Mechanically Reducing Cardiac Preload With the preCARDIA System in Acutely Decompensated Heart Failure.
Publication Title
JACC Heart Fail
Document Type
Article
Publication Date
12-11-2025
Keywords
acute decompensated heart failure; cardiac preload; congestion; device therapy.; oregon; portland
Abstract
BACKGROUND: The preCARDIA device is a novel intervention designed to mechanically reduce cardiac filling pressures in patients with acute decompensated heart failure (ADHF) by regulating flow through the superior vena cava.
OBJECTIVES: The VENUS-HF Early Feasibility Study (SVC Occlusion in Subjects With Acute Decompensated Heart Failure; NCT03836079) tested the safety and feasibility of the next-generation preCARDIA system, which includes updates to the sheath, catheter, and console.
METHODS: In a multicenter, prospective, single-arm safety and feasibility study, 60 subjects with ADHF received preCARDIA support for up to 24 hours. Primary and secondary endpoints testing the safety and technical feasibility of the device were analyzed.
RESULTS: Freedom from device- or procedure-related major adverse events was observed in 98.3% (n = 59/60), and successful device deployment and removal in all subjects (n = 60/60). No statistically significant difference in major adverse events was observed between recipients of the original (0%, n = 0/30) and newest (3.3%, n = 1/30) generation preCARDIA devices. In subjects with 24 ± 3 hours of preCARDIA duration (n = 52), paired right atrial and pulmonary capillary wedge pressures decreased by 23% (18 ± 6 vs 11 ± 6 mm Hg, P < 0.0001) and 18% (30 ± 8 vs 24 ± 9 mm Hg, P < 0.0001), respectively, from baseline to end of device use. Compared with 24 hours before device initiation, net urine output increased during the 24-hour period during device use (-1.5 ± 0.9 vs -3.4 ± 2.4 L, P < 0.001).
CONCLUSIONS: Use of the preCARDIA system in patients with ADHF was feasible and well tolerated, with early exploratory signals of significantly reduced cardiac filling pressures and increased urine output. These findings provide a foundation for larger, prospective studies, such as the upcoming COR-ADHF (Cardiovascular UnlOading with preCARDIA in Acute Decompensated Heart Failure) trial, to determine clinical efficacy.
Area of Special Interest
Cardiovascular (Heart)
Specialty/Research Institute
Cardiology
Specialty/Research Institute
Surgery
DOI
10.1016/j.jchf.2025.102841
