Fast myocardial recovery ensured by the combined use of V-A ECMO and IMPELLA CP in cardiogenic shock related to a pheochromocytoma crisis

J Card Surg. 2020 Sep;35(9):2367-2369. doi: 10.1111/jocs.14805. Epub 2020 Jul 27.

Abstract

Background: Pheochromocytoma is a rare catecholamine-secreting tumor derived from chromaffin cells in the adrenal glands. An excessive stimulation of cardiac myocytes, when pheochromocytoma 'crisis' occurs, lead to myocardial damage with cardiogenic shock.

Aim of the study: We present the case of a A 28-year old female patient admitted with signs of severe cardiogenic shock. She was successfully supported with extracorporeal membrane oxygenation (ECMO) combined with IMPELLA CP heart pump (Abiomed Danvers, MA), for left ventricular unloading. Mechanical circulatory support (MCS) was used to favour myocardial recovery and avoid cardiac remodeling.

Results: A very fast recovery was observed. The ECMO was discontinued after four days. The IMPELLA-CP was safely removed after six days. A completely myocardial recovery was observed.

Conclusions: Use of MCS might find an indication in case of PCC as a bridge to myocardial recovery.

Keywords: ECMO; IMPELLA CP; cardiogenic shock; pheochromocytoma.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Gland Neoplasms* / complications
  • Adrenal Gland Neoplasms* / therapy
  • Adult
  • Extracorporeal Membrane Oxygenation*
  • Female
  • Heart-Assist Devices*
  • Humans
  • Pheochromocytoma* / complications
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / therapy