Favorable Effects of Impella on Takotsubo Syndrome Complicated with Cardiogenic Shock

Nishikawa, Ryo; Nagano, Nobutaka; Kokubu, Nobuaki; Hashimoto, Kouhei; Nakata, Jun; Kishiue, Naohiro; Takahashi, Ryo; Otomo, Shunsaku; Tsuchihashi, Kazufumi; Yano, Toshiyuki

doi:10.1536/ihj.21-299

Cited by 7 publications

(6 citation statements)

References 29 publications

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“…MCS with ECMELLA also provides LV unloading and full circulatory support, but evidence suggests that MCS with two devices is also associated with higher complication rates [ 22 ]. Recently published case reports and series [ 15 , 23 ] confirmed the pathophysiological assumed benefit of MCS support via Impella in TTS-CS and showed noteworthy survival rates and excellent myocardial recovery. These publications included cases in which Impella CP, Impella 2.5 and Impella 5.0 (only once) were used.…”

Section: Discussionmentioning

confidence: 86%

Successful treatment of cardiogenic shock due to Takotsubo syndrome with implantation of a temporary microaxial left ventricular assist device in transaxillary approach

von Mackensen,

Shazly,

Schoenrath

et al. 2023

J Cardiothorac Surg

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Objectives Cardiogenic shock (CS) can occur in patients with Takotsubo syndrome (TTS). As TTS has received increasing attention and has been more closely researched, several aspects of the pathogenesis have been identified, particularly that an excessive release of catecholamines plays an important role. Nevertheless, evidence on specific therapy concepts is still lacking. As a result, TTS with severe hemodynamic instability and low cardiac output creates unique challenges, and mechanical circulatory support is needed with as few inotropic drugs as possible. Methods We present a 77-year-old female patient who underwent minimally invasive surgical mitral valve replacement. After an uneventful course, the patient developed acute heart failure eleven days after surgery. Transthoracic echocardiography (TTE) revealed a new onset of TTS. The patient needed left ventricular venting and full haemodynamic flow. We successfully implanted a microaxial left ventricular assist device (Impella 5.5) using the transaxillary approach. The haemodynamic situation stabilised immediately. The patient was weaned and the Impella 5.5 was explanted after five days. Conclusion We present the first-in-man implantation of a transaxillary Impella 5.5 in a patient with TTS. The patient benefitted from Impella 5.5 therapy with full haemodynamic support and venting of the left ventricle.

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Section: Discussionmentioning

confidence: 86%

Successful treatment of cardiogenic shock due to Takotsubo syndrome with implantation of a temporary microaxial left ventricular assist device in transaxillary approach

von Mackensen,

Shazly,

Schoenrath

et al. 2023

J Cardiothorac Surg

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“…Nishikawa et al . [ 3 ] reported that short-term improvement in myocardial haemodynamics with Impella is useful in patients with Takotsubo syndrome and cardiogenic shock. Several recent reports have demonstrated the usefulness of Impella as a preoperative circulatory aid in cardiac surgery or as an adjunct to percutaneous procedures.…”

Section: Discussionmentioning

confidence: 99%

Successful use of left ventricular support device (Impella 5.0) and extracorporeal membrane oxygenation (ECMO) for postoperative cardiac arrest after lung cancer surgery: a case report

Hara

Miyamoto

Furukawa

et al. 2023

Journal of Surgical Case Reports

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Postoperative hemodynamic support with an Impella 5.0 was effective in a man who underwent lung lobectomy for lung cancer and cardiogenic shock. A 75-year-old man presented to hospital with an abnormal chest shadow on radiography. After thorough examination, the patient was diagnosed with lung cancer, and left lower lobectomy was performed. On the 2nd postoperative day, the patient experienced cardiac arrest because of a sudden drop in saturation of percutaneous oxygen. After a third defibrillation, his heartbeat resumed, and he was intubated and placed on a ventilator. Coronary angiography revealed acute coronary syndrome and the patient fell into a state of shock, which required venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. Nevertheless, the circulatory dynamics are unstable, and Impella 5.0 was introduced. VA-ECMO and the Impella 5.0 were discontinued on the 6th and 8th postoperative days, respectively. The patient was eventually transferred to a nearby facility for further rehabilitation 109 days later.

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“…Impella seemed to provide an adequate amount of supplemental circulation, but it had to pass through the replaced aortic bioprosthetic valve, which could cause mechanical damage to the aortic valve, which we wanted to avoid. He also had to use heparin, which carries the risk of contributing to cerebral hemorrhage [4]. ECMO appeared to provide adequate supplemental circulating volume, but had the disadvantage of increased afterload to the left ventricle, and required heparin, which could have contributed to cerebral hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

A Case of Takotsubo Cardiomyopathy After Mitral Valvuloplasty

Nakajima¹,

Iba²,

Shibata³

et al. 2023

Cureus

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We present a case of an 82-year-old male patient with a history of severe mitral regurgitation, severe aortic regurgitation, chronic atrial fibrillation, and suicide attempts due to depression. The patient underwent mitral valvuloplasty and aortic valve replacement for mitral valve regurgitation and aortic valve regurgitation. The patient was extubated on the morning of the sixth postoperative day, but he was reintubated in the evening because of hypotension and an unstable respiratory status. Echocardiography revealed Takotsubo cardiomyopathy development, and the patient was treated with intra-aortic balloon pump (IABP) implantation, which was removed on postoperative day 11.

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Favorable Effects of Impella on Takotsubo Syndrome Complicated with Cardiogenic Shock

Cited by 7 publications

References 29 publications

Successful treatment of cardiogenic shock due to Takotsubo syndrome with implantation of a temporary microaxial left ventricular assist device in transaxillary approach

Successful treatment of cardiogenic shock due to Takotsubo syndrome with implantation of a temporary microaxial left ventricular assist device in transaxillary approach

Successful use of left ventricular support device (Impella 5.0) and extracorporeal membrane oxygenation (ECMO) for postoperative cardiac arrest after lung cancer surgery: a case report

A Case of Takotsubo Cardiomyopathy After Mitral Valvuloplasty

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