Key result
Immediate PCPS rescues a patient from Takotsubo-induced cardiac arrest during emergency surgery.
Why the study?
Although Takotsubo cardiomyopathy generally has a favorable prognosis, fatal cardiopulmonary arrest cases have been reported, raising concerns about similar cases as surgeries in elderly patients increase.
Case Report (n=1)
No
Immediate percutaneous cardiopulmonary support can successfully rescue patients who develop cardiopulmonary arrest due to Takotsubo cardiomyopathy.
May support percutaneous cardiopulmonary support in refractory Takotsubo arrest; hypothesis-generating from single case report.
巨大肝細胞癌の70代の男性に対し肝右葉切除術を施行したが，術翌日に腹腔内出血を認めたため，緊急開腹止血術の方針となった．全身麻酔導入時に，たこつぼ型心筋症に由来する心停止をきたしたが，即座にpercutaneous cardiopulmonary support （PCPS）を導入することで蘇生し，血管造影下での塞栓術で止血が得られた．その後，後遺症はなく第36病日に転院となった．たこつぼ型心筋症は，左室心尖部を中心とした広範囲の壁運動異常を呈する疾患であり，多くは1カ月以内に左室壁運動がほぼ正常化する，予後良好な疾患とされている．しかし，近年，たこつぼ型心筋症による心停止から不幸な転帰を辿った報告も見受けられ，今後の高齢者手術の増加に伴い，類似症例の増加が懸念される．本症例は，たこつぼ型心筋症による心停止に対しPCPSを導入することで救命できた本邦初の貴重な症例である．
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Sato et al. (2016) conducted a case report in Cardiopulmonary arrest due to Takotsubo cardiomyopathy (n=1). Immediate percutaneous cardiopulmonary support (PCPS) was evaluated on Survival and recovery. Immediate percutaneous cardiopulmonary support successfully rescued a patient who experienced cardiopulmonary arrest due to Takotsubo cardiomyopathy during emergency surgery.
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