Abstract
Heart failure has a high prevalence in the general population. Morbidity and mortality of heart failure patients remain high, despite improvements in drug therapy, implantable cardioverter-defibrillators and cardiac resynchronisation therapy. New transcatheter implantable devices have been developed to improve the treatment of heart failure. There has been a rapid development of minimally invasive or transcatheter devices used in the treatment of heart failure associated with aortic and mitral valve disease and these devices are being incorporated into routine clinical practice at a fast rate. Several other new transcatheter structural heart interventions for chronic heart failure aimed at a variety of pathophysiologic approaches are currently being developed. In this review, we focus on devices used in the treatment of chronic heart failure by means of left ventricular remodelling, left atrial pressure reduction, tricuspid regurgitation reduction and neuromodulation. The clinical evaluations of these devices are early-stage evaluations of initial feasibility and safety studies and additional clinical evidence needs to be gathered in appropriately designed clinical trials.
Highlights
Heart failure (HF) is a major public health issue in both developed and developing countries [1]
In the past 2 decades, developments in drug therapy, implantable cardioverter-defibrillators and cardiac resynchronisation therapy, as well as mechanical circulatory support with left ventricular assist devices and heart transplantation have improved the prognosis of patients with HF and a reduced ejection fraction (HFrEF) [1]
We aim to describe a spectrum of recently introduced devices for the treatment of chronic HF by means of left ventricular (LV) remodelling, reduction of left atrial (LA) pressure, reduction of tricuspid regurgitation and neuromodulation
Summary
Heart failure (HF) is a major public health issue in both developed and developing countries [1]. The only randomised trial far (STICH: Surgical Treatment for Ischemic Heart Failure) failed to demonstrate any benefit in the composite endpoint of death and rehospitalisation for cardiac causes [12]. These procedures have a high surgical risk related to cannulation, cardiopulmonary bypass and ventriculotomy. A dedicated curved needle is inserted in the LV free wall to reach the septum and right ventricle where its tip can be ‘captured’ through a jugular venous access catheter This creates a connection wire between the LV access site and the jugular access site. Several anchors are implanted until optimal plication of the aneurysm is achieved (Fig. 1c)
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