Temporary mechanical circulatory support for Takotsubo cardiomyopathy secondary to primary mediastinal B-cell lymphoma.
BACKGROUND
Left heart mechanical circulatory support (MCS) through the left chest via the pulmonary vein and descending thoracic aorta is a good option for patients with an inaccessible anterior mediastinum and/or poor peripheral access.


METHODS
We report the case of a 19-year-old small female with a newly discovered bulky primary mediastinal diffuse large B-cell lymphoma (PMBL) who developed refractory inverted Takotsubo cardiomyopathy (TC) with cardiogenic shock.


RESULTS
Temporary MCS was implemented in order to stabilize the patient and proceed with a chemotherapy treatment. Given the patient's oncologic "frozen" mediastinum and the presence of poor peripheral arterial access, the left heart temporary MCS was successfully implanted through a left mini-thoracotomy via the left inferior pulmonary vein and descending thoracic aorta.


CONCLUSIONS
This is the first report of temporary MCS to treat inverted TC and diffuse PMBL.
The Department of Cardiovascular and Thoracic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA.
Carla
C
Zeballos
Robert J
RJ
Moraca
Stephen H
SH
Bailey
George J
GJ
Magovern
D005260:Female; D018611:Heart Bypass, Left / Q000379:methods; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications*; D008479:Mediastinal Neoplasms / Q000150:complications*; D054549:Takotsubo Cardiomyopathy / Q000209:etiology / Q000601:surgery*; D013908:Thoracotomy; D055815:Young Adult