A 28-week, feasibility study to investigate the safety and efficiency of the Automatic Fluid Shunt in patients with chronic congestive heart failure, ascites and diuretic resistance.

Inclusion Criteria:

• Female or male patients ≥ 18 years of age
• A clinical diagnosis of chronic congestive heart failure > 6 months
• At least one episode of documented ADHF during the previous 6 months
• NYHA functional class III-IV
• Circulating levels of NT-proBNP ≥ 800 ng/L.
• Stable, optimized therapy for heart failure for at least 4 weeks prior to enrollment
• Echocardiography performed within 3 months
• Detectable ascites by ultrasound and/or computed tomography
• Diuretic resistance defined as a daily dose of furosemide > 80 mg, torsemide > 40 mg or bumetanide > 2 mg
• Written informed consent

Exclusion Criteria:

• Present or recurring systemic or local infection, such as peritonitis, urinary tract infection, or abdominal skin infection.
• Ongoing malignant disease with adverse prognosis
• Evidence of firmly loculated peritoneal effusion.
• Obstructive uropathy
• Severely reduced renal function (S-Creatinine 300 mol/l) or end-stage renal disease requiring dialysis
• Severe liver disease (ASAT and/or ALAT and/or total bilirubin three times upper limit of normal range laboratory values)
• Pregnancy
• Requirement for intravenous inotropes
• Acute coronary syndrome or any condition requiring emergency treatment
• Heart disease requiring surgical intervention during the course of the study
• Any other clinically significant disease that could be adversely affected by study participation judged by the Investigator