Email this article Takotsubo syndrome after palliative transcatheter treatment of acquired aortic stenosis in patient with congenital ventricular septal defect. Case report
- Authors: Komlev A.E.1, Muksinova M.D.1, Saidova M.A.1, Kurilina E.V.1, Imaev T.E.1
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Affiliations:
- Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology
- Issue: Vol 93, No 9 (2021)
- Pages: 1078-1085
- Section: Clinical notes
- URL: https://journals.rcsi.science/0040-3660/article/view/82976
- DOI: https://doi.org/10.26442/00403660.2021.09.201031
- ID: 82976
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Abstract
The authors report the clinical case of secondary Takotsubo syndrome developed after transcatheter aortic valve replacement that was performed in compassionate manner in female patient with combination of congenital ventricular septal defect and acquired severe aortic stenosis. In the team’s view, Takotsubo syndrome was triggered with profound changes of intracardial hemodynamics subsequent to iatrogenic impairment of preexisting interventricular shunt.
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##article.viewOnOriginalSite##About the authors
Alexey E. Komlev
Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology
Author for correspondence.
Email: pentatonika@bk.ru
ORCID iD: 0000-0001-6908-7472
кардиолог отд. сердечно-сосудистой хирургии
Russian Federation, MoscowMarina D. Muksinova
Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology
Email: pentatonika@bk.ru
ORCID iD: 0000-0001-6516-5322
кардиолог отд. сердечной недостаточности и заболеваний миокарда
Russian Federation, MoscowMarina A. Saidova
Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology
Email: pentatonika@bk.ru
ORCID iD: 0000-0002-3233-1862
д-р мед. наук, проф., рук. отд. ультразвуковых методов исследования
Russian Federation, MoscowElla V. Kurilina
Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology
Email: pentatonika@bk.ru
ORCID iD: 0000-0002-3208-534X
врач-патологоанатом, зав. патологоанатомическим отд-нием
Russian Federation, MoscowTimur E. Imaev
Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology
Email: pentatonika@bk.ru
ORCID iD: 0000-0002-5736-5698
д-р мед. наук, сердечно-сосудистый хирург, гл. науч. сотр. отд. сердечно-сосудистой хирургии
Russian Federation, MoscowReferences
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Supplementary files
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Fig. 1. Electrocardiogram on admission.
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Fig. 2. Echocardiography (EchoCG) on admission. High intraventricular septum defect (indicated by the arrow) with determining the ratio of pulmonary and systemic blood flow.
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Fig. 3. Multispiral computed tomography of the heart with intravenous contrast. The arrow indicates the defect in the membranous part of interventricular septum.
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Fig. 4. Coronary angiogram: a – left coronary artery; b – right coronary artery (arrow indicates stenosis of the right coronary artery).
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Fig. 5. Final intraoperative aortography. A self-expanding aortic valve prosthesis is installed in the aortic position.
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Fig. 6. EchoCG after surgery. Akinesis in the mid- and apical segments of left ventricle (LV): a – diastole; b – systole.
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Fig. 7. Coagulative myocardial necrosis zone without a marked demarcation shaft, with a sharp expansion and plethora of vessels in the border area. Staining with hematoxylin and eosin. ×100.
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Fig. 8. Diffuse myocardial stromal edema with mucoidization. Diffuse moderate lymphocytic-macrophage infiltration of the stroma. Focal myocytolysis. Hypertrophy of cardiomyocytes. Staining with hematoxylin and eosin. ×200.
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Fig. 9. Focal lymphocytic infiltration in the myocardial stroma. Myocardial stromal edema. Coagulative necrosis of certain groups of cardiomyocytes. Hypertrophy of cardiomyocytes. Expansion and plethora of venous vessels. Sludge phenomenon. Staining with hematoxylin and eosin. ×200.
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Fig. 10. Area of cardiosclerosis with loosening and edema of fibrous tissue, diffuse lymphohistiocytic infiltration. Pronounced stromal edema. Capillary congestion. Coagulative necrosis of individual cardiomyocytes. Hypertrophy of cardiomyocytes. Staining with hematoxylin and eosin. ×200.
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Fig. 11. Emphasized transverse striation of cardiomyocytes in the apical part of left ventricle. Myocardial stromal edema. Staining with hematoxylin and eosin. ×400.
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