Key result
A 76-year-old woman developed Takotsubo cardiomyopathy complicated by cardiogenic cerebral infarction after elective mitral valve repair, eventually recovering with normal left ventricular function.
Why the study?
Takotsubo cardiomyopathy developing after open-heart surgery is relatively rare, warranting a report of its clinical characteristics and a literature review.
Case Report (n=1)
No
Takotsubo cardiomyopathy is a rare but severe complication that can occur after elective mitral valve repair, requiring careful postoperative monitoring and management of complications like thrombosis.
May warrant heightened vigilance for Takotsubo after mitral valve repair; leaves open its incidence and optimal management.
症例は76歳女性．僧帽弁逸脱による重症の僧帽弁閉鎖不全症，三尖弁閉鎖不全症に対して僧帽弁形成術および三尖弁形成術を施行した．人工心肺からの離脱は容易で経食道心エコー検査でも壁運動異常は認められなかった．手術翌日より低心拍出量症候群に陥り，トランスアミナーゼ値および血清心筋逸脱酵素値が上昇した．経胸壁心エコー検査（TTE）では，広範囲にわたる心尖部の無収縮およびballooningと基部の過収縮を認め左室駆出率（LVEF）は20%と低下していた．左室壁運動の改善は認められず術後8日目に左房内血栓を原因とする心原性脳梗塞を発症した．同日カテーテルを用いた血栓回収術を施行し後遺症なく経過，術後13日目のTTEにてLVEF 29%となり，わずかに心尖部の壁運動の増強が認められるようになった．術後27日目にはLVEF 65%となり，壁運動は正常化した．心電図所見はII，III，aVF，V3-6の陰性T波が術後1カ月以上遷延し，2カ月後に正常化した．手術前後の冠動脈造影検査に異常を認めなかったため，僧帽弁形成術後に発症したたこつぼ心筋症と診断した．開心術後に発症するたこつぼ心筋症は比較的に稀であり，その特徴とともに文献的考察を加えて報告する．
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Dohi et al. (2024) conducted a case report in Takotsubo cardiomyopathy (n=1). Mitral valve repair and tricuspid annuloplasty was evaluated on Clinical course of Takotsubo cardiomyopathy. A 76-year-old woman developed Takotsubo cardiomyopathy complicated by cardiogenic cerebral infarction after elective mitral valve repair, eventually recovering with normal left ventricular function.
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