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A 72-year-old man with ischaemic cardiomyopathy and secondary mitral regurgitation developed heart failure. Due to the absence of options for revascularisation that would improve left ventricular function, poor functional status and a high Euro-SCORE II, the patient was deemed unfit for surgery. Furthermore, a cleft mitral valve also made him unsuitable for MitraClip [1]. To reduce mitral regurgitation he received treatment with a Carillon device for mitral valve annuloplasty in the coronary sinus (Fig. 1; [2]). Unfortunately, this did not reduce MR. In time he developed a left bundle branch block which made him eligible for placement of a cardiac resynchronisation therapy defibrillator (CRT-D) [3].
a The Carillon device (1) with the right atrial (2) and right ventricular (3) leads; b the Carillon device (1) and the left ventricular epicardial lead (4) in the coronary sinus. This illustrates the possibility of placing a Carillon device and a left ventricular lead in the coronary sinus in the treatment of mitral regurgitation and heart failure
There were no complications and the patient’s functional status improved significantly.
References
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Siminiak T, Wu J, Haude M, et al. Treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the TITAN Trial. Eur J Heart Fail. 2012;14(8):931–8.
Siminiak T, Jerzykowska O, Kalmucki P. Cardiac resynchronisation therapy after percutaneous trans-coronary-venous mitral annuloplasty. Kardiol Polska. 2013;71(12):1293–4.
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C.A. da Fonseca, F.S. van den Brink, M. Feenema, K. Kraaier andT.N. Vossenberg declare that they have no competing interests.
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da Fonseca, C.A., van den Brink, F.S., Feenema, M. et al. Left ventricular epicardial lead placement after Carillon placement in the coronary sinus. Neth Heart J 27, 514–517 (2019). https://doi.org/10.1007/s12471-019-1298-2
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DOI: https://doi.org/10.1007/s12471-019-1298-2