Key result
Impella CP implantation successfully improved hemodynamics and resolved left ventricular outflow tract obstruction and severe mitral regurgitation in a patient with Takotsubo syndrome.
Why the study?
Treatment of cardiogenic shock in patients with Takotsubo syndrome is challenging because it depends on the specific mechanisms causing haemodynamic instability.
Does the Impella CP assist device improve hemodynamics and clinical outcomes in a patient with Takotsubo syndrome complicated by cardiogenic shock, LVOTO, and severe MR?
Case Report (n=1)
Does the Impella CP assist device improve hemodynamics and clinical outcomes in a patient with Takotsubo syndrome complicated by cardiogenic shock, LVOTO, and severe MR?
Impella mechanical circulatory support may be a useful bridge-to-recovery option in selected patients with cardiogenic shock due to Takotsubo syndrome complicated by LVOTO and severe MR.
May support Impella as bridge-to-recovery in selected Takotsubo shock with LVOTO/MR; hypothesis-generating, needs prospective validation.
The treatment of cardiogenic shock in patients with Takotsubo syndrome (TTS) is challenging because it depends on the mechanisms leading to the haemodynamic instability. We report the case of a 70-year-old woman admitted for TTS complicated by cardiogenic shock. The early echocardiographic identification of left ventricular outflow tract obstruction (LVOTO) and severe mitral regurgitation (MR) prompted us to implant an Impella CP assist device as a bridge-to-recovery therapy. After device positioning, the haemodynamic status improved and LVOTO and severe MR disappeared. Because of the persistence of severe hypotension, the mechanical circulatory support was continued in intensive care unit and stopped only 5 days later, when intraventricular gradient spontaneously dropped. The patient was discharged after 1 week in stable conditions. Our case suggests that Impella circulating support may be a useful bridge-to-recovery therapeutic option in selected patients with cardiogenic shock due to TTS complicated by LVOTO and severe MR.
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Attisano et al. (2020) conducted a case report in Takotsubo syndrome complicated by cardiogenic shock, LVOTO, and severe MR (n=1). Impella CP assist device was evaluated on Haemodynamic status, LVOTO, and severe MR. Impella CP implantation successfully improved hemodynamics and resolved left ventricular outflow tract obstruction and severe mitral regurgitation in a patient with Takotsubo syndrome.
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