Annals of Internal Medicine: Clinical Cases · Published 2026-08-01 · DOI 10.7326/aimcc.2026.0428
Joshua A. Rushakoff, Brian Kolski, Jeffrey M. Tyler, Marat Fudim
Patients with advanced valvular disease frequently experience oral diuretic resistance. We describe the use of intranasal bumetanide, a nonoral diuretic, in a 76-year-old woman with severe mitral regurgitation who had recurrent volume overload and oral diuretic resistance. Decongestion following intranasal bumetanide ultimately allowed for advanced evaluation and successful transcatheter mitral valve replacement. This case demonstrates that nonoral diuretic therapy may serve as an effective bridge to advanced structural interventions, allowing for home administration and avoidance of hospitalizations. Nonoral diuretics can be an alternative to preadmission and in-hospital optimization before minimally invasive valvular procedures.
Abstract from DOAJ. Public domain (CC0 1.0).
Read the article at the publisher →
Rushakoff, J., Kolski, B., Tyler, J., et al. (2026). Intranasal Bumetanide in a Patient With Diuretic-Resistant Heart Failure Awaiting Transcatheter Mitral Valve Replacement. Annals of Internal Medicine: Clinical Cases. https://doi.org/10.7326/aimcc.2026.0428