Management of Flow Reversal in Patients With Atrial Shunts Implanted to Reduce Left Atrial Pressure
This case series presents 6 patients with heart failure (HF) and preserved or mildly reduced ejection fraction who underwent atrial shunt implantation in a clinical trial evaluating its safety and efficacy. Shunt closure was considered in selected cases of worsening HF, particularly when shunt flow...
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| Language: | English |
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Elsevier
2025-07-01
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| Series: | JACC: Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666084925006710 |
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| author | Hidenori Yaku, MD, PhD Jean-Christophe Eicher, MD Martin W. Bergmann, MD Tobias Kister, MD Tudor C. Pörner, MD Barry A. Borlaug, MD Rajeev C. Mohan, MD Matthew Price, MD Jan Komtebedde, DVM Sanjiv J. Shah, MD |
| author_facet | Hidenori Yaku, MD, PhD Jean-Christophe Eicher, MD Martin W. Bergmann, MD Tobias Kister, MD Tudor C. Pörner, MD Barry A. Borlaug, MD Rajeev C. Mohan, MD Matthew Price, MD Jan Komtebedde, DVM Sanjiv J. Shah, MD |
| author_sort | Hidenori Yaku, MD, PhD |
| collection | DOAJ |
| description | This case series presents 6 patients with heart failure (HF) and preserved or mildly reduced ejection fraction who underwent atrial shunt implantation in a clinical trial evaluating its safety and efficacy. Shunt closure was considered in selected cases of worsening HF, particularly when shunt flow reversal was observed. Detailed hemodynamic evaluation revealed that shunt closure may have been detrimental in 5 cases and beneficial in only 1 case. Intentional closure of an implanted atrial shunt has not been previously reported; here, we describe the clinical decision-making process and outcomes based on comprehensive hemodynamic assessments, including pulmonary vascular dynamics and shunt flow patterns in such cases. These findings highlight the critical importance of thorough hemodynamic evaluation in patient management after atrial shunt placement in recognition of other factors that may play a role in the presence of the shunt. Additional research is needed to establish optimal management strategies for patients experiencing worsening HF after atrial shunt implantation. |
| format | Article |
| id | doaj-art-5ab60fa73d9c4f0c8e0f575f753bde40 |
| institution | DOAJ |
| issn | 2666-0849 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JACC: Case Reports |
| spelling | doaj-art-5ab60fa73d9c4f0c8e0f575f753bde402025-08-20T02:43:24ZengElsevierJACC: Case Reports2666-08492025-07-01301710389310.1016/j.jaccas.2025.103893Management of Flow Reversal in Patients With Atrial Shunts Implanted to Reduce Left Atrial PressureHidenori Yaku, MD, PhD0Jean-Christophe Eicher, MD1Martin W. Bergmann, MD2Tobias Kister, MD3Tudor C. Pörner, MD4Barry A. Borlaug, MD5Rajeev C. Mohan, MD6Matthew Price, MD7Jan Komtebedde, DVM8Sanjiv J. Shah, MD9Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Address for correspondence: Dr Hidenori Yaku, Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, 633 North St Clair Street, Suite 19-073, Chicago, Illinois 60611, USA.Department of Cardiology, François Mitterrand University Hospital, Dijon, FranceDepartment of Cardiology and Intensive Care Medicine, Asklepios Klinik Altona, Hamburg, GermanyDepartment of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, GermanyDivision of Cardiology, Angiology, Pneumology and Intensive Medical Care, Department of Internal Medicine, University Hospital Jena, Friedrich Schiller University Jena, Jena, GermanyDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USAScripps Clinic, La Jolla, California, USAScripps Clinic, La Jolla, California, USACorvia Medical, Inc, Tewksbury, Massachusetts, USADivision of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USAThis case series presents 6 patients with heart failure (HF) and preserved or mildly reduced ejection fraction who underwent atrial shunt implantation in a clinical trial evaluating its safety and efficacy. Shunt closure was considered in selected cases of worsening HF, particularly when shunt flow reversal was observed. Detailed hemodynamic evaluation revealed that shunt closure may have been detrimental in 5 cases and beneficial in only 1 case. Intentional closure of an implanted atrial shunt has not been previously reported; here, we describe the clinical decision-making process and outcomes based on comprehensive hemodynamic assessments, including pulmonary vascular dynamics and shunt flow patterns in such cases. These findings highlight the critical importance of thorough hemodynamic evaluation in patient management after atrial shunt placement in recognition of other factors that may play a role in the presence of the shunt. Additional research is needed to establish optimal management strategies for patients experiencing worsening HF after atrial shunt implantation.http://www.sciencedirect.com/science/article/pii/S2666084925006710heart failure with preserved ejection fractionhemodynamicsinterventional cardiologyright heart catheterizationtreatment |
| spellingShingle | Hidenori Yaku, MD, PhD Jean-Christophe Eicher, MD Martin W. Bergmann, MD Tobias Kister, MD Tudor C. Pörner, MD Barry A. Borlaug, MD Rajeev C. Mohan, MD Matthew Price, MD Jan Komtebedde, DVM Sanjiv J. Shah, MD Management of Flow Reversal in Patients With Atrial Shunts Implanted to Reduce Left Atrial Pressure JACC: Case Reports heart failure with preserved ejection fraction hemodynamics interventional cardiology right heart catheterization treatment |
| title | Management of Flow Reversal in Patients With Atrial Shunts Implanted to Reduce Left Atrial Pressure |
| title_full | Management of Flow Reversal in Patients With Atrial Shunts Implanted to Reduce Left Atrial Pressure |
| title_fullStr | Management of Flow Reversal in Patients With Atrial Shunts Implanted to Reduce Left Atrial Pressure |
| title_full_unstemmed | Management of Flow Reversal in Patients With Atrial Shunts Implanted to Reduce Left Atrial Pressure |
| title_short | Management of Flow Reversal in Patients With Atrial Shunts Implanted to Reduce Left Atrial Pressure |
| title_sort | management of flow reversal in patients with atrial shunts implanted to reduce left atrial pressure |
| topic | heart failure with preserved ejection fraction hemodynamics interventional cardiology right heart catheterization treatment |
| url | http://www.sciencedirect.com/science/article/pii/S2666084925006710 |
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