Mending a Broken Heart: Treatment of Stress-Induced Heart Failure after Solid Organ Transplantation

Stress-induced heart failure, also known as Broken Heart Syndrome or Takotsubo Syndrome, is a phenomenon characterized as rare but well described in the literature, with increasing incidence. While more commonly associated with postmenopausal women with psychiatric disorders, this entity is found in...

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Main Authors: N. Thao Galván, Kayla Kumm, Michael Kueht, Cindy P. Ha, Dor Yoeli, Ronald T. Cotton, Abbas Rana, Christine A. O’Mahony, Glenn Halff, John A. Goss
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Journal of Transplantation
Online Access:http://dx.doi.org/10.1155/2018/9739236
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author N. Thao Galván
Kayla Kumm
Michael Kueht
Cindy P. Ha
Dor Yoeli
Ronald T. Cotton
Abbas Rana
Christine A. O’Mahony
Glenn Halff
John A. Goss
author_facet N. Thao Galván
Kayla Kumm
Michael Kueht
Cindy P. Ha
Dor Yoeli
Ronald T. Cotton
Abbas Rana
Christine A. O’Mahony
Glenn Halff
John A. Goss
author_sort N. Thao Galván
collection DOAJ
description Stress-induced heart failure, also known as Broken Heart Syndrome or Takotsubo Syndrome, is a phenomenon characterized as rare but well described in the literature, with increasing incidence. While more commonly associated with postmenopausal women with psychiatric disorders, this entity is found in the postoperative patient. The nonischemic cardiogenic shock manifests as biventricular failure with significant decreases in ejection fraction and cardiac function. In a review of over 3000 kidney and liver transplantations over the course of 17 years within two transplant centers, we describe a series of 7 patients with Takotsubo Syndrome after solid organ transplantation. Furthermore, we describe a novel approach of successfully treating the transient, though potentially fatal, cardiogenic shock with a percutaneous ventricular assistance device in two liver transplant patients, while treating one kidney transplant patient medically and the remaining four liver transplant patients with an intra-aortic balloon pump. We describe our experience with Takotsubo’s Syndrome and compare the three modalities of treatment and cardiac augmentation. Our series is novel in introducing the percutaneous ventricular assist device as a more minimally invasive intervention in treating nonischemic heart failure in the solid organ transplant patient, while serving as a comprehensive overview of treatment modalities for stress-induced heart failure.
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spelling doaj-art-c4dcab7a3d1d41ea934e05830af906902025-08-20T02:18:47ZengWileyJournal of Transplantation2090-00072090-00152018-01-01201810.1155/2018/97392369739236Mending a Broken Heart: Treatment of Stress-Induced Heart Failure after Solid Organ TransplantationN. Thao Galván0Kayla Kumm1Michael Kueht2Cindy P. Ha3Dor Yoeli4Ronald T. Cotton5Abbas Rana6Christine A. O’Mahony7Glenn Halff8John A. Goss9Division of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, 6620 Main Street, Suite 1425, Houston, TX 77030, USADivision of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, 6620 Main Street, Suite 1425, Houston, TX 77030, USADivision of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, 6620 Main Street, Suite 1425, Houston, TX 77030, USADivision of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, 6620 Main Street, Suite 1425, Houston, TX 77030, USADivision of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, 6620 Main Street, Suite 1425, Houston, TX 77030, USADivision of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, 6620 Main Street, Suite 1425, Houston, TX 77030, USADivision of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, 6620 Main Street, Suite 1425, Houston, TX 77030, USADivision of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, 6620 Main Street, Suite 1425, Houston, TX 77030, USAUniversity of Texas Health Science Center at San Antonio, UT Transplant Center, 4502 Medical Drive, San Antonio, TX 78229, USADivision of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, 6620 Main Street, Suite 1425, Houston, TX 77030, USAStress-induced heart failure, also known as Broken Heart Syndrome or Takotsubo Syndrome, is a phenomenon characterized as rare but well described in the literature, with increasing incidence. While more commonly associated with postmenopausal women with psychiatric disorders, this entity is found in the postoperative patient. The nonischemic cardiogenic shock manifests as biventricular failure with significant decreases in ejection fraction and cardiac function. In a review of over 3000 kidney and liver transplantations over the course of 17 years within two transplant centers, we describe a series of 7 patients with Takotsubo Syndrome after solid organ transplantation. Furthermore, we describe a novel approach of successfully treating the transient, though potentially fatal, cardiogenic shock with a percutaneous ventricular assistance device in two liver transplant patients, while treating one kidney transplant patient medically and the remaining four liver transplant patients with an intra-aortic balloon pump. We describe our experience with Takotsubo’s Syndrome and compare the three modalities of treatment and cardiac augmentation. Our series is novel in introducing the percutaneous ventricular assist device as a more minimally invasive intervention in treating nonischemic heart failure in the solid organ transplant patient, while serving as a comprehensive overview of treatment modalities for stress-induced heart failure.http://dx.doi.org/10.1155/2018/9739236
spellingShingle N. Thao Galván
Kayla Kumm
Michael Kueht
Cindy P. Ha
Dor Yoeli
Ronald T. Cotton
Abbas Rana
Christine A. O’Mahony
Glenn Halff
John A. Goss
Mending a Broken Heart: Treatment of Stress-Induced Heart Failure after Solid Organ Transplantation
Journal of Transplantation
title Mending a Broken Heart: Treatment of Stress-Induced Heart Failure after Solid Organ Transplantation
title_full Mending a Broken Heart: Treatment of Stress-Induced Heart Failure after Solid Organ Transplantation
title_fullStr Mending a Broken Heart: Treatment of Stress-Induced Heart Failure after Solid Organ Transplantation
title_full_unstemmed Mending a Broken Heart: Treatment of Stress-Induced Heart Failure after Solid Organ Transplantation
title_short Mending a Broken Heart: Treatment of Stress-Induced Heart Failure after Solid Organ Transplantation
title_sort mending a broken heart treatment of stress induced heart failure after solid organ transplantation
url http://dx.doi.org/10.1155/2018/9739236
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