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Left Atrial to Coronary Sinus Shunting for Treatment of Symptomatic Heart Failure

Benjamin Hibbert1, Firas Zahr2, Trevor Simard3

  • 1CAPITAL Research, Department of Medicine, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.

JACC. Cardiovascular Interventions
|March 29, 2023
PubMed

Insights

The APTURE Transcatheter Shunt System shows promise for heart failure (HF) patients, improving health status and reducing pulmonary capillary wedge pressure safely. This novel interatrial shunting therapy offers a new option for symptomatic HF management.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Heart failure (HF) significantly impacts mortality and patient health status.
  • Interatrial shunting is an emerging therapeutic strategy for HF management.

Purpose of the Study:

  • To evaluate the safety and efficacy of the Edwards APTURE Transcatheter Shunt System in patients with symptomatic HF.
  • Assessed the impact of the shunt on pulmonary capillary wedge pressure, HF symptoms, and quality of life.

Main Methods:

  • The ALT FLOW Early Feasibility Study enrolled 87 patients with symptomatic HF across 18 centers.
  • Patients had elevated pulmonary capillary wedge pressure (>15 mmHg rest or >25 mmHg exercise).
  • The APTURE shunt was implanted, and safety and clinical outcomes were assessed up to 6 months.

Main Results:

  • Device success was achieved in 90% of patients, with a low primary safety event rate (2.3% at 30 days).
  • At 6 months, 67% of patients improved to NYHA functional class I-II, with a 23-point increase in quality of life scores.
  • Pulmonary capillary wedge pressure decreased by 7 mmHg during exercise, with no adverse effects on right heart function.

Conclusions:

  • The APTURE Transcatheter Shunt System demonstrated safety in symptomatic HF patients.
  • The system effectively reduced pulmonary capillary wedge pressure.
  • Clinically meaningful improvements in HF symptoms and quality of life were observed.
Abstract

Keywords:
HFpEFHFrEFatrial shuntingcoronary sinusheart failureinteratrial shuntingleft atrial

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