Key result
10-day ECMO successfully supports a pediatric patient with cardiogenic shock from Takotsubo cardiomyopathy.
Why the study?
Takotsubo cardiomyopathy is rarely described in childhood and its occurrence during percutaneous pulmonary valve implantation in congenital heart disease is unusual.
Case Report (n=1)
Takotsubo cardiomyopathy can occur during interventional catheterization in children with congenital heart disease, and may require temporary mechanical circulatory support with potential for full recovery.
May support ECMO consideration in pediatric Takotsubo shock; hypothesis-generating from single case, should not yet change practice.
Takotsubo cardiomyopathy describes a sudden onset cardiomyopathy with acute impairment of left ventricular function and spontaneous resolution over time. Only a few cases of Takotsubo cardiomyopathy in childhood have been described. We report the case of a 12-year-old girl with repaired tetralogy of Fallot who experienced acute onset of left ventricular dysfunction without coronary arterial involvement, suggesting Takotsubo cardiomyopathy, during an interventional catheterization procedure. Cardiogenic shock necessitated mechanical circulatory support with extracorporeal membrane oxygenator for ten days and mechanical ventilation for 12 days. The girl recovered without sequelae. Percutaneous pulmonary valve implantation was performed four months later without complications. Unusual aspects of this case include the use of mechanical circulatory support during the recovery phase of Takotsubo cardiomyopathy in a patient with congenital heart disease.
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Pozza et al. (2017) conducted a case report in Takotsubo cardiomyopathy (n=1). Mechanical circulatory support with extracorporeal membrane oxygenator was evaluated. Mechanical circulatory support with extracorporeal membrane oxygenator was successfully used for 10 days to treat cardiogenic shock from Takotsubo cardiomyopathy in a 12-year-old girl.
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