Langenbeck's Archives of Surgery

, Volume 398, Issue 5, pp 729–733

Pheochromocytoma revealed by acute heart failure. When should we operate? Presented at the ESES Congress, Gothenburg May 25–26, 2012

  • G. Müller
  • F. Saint
  • A. Hamy
  • J. C. Lifante
  • B. Carnaille
  • F. Sebag
  • F. Ménégaux
  • J. Vandwalle
  • D. Drui
  • C. Caillard
  • P. Rodien
  • M. Roy
  • J. L. Peix
  • F. Pattou
  • L. Brunaud
  • J. F. Henry
  • E. Mirallié
Original Article

DOI: 10.1007/s00423-012-1040-7

Cite this article as:
Müller, G., Saint, F., Hamy, A. et al. Langenbecks Arch Surg (2013) 398: 729. doi:10.1007/s00423-012-1040-7

Abstract

Purpose

The aim of this study was to assess the safety and efficacy of adrenalectomy on patients with pheochromocytoma diagnosed at the time of an acute heart failure (AHF).

Methods

We reported cases of patients who presented an AHF secondary to a pheochromocytoma during a period of 10 years. The diagnosis of AHF was defined by a left ventricular ejection fraction of less than 30 % or the use of circulatory assistance. They had adrenalectomy as emergency surgery or later. Morbidity and mortality of surgery were studied.

Results

Thirteen patients required an adrenalectomy for AHF secondary to pheochromocytoma. Four patients (31 %) had an adrenalectomy in emergency. Nine patients (69 %) had a delayed surgery with a median delay of 25 days (7–180). Eight patients had circulatory assistance (61 %). Five of them had a circulatory assistance and a delayed surgery (38 %), two of them had a circulatory assistance followed by emergency surgery (at 1.5 and 3 days) and one had emergency surgery immediately followed by circulatory assistance. Emergency surgery was performed by laparotomy in all cases and delayed surgery by laparoscopy for seven patients (54 %). Perioperative complications consisted in: one circulatory arrest, two bleedings requiring transfusion, one intestinal ischaemia, one haemoperitoneum with re-operation (day 8). One patient died on day 5. Post-operative course of patients with delayed surgery was uneventful.

Conclusions

AHF revealing a pheochromocytoma is a rare and serious event. Patients with emergency surgery have more complications than those with delayed surgery.

Keywords

PheochromocytomaAcute heart failureAdrenalectomyEmergency

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • G. Müller
    • 1
  • F. Saint
    • 2
  • A. Hamy
    • 3
  • J. C. Lifante
    • 4
  • B. Carnaille
    • 5
  • F. Sebag
    • 6
  • F. Ménégaux
    • 7
  • J. Vandwalle
    • 2
  • D. Drui
    • 9
  • C. Caillard
    • 1
  • P. Rodien
    • 10
  • M. Roy
    • 1
  • J. L. Peix
    • 4
  • F. Pattou
    • 5
  • L. Brunaud
    • 8
  • J. F. Henry
    • 6
  • E. Mirallié
    • 1
  1. 1.Department of Digestive and Endocrine Surgery, CCDE, IMADCHU NantesNantesFrance
  2. 2.Department of Urology and TransplantationCHU AmiensAmiensFrance
  3. 3.Department of Digestive and Endocrine SurgeryCHU d’AngersAngersFrance
  4. 4.Department of General and Endocrine SurgeryCHU Lyon SudLyonFrance
  5. 5.Department of Digestive and Endocrine SurgeryLille University HospitalLilleFrance
  6. 6.Department of General and Endocrine SurgeryHôpital de la TimoneMarseilleFrance
  7. 7.Department of General and Digestive SurgeryHôpital de la Pitié-SalpêtrièreParisFrance
  8. 8.Department of Hepatobiliary, Digestive and Endocrine SurgeryCHU Nancy-BraboisVandoeuvre-les-NancyFrance
  9. 9.Department of EndocrinologyCHU NantesNantesFrance
  10. 10.Department of EndocrinologyCHU AngersAngersFrance