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J Thorac Cardiovasc Surg 2006;131:913-914
© 2006 The American Association for Thoracic Surgery

Brief Communication

Unusual cardiogenic shock due to pheochromocytoma: Recovery after bridge-to-bridge (extracorporeal life support and DeBakey ventricular assist device) and right surrenalectomy

J.-M. Grinda, MD a , * , M.-O. Bricourt, MD a , S. Salvi, MD a , M. Carlier, MD b , F. Grossenbacher, MD b , C. Brasselet, MD c , J.-N. Fabiani, MD a

a Department of Cardiovascular Surgery, European Hospital Georges Pompidou, Paris, France
b Department of Anaesthesiology and Intensive Care, "Maison Blanche" Hospital, Reims, France.
c Department of Cardiology, "Maison Blanche" Hospital, Reims, France.

Received for publication October 27, 2005; revisions received November 25, 2005; accepted for publication December 1, 2005.

* Address for reprints: Jean Michel Grinda, MD, Department of Cardiovascular Surgery, Hôpital Européen Georges Pompidou, 20 rue Leblanc 75015, Paris, France. (Email: jean-michel.grinda@hop.egp.ap-hop-paris.fr).

The first 20% of the full text of this article appears below.

Acute adrenergic cardiomyopathy resulting in intractable pulmonary edema and life-threatening cardiogenic shock is an unusual revelation of a pheochromocytoma. 1-4 Go Dealing with such a patient, we have performed a bridge-to-bridge (extracorporeal life support [ECLS] secondarily switched for a DeBakey axial pump ventricular assist device) associated to a right surrenalectomy, allowing cardiac function recovery.

Clinical Summary

A 49-year-old man with no previously known pathology or risk factors complained of brutal abdominal pain, vomiting, headache, and malaise. On arrival to his referring hospital, he presented with a massive pulmonary edema, followed by cardiogenic shock and cardiac arrest requiring cardiopulmonary resuscitation. Initial laboratory findings showed troponin I and pro-brain natriuretic peptid levels at 0.23 µg/L and 5667 pg/mL, respectively (normal, <0.06 µg/L and <84 pg/mL, respectively). Arterial blood gases revealed a partial oxygen pressure of 218 mm Hg at a fraction of inspired oxygen of 1. Electrocardiography did not identify signs of ischemia or infarction, and chest radiography showed bilateral infiltration consistent with pulmonary edema. An echocardiogram revealed a . . . [Full Text of this Article]




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