Corvia atrial shunt system: Mean LA pressure reduction device in HFpEF

Lowering the raised LA mean pressure is a major therapeutic goal in any severely symptomatic left heart disease, whether it is valvular or myocardial disease. It is prudent to understand, that even in systolic LV failure; it is the raised LVEDP that causes the symptoms and marks the limits of exercise capacity. Drugs like inotropes, pre-load , afterload modulators like diuretics and vasodilators can take care to a certain extent. When symptoms are refractory and the underlying condition has no primary correction , we need to intervene with some extreme procedures. We know a small ASD decompresses mitral stenosis, and the combination of ASD and MS, Lutembacher, is a well-known syndrome called Lutembacher. The concept of LA flow regulator or decompressor came from this . When the left ventricle is stiffened and restrictive, and LA mean pressure is prohibitively high,we have a viable option now. This is to create a small regulatory orifice in the IAS ( A complicated term for a small ASD) to decompress the LA and reduce pulmonary congestive symptoms. Curious minds might ask, can’t we decompress LV it self by creating a small VSD. Probably in the thin membranous area. May be, it will come soon in the innovative lanes of cardiology. As of now, we have an important human study REDUCE LAP-HF II , from Chicago with a 2-year follow-up up .The device used here was Corvia atrial shunt system. The study finds the device can be beneficial without compromising much on RV ...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Uncategorized acquired asd in hfpef atrial flow regulator corvia atrial shunt system decompression of left atrium hhpef lutembacher syndrome Source Type: blogs