Occlutech Atrial Flow Regulator (AFR) leads to significant symptomatic improvement in young patient with restrictive cardiomyopathy
Case:
A patient in his early 50s was diagnosed with restrictive cardiomyopathy a few years ago and showed progressive symptoms.
Background:
In the last six months, two inpatient stays for intravenous diuretic therapy were necessary to treat a severe right- sided cardiac decompensation. During these periods, the patient had severe dyspnoea (NYHA IV). The reduced performance capacity had led to employment issues.
The treatment:
An interatrial shunt device (Occlutech Atrial Flow Regulator (AFR)) was planned. Consistent with the restrictive cardiomyopathy, the pulmonary arterial wedge pressure (PCWP) was significantly elevated at 18 mmHg at rest. Furthermore, this value was significantly higher than the mean right atrial pressure of 3 mmHg. Thus, all criteria for the implantation of the AFR were fulfilled.
According to the previous taken measurements the size of the Atrial Flow Regulator was chosen as AFR08M (8mm fenestration; 5mm height). TEE showed an optimal position with a continuous left-right shunt. After implantation, a reduction in left atrial pressure from the previous 18 to 11 mmHg was measured.
Follow up:
Outcome:
Dr. med. Mathias Lange, FESC
Managing Senior Physician of the Clinic for Cardiology (Med. Klinik I)
Head of the Department of Structural Heart Disease
Specialist in internal medicine and cardiology, intensive care medicine, emergency medicine, hypertensiologist DHL
Main areas of activity: Interventional cardiology / structural heart specialist
Head of the special outpatient clinic for pulmonary arterial hypertension
Klinikum Osnabrück GmbH
1. Paitazoglou, Christina et. al. (2021). 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. European journal of heart failure. 10.1002/ejhf.2119.
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