Transcatheter treatment of heart failure with preserved or mildly reduced ejection fraction using a novel interatrial implant to lower left atrial pressure

摘要: Background Heart failure with preserved or mildly reduced ejection fraction (HFpEF) is common and, to date, therapeutic options are limited. Increased left atrial pressure a key contributor the symptoms associated HFpEF, particularly during physical activity. We report 30-day outcome of patients treated novel device intended lower by creating an 8 mm permanent shunt in septum. Methods and results Eleven were enrolled pilot trial. Key inclusion criteria were: EF >45%; baseline PCWP ≥15 mmHg (rest), ≥ 25 (exercise); ≥1 hospitalization for heart within past 12 months, persistent NYHA class III/IV at least 3 months. Mean age, LVEF, 70 ± years, 57 9%, 3.2 0.4, respectively. Most had significant co-morbidities. The interatrial septal (IASD) was implanted using percutaneous trans-septal access via femoral vein. successfully all patients. At 30 days, LV filling pressures significantly 5.5 (19.7 3.4 vs. 14.2 2.7; P = 0.005), improved two classes patients, one five worsened patient. No patient developed pulmonary hypertension. Two serious adverse events occurred; re-hospitalization, implant malposition new device. Conclusion Contemporary management HFpEF confounded lack effective therapies. use device-based approach reduce provides means improve haemodynamic symptomatic status warrants further investigation.