ThoroughFare atrial pressure controller device to create a controlled interatrial right-to-left shunt in advanced pulmonary arterial hypertension - A pilot study.

IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Annals of Pediatric Cardiology Pub Date : 2024-11-01 Epub Date: 2025-04-24 DOI:10.4103/apc.apc_209_24
Bojja Venkata Satya Roopesh, Girija Haritha, S V Kishore, Muthukumaran Chinnasamy Sivaprakasam, Shreesha Maiya, Saileela Rajan, Pramod Sagar, Kothandam Sivakumar
{"title":"ThoroughFare atrial pressure controller device to create a controlled interatrial right-to-left shunt in advanced pulmonary arterial hypertension - A pilot study.","authors":"Bojja Venkata Satya Roopesh, Girija Haritha, S V Kishore, Muthukumaran Chinnasamy Sivaprakasam, Shreesha Maiya, Saileela Rajan, Pramod Sagar, Kothandam Sivakumar","doi":"10.4103/apc.apc_209_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Atrial flow regulators are used in patients with pulmonary arterial hypertension (PAH) who present with syncope or advanced heart failure. The ThoroughFare atrial pressure controller (Meril Life Sciences, Vapi, India) is a new device for similar use. The differences in structural design include a cable-screw release mechanism and a low profile.</p><p><strong>Methods: </strong>A multi-institutional study assessed the feasibility and safety of this device and reported short-term follow-up. This device, with an 8-mm fenestration diameter, was deployed after transseptal puncture using a 12F sheath.</p><p><strong>Results: </strong>Between April 2023 and June 2024, 15 symptomatic patients aged 5-39 years, including four children, received this implant after dual pulmonary vasodilator pharmacotherapy for at least 2 years. Etiology included idiopathic PAH in eight patients, hereditary PAH in two, operated shunt lesions in four, and human immunodeficiency virus-associated PAH in one patient. The key indication was recurrent syncope in 11 and right heart failure in the rest. The mean N-terminal pro-brain natriuretic peptide was 2414 ± 2046 pg/mL. The hemodynamic assessment revealed high right atrial pressures in 80% of patients, low cardiac index in half, and suprasystemic pulmonary pressures in four patients. The procedure was completed in all patients without any complications. Pulse oximeter saturations dropped from 98% ±2% to 92% ±4%. Symptoms improved over a median follow-up of 8 months, and the device patency was confirmed in all patients except one patient who died 5 months postprocedure after a heart-lung transplantation.</p><p><strong>Conclusion: </strong>ThoroughFare atrial pressure controller implantation was feasible and safe for all patients with severe PAH without any complications. Longer follow-up with more patients is needed to ascertain the functional improvements.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"17 6","pages":"408-414"},"PeriodicalIF":0.9000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063982/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Pediatric Cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/apc.apc_209_24","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/24 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Atrial flow regulators are used in patients with pulmonary arterial hypertension (PAH) who present with syncope or advanced heart failure. The ThoroughFare atrial pressure controller (Meril Life Sciences, Vapi, India) is a new device for similar use. The differences in structural design include a cable-screw release mechanism and a low profile.

Methods: A multi-institutional study assessed the feasibility and safety of this device and reported short-term follow-up. This device, with an 8-mm fenestration diameter, was deployed after transseptal puncture using a 12F sheath.

Results: Between April 2023 and June 2024, 15 symptomatic patients aged 5-39 years, including four children, received this implant after dual pulmonary vasodilator pharmacotherapy for at least 2 years. Etiology included idiopathic PAH in eight patients, hereditary PAH in two, operated shunt lesions in four, and human immunodeficiency virus-associated PAH in one patient. The key indication was recurrent syncope in 11 and right heart failure in the rest. The mean N-terminal pro-brain natriuretic peptide was 2414 ± 2046 pg/mL. The hemodynamic assessment revealed high right atrial pressures in 80% of patients, low cardiac index in half, and suprasystemic pulmonary pressures in four patients. The procedure was completed in all patients without any complications. Pulse oximeter saturations dropped from 98% ±2% to 92% ±4%. Symptoms improved over a median follow-up of 8 months, and the device patency was confirmed in all patients except one patient who died 5 months postprocedure after a heart-lung transplantation.

Conclusion: ThoroughFare atrial pressure controller implantation was feasible and safe for all patients with severe PAH without any complications. Longer follow-up with more patients is needed to ascertain the functional improvements.

通达心房压控制装置在晚期肺动脉高压患者中创建可控的心房间右至左分流——一项初步研究。
背景:心房血流调节剂用于伴有晕厥或晚期心力衰竭的肺动脉高压(PAH)患者。通透心房压力控制器(Meril Life Sciences, Vapi, India)是一种类似用途的新设备。在结构设计上的不同之处包括一个电缆螺钉释放机构和一个低轮廓。方法:一项多机构研究评估了该装置的可行性和安全性,并报告了短期随访。该装置开窗直径为8mm,使用12F护套经隔膜穿刺后部署。结果:2023年4月至2024年6月,15例5-39岁的有症状患者,包括4例儿童,在双肺血管扩张剂药物治疗至少2年后接受了该植入物。病因包括8例特发性多环芳烃,2例遗传性多环芳烃,4例手术分流病变,1例人类免疫缺陷病毒相关多环芳烃。关键指征为11例复发性晕厥,其余为右心衰。平均n端脑利钠肽前体为2414±2046 pg/mL。血流动力学评估显示80%的患者右心房压高,一半的患者心脏指数低,4例患者体表肺动脉压高。所有患者均完成手术,无任何并发症。脉搏血氧饱和度从98%±2%下降到92%±4%。中位随访8个月后症状得到改善,除1例患者在心肺移植术后5个月死亡外,所有患者均证实该装置通畅。结论:通通性心房压控制器植入术对重度PAH患者安全可行,无并发症。需要更长的随访时间和更多的患者来确定功能的改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Annals of Pediatric Cardiology
Annals of Pediatric Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.40
自引率
14.30%
发文量
51
审稿时长
23 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信