Rare but real: Takotsubo syndrome following mitral valve surgery

Totaro, Pasquale; Triolo, Oreste Fabio; Argano, Vincenzo

doi:10.1111/jocs.14453

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…Diagnosis of TTC was made on day 4 (1-4) after surgery. Whenever described (27 available data), concomitant left ventricular dysfunction was always observed with a median LVEF of 26.5% (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30).…”

Section: Assessment and Diagnosismentioning

confidence: 99%

Takotsubo cardiomyopathy after cardiac surgery: A case-series and systematic review of literature

Laghlam

Touboul

Herry

et al. 2023

Front. Cardiovasc. Med.

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BackgroundTakotsubo cardiomyopathy (TTC) is a rare entity after cardiac surgery.AimsTo describe patients’ profile who developed postoperative TTC after cardiac surgery, management, and outcomes.MethodsWe performed a systematic literature search to extract cases of TTC after adult cardiac surgery (from 1990 to 2021). Additionally, we extracted all cases of TTC in a prospective single-center cohort database of 10,000+ patients (from 2007 to 2019). We then combined all cases in a single cohort to describe its clinical features.ResultsFrom 694 screened articles, we retained 71 individual cases published in 20 distinct articles (19 cases reports and 1 case-series). We combined these to 10 cases extracted from our cohort [among 10,682 patients (0.09%)]. Overall, we included 81 cases. Patients were aged 68 ± 10 years-old and 64/81 (79%) were women. Surgery procedures included mitral valve and/or tricuspid valve surgery in 70/81, 86%. TTC was diagnosed in the first days after surgery [median 4 (1–4) days]. Incidence of cardiogenic shock, defined as requirement of vasopressor and/or inotropic support was 24/29, 83% (data available on 29/81 patients). Refractory cardiogenic appeared in 5/81, 6% who required implantation of arterio-venous extra-corporeal membrane oxygenation, and 6/81, 7%, intra-aortic balloon pump. In-hospital mortality was 5/81, 6%.ConclusionThis systematic review, based on case reports and case series, showed that postoperative TTC appears as a rare complication after cardiac surgery and mainly occurred after mitral and/or tricuspid valve repair procedures. In this population, TTC is associated with high rate of cardiogenic shock.

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Section: Assessment and Diagnosismentioning

confidence: 99%

Takotsubo cardiomyopathy after cardiac surgery: A case-series and systematic review of literature

Laghlam

Touboul

Herry

et al. 2023

Front. Cardiovasc. Med.

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弓部大動脈全置換術中に St 上昇を伴い発症したたこつぼ型心筋症の1例

2022

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Aside from myocardial infarction, coronary spastic angina, and air embolism of the coronary arteries, Takotsubo cardiomyopathy is a rare cause of ST elevation during the perioperative period of cardiovascular surgery. Here we report a case of Takotsubo cardiomyopathy that developed with ST elevation during total arch replacement. A 71-year-old man was found to have an abnormality on chest X-ray. A thoracic aortic aneurysm with a maximum diameter of 68 mm was diagnosed on CT, and surgical intervention was indicated. Preoperative ECG showed no abnormality. Transthoracic echocardiography showed normal left ventricular wall motion. No valvular disease was observed. Coronary angiography showed a 50% stenotic lesion in the right coronary artery, but it was not considered significant. Total arch replacement was performed under moderate hypothermic circulatory arrest with anterograde selective cerebral perfusion. After retrograde terminal warm blood cardioplegia and aortic declamping while removing air from the root cannula, ST elevation in the II, III, and chest leads was noted and transesophageal echo showed impaired left ventricular wall motion. However, the right ventricular wall motion appeared normal under direct vision. While cardiopulmonary bypass was maintained with total perfusion, the ST level gradually improved. He was weaned from cardiopulmonary bypass 62 min after aortic declamping. ST elevation was observed again during sternal closure, so the patient was taken to the cardiac catheterization room immediately after the operation. Coronary angiography showed no significant change from before surgery. Left ventriculography revealed hypokinesia of the apex, leading to a diagnosis of Takotsubo cardiomyopathy. Inotropic agents and coronary dilators were discontinued. After confirming the stability of hemodynamics and the improvement of ST elevation on ECG, the patient was extubated on the first day after surgery and left the intensive care unit on the third day. On the 15th day, he was discharged from the hospital. This case shows that, if the right ventricu-2022 年 2 月 17 日受付，2022 年 6 月 1 日採用

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Rare but real: Takotsubo syndrome following mitral valve surgery

Cited by 2 publications

References 4 publications

Takotsubo cardiomyopathy after cardiac surgery: A case-series and systematic review of literature

Takotsubo cardiomyopathy after cardiac surgery: A case-series and systematic review of literature

弓部大動脈全置換術中に St 上昇を伴い発症したたこつぼ型心筋症の1例

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