title: Successful extracorporeal membrane oxygenation treatment for pheochromocytoma-induced acute cardiac failure.
abstract: The aim of this study is to report the case of a catecholamine-induced cardiogenic shock bridged to curative adrenalectomy using extracorporeal membrane oxygenation (ECMO) and medical management. A 37-year-old woman presented an acute cardiogenic shock due to a left-sided pheochromocytoma. Echocardiography revealed a severe global hypokinesia with a left ventricular ejection fraction of 15%. Despite maximal ionotropic support, adequate perfusion could not be achieved; and ECMO was used to bridge the patient during medical management with calcium-channel blockers. The left ventricular ejection fraction improved to 65%, and ECMO was discontinued after 11 days. An open left adrenalectomy was performed 10 days after ECMO. At 1-year follow-up, the patient is in good health with normal cardiac function. Pheochromocytomas can present with dramatic cardiovascular collapse. With timely diagnosis and medical therapy, followed by surgical resection, the cardiovascular effects can be reversed; and the condition, cured. Young patients with catecholamine-induced cardiac failure refractory to medical therapy are ideal candidates for short-term ECMO support, as the underlying cause is imminently reversible.
authors: Department of General, Digestive and Endocrine Surgery, IRCAD/EITS, University Hospital, Strasbourg 67091, France.
authors: Ghassam
authors: G
authors: Sojod
authors: Michele
authors: M
authors: Diana
authors: James
authors: J
authors: Wall
authors: Jacopo
authors: J
authors: D'Agostino
authors: Didier
authors: D
authors: Mutter
authors: Jacques
authors: J
authors: Marescaux
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000601:surgery; D000315:Adrenalectomy; D000328:Adult; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D010673:Pheochromocytoma / Q000150:complications* / Q000601:surgery; D012770:Shock, Cardiogenic / Q000209:etiology / Q000628:therapy*