肝移植术中逆 Takotsubo 心肌病：麻醉医师的噩梦。
Intraoperative Reverse Takotsubo Cardiomyopathy in Liver Transplantation: An Anesthesiologist's Nightmare.
机构信息
Department of Anesthesiology and Critical care, Indraprastha Apollo Hospital, New Delhi, India.
Department of Anesthesiology and Critical care, Indraprastha Apollo Hospital, New Delhi, India.
出版信息
Transplant Proc. 2024 Oct;56(8):1757-1758. doi: 10.1016/j.transproceed.2024.08.011. Epub 2024 Aug 26.
BACKGROUND
Reverse Takotsubo cardiomyopathy (TTC) is a rare variant of stress cardiomyopathy, characterized by basal akinesia with apical sparing. To our knowledge, this case is the first reported in the literature of intraoperative reverse TTC (rTTC) in liver transplantation.
CASE
After a thorough workup, a 19-year-old man, diagnosed with extrahepatic biliary atresia, was taken up for living-related donor liver transplantation. The patient developed intraoperative rTTC. This case report describes the challenges and successful management of this cardiomyopathy intraoperatively and postoperatively.
CONCLUSION
Intraoperative rTTC is challenging and requires aggressive and immediate hemodynamic and pharmacological management, along with supportive treatment and management of complications. This case report describes the challenges and successful management of this cardiomyopathy intraoperatively and postoperatively. To our knowledge, this case is the first reported in the literature of intraoperative rTTC in liver transplantation.
背景
反向心尖球囊样综合征（TTC）是应激性心肌病的一种罕见变异，特征为基底段无运动伴心尖段运动保留。据我们所知，这是文献中首例肝移植术中出现的反向 TTC（rTTC）病例。
病例
经过全面检查，一名 19 岁男性，被诊断为肝外胆道闭锁，被收治行活体供肝移植。患者术中出现 rTTC。本病例报告描述了术中及术后对此心肌病的挑战和成功管理。
结论
术中 rTTC 具有挑战性，需要积极和立即的血流动力学和药物管理，以及支持治疗和并发症的管理。本病例报告描述了术中及术后对此心肌病的挑战和成功管理。据我们所知，这是文献中首例肝移植术中出现的反向 TTC（rTTC）病例。
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