ALT-FLOW II Trial: Shunting Innovation for HFpEF and Beyond with Dr. Firas Zahr and Dr. Andrei Pop

Can creating a shunt between the left atrium and the coronary sinus improve symptoms for patients with heart failure with preserved ejection fraction (HFpEF)?In this in-depth discussion, Dr. Andrei Pop and Dr. Firas Zahr, PI of the ALT-FLOW II Trial, explore the science, physiology, and patient selection behind one of the most intriguing new frontiers in interventional heart failure.Key takeaways:What makes ALT-FLOW different from previous intra-atrial shunt devicesHow shunt location, size, and flow patterns affect outcomesWhich heart failure patients respond best — HFpEF, HFrEF, or mixed phenotypesWhy resting wedge pressures don’t predict exercise hemodynamicsThe importance of exercise right heart catheterization and PCWL measurementInsights on stroke risk and why preserving the atrial septum may matter for lifetime proceduresHow ALT-FLOW maintains procedural simplicity and safety through the coronary sinus approachExpanding the field of interventional heart failure and device-based diastolic therapiesThis conversation is essential for structural heart and heart failure specialists exploring new options for symptomatic HFpEF patients in the modern era of shunt-based therapy.🔔 Subscribe for more insights from interventional experts and real-world program builders.📱 Download the app: https://apps.apple.com/app/apple-store/id1586692687📺 Follow us on YouTube: https://www.youtube.com/channel/UCfrLYhAhliQ2ZvXinkDCZvAChapters:00:00 – Intro: The rise of interventional heart failure 00:45 – What makes the ALT-FLOW device unique 01:20 – Lessons learned from prior shunt trials 02:30 – Which patients may benefit most 04:00 – Persistent symptoms after valve repair and TAVR 05:00 – Stroke risk and shunt design safety 06:30 – Importance of preserving the interatrial septum 07:00 – Exercise right heart catheterization and PCWL 08:30 – What exercise reveals about true physiology 10:30 – When wedge pressures tell the real story 12:00 – Expanding tools for diastolic dysfunction 13:30 – Sham control and endpoint selection in ALT-FLOW II 15:30 – Heart failure specialists re-engaging with HFpEF 17:00 – Pacemaker leads and coronary sinus access 18:00 – Future of interventional heart failure 19:30 – Industry, innovation, and economics of device therapy 21:00 – Safety data and operator experience so far 23:00 – Future: Finding the right HFpEF subsets 24:30 – Closing reflections and next steps in research#ALTFlow #HFpEF #HeartFailure #StructuralHeart #InterventionalCardiology #CoronarySinusShunt #HeartFailureDevice #CathLab #MurmurMD