Introduction to Refractory Heart

What is/are Refractory Heart?

Refractory Heart - During followup, 1 patient died from refractory heart failure. ^[1] HCM-related deaths included: (1) sudden cardiac death (SCD) – death due to sudden cardiac arrest or unexpected sudden death; (2) heart failure – death due to refractory heart failure; or (3) stroke - death due to embolic stroke associated with atrial fibrillation. ^[2] Background and objective: Heart transplant is a life-saving treatment and currently is the definitive gold-standard in the treatment of refractory heart failure. ^[3] We present two cases of patients admitted to the Hospital at Home Unit who had refractory heart failure despite adequate diuretic treatment. ^[4] Substantial evidence is underscoring the importance of a combined assessment of liver and kidney function in patients with refractory heart failure, to stratify early post- heart transplant risk: multi-organ dysfunction, while identifying sickest patients on the list is also associated with a high risk of post transplant complications. ^[5] The older sister, who was at a high surgical risk due to progressive LV systolic dysfunction with an ejection fraction of 19%, underwent LAA plication in combination with implantation of an LV assist device after progression to treatment-refractory heart failure at the age of 49. ^[6] Cardiac arrhythmias that occur in patients referred to intensive care units worsen symptoms and outcomes and need urgent correction, especially in patients admitted for refractory heart failure. ^[7] As such, VAD utilization in single ventricle patients with refractory heart failure continues to be explored. ^[8] To assess the feasibility and clinical impact of lung ultrasound-driven therapeutic thoracentesis in refractory heart failure. ^[9] We want to emphasize the usefulness of this therapy in the management of volume excess in patients with refractory heart failure and renal failure promoting a greater sodium removal compared with traditional diuretic strategies. ^[10] Refractory heart failure,dilated cardiomyopathy,ischemic cardiomyopathy,and valvular heart disease belong to the traditional category of " consumptive disease". ^[11] The potassium‐sparing diuretic amiloride is among a class of proton pump inhibitors prescribed for refractory heart failure treatment in dogs. ^[12] He developed severe left ventricular (LV) dysfunction with refractory heart failure and underwent implant of a HeartWare (Medtronic, Minneapolis MN) in the morphologic LV on the right side at almost 5 years of age (weight 13. ^[13] Cardiac resynchronization therapy is an effective and widely accessible treatment for patients with advanced, drug-refractory heart failure. ^[14] Objective To compare efficacy and safety of indapamide-furosemide combination against metolazone-furosemide combination in refractory heart failure patients. ^[15] Extracorporeal life support (ECLS) is a strategy that substitute whole-body circulation when refractory heart failure cannot be further treated with conventional therapies. ^[16] In a randomized, controlled trial, researchers compared treatment success with the following therapies for refractory heartburn: laparoscopic Nissen. ^[17] Early generation left ventricular assist devices (LVAD) for treatment of refractory heart failure attempted to mimic the pulsatility of a native heart and were bulky and less durable due to valves within the inflow and outflow pathways. ^[18] OBJECTIVES: Although extracorporeal membrane oxygenation (ECMO) represents a rapidly evolving treatment option in patients with refractory heart or lung failure, survival remains poor and appropriate risk stratification challenging because established risk prediction models have not been validated for this specific population. ^[19] Diuretic therapy is a corner stone in the treatment patients with heart failure, and renal replacement therapies are mainly used for patients with refractory heart failure who have not reached the worst stages of renal disfunction. ^[20] Methods The study included 16 patients with non-ischemic dilated cardiomyopathy and refractory heart failure: 10 patients underwent mitral valve plasty and left ventricular plasty (MVP + LVP group) and 6 patients who underwent mitral valve replacement and papillary muscle tugging approximation (MVR + PMTA group). ^[21] He underwent aortic valve replacement for refractory heart failure and bulky vegetations after failed medical therapy. ^[22] Results We treated a 71-year-old man with refractory heart failure due to ATTRwt. ^[23] Only a minority of patients died of refractory heart failure. ^[24] The most common cause of death was refractory heart failure (267 patients [65. ^[25] Treatments for PPI-refractory heartburn are of unproven efficacy and focus on controlling gastroesophageal reflux with reflux-reducing medication (e. ^[26] PD is particularly suitable for neonates, children, and patients with refractory heart failure or who are otherwise hemodynamically unstable. ^[27] Early indications are 1Refractory heart failure 2Uncontrolled infection 3Prevention of systemic embolism within 2 weeks after diagnosis. ^[28] A 4-year-old boy with Noonan syndrome accompanied by hypertrophic obstructive cardiomyopathy presented with refractory heart failure owing to severe left ventricular outflow obstruction and mitral regurgitation. ^[29] PDE3 inhibitors (PDE3i) are used for short-term treatment of refractory heart failure (HF), but do not produce uniform long-term benefit. ^[30] Cardiac sarcoidosis is underdiagnosed; it may occur in asymptomatic patients or be fatal as a consequence of severe arrhythmias, sudden death and refractory heart failure. ^[31] Because of refractory heart failure despite medical therapy, surgical mitral and tricuspid valve repair was performed, and an excellent 24-month outcome was achieved. ^[32] Methods: Subjects were 26 patients who had refractory heart failure due to cardiomyopathy andmitral regurgitation (MR): 14 patients with more than moderate MR who had implantable LVAD and 12 patients with severe MR who were not candidates for heart transplantation and underwent chordal sparing MVR. ^[33] We evaluated immediate, 30-day and 1-year outcomes after the procedure in patients with refractory heart failure and severe functional mitral regurgitation, including patients with acute ischemic mitral regurgitation. ^[34] Patients with refractory heart failure may be considered for advanced surgery, including left ventricular assist device implantation, heart transplantation and left ventricular reconstruction. ^[35] Renal dysfunction after transplant is rare and associated iliac artery stenosis leading to refractory heart failure is extremely rare. ^[36] Most TMVR candidates are elderly and/or have refractory heart failure, and may not obtain sufficient load on cycle exercise. ^[37] Left Ventricular Assist Device (LVAD) is an effective therapy for patients with advanced or refractory heart failure. ^[38]

mechanical circulatory support

Improving outcomes with durable mechanical circulatory support have led to expanding interest in the earlier recognition of patients destined to develop refractory heart failure (HF). ^[1] We also retrospectively assessed our institutional experience with mechanical circulatory support in refractory heart failure due to Chagas cardiomyopathy over a 10-year period. ^[2] Late systemic (right) ventricular failure is common after the Mustard procedure for transposition of the great arteries (TGA), and mechanical circulatory support may be required for patients presenting with refractory heart failure; however, clinical experience with this approach is limited. ^[3] Background Temporary mechanical circulatory support (MCS) offers a valuable option for treatment of refractory heart failure. ^[4]

Medically Refractory Heart

Cardiac implantable electronic devices (CIEDs) are essential for the management of a variety of cardiac conditions, including tachyarrhythmias, bradyarrhythmias, and medically refractory heart failure (HF). ^[1] A 58-year-old woman suffered from medically refractory heart failure due to idiopathic dilated cardiomyopathy. ^[2] Cardiac resynchronization therapy (CRT) has been shown to be beneficial in patients with medically refractory heart failure. ^[3] CRT is indicated in patients with medically refractory heart failure and wide QRS duration. ^[4] The Impella is a catheter-based ventricular assist device that is used in cardiogenic shock after myocardial infarction, high-risk percutaneous coronary intervention, and medically refractory heart failure. ^[5]

Developed Refractory Heart

This paper describes the case of a patient who developed refractory heart failure due to a fistula from the left ventricle to the coronary sinus that was unintentionally created after a surgical myectomy and mitral valve replacement. ^[1] During follow-up, one patient had developed refractory heart failure and died in 2014. ^[2] Afterwards, she developed refractory heart failure with severe global left ventricular dysfunction and was transferred to our hospital. ^[3] A 34-year-old woman, who developed refractory heart failure associated with chronic myocarditis, underwent implantation of a HeartMate II via T-shaped ministernotomy without any additional incisions. ^[4]

Drug Refractory Heart

Cardiac resynchronization therapy (CRT) is a well‐established treatment for patients with drug refractory heart failure. ^[1] Hypertrophic cardiomyopathy (HCM) is the most common monogenic cardiac disease with a highly variable phenotypic expression, ranging from asymptomatic to drug refractory heart failure (HF) presentation. ^[2] Introduction Cardiac resynchronization therapy (CRT) is a well-established treatment for patients with drug refractory heart failure. ^[3]

refractory heart failure

More important, our results suggest that reduction of NO or denitrosylation of HDAC2 may provide a new therapeutic platform for the treatment of refractory heart failure with preserved ejection fraction. ^[1] BACKGROUND Heart transplantation is recommended for the treatment of patients with refractory heart failure. ^[2] CONCLUSION IE should be considered in critical patients with refractory heart failure caused by severe bicuspid aortic valve regurgitation. ^[3] Heart Transplantation (CT) is the latest therapy for patients with refractory Heart Failure (HF). ^[4] Her background was significant for previous pacemaker lead infection, refractory heart failure secondary to severe tricuspid valve distortion by her pacemaker lead, tricuspid and mitral valve replacements complicated by recurrent endocarditis over several years. ^[5] During the follow-up period, the patient died of refractory heart failure. ^[6] The current case highlighted that comprehensive assessment of laboratory, imaging, and pathological examinations including CMR is crucial to develop the appropriate therapeutic strategy for refractory heart failure. ^[7] We sought to develop a risk profile for refractory heart failure and life-threatening arrhythmias in a multicenter cohort of FLNCtv carriers. ^[8] This paper describes the case of a patient who developed refractory heart failure due to a fistula from the left ventricle to the coronary sinus that was unintentionally created after a surgical myectomy and mitral valve replacement. ^[9] Case summary We present a case of a 61-year-old male patient with an ischaemic cardiomyopathy, poor LV function, moderate to severe mitral regurgitation, and severe aortic valve regurgitation in refractory heart failure. ^[10] Of these, four (6%) had resuscitated cardiac arrest (of whom, one subsequently died of refractory heart failure, patient 6; Fig 1, Table I) whereas four died (Fig 1, Table I). ^[11] Congestive heart failure affects about 23 million people worldwide, and cardiac allograft transplantation remains one of the last options for patients with terminal refractory heart failure. ^[12] Cardiac implantable electronic devices (CIEDs) are essential for the management of a variety of cardiac conditions, including tachyarrhythmias, bradyarrhythmias, and medically refractory heart failure (HF). ^[13] During follow-up, one patient had developed refractory heart failure and died in 2014. ^[14] Cardiac resynchronization therapy (CRT) is a treatment modality for selected patients with refractory heart failure. ^[15] Two of these underwent HTX, one died for refractory heart failure (HF) and one is still on the waiting list. ^[16] The boy underwent heart transplantation due to refractory heart failure caused by dilated cardiomyopathy at the age of 7 months. ^[17] Subsequently, she was referred to our Department for both lead extraction and treatment of refractory heart failure, 10 months later, initial implant. ^[18] Inflammatory cardiomyopathy often leads to refractory heart failure. ^[19] Since implantation of the durable implantable LVAD (I-LVAD) is still controversial in patients with cardiogenic shock or refractory heart failure because of its significant inferiority of outcomes as compared with higher INTERMACS profile patients, short-term E-LVADs have been still clinically important for bridging strategy for the next definitive treatment. ^[20] Animals were euthanized due to incurable neurological disease, refractory heart failure, or by owners will. ^[21] We report a case of urgent PTSMA for treating refractory heart failure due to exacerbated obstruction of the left ventricular outflow tract after surgical aortic valvular replacement to treat severe aortic stenosis. ^[22] Left ventricular assist device (LVAD) is an alternative treatment for refractory heart failure in DMD. ^[23] While smaller communications may initially be asymptomatic, the natural course of these connections is generally refractory heart failure as they do not spontaneously heal. ^[24] Purpose Central extracorporeal life support (ECLS) has been shown to yield a sufficient flow support with unloading of heart and lung in cases having acute refractory heart failure with durable LVAD candidacy being uncertain. ^[25] The progressive ageing of the general population and the advancements in treating left-sided heart diseases by transcatheter procedures, have contributed to the tricuspid regurgitation (TR) becoming a major public health problem associated with progression to refractory heart failure and poor outcome. ^[26] Although CRT is a highly effective treatment for drugrefractory heart failure (HF) with reduced ejection fraction (HFrEF), the longterm mortality of these patients is not negligible. ^[27] Introduction: Cardiac resynchronization therapy (CRT), is a therapeutic option for patients with refractory heart failure. ^[28] Lack of efficacy: case report A woman in her late 50s [exact age not stated] exhibited lack of efficacy during treatment with carperitide, milrinone, dobutamine and furosemide for recurrent and refractory heart failure (HF). ^[29] Background: Previous predictors of mechanical dyssynchrony using echocardiography has not improved refractory heart failure in patients treated with cardiac resynchronization therapy. ^[30] The patient was a 4-year-old boy who underwent heart transplantation at 7 months of age for refractory heart failure due to dilated cardiomyopathy. ^[31] INTRODUCTION Heart transplantation is the treatment indicated for patients with advanced and refractory heart failure (HF). ^[32] Afterwards, she developed refractory heart failure with severe global left ventricular dysfunction and was transferred to our hospital. ^[33] Cardiac resynchronization therapy (CRT) is a well‐established treatment for patients with drug refractory heart failure. ^[34] Four patients of group 1 (13%) and five patients of group 2 (16%) died due to refractory heart failure. ^[35] Case Report A 20-year-old man affected by Danon disease with mild muscular affection and refractory heart failure underwent HT in May 2020. ^[36] Hypertrophic cardiomyopathy (HCM) is the most common monogenic cardiac disease with a highly variable phenotypic expression, ranging from asymptomatic to drug refractory heart failure (HF) presentation. ^[37] The ultimate focus will be directed toward neurologic manifestations of myocarditis and its subtypes, complications of specific therapies including extracorporeal membrane oxygenation (ECMO) for refractory heart failure, and review the current literature regarding the appropriate use of therapeutic anticoagulation in myocarditis and heart failure for stroke prevention. ^[38] Despite the optimal GDMT, dapagliflozin, SGLT2i was added inpatients withrefractory heart failure. ^[39] For those with refractory heart failure, intravenous milrinone therapy has become a mainstay of bridging children to cardiac transplantation. ^[40] Emergency TAVI was considered as any unscheduled TAVI performed to treat refractory heart failure or cardiogenic shock. ^[41] Conclusions: In selected cases, particularly in severe diuretic refractory heart failure, PDC placement placed by a nephrologist is feasible with a low rate of complications even in a low-volume center setting. ^[42] During followup, 1 patient died from refractory heart failure. ^[43] HCM-related deaths included: (1) sudden cardiac death (SCD) – death due to sudden cardiac arrest or unexpected sudden death; (2) heart failure – death due to refractory heart failure; or (3) stroke - death due to embolic stroke associated with atrial fibrillation. ^[44] Heart transplantation is an established life-saving treatment for individuals with end-stage refractory heart failure. ^[45] Background and objective: Heart transplant is a life-saving treatment and currently is the definitive gold-standard in the treatment of refractory heart failure. ^[46] Improving outcomes with durable mechanical circulatory support have led to expanding interest in the earlier recognition of patients destined to develop refractory heart failure (HF). ^[47] We present two cases of patients admitted to the Hospital at Home Unit who had refractory heart failure despite adequate diuretic treatment. ^[48] Substantial evidence is underscoring the importance of a combined assessment of liver and kidney function in patients with refractory heart failure, to stratify early post- heart transplant risk: multi-organ dysfunction, while identifying sickest patients on the list is also associated with a high risk of post transplant complications. ^[49] Results 58 patients underwent successful IPC insertion of which 5 were for non-malignant disease (2/5 refractory heart failure, 3/5 advanced liver cirrhosis). ^[50]