Abstract
In this report, we present a case of a post pump chorea in a 77-year-old male after concomitant cardiac procedure. Since this complication usually occurs in children, to our knowledge, the presented patient is the eldest described in literature. We discuss a long aortic clamp, resp. pump time presumably as a risk factor in this case. The symptoms improved after treatment with tetrabenazine.
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References
Adar A, Dagan O, Weitz R (1999) Choreoathetosis after cardiac surgery in children. Harefuah 137:460–462
Andrich J, Arning L, Wieczorek S et al (2008) Huntington’s disease as caused by 34 CAG repeats. Mov Disord 23:879–881
Bellinger DC, Wypij D, Kuban KC et al (1999) Developmental and neurological status of children at 4 years of age after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. Circulation 100:526–532
Bergouignan M, Fontan F, Trarieux M et al (1961) Choreiform syndromes in children during cardiosurgical operations under deep hypothermia. Rev Obstet Ginecol Venez 105:48–60
Björk V, Hultquist G (1960) Brain damage in children after deep hypothermia for open-heart surgery. Thorax 15:284–291
Brunberg JA, Doty DB, Reilly EL (1974) Choreoathetosis in infants following cardiac surgery with deep hypothermia and circulatory arrest. J Pediatr 84:232–235
Brunberg JA, Reilly EL, Doty DB (1974) Central nervous system consequences in infants of cardiac surgery using deep hypothermia and circulatory arrest. Circulation 50(II):60–68
Chock VY, Reddy VM, Bernstein D et al (2006) Neurologic events in neonates treated surgically for congenital heart disease. J Perinatol 26:237–242
Curless RG, Katz DA, Perryman RA et al (1994) Choreoathetosis after surgery for congenital heart disease. J Pediatr 124:737–739
Dale RC, Singh H, Troedson C et al (2010) A prospective study of acute movement disorders in children. Dev Med Child Neurol 52:739–748
De Bie RM, Surie S, Kloek JJ et al (2008) Chorea in adults after pulmonary endarterectomy with deep hypothermia and circulatory arrest. Ann Intern Med 149:842
Deleon S, Ilbawi M, Arcilla R et al (1990) Choreoathetosis after deep hypothermia without circulatory arrest. Ann Thorac surg 50:714–719
Du Plessis AJ, Bellinger DC, Gauvreau K et al (2002) Neurologic outcome of choreoathetoid encephalopathy after cardiac surgery. Pediatr Neurol 27:9–17
Egerton N, Egerton WS, Kay JH (1963) Neurologic Changes Following Profound Hypothermia. Ann Surg 157:366–374
Ferry PC (1987) Neurologic sequelae of cardiac surgery in children. Am J Dis Child 141:309–312
Ferry PC (1990) Neurologic sequelae of open-heart surgery in children. An ‘irritating question’. Am J Dis Child 144:369–373
Gherpelli JL, Azeka E, Riso A et al (1998) Choreoathetosis after cardiac surgery with hypothermia and extracorporeal circulation. Pediatr Neurol 19:113–118
Holden KR, Sessions JC, Cure J et al (1998) Neurologic outcomes in children with post-pump choreoathetosis. J Pediatr 132:162–164
Kaulitz R, Bergmann P, Heyer R et al (1997) Akutes Chorea-Syndrom nach Herzoperation am hypothermen kardiopulmonalen Bypass (Post pump chorea, PPC). Monatsschr Kinderheilkd 145:887–891
Kobayashi KJ, Williams JA, Nwakanma L et al (2007) Aortic valve replacement and concomitant coronary artery bypass: assessing the impact of multiple grafts. Ann Thorac Surg 83:969–978
Kupsky WJ, Drozd MA, Barlow CF (1995) Selective injury of the globus pallidus in children with post-cardiac surgery choreic syndrome. Dev Med Child Neurol 37:135–144
Levin DA, Seay AR, Fullerton DA et al (2005) Profound hypothermia with alpha-stat pH management during open-heart surgery is associated with choreoathetosis. Pediatr Cardiol 26:34–38
Medlock MD, Cruse RS, Winek SJ et al (1993) A 10-year experience with postpump chorea. Ann Neurol 34:820–826
Miller G, Eggli KD, Contant C et al (1995) Postoperative neurologic complications after open heart surgery on young infants. Arch Pediatr Adolesc Med 149:764–768
Osari S, Muranaka H, Kojima T et al (1995) Persistent chorea following cardiac surgery for congenital heart disease. Acta Paediatr Jpn 37:409–412
Passarin MG, Romito S, Avesani M et al (2010) Late-onset choreoathetotic syndrome following heart surgery. Neurol Sci 31:95–97
Robinson RO, Samuels M, Pohl KR (1988) Choreic syndrome after cardiac surgery. Arch Dis Child 63:1466–1469
Thobois S, Bozio A, Ninet J et al (2004) Chorea after cardiopulmonary bypass. Eur Neurol 51:46–47
Treasure T, Naftel DC, Conger KA et al (1983) The effect of hypothermic circulatory arrest time on cerebral function, morphology, and biochemistry. An experimental study. J Thorac Cardiovasc Surg 86:761–770
Wong PC, Barlow CF, Hickey PR et al. (1992) Factors associated with choreoathetosis after cardiopulmonary bypass in children with congenital heart disease. Circulation 86(II):118-126
Acknowledgments
This work was supported by the Ruhr-University Bochum (FoRUM grant K040-90).
Conflicts of interest
Carsten Saft received honorarium from Temmler Pharma GmbH & Co.KG for scientific talks, compensation in the context of the Registry-Study of the Euro-HD-Network, in the context of the ACR16-Study (Neurosearch), the AFQ-Study (Novartis) and received research support for a research project with Teva Pharma GmbH and from the FoRUM–Forschungsförderung Ruhr-Universität Bochum Medizinische Fakultät. Delawer Reber, Monika Streuer and Jürgen Andrich have no competing interests. The authors report no conflicts of interest.
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Saft, C., Reber, D., Streuer, M. et al. Post pump chorea in a 77-year-old male. Neurol Sci 32, 699–701 (2011). https://doi.org/10.1007/s10072-011-0583-7
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DOI: https://doi.org/10.1007/s10072-011-0583-7