Extracorporeal life support as ultimate strategy for refractory severe cardiogenic shock induced by Tako-tsubo cardiomyopathy: a new effective therapeutic option.
We report a possible new therapeutic strategy, using extracorporeal cardiopulmonary support (ECLS), for severe refractory cardiogenic shock (SRCS) in a patient with Tako-tsubo cardiomyopathy (TC). TC is a syndrome characterized by left ventricular wall motion abnormalities, without coronary artery disease, mimicking the diagnosis of acute coronary syndrome. This ventricular dysfunction can be reversible; however, it can progress into refractory cardiogenic shock with limited therapeutic options available. For the first time in a Tako-tsubo patient with refractory cardiogenic shock, we used ECLS treatment in order to rest the heart, sustain circulation and end-organ perfusion, and promote potential ventricular recovery. ECLS might be the selected treatment for SRCS in patients with TC, and seems to be an effective and useful ultimate therapeutic strategy for preventing death.
Bonacchi
Massimo
M
Cardiac Surgery, Medical and Surgical Critical Care Department, University of Florence, Viale Morgagni 85, Florence, Italy. mbonacchi@unifi.it
Valente
Serafina
S
Harmelin
Guy
G
Gensini
Gian Franco
GF
Sani
Guido
G
D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use; D017548:Echocardiography, Transesophageal; D005112:Extracorporeal Circulation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D020127:Recovery of Function; D012720:Severity of Illness Index; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D013315:Stress, Psychological / Q000150:complications* / Q000503:physiopathology; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D017211:Treatment Failure; D016277:Ventricular Function, Left
D002317:Cardiovascular Agents