Transcatheter interatrial shunt device IASD Lancet 2016 Mar










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Transcatheter interatrial shunt device (IASD) Lancet. 2016 Mar 26 A transcatheter intracardiac shunt device for heart failure with preserved ejection fraction (REDUCE LAPHF): a multicentre, open-label, single-arm, phase 1 trial. Hasenfuß G 1, Hayward C 2, Burkhoff D 3, Silvestry FE 4, Mc. Kenzie S 5, Gustafsson F 6, Malek F 7, Van der Heyden J 8, Lang I 9, Petrie MC 10, Cleland JG 11, Leon M 12, Kaye DM 13; REDUCE LAP‐HF study investigators.

Heart failure: • left ventricular systolic dysfunction (impairment in ability of the heart to pump sufficient amounts of blood into the circulation during systole) • heart failure with preserved left ventricular ejection fraction (HFPEF) or “diastolic” heart failure (patients with normal left ventricular systolic function in whom higher filling pressures are needed to obtain a normal end‐diastolic volume of the left ventricle)1

Consequences: Exercise inevitably produce an abrupt rise in pulmonary and left atrial pressure, the main driver of dyspnoea in patients with heart failure with preserved ejection fraction. 3

Heart failure with preserved ejection fraction (HFPEF) is a common, globally recognised, form of heart failure for which no treatment has yet been shown to improve symptoms or prognosis. 2

Targets: patients older than 40 years of age with symptoms of HFPEF despite pharmacological therapy, left ventricular ejection fraction higher than 40%, and a raised pulmonary capillary wedge pressure at rest (>15 mm Hg) or during exercise (>25 mm Hg)2




Results: In this open‐label study of a novel transcatheter interatrial shunt device, which was developed for the management of patients with HFPEF, we recorded reductions in left atrial pressure during exercise with improvements in functional capacity and quality of life 6 months after implantation. 2

References: 1. https: //www. ncbi. nlm. nih. gov/pubmed/17699180 2. https: //www. ncbi. nlm. nih. gov/pubmed/? term=A+transcatheter+intracardiac+shunt+device+for+heart+f ailure+with+preserved+ejection+fraction+(REDUCE+LAP‐HF)%3 A+a+multicentre%2 C+open‐ label%2 C+single‐arm%2 C+phase+1+trial 3. https: //www. ncbi. nlm. nih. gov/pubmed/27025419 Images: http: //osuwmc. multimedianewsroom. tv/story. php? id=1130&enter http: //corviamedical. com/treatment/