Open AccessRefractory congestive heart failure: when the solution is outside the heart
Author(s) -
Pernias Vicente,
González Miguel,
Miñana Gema,
Górriz Jose Luis,
Juan Isabel,
Chorro Francisco J.,
Sanchis Juan,
Núñez Julio
Publication year - 2020
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12554
Subject(s) - medicine , heart failure , cardiology , anasarca , refractory (planetary science) , intensive care medicine , peritoneal dialysis , continuous ambulatory peritoneal dialysis , dialysis , physics , astrobiology
Refractory congestive heart failure is associated with an ominous prognosis in which the treatments strategies remain scarce and not well validated. In the last years, continuous ambulatory peritoneal dialysis (CAPD) has emerged as a therapeutic alternative in this subset of patients. So far, it has been associated with a significant improvement in functional capacity and quality of life, together with a striking reduction in the risk of readmissions. We present the case of an elderly patient with severe left ventricular dysfunction and severe mitral and tricuspid regurgitation who presents recurrent admissions for anasarca. After its inclusion in a CAPD programme, the patient experienced a marked clinical and biochemical improvement despite the persistence of cardiac abnormalities. CAPD onset translates into greater sodium removal. 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.