Impella in Takotsubo syndrome complicated by left ventricular outflow tract obstruction and severe mitral regurgitation.
Impella
Left ventricular outflow tract obstruction
Mechanical circulatory support
Mitral regurgitation
Takotsubo syndrome
Journal
ESC heart failure
ISSN: 2055-5822
Titre abrégé: ESC Heart Fail
Pays: England
ID NLM: 101669191
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
26
06
2019
revised:
21
08
2019
accepted:
29
09
2019
pubmed:
4
1
2020
medline:
14
4
2021
entrez:
4
1
2020
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 31898420
doi: 10.1002/ehf2.12546
pmc: PMC7083498
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
306-310Informations de copyright
© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.
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