Key result
ECMO enables full cardiac recovery in severe Takotsubo cardiomyopathy and cardiogenic shock after MVR.
Why the study?
Takotsubo cardiomyopathy can occur perioperatively after cardiac surgery, but few cases managed with extracorporeal membrane oxygenation have been reported.
Case Report (n=1)
This case report highlights the potential use of ECMO for managing severe perioperative Takotsubo cardiomyopathy following cardiac surgery.
ECMO may aid recovery in refractory perioperative Takotsubo shock; this single case leaves open its broader safety and efficacy.
Takotsubo cardiomyopathy is a transient systolic and diastolic left ventricular dysfunction that presents several wall-motion abnormalities, while the coronary artery shows normal findings. Because patients with Takotsubo cardiomyopathy present with symptoms similar to acute coronary syndrome, the initial diagnosis and treatment are often difficult. The condition is often precipitated by acute emotional or physical stress and frequently occurs in postmenopausal women. Takotsubo cardiomyopathy may also occur in the perioperative period after cardiac and noncardiac surgery; surgery-associated Takotsubo cardiomyopathy reportedly accounts for 3%-23% of all cases. Of these perioperative cases, cardiothoracic surgery accounted for 16%. However, few cases have been reported in patients undergoing cardiac surgery and managed with extracorporeal membrane oxygenation (ECMO). We report a case of Takotsubo cardiomyopathy managed with ECMO in a patient in the intensive care unit after mitral valve replacement.
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Choi et al. (2019) conducted a case report in Takotsubo cardiomyopathy (n=1). Extracorporeal membrane oxygenation was evaluated on Recovery of cardiac function. Extracorporeal membrane oxygenation successfully supported a 52-year-old woman with severe Takotsubo cardiomyopathy and cardiogenic shock after mitral valve replacement, enabling full cardiac recovery.
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