Cardiac resynchronization therapy following Carillon® annuloplasty device for symptomatic heart failure and
Haqeel A Jamil1, Steven L Goldberg2,3, Klaus K Witte1
1Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, LIGHT Building, Clarendon Way, Leeds LS2 9JT, UK.
Insights
This case study shows how combining transvenous mitral annuloplasty and cardiac resynchronization therapy can effectively manage patients with left ventricular systolic dysfunction, functional mitral regurgitation, and left bundle branch block.
Area of Science:
- Cardiology
- Medical Devices
- Heart Failure Management
Background:
- Left ventricular systolic dysfunction (LVSD) with functional mitral regurgitation (FMR) and left bundle branch block (LBBB) presents complex challenges.
- Optimal medical therapy (OMT) may be insufficient for symptomatic patients with these co-existing conditions.
- These comorbidities contribute to clinical deterioration and poorer prognosis.
Background:
Symptomatic patients with significant left ventricular systolic dysfunction (LVSD) require a tailored treatment approach. Both functional mitral regurgitation (FMR) and left bundle branch block (LBBB) can develop, contributing to clinical deterioration, and worse prognosis despite optimal medical therapy (OMT).
Case Summary:
We report the case of a symptomatic 60-year-old man on OMT with LVSD and significant FMR. His symptoms and FMR initially improved following transvenous mitral annuloplasty using the Carillon® Mitral Contour System® annuloplasty device. However, he subsequently developed LBBB with associated reduction in exercise capacity, for which he underwent cardiac resynchronization therapy, and ensuing symptom improvement and stabilization.
Discussion:
Our case describes how targeted device interventions can be combined synergistically to optimize patient symptoms.
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