[Suspected Takotsubo Cardiomyopathy after Elective Mitral Valve Replacement:Report of a Case]

Reports of takotsubo cardiomyopathy following cardiac surgery are rare. We report a case of postoperative takotsubo cardiomyopathy after mitral valve replacement (MVR). The patient was a 70-yearold woman with mitral stenosis, regurgitation, and a medical history of long-standing persistent atrial fibrillation. Preoperative echocardiogram confirmed severe mitral regurgitation, severe mitral stenosis, severe tricuspid regurgitation, and slight left ventricular dysfunction. Coronary lesions were not observed on preoperative diagnostic coronary angiography. MVR with a bioprosthetic valve, tricuspid annuloplasty, and left atrial maze were performed. Electrocardiogram on postoperative day (POD) 1 revealed a deep negative T wave in V3-V6. Echocardiogram revealed "takotsubo-like" wall motion, and the ejection fraction( EF) was 19%. The EF improved on POD 7. After three months, the electrocardiogram findings and EF appeared normal. We suspected takotsubo cardiomyopathy although postoperative coronary angiography was not performed. Takotsubo cardiomyopathy should be considered as a possible complication of cardiac surgery, especially after MVR.