title: Pheochromocytoma revealed by acute heart failure. When should we operate? Presented at the ESES Congress, Gothenburg May 25-26, 2012.
abstract: OBJECTIVE
  The aim of this study was to assess the safety and efficacy of adrenalectomy on patients with pheochromocytoma diagnosed at the time of an acute heart failure (AHF).
  
  
  METHODS
  We reported cases of patients who presented an AHF secondary to a pheochromocytoma during a period of 10 years. The diagnosis of AHF was defined by a left ventricular ejection fraction of less than 30 % or the use of circulatory assistance. They had adrenalectomy as emergency surgery or later. Morbidity and mortality of surgery were studied.
  
  
  RESULTS
  Thirteen patients required an adrenalectomy for AHF secondary to pheochromocytoma. Four patients (31 %) had an adrenalectomy in emergency. Nine patients (69 %) had a delayed surgery with a median delay of 25 days (7-180). Eight patients had circulatory assistance (61 %). Five of them had a circulatory assistance and a delayed surgery (38 %), two of them had a circulatory assistance followed by emergency surgery (at 1.5 and 3 days) and one had emergency surgery immediately followed by circulatory assistance. Emergency surgery was performed by laparotomy in all cases and delayed surgery by laparoscopy for seven patients (54 %). Perioperative complications consisted in: one circulatory arrest, two bleedings requiring transfusion, one intestinal ischaemia, one haemoperitoneum with re-operation (day 8). One patient died on day 5. Post-operative course of patients with delayed surgery was uneventful.
  
  
  CONCLUSIONS
  AHF revealing a pheochromocytoma is a rare and serious event. Patients with emergency surgery have more complications than those with delayed surgery.
authors.affiliation: Department of Digestive and Endocrine Surgery, CCDE, IMAD, CHU Nantes, Nantes, France.
authors.forename: G
authors.initials: G
authors.lastname: Müller
authors.forename: F
authors.initials: F
authors.lastname: Saint
authors.forename: A
authors.initials: A
authors.lastname: Hamy
authors.forename: J C
authors.initials: JC
authors.lastname: Lifante
authors.forename: B
authors.initials: B
authors.lastname: Carnaille
authors.forename: F
authors.initials: F
authors.lastname: Sebag
authors.forename: F
authors.initials: F
authors.lastname: Ménégaux
authors.forename: J
authors.initials: J
authors.lastname: Vandwalle
authors.forename: D
authors.initials: D
authors.lastname: Drui
authors.forename: C
authors.initials: C
authors.lastname: Caillard
authors.forename: P
authors.initials: P
authors.lastname: Rodien
authors.forename: M
authors.initials: M
authors.lastname: Roy
authors.forename: J L
authors.initials: JL
authors.lastname: Peix
authors.forename: F
authors.initials: F
authors.lastname: Pattou
authors.forename: L
authors.initials: L
authors.lastname: Brunaud
authors.forename: J F
authors.initials: JF
authors.lastname: Henry
authors.forename: E
authors.initials: E
authors.lastname: Mirallié
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000150:complications* / Q000601:surgery*