scholarly journals Takotsubo syndrome after mitral valve surgery: a case report

Author(s):  
Ana Devesa ◽  
Rafael Hernández-Estefanía ◽  
José Tuñón ◽  
Álvaro Aceña

Abstract Background Takotsubo syndrome is a frequent entity; however, it has never been described after a mitral valve surgery. Case summary  We present the case of a 79-year-old woman, with background of atrial fibrillation and a left atrial appendage closure device, who was admitted for elective mitral valve replacement, because of asymptomatic severe primary mitral regurgitation. Biologic mitral valve was implanted without incidences, but in the postoperative, she developed cardiogenic shock. Electrocardiogram (ECG) showed inverted T waves in precordial leads and an echocardiography showed severe left ventricular (LV) dysfunction with mid to distal diffuse hypokinesis, and better contractility in basal segments. Troponin levels were mildly elevated. With the suspicion of a postoperative acute coronary syndrome, a coronary angiography was performed and showed no significant coronary lesions. The haemodynamic situation was compromised for the next 48 h, in which vasoactive support and intra-aortic balloon counterpulsation were implemented. After 48 h, the haemodynamic situation suddenly improved. The ECG was normalized, and a control echocardiogram showed partial recovery of the LV function with resolution of regional wall motion abnormalities. The patient could be discharged at 1 week. The clinical picture was interpreted as a stress cardiomyopathy after mitral valve surgery. Discussion  Takotsubo syndrome is a threatening condition; complications in acute phase could lead to a fatal outcome. Mitral valve surgery has to be considered as a trigger for this entity, after excluding coronary involvement, specially of left circumflex artery.

1998 ◽  
Vol 12 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Serge M. Broka ◽  
Anne R. Ducart ◽  
Jacques Jamart ◽  
Edith L. Collard ◽  
Xavier R. Fournet ◽  
...  

1998 ◽  
Vol 31 ◽  
pp. 284
Author(s):  
J.J. Gomez ◽  
D.J.S. Schor ◽  
E.A. Traad ◽  
R.G. Carrillo ◽  
D.B. Williams ◽  
...  

ASAIO Journal ◽  
2020 ◽  
Vol 66 (4) ◽  
pp. 355-361
Author(s):  
Teruhiko Imamura ◽  
Jerry Nnanabu ◽  
Daniel Rodgers ◽  
Jayant Raikehlkar ◽  
Sara Kalantar ◽  
...  

2019 ◽  
Vol 8 (4) ◽  
pp. 526 ◽  
Author(s):  
Simone Gasser ◽  
Maria von Stumm ◽  
Christoph Sinning ◽  
Ulrich Schaefer ◽  
Hermann Reichenspurner ◽  
...  

Objective: To identify echocardiographic and surgical risk factors for failure after mitral valve repair. Methods: We identified a total of 77 consecutive patients from our institutional mitral valve surgery database who required redo mitral valve surgery due to recurrence of mitral regurgitation after primary mitral valve repair. A control group of 138 patients who had a stable echocardiographic long-term result was included based on propensity score matching. Systematic analysis of echocardiographic parameters was performed before primary surgery; after mitral valve repair and prior to redo surgery. Risk factor analysis was performed using multivariate Cox regression model. Results: Redo surgery was associated with the presence of pulmonary hypertension ≥ 50 mmHg (p = 0.02), a mean transmitral gradient > 5 mmHg (p = 0.001), left ventricular ejection fraction ≤ 45% (p = 0.05) before surgery and mitral regurgitation ≥moderate at time of discharge (p = 0.002) in the whole cohort. Patients with functional mitral valve regurgitation had a higher tendency to undergo redo surgery if preoperative left ventricular end-diastolic diameter exceeded 65 mm (p = 0.043) and if postoperative tenting height exceeded 6 mm (p = 0.018). Low ejection fraction was not significantly associated with the need for redo mitral valve surgery in the functional subgroup. Conclusions: Recurrent mitral regurgitation is still a valuable problem and is associated with relevant perioperative mortality. Patients with severe mitral regurgitation should undergo early mitral valve repair surgery as long as systolic pulmonary artery pressure is low, left ventricular ejection fraction is preserved, and LVEED is deceeds 65 mm.


1978 ◽  
Vol 41 (2) ◽  
pp. 383
Author(s):  
Gerhard Schuler ◽  
John Ross ◽  
Allen Johnson ◽  
George Dennish ◽  
Heinz Schelbert ◽  
...  

2004 ◽  
Vol 78 (3) ◽  
pp. 820-825 ◽  
Author(s):  
Constance K. Haan ◽  
Cristina I. Cabral ◽  
Donald A. Conetta ◽  
Laura P. Coombs ◽  
Fred H. Edwards

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