JACC. Case reports · 2025
Rescue of Acute VSD in Takotsubo Cardiomyopathy: The Role of BiPella Support in High-Risk Recovery.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Cui Yuqi, Ahmed Ahmed S, Bhama Jay K, Arroyo Maximiliano
Аннотация
BACKGROUND: Takotsubo cardiomyopathy (TTC) mimics acute coronary syndrome but typically occurs without obstructive coronary disease. Rare complications such as acute ventricular septal defect (VSD) carry a poor prognosis.
CASE SUMMARY: An 83-year-old woman with multiple comorbidities presented with chest pain and dyspnea. Suspected ST-segment elevation myocardial infarction led to coronary angiography, which confirmed TTC with acute VSD. Echocardiography revealed VSD and reduced ejection fraction (30%-35%). An Impella CP device (Abiomed) was placed within 2 hours, and urgent surgical VSD repair was performed within 32 hours. Postoperatively, BiPella (biventricular Impella) support optimized biventricular unloading.
DISCUSSION: Acute VSD in TTC is rare and often fatal. Early mechanical circulatory support can stabilize patients and improve surgical outcomes. This case highlights the importance of prompt intervention in TTC-related VSD.
TAKE-HOME MESSAGE: Early mechanical support and timely surgical intervention in TTC with VSD can be lifesaving and improve outcomes.
CASE SUMMARY: An 83-year-old woman with multiple comorbidities presented with chest pain and dyspnea. Suspected ST-segment elevation myocardial infarction led to coronary angiography, which confirmed TTC with acute VSD. Echocardiography revealed VSD and reduced ejection fraction (30%-35%). An Impella CP device (Abiomed) was placed within 2 hours, and urgent surgical VSD repair was performed within 32 hours. Postoperatively, BiPella (biventricular Impella) support optimized biventricular unloading.
DISCUSSION: Acute VSD in TTC is rare and often fatal. Early mechanical circulatory support can stabilize patients and improve surgical outcomes. This case highlights the importance of prompt intervention in TTC-related VSD.
TAKE-HOME MESSAGE: Early mechanical support and timely surgical intervention in TTC with VSD can be lifesaving and improve outcomes.