Bilateral renal artery revascularisation in heart failure

BMJ Case Rep. 2024 Apr 24;17(4):e256323. doi: 10.1136/bcr-2023-256323.

Abstract

Renal artery stenosis can complicate the management of heart failure with reduced ejection fraction, as it is a conventional contraindication to the use of ACE inhibitors. We report a case in which bilateral renal artery revascularisation allowed the safe reintroduction of enalapril (and subsequently sacubitril valsartan) in a patient with severe left ventricular systolic dysfunction. There is a role for renal artery angioplasty in selected patients to allow optimal medical therapy for patients with heart failure due to impaired systolic function.

Keywords: Heart failure; Interventional cardiology; Renal system.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aminobutyrates / therapeutic use
  • Angiotensin Receptor Antagonists / therapeutic use
  • Biphenyl Compounds
  • Drug Combinations
  • Enalapril* / therapeutic use
  • Heart Failure*
  • Humans
  • Male
  • Renal Artery Obstruction* / complications
  • Renal Artery Obstruction* / surgery
  • Renal Artery Obstruction* / therapy
  • Renal Artery* / surgery
  • Tetrazoles / therapeutic use
  • Valsartan* / therapeutic use
  • Ventricular Dysfunction, Left

Substances

  • Valsartan
  • Enalapril
  • Tetrazoles
  • Drug Combinations
  • Aminobutyrates
  • sacubitril and valsartan sodium hydrate drug combination
  • Biphenyl Compounds
  • Angiotensin Receptor Antagonists