Postoperative Apical Ballooning Syndrome Following Orthotopic Liver Transplantation

Osamah Z Badwan; Osama Abu-Shawer; Aritra Paul; Michael Faulx; Benico Barzilai

doi:10.7759/cureus.34450

Postoperative Apical Ballooning Syndrome Following Orthotopic Liver Transplantation

Cureus. 2023 Jan 31;15(1):e34450. doi: 10.7759/cureus.34450. eCollection 2023 Jan.

Authors

Osamah Z Badwan¹, Osama Abu-Shawer¹, Aritra Paul², Michael Faulx³, Benico Barzilai⁴

Affiliations

¹ Internal Medicine, Cleveland Clinic, Cleveland, USA.
² Surgery, Nil Ratan Sircar Medical College and Hospital, Kolkata, IND.
³ Cardiology, Cleveland Clinic, Cleveland, USA.
⁴ Heart, Vascular, and Thoracic Institute, Cleveland Clinic, USA.

Abstract

As the mainstay of therapy for end-stage liver disease (ESLD), orthotopic liver transplantation (OLT) has complex effects on multiple organ systems. We present a representative case of acute heart failure with apical ballooning syndrome following OLT and review its mechanisms. Recognition of this and other potential cardiovascular and hemodynamic complications of OLT are essential to periprocedural anesthesia management. Once an acute phase of the condition is stabilized, conservative treatment and resolution of physical or emotional stressors usually allow for rapid resolution of symptoms, typically recovering systolic ventricular function within one to three weeks.

Keywords: apical ballooning syndrome; cardiomyopathy; orthotropic liver transplant; post-op complications; takotsubo cardiomyopathy (ttc).

Publication types

Case Reports