers. Until now, in the literature there are not methods that allow study with reconstruction of fetal/infant coronary arteries throughout micro-CT. The present paper pointed out the first indications for the application of this technique in human samples.