The Operated Heart at Autopsy addresses the need of pathologists in practice and, especially, in training to achieve a new level of competence in dealing, at the time of autopsy, with the anatomic complexity of a heart that has undergone previous surgical treatment, whether that treatment occurred in the recent or remote past. Ready identification of post-operative morphologic changes in the heart will greatly increase the comfort level of the pathologist as he takes on the challenge of the operated heart. By drawing on lessons learned as a cardiac surgeon, the author offers reasonable guidelines to the pathologist facing this challenging task. Such guidelines include a methodical approach to assess multiple operative procedures on the heart. Previous surgery may include construction of coronary artery bypass grafts (CABG), replacement or repair of one or more heart valves, repair of one or more congenital heart anomalies, or some other procedure. Questions will arise at such an autopsy.