{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:48:54Z","timestamp":1753876134656,"version":"3.41.2"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T00:00:00Z","timestamp":1710201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Kaufman Center for Heart Failure Treatment and Recovery at the Cleveland Clinic"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cardiac resynchronization therapy (CRT) is recommended for patients with symptomatic heart failure in sinus rhythm with left ventricular ejection fraction (LVEF) \u2264 35%, QRS duration \u2265 150\u2005ms, and left bundle branch block (LBBB) morphology. However, when severe left ventricular dysfunction and cardiogenic shock are present, treatment paradigms are often limited to palliative medical therapy or advanced therapies with durable left ventricular assist device or heart transplant as the functional and survival benefit of CRT in these patients remains uncertain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 77-year-old white man with long-standing LBBB with dyssynchrony, severely reduced LVEF of 4%, and severe bicuspid aortic stenosis (AS) presented with worsening heart failure symptoms. After multidisciplinary heart team evaluation and pre-operative optimization, the patient underwent a surgical aortic valve replacement with simultaneous intraoperative initiation of CRT with pacemaker (CRT-P) and temporary mechanical circulatory support. Echocardiography at 44 days and 201 days post-discharge showed an LVEF of 29% and 40%, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case demonstrates that reverse remodelling and native heart recovery were successfully achieved in a patient with advanced structural heart disease, presenting with cardiogenic shock, through an early and aggressive approach involving multidisciplinary heart team evaluation, treatment of severe AS with surgical aortic valve replacement, prophylactic intraoperative initiation of temporary mechanical circulatory support, and early initiation of CRT-P.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae127","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T14:59:01Z","timestamp":1710169141000},"source":"Crossref","is-referenced-by-count":0,"title":["Multidisciplinary approach to long-standing left bundle branch block with dyssynchrony and aortic stenosis: case report"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2632-3142","authenticated-orcid":false,"given":"Jean-Luc A","family":"Maigrot","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Kaufman Center for Heart Failure Treatment and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic , Cleveland, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron J","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Kaufman Center for Heart Failure Treatment and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic , Cleveland, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7115-7716","authenticated-orcid":false,"given":"Oussama","family":"Wazni","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Section of Cardiac Electrophysiology and Pacing, Heart, Vascular and Thoracic Institute, Cleveland Clinic , Cleveland, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randall C","family":"Starling","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kaufman Center for Heart Failure Treatment and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic , 9500 Euclid Avenue, Desk J3-4 , Cleveland, OH 44195, 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cardiac resynchronization therapy of the European Society of Cardiology (ESC) with the special contribution of the European Heart Rhythm Association (EHRA)","volume":"42","author":"Glikson","year":"2021","journal-title":"Eur Heart J"},{"key":"2024043014055080400_ytae127-B4","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/j.cardfail.2010.07.253","article-title":"Role of cardiac resynchronization in end-stage heart failure patients requiring inotrope therapy","volume":"16","author":"Bhattacharya","year":"2010","journal-title":"J Card Fail"},{"key":"2024043014055080400_ytae127-B5","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1056\/NEJMoa022021","article-title":"Nitroprusside in critically ill patients with left ventricular dysfunction and aortic stenosis","volume":"348","author":"Khot","year":"2003","journal-title":"N Engl J 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