Safety, Feasibility of Controllable Decrease of Vena Cava Pressure by Doraya Catheter in Heart Failure

Robert Zymliński; Jan Biegus; Marc Vanderheyden; Piotr Gajewski; Riet Dierckx; Jozef Bartunek; Piotr Ponikowski

doi:10.1016/j.jacbts.2023.02.010

Safety, Feasibility of Controllable Decrease of Vena Cava Pressure by Doraya Catheter in Heart Failure

JACC Basic Transl Sci. 2023 Apr 24;8(4):394-402. doi: 10.1016/j.jacbts.2023.02.010. eCollection 2023 Apr.

Authors

Robert Zymliński^{1

2}, Jan Biegus^{1

2}, Marc Vanderheyden³, Piotr Gajewski^{1

2}, Riet Dierckx³, Jozef Bartunek³, Piotr Ponikowski^{1

2}

Affiliations

¹ Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
² Institute of Heart Diseases, University Hospital, Wroclaw, Poland.
³ Cardiovascular Center, OLV Hospital, Aalst, Belgium.

Abstract

Lowering elevated central venous pressure may reduce renal dysfunction in acute heart failure (AHF) patients. The Doraya catheter lowers renal venous pressure by creating a gradient in the inferior vena cava below the renal veins. Here, we present a first-in-human feasibility study of the Doraya catheter performed on 9 AHF patients. We assessed the safety, feasibility, and acute clinical (hemodynamic and renal) effects of transient Doraya catheter deployment when added to the standard diuretic-based regimen in AHF patients with a poor diuretic response. The procedures decreased central venous pressure from 18.4 ± 3.8 mm Hg to 12.4 ± 4.7 mm Hg (P < 0.001) and improved mean diuresis and clinical signs of congestion. No device-related serious adverse events were observed. Thus, Doraya catheter deployment was safe and feasible in AHF patients. (First In Human Study of the Doraya Catheter for the Treatment of AHF Patients; NCT03234647).

Keywords: acute heart failure; device therapy; diuretic resistance; insufficient response; venous congestion.

Associated data

ClinicalTrials.gov/NCT03234647