Yale Cardiovascular Pathology

Yale Cardiovascular Pathology Service provides comprehensive diagnostic expertise in the pathology of the heart and blood vessels. Our services include the most up-to-date classification of antibody and acute cellular rejection in adult and pediatric transplanted hearts.

Yale Cardiovascular Pathology Service members participate in weekly heart-transplant multidisciplinary team meetings to provide real-time treatment advice. As a research-oriented service, we work with clinicians and provide one-on-one consult on interesting cases. We provide pathological expertise on morphological interpretation, suggesting and conducting relevant special and immunohistochemical stains and selected whole genome-based assays. We also provide expert consult to autopsy with challenging cardiovascular lesions. We have special expertise in the area of myocardial biopsy evaluation, especially myocarditis and transplant rejection. We currently receive and review 2,000 cardiovascular specimens annually. These specimens often require same-day interpretation on a routine basis directing and affecting the immediate treatment of patients. In addition, we have special expertise in evaluating vasculitis, atherosclerosis and its complications, and benign and malignant vascular tumors. Electron microscope use is employed in the rare occasions of fetal and toxic cardiomyopathy.

Clinical specimens we receive and review typically include:

• Myocardial biopsies (90% of which are obtained from patients following cardiac transplantation), explanted hearts, cardiac valves (native and prosthetic) and cardiac tumor.
• Vascular specimens including lower leg amputation, resections of aneurysm, biopsies for vasculitis, pericardial specimens, temporal arteritis and amyloid deposition.

Cardiovascular pathology plays a key role in the understanding and management of a series of cardiovascular diseases, which remain the No. 1 cause of mortality in the U.S. and worldwide. Our faculty members collaborate closely with cardiologists, cardiac surgeons, cardiovascular radiologists and translational investigators. At the request of Yale Basic Science investigators and clinicians, we are establishing a Cardiovascular Histology Bank, with an ongoing expansion of the tissue collection to autopsy samples. Ample clinical, translational and basic research and training opportunities are available for our trainees, including fellows and residents. Our Director, Dr. Peter Wang, has extensive experience in cardiovascular research and therapeutics as his research lab focuses on the mechanism of atherosclerosis and arterial stiffness changes, especially the role of smoking – including E-cigarette vaporing – on endothelial cell injury and monocyte/macrophage activation through whole genome DNA methylation profiling and whole genome association studies.

In conjunction with the Yale Thoracic Pathology Service, we have established a dedicated cardiothoracic subspecialty fellowship. Yale Cardiovascular Service is actively involved in resident teaching on cardiovascular pathology and techniques of cardiac dissection through structured rotations. Our regular sessions with pathology residents, cardiovascular fellows and cardiac surgical house officers provide structure-function correlation for these trainees. Yale Cardiovascular Service routinely participates in weekly transplantation conference and is expanding our presence in the cardiac-related morbidity and mortality and autopsy conferences. Our members serve as lecturers and laboratory instructors for medical and graduate student courses at Yale School of Medicine. Our members also participate in national and international professional and educational activities including USCAP annual meetings and the Society of Cardiovascular Pathology.