Corneliu Iorgulescu
Inter Cardio Clinique, Romania
Title: Interventional management in a heart failure patient
Biography
Biography: Corneliu Iorgulescu
Abstract
We present the case of 72 years male; diabetic, hypertensive with ischemic cardiomyopathy, moderate-severe mitral regurgitation and left bundle branch block. At the initial hospitalization the patient had a 25% LVEF and was NYHA 4 with optimal medical therapy- ACE inhibitor, Beta-blocker, Spironolactone and Furosemide. He had trivascular coronary heart disease with complete interventional revascularization. A CRT-D was implanted with an increase of LVEF at 35% to 40% at six months and NYHA class II symptoms. After two years he developed atrial fibrillation and NYHA class III symptoms. Amiodarone was attempted unsuccessfully so after six months a pulmonary veins isolation procedure was performed. The patient remained in sinus rhythm and NYHA II for one year than atrial fibrillation reoccurred. At that moment he was NYHA III with optimal medical therapy, LVEF was 35% with severe mitral regurgitation. The patient was proposed for mitral clip implant and he was switched to Sacubitril/Valsartan therapy. He improved to NYHA II class and remained stable for two years. No mitral clip was implanted.