Right Ventricular Function and Echocardiographic Characteristics After Left Atrial-to-Coronary Sinus Shunting; Insights from ALT-FLOW Early Feasibility Study 3-Year Follow-Up

Exertional dyspnea attributable to elevations in left atrial pressure (LAP) is a hallmark symptom of heart failure. As an adjunct to guideline-directed medical therapy, therapeutic shunting devices have been explored as a mechanism to unload the left atrium, decongest the lungs, and relieve symptoms. However, studies in longitudinal heart failure have demonstrated a propensity for progressive right ventricular (RV) dilation and dysfunction, particularly among patients with heart failure with preserved ejection fraction (HFpEF), and thus, there is a legitimate concern that interatrial shunts could adversely impact the right heart or accelerate this process.