Takotsubo Cardiomyopathy after Hybrid Repair of Thoracic and Thoracoabdominal Aortic Aneurysm

Abstract

Context: Takotsubo cardiomyopathy is characterized by transient and acute left ventricular dysfunction with apical dyskinesia in the absence of coronary artery disease. The pathophysiology of this rare disease is considered to be associated with physical and psychological stress. Recently published case reports have described the association between Takotsubo syndrome and various surgical procedures as the causative stress factors. However, Takotsubo cardiomyopathy is extremely rare in patients who have undergone cardiovascular surgery. Case report: Here, we report a rare case of Takotsubo cardiomyopathy developing after thoracic endovascular aortic repair for chronic dissecting aortic aneurysm. Conclusion: This patient developed Takotsubo cardiomyopathy 14 days after thoracic endovascular aortic repair, potentially because of the prolonged perioperative physical and psychological stress induced by multi-stage surgery. To our knowledge, this is the first report of Takotsubo cardiomyopathy after thoracic endovascular aortic repair. Through this report, we emphasize the importance of considering the possibility of Takotsubo cardiomyopathy in patients presenting symptoms of cardiogenic shock and unexplained hemodynamic deterioration, despite having undergone relatively less-invasive cardiovascular surgery. Early diagnosis is required to initiate appropriate treatment and to minimize the chance of complications.