Cardiac Pathology

Cardiac Pathology Services

Cardiac / cardiovascular pathology services offers expert on-site cardiac biopsy interpretation, as well as dissection of explanted hearts and autopsy specimens. Consultation is available to pathologists and clinical physicians in the diagnosis of a wide variety of cardiac disorders. We welcome either biopsy specimens or whole organs obtained at other hospitals / surgical facilities referred to our laboratory for interpretation, including complete dissection. Slides from previously prepared samples (specimens that were obtained and processed elsewhere) may likewise be referred for consultation or second opinion. 

Endomyocardial Biopsy

  • Helpful in diagnosis of:
  • Transplant rejection
  • Post-transplant lymphoproliferative disorders
  • Myocarditis
  • Cardiomyopathies
  • Other: tumors, post-surgical changes, systemic conditions

Services Offered:

  • Routine endomyocardial histologic examination and immunohistochemical studies (standard transplant panel: H&E, CD3, C4d, CD34/CD68 dual).
  • Special studies: additional histochemical and immunohistochemical studied are utilized as indicated (e.g. in/situ hybridization, T and B cell markers, etc.).
  • We routinely fix a small portion of each fresh frozen biopsy in glutaraldehyde in the event electron microscopy (EM) is necessary.

Whole-Organ Heart Dissection

Helpful in diagnosis of:

  • Congenital cardiac native anatomy
  • Congenital cardiac post-surgical anatomy
  • Shunt malfunction or thrombi
  • Cardiomyopathies
  • Remodelling
  • Cardiac or cardiovascular tumors
  • Valve disorders
  • Device malposition, anatomic malfunction
  • Infectious disorders
  • Allograft rejection
  • Vasculopathies
  • Myocardial infarctions
  • Conduction system disorders

Services Offered: 

  • Expert dissection of fresh or formalin-fixed whole organ heart explants, autopsy hearts, and heart/lung/great vessel blocs.
  • Delineation of complex native anatomy, palliated anatomy, and postoperative changes.
  • Routine histological examination of pathology of the myocardium, vessels, valves, surgical shunts or conduits, device cannulas, epicardium, pericardium, great vessels and pulmonary vasculature.

Special Studies:

  • Immunohistochemical staining is available for workup of allograft rejection, myocarditis, and cardiac tumors.
  • Viral PCR is available for suspected infectious myocarditis cases, if fresh tissue is provided.
  • We can fix a small portion of myocardium in glutaraldehyde in the event electron microscopy (EM) is necessary, if the heart or organ bloc is sent fresh.

Specimen Handling for Whole-Organ Dissection

  • A surgical pathology accession sheet with adequate clinical history and differential diagnosis must accompany the specimen for proper interpretation. 
  • Operative notes from cardiac surgical procedures, if applicable, must accompany the specimen; additional studies (echocardiograms, catheterizations) are extremely helpful. 
  • Advance notice is crucial for proper shipment and processing: please notify Cincinnati Children’s Hospital Pathology Department at 513-636-4261 that a whole organ specimen will be arriving.
  • Please indicate if you would like the specimen returned.

Where to Send Materials?

Please mail all material to:  


Division of Pathology and Laboratory Medicine
Cincinnati Children’s Hospital Medical Center
3333 Burnet Avenue, MLC1035
Cincinnati, OH