Takotsubo Syndrome Following Mitral Transcatheter Edge-to-Edge Repair: A case report and literature review

Si Pang haobo Huang yunlong Zhu rong Zhou Dan Tan yuqing Zhang Mingxing Wu ^*

• Xiangtan Central Hospital, Xiangtan, China

Background: Takotsubo syndrome (TTS), characterized by transient wall-motion aberrations and clinical manifestations akin to acute coronary syndrome, predominantly arises from significant physical or emotional stress, often throughout the perioperative period. The prevalence and mechanisms of this condition remain inadequately elucidated, particularly in the context of transcatheter valvular disease procedures. This knowledge gap may result in under-recognition and subsequent delays in diagnosis. Case summary: A 76-year-old female was scheduled for our department for mitral transcatheter edge-to-edge repair (TEER). Despite the procedural success, multi-lead T-wave inversions and a 43% decrease in ejection fraction accompanied by new apical hypokinesis were noted post-operatively. Subsequent assessment revealed TTS. After receiving the optimal medical therapy, the patient was discharged after ten days without experiencing acute chest pain or shortness of breath. Electrocardiogram (ECG) and function of the left ventricular function, particularly regional wall motion abnormalities, recovered on the 20th day after surgery. Discussion: In addition, the limited literature reporting TTS post-TEER that we reviewed suggests that this rare complication must be anticipated in patients exhibiting unexpected postoperative ECG and impaired myocardial contraction. Conclusion: Researchers call for high-risk patient identification, adequate preoperative evaluation, vigilant postoperative monitoring, and the significance of early detection in optimizing therapeutic outcomes. Further research is imperative to further explore the management and prognosis of TTS following TEER.