title: Extracorporeal life support as ultimate strategy for refractory severe cardiogenic shock induced by Tako-tsubo cardiomyopathy: a new effective therapeutic option.
abstract: 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.
authors.affiliation: Cardiac Surgery, Medical and Surgical Critical Care Department, University of Florence, Viale Morgagni 85, Florence, Italy. mbonacchi@unifi.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Bonacchi
authors.forename: Serafina
authors.initials: S
authors.lastname: Valente
authors.forename: Guy
authors.initials: G
authors.lastname: Harmelin
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
authors.forename: Guido
authors.initials: G
authors.lastname: Sani
mesh_terms: 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
chemical_list: D002317:Cardiovascular Agents