Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GMC, Coats AJS (2023) Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res 118(18):3272–3287. https://doi.org/10.1093/cvr/cvac013

Article  CAS  PubMed  Google Scholar 

Zhang Z, Wang C, Tu T, Lin Q, Zhou J, Huang Y, Wu K, Zhang Z, Zuo W, Liu N, Xiao Y, Liu Q (2024) Advancing guideline-directed medical therapy in heart failure: overcoming challenges and maximizing benefits. Am J Cardiovasc Drugs 24(3):329–342. https://doi.org/10.1007/s40256-024-00646-4

Article  PubMed  PubMed Central  Google Scholar 

Riccardi M, Tomasoni D, Vizzardi E, Metra M, Adamo M (2023) Device-based percutaneous treatments to decompress the left atrium in heart failure with preserved ejection fraction. Heart Fail Rev 28(2):315–330. https://doi.org/10.1007/s10741-022-10280-4

Article  PubMed  Google Scholar 

Borlaug BA, Sharma K, Shah SJ, Ho JE (2023) Heart failure with preserved ejection fraction: JACC scientific statement. J Am Coll Cardiol 81(18):1810–1834. https://doi.org/10.1016/j.jacc.2023.01.049

Article  PubMed  Google Scholar 

Tsang TS, Barnes ME, Gersh BJ, Bailey KR, Seward JB (2002) Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol 90(12):1284–1289. https://doi.org/10.1016/s0002-9149(02)02864-3

Article  PubMed  Google Scholar 

Hasenfuß G, Hayward C, Burkhoff D, Silvestry FE, McKenzie S, Gustafsson F, Malek F, Van der Heyden J, Lang I, Petrie MC, Cleland JG, Leon M, Kaye DM (2016) A transcatheter intracardiac shunt device for heart failure with preserved ejection fraction (REDUCE LAP-HF): a multicentre, open-label, single-arm, phase 1 trial. Lancet 387(26):1298–304. https://doi.org/10.1016/S0140-6736(16)00704-2

Article  PubMed  Google Scholar 

Feldman T, Mauri L, Kahwash R, Litwin S, Ricciardi MJ, van der Harst P, Penicka M, Fail PS, Kaye DM, Petrie MC, Basuray A, Hummel SL, Forde-McLean R, Nielsen CD, Lilly S, Massaro JM, Burkhoff D, Shah SJ, REDUCE LAP-HF I Investigators and Study Coordinators (2018) Transcatheter interatrial shunt device for the treatment of heart failure with preserved ejection fraction (REDUCE LAP-HF I [Reduce elevated left atrial pressure in patients with heart failure]): a phase 2, randomized, sham-controlled trial. Circulation 137(4):364–375. https://doi.org/10.1161/CIRCULATIONAHA.117.032094

Article  PubMed  Google Scholar 

Shah SJ, Borlaug BA, Chung ES, Cutlip DE, Debonnaire P, Fail PS, Gao Q, Hasenfuß G, Kahwash R, Kaye DM, Litwin SE, Lurz P, Massaro JM, Mohan RC, Ricciardi MJ, Solomon SD, Sverdlov AL, Swarup V, van Veldhuisen DJ, Winkler S, Leon MB (2022) Atrial shunt device for heart failure with preserved and mildly reduced ejection fraction (REDUCE LAP-HF II): a randomised, multicentre, blinded, sham-controlled trial. Lancet 399(19):1130–1140. https://doi.org/10.1016/S0140-6736(22)00016-2

Article  PubMed  Google Scholar 

ClinicalTrials.gov RESPONDER-HF (NCT05425459). U.S. National Library of Medicine. https://clinicaltrials.gov/ct2/show/NCT05425459

Stone GW, Lindenfeld J, Rodés-Cabau J, Anker SD, Zile MR, Kar S et al. RELIEVE-HF Investigators. Interatrial shunt treatment for heart failure: the randomized RELIEVE-HF trial

De Rosa R, Schranz D (2018) Creation of a restrictive atrial left-to-right shunt: a novel treatment for heart failure. Heart Fail Rev 23(6):841–847. https://doi.org/10.1007/s10741-018-9741-9

Article  PubMed  Google Scholar 

Amat-Santos IJ, Bergeron S, Bernier M, Allende R, Barbosa Ribeiro H, Urena M, Pibarot P, Verheye S, Keren G, Yaacoby M, Nitzan Y, Abraham WT, Rodés-Cabau J (2015) Left atrial decompression through unidirectional left-to-right interatrial shunt for the treatment of left heart failure: first-in-man experience with the V-Wave device. EuroIntervention 10(9):1127–1131. https://doi.org/10.4244/EIJY14M05_07

Article  PubMed  Google Scholar 

Simard T, Labinaz M, Zahr F, Nazer B, Gray WA, Hermiller J et al (2020) Percutaneous atriotomy for levoatrial-to-coronary sinus shunting in symptomatic heart failure: first-in-human experience. JACC Cardiovasc Interv 13(10):1236–1247. https://doi.org/10.1016/j.jcin.2020.02.022

Article  PubMed  Google Scholar 

Paitazoglou C, Bergmann MW, Özdemir R, Pfister R, Bartunek J, Kilic T, Lauten A, Schmeisser A, Zoghi M, Anker SD, Sievert H, Mahfoud F (2021) AFR-PRELIEVE Investigators. One-year results of the first-in-man study investigating the atrial flow regulator for left atrial shunting in symptomatic heart failure patients: the PRELIEVE study. Eur J Heart Fail 23(5):800–810. https://doi.org/10.1002/ejhf.2119

Article  PubMed  Google Scholar 

Flow Regulation by Opening the septum in patients with heart failure (FROST-HF).(NCT05136820)

Fioretti F, Hibbert B, Eckman PM, Simard T, Labinaz M, Nazer B, Wiley M, Gupta B, Sauer AJ, Shah H, Sorajja P, Pineda AM, Missov E, Aldaia L, Koulogiannis K, Gray WA, Zahr F, Butler J (2025) Left atrial-to-coronary sinus shunting in heart failure with mildly reduced or preserved ejection fraction: the ALT-FLOW trial (early feasibility study) 2-year results. JACC Heart Fail 13(6):987–999. https://doi.org/10.1016/j.jchf.2025.02.003

Article  CAS  PubMed  Google Scholar 

Zhou Y, Wang X, Liu M et al (2023) Biventricular longitudinal strain as a predictor of functional improvement after D-shant device implantation in patients with heart failure. Front Cardiovasc Med 10:1121689. https://doi.org/10.3389/fcvm.2023.1121689

Article  CAS  PubMed  PubMed Central  Google Scholar 

Jagadeesan V, Gray WA, Shah SJ (2023) Atrial shunt therapy for heart failure: an update. J Soc Cardiovasc Angiogr Interv 2(6):101203

PubMed  PubMed Central  Google Scholar 

ALT-FLOW II—Edwards APTURE Transcatheter Shunt System. ClinicalTrials.gov (NCT05686317)

Feldman T, Mauri L, Burkhoff D (2021) Interatrial shunts: device-based therapies for heart failure with preserved ejection fraction. EuroIntervention 16(Suppl A):A68–A76

Google Scholar 

InterShunt PAS-C. ClinicalTrials.gov. EASE-HF: evaluation of atrial shunt excision for heart failure. NCT05403372

Guimarães L, Lindenfeld J, Sandoval J, Bayés-Genis A, Bernier M, Provencher S, Rodés-Cabau J (2019) Interatrial shunting for heart failure: current evidence and future perspectives. EuroIntervention 15(2):164–171

Article  PubMed  Google Scholar 

Oakland HP, Zolty R, Shaddy RE, Vanderpool RR (2021) Arterial load and right ventricular-vascular coupling in pulmonary hypertension. Pulm Circ 11(1):20458940211013505

Google Scholar 

Shang X, Liu M, Zhong Y et al (2022) Clinical study on the treatment of chronic heart failure with a novel D-shant atrium shunt device. ESC Heart Fail 9(3):1713–1720. https://doi.org/10.1002/ehf2.13842

Article  PubMed  PubMed Central  Google Scholar 

Spring AM, Kwon DH, Rogers JH et al (2025) Atrial shunting for heart failure. Struct Heart 9(8):100704

Article  PubMed  PubMed Central  Google Scholar 

Alleviant Medical. ALLEVIANT-HF I clinical trial. ClinicalTrials.gov Identifier: NCT04559466

ALLAY-HF Trial. ClinicalTrials.gov Identifier: NCT05685303. Available at: https://clinicaltrials.gov/ct2/show/NCT05685303

Hasenfuß G, Gustafsson F, Shah SJ, Lam CSP (2022) Interatrial shunt devices for heart failure with preserved ejection fraction. Eur Heart J 43(37):3491–3503. https://doi.org/10.1093/eurheartj/ehac388

Article  Google Scholar 

Kaye DM, Gustafsson F, Hasenfuß G, Lam CSP, Petrie MC, Vedin O et al (2023) First-in-human trial of a novel radiofrequency-based, no-implant septostomy system (RAISE) in patients with HFpEF. JACC Heart Fail 11(7):655–667. https://doi.org/10.1016/j.jchf.2023.03.014

Article  CAS  Google Scholar 

Alkhouli M, Rihal CS, Holmes DR (2021) Interatrial shunt therapy for heart failure and pulmonary hypertension: rationale, devices, and trials. J Am Coll Cardiol Intv 14(23):2603–2616. https://doi.org/10.1016/j.jcin.2021.08.014

Article  Google Scholar 

Topilsky Y, Maltais S, Medina Inojosa J, Oguz D, Michelena H, Maalouf J et al (2019) Burden of tricuspid regurgitation in patients diagnosed in the community setting. JACC Cardiovasc Imaging 12(3):433–442. https://doi.org/10.1016/j.jcmg.2018.06.014

Article  PubMed  Google Scholar 

Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J et al (2022) 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J 43(7):561–632. https://doi.org/10.1093/eurheartj/ehab395

Article  PubMed  Google Scholar 

Sandoval J, Gaspar J, Pulido T, Bautista E, Martínez-Guerra ML, Zeballos M et al (1998) Graded balloon dilation atrial septostomy in severe primary pulmonary hypertension. A therapeutic alternative for patients nonresponsive to vasodilator treatment. J Am Coll Cardiol 32(2):297–304. https://doi.org/10.1016/S0735-1097(98)00213-6

Article  CAS  PubMed  Google Scholar 

Ambrosy AP, Fonarow GC, Butler J, Chioncel O, Greene SJ, Vaduganathan M et al (2014) The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. J Am Coll Cardiol 63(12):1123–1133. https://doi.org/10.1016/j.jacc.2013.11.053

Article  PubMed  Google Scholar 

Desai AS, Bhimaraj A, Bhatt K, Ducharme A, Adamson PB, Heywood JT et al (2017) Ambulatory hemodynamic monitoring reduces heart failure hospitalizations in real-world clinical practice. J Am Coll Cardiol 69(19):2357–2365. https://doi.org/10.1016/j.jacc.2017.03.009

Article  PubMed  Google Scholar 

Rajaram S, Desai AS, Rigby A, Yao RJ, Ghosh J, McDonagh T et al (2020) Cost-effectiveness of pulmonary artery pressure monitoring with cardiomems in the united Kingdom. ESC Heart Fail 7(6):3687–3698. https://doi.org/10.1002/ehf2.13054