Heart failure induced by pheochromocytoma: laparoscopic treatment and intraoperative changes of several new cardiovascular hormones.
Since 1992, adrenalectomy for pheochromocytoma has been recognized as a safe and efficient technique when performed by a laparoscopic approach. Most of the cases of pheochromocytomas treated as such and published in the literature were not associated with malignant hypertension and acute heart failure. We report the case of a 23-year-old woman who presented with this clinical picture and show that laparoscopic adrenalectomy may be as safe and efficient as conventional adrenalectomy when performed in this situation. The intraoperative changes in the secretion of catecholamines, endothelin-1, angiotensin II, N- and C-terminus of atrial natriuretic factor prohormone were also analyzed. Noradrenaline release during tumor dissection was associated with a stimulation of atrial natriuretic factor.
Col
V
V
Department of General Internal Medicine and Endocrinology, University Hospital UCL of Mont-Godinne, Yvoir, Belgium.
de Cannière
L
L
Messaoudi
L
L
Michel
L
L
Donckier
J
J
D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D000804:Angiotensin II / Q000097:blood / Q000378:metabolism*; D009320:Atrial Natriuretic Factor / Q000378:metabolism; D001794:Blood Pressure; D019332:Endothelin-1 / Q000097:blood* / Q000378:metabolism; D004837:Epinephrine / Q000097:blood* / Q000378:metabolism; D005260:Female; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D010535:Laparoscopy; D016343:Monitoring, Intraoperative; D009638:Norepinephrine / Q000097:blood* / Q000378:metabolism; D010673:Pheochromocytoma / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D011498:Protein Precursors / Q000097:blood / Q000378:metabolism
D019332:Endothelin-1; D011498:Protein Precursors; D000804:Angiotensin II; D009320:Atrial Natriuretic Factor; D009638:Norepinephrine; D004837:Epinephrine