Key result
V-A ECMO and Impella CP achieve complete myocardial recovery in 6 days during severe pheochromocytoma crisis.
Why the study?
Excessive stimulation of cardiac myocytes during a pheochromocytoma crisis can lead to myocardial damage and cardiogenic shock.
Does combined V-A ECMO and IMPELLA CP improve myocardial recovery in a patient with cardiogenic shock related to pheochromocytoma crisis?
Case Report (n=1)
No
Does combined V-A ECMO and IMPELLA CP improve myocardial recovery in a patient with cardiogenic shock related to pheochromocytoma crisis?
Combined use of V-A ECMO and IMPELLA CP may serve as an effective bridge to myocardial recovery in patients with cardiogenic shock due to pheochromocytoma crisis.
Hypothesis-generating for combined V-A ECMO and IMPELLA CP in pheochromocytoma crisis; prospective studies needed before clinical adoption.
BACKGROUND: Pheochromocytoma is a rare catecholamine-secreting tumor derived from chromaffin cells in the adrenal glands. An excessive stimulation of cardiac myocytes, when pheochromocytoma 'crisis' occurs, lead to myocardial damage with cardiogenic shock. AIM OF THE STUDY: We present the case of a A 28-year old female patient admitted with signs of severe cardiogenic shock. She was successfully supported with extracorporeal membrane oxygenation (ECMO) combined with IMPELLA CP heart pump (Abiomed Danvers, MA), for left ventricular unloading. Mechanical circulatory support (MCS) was used to favour myocardial recovery and avoid cardiac remodeling. RESULTS: A very fast recovery was observed. The ECMO was discontinued after four days. The IMPELLA-CP was safely removed after six days. A completely myocardial recovery was observed. CONCLUSIONS: Use of MCS might find an indication in case of PCC as a bridge to myocardial recovery.
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Montalto et al. (2020) conducted a case report in Cardiogenic shock related to a pheochromocytoma crisis (n=1). V-A ECMO and IMPELLA CP was evaluated on Myocardial recovery. Combined use of V-A ECMO and IMPELLA CP led to complete myocardial recovery within 6 days in a patient with severe cardiogenic shock related to a pheochromocytoma crisis.
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