Transapical Implantation of Ventor Embracer™ Valve in Patients With Severe Aortic Valve Disease
Primary Purpose
Aortic Valve Disease
Status
Unknown status
Phase
Not Applicable
Locations
Germany
Study Type
Interventional
Intervention
Ventor Embracer
Sponsored by
About this trial
This is an interventional treatment trial for Aortic Valve Disease
Eligibility Criteria
Inclusion Criteria:
- Patient understands the implications of participating in the study and provides informed consent
- Patient is willing to comply with specified follow-up evaluation and can be contacted by telephone
- Age >75 years
- Severe, aortic stenosis (echocardiographically derived mean gradient > 40 mm Hg, and/or jet velocity > 4m/s, or an initial aortic valve area of < 0.8 cm2)
- Symptoms related to the aortic valve disease, as demonstrated by NYHA Functional Class II or greater
- EuroSCORE scale of >9 points indicating a predicted risk for mortality of >11% according to the logistic EuroSCORE
- Echocardiographically determined anteroposterior aortic annulus diameter of >19 and <23 mm
- Echocardiographically determined sinotubular junction diameter of ≥23 mm
Exclusion Criteria:
- Congenital unicuspid or bicuspid aortic valve
- Fused commissures
- Severe eccentricity of calcification
- Echocardiographic evidence of intracardiac mass, thrombus, or vegetation.
- Severe left ventricular dysfunction (LVEF < 25%)
- More than mild right ventricular dysfunction
- Hypertrophic obstructive cardiomyopathy
- Moribund patients, or patients with a noncardiac disease limiting by itself life expectancy to less than 12 months
- Known hypersensitivity or contraindication to any study medication
- Known sensitivity to contrast medium that cannot be adequately controlled with pre-medication
- Known allergy or sensitivity to Nitinol
- Sepsis, or acute endocarditis
- Blood dyscrasia such as acute anemia, leucopenia, or thrombocytopenia; bleeding diathesis, or coagulopathy.
- Renal insufficiency and/or end stage renal disease requiring chronic dialysis
- Liver disease as indicated by jaundice, ascites, ALT/AST > 3 x ULN, elevation of total bilirubin > 1.5 mg/dl, albumin < 3.0 g/l, or INR > 1.5 (if not on anticoagulation).
- Significant lung disease (e.g. FEV1 < 1.2L or FEV1 < 50%).
- Active peptic ulcer or GI bleeding within 3 months from the planned index procedure
- Untreated clinically significant coronary artery disease requiring revascularisation
- Cardiogenic shock, suspected cardiogenic shock, or hemodynamic instability requiring inotropic support or mechanical heart assistance
- Peripheral vascular disease, including abdominal and thoracic aortic disease, which could pose a problem for eventual transarterial mechanical support (e.g. Intraaortic Balloon Pump)
- Need for emergency surgery, cardiac or noncardiac
- History of myocardial infarction in the last 6 weeks.
- History of TIA or stroke in the last 6 months.
- Any therapeutic invasive cardiac procedure, except aortic balloon valvuloplasty, performed within 30 days from the planned index procedure, or 6 months, in case of implantation of drug-eluting stents.
- Uncontrolled atrial fibrillation
- Pre-existing aortic valve replacement
- Severe (greater than 3+) mitral regurgitation
- Severe (greater than 3+) aortic regurgitation
- Patient is currently enrolled in another investigational device or drug trial
Sites / Locations
- Prof. Jochen Schaefers
- Prof. Thorsten Wahlers
- Friedrich Mohr, MD
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
1
Arm Description
Embracer implantation
Outcomes
Primary Outcome Measures
Stable device placement and adequate function as assessed by angiography and echocardiography immediately post-procedure
A composite of any death, myocardial infarction, or disabling stroke at 30 days post-procedure
Secondary Outcome Measures
Device success and the absence of periprocedural MACCEs at post-operative day 1
Any of the following adverse events: death, myocardial infarction, disabling stroke, repeat aortic valve procedure, cardiogenic shock, or endocarditis at 30 days
Any of the following adverse events: death, disabling stroke, repeat aortic valve procedure or endocarditis at 6 months
Freedom from death at 1 year
Functional improvement from baseline per New York Heart Association (NYHA) functional classification at 30 days, 6 months and 1 year
Peak & mean pressure gradient, derived calculated measures of prosthetic valve function, aortic regurgitation - assessed by echocardiography immediately after deployment, at POD 1, 30 days, 6 months and 5 years annually
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00677638
Brief Title
Transapical Implantation of Ventor Embracer™ Valve in Patients With Severe Aortic Valve Disease
Official Title
Catheter-Based Transapical Implantation of the Ventor Embracer™ Heart Valve Prosthesis in Patients With Severe Aortic Valve Disease
Study Type
Interventional
2. Study Status
Record Verification Date
December 2009
Overall Recruitment Status
Unknown status
Study Start Date
June 2008 (undefined)
Primary Completion Date
January 2010 (Anticipated)
Study Completion Date
December 2014 (Anticipated)
3. Sponsor/Collaborators
Name of the Sponsor
Ventor Technologies
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
A prospective single arm study evaluating feasibility and safety of a catheter-based transapical implantation of the Ventor Embracer™ aortic valve bioprosthesis in patients with severe aortic valve disease, specifically aortic stenosis, who are at elevated risk for standard surgical valve replacement.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Aortic Valve Disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
1
Arm Type
Experimental
Arm Description
Embracer implantation
Intervention Type
Device
Intervention Name(s)
Ventor Embracer
Intervention Description
Implantation of Ventor Embracer
Primary Outcome Measure Information:
Title
Stable device placement and adequate function as assessed by angiography and echocardiography immediately post-procedure
Time Frame
day one
Title
A composite of any death, myocardial infarction, or disabling stroke at 30 days post-procedure
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Device success and the absence of periprocedural MACCEs at post-operative day 1
Time Frame
day one
Title
Any of the following adverse events: death, myocardial infarction, disabling stroke, repeat aortic valve procedure, cardiogenic shock, or endocarditis at 30 days
Time Frame
30 days
Title
Any of the following adverse events: death, disabling stroke, repeat aortic valve procedure or endocarditis at 6 months
Time Frame
6 months
Title
Freedom from death at 1 year
Time Frame
1 year
Title
Functional improvement from baseline per New York Heart Association (NYHA) functional classification at 30 days, 6 months and 1 year
Time Frame
1 year
Title
Peak & mean pressure gradient, derived calculated measures of prosthetic valve function, aortic regurgitation - assessed by echocardiography immediately after deployment, at POD 1, 30 days, 6 months and 5 years annually
Time Frame
5 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patient understands the implications of participating in the study and provides informed consent
Patient is willing to comply with specified follow-up evaluation and can be contacted by telephone
Age >75 years
Severe, aortic stenosis (echocardiographically derived mean gradient > 40 mm Hg, and/or jet velocity > 4m/s, or an initial aortic valve area of < 0.8 cm2)
Symptoms related to the aortic valve disease, as demonstrated by NYHA Functional Class II or greater
EuroSCORE scale of >9 points indicating a predicted risk for mortality of >11% according to the logistic EuroSCORE
Echocardiographically determined anteroposterior aortic annulus diameter of >19 and <23 mm
Echocardiographically determined sinotubular junction diameter of ≥23 mm
Exclusion Criteria:
Congenital unicuspid or bicuspid aortic valve
Fused commissures
Severe eccentricity of calcification
Echocardiographic evidence of intracardiac mass, thrombus, or vegetation.
Severe left ventricular dysfunction (LVEF < 25%)
More than mild right ventricular dysfunction
Hypertrophic obstructive cardiomyopathy
Moribund patients, or patients with a noncardiac disease limiting by itself life expectancy to less than 12 months
Known hypersensitivity or contraindication to any study medication
Known sensitivity to contrast medium that cannot be adequately controlled with pre-medication
Known allergy or sensitivity to Nitinol
Sepsis, or acute endocarditis
Blood dyscrasia such as acute anemia, leucopenia, or thrombocytopenia; bleeding diathesis, or coagulopathy.
Renal insufficiency and/or end stage renal disease requiring chronic dialysis
Liver disease as indicated by jaundice, ascites, ALT/AST > 3 x ULN, elevation of total bilirubin > 1.5 mg/dl, albumin < 3.0 g/l, or INR > 1.5 (if not on anticoagulation).
Significant lung disease (e.g. FEV1 < 1.2L or FEV1 < 50%).
Active peptic ulcer or GI bleeding within 3 months from the planned index procedure
Untreated clinically significant coronary artery disease requiring revascularisation
Cardiogenic shock, suspected cardiogenic shock, or hemodynamic instability requiring inotropic support or mechanical heart assistance
Peripheral vascular disease, including abdominal and thoracic aortic disease, which could pose a problem for eventual transarterial mechanical support (e.g. Intraaortic Balloon Pump)
Need for emergency surgery, cardiac or noncardiac
History of myocardial infarction in the last 6 weeks.
History of TIA or stroke in the last 6 months.
Any therapeutic invasive cardiac procedure, except aortic balloon valvuloplasty, performed within 30 days from the planned index procedure, or 6 months, in case of implantation of drug-eluting stents.
Uncontrolled atrial fibrillation
Pre-existing aortic valve replacement
Severe (greater than 3+) mitral regurgitation
Severe (greater than 3+) aortic regurgitation
Patient is currently enrolled in another investigational device or drug trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jochen Schaefers, MD
Organizational Affiliation
Universitatsklinikum des Saarlandes
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Friedrich Mohr, MD
Organizational Affiliation
Universität Leipzig
Official's Role
Principal Investigator
Facility Information:
Facility Name
Prof. Jochen Schaefers
City
Homburg
ZIP/Postal Code
66421
Country
Germany
Facility Name
Prof. Thorsten Wahlers
City
Koln
ZIP/Postal Code
50924
Country
Germany
Facility Name
Friedrich Mohr, MD
City
Leipzig
ZIP/Postal Code
04289
Country
Germany
12. IPD Sharing Statement
Citations:
PubMed Identifier
21148541
Citation
Falk V, Walther T, Schwammenthal E, Strauch J, Aicher D, Wahlers T, Schafers J, Linke A, Mohr FW. Transapical aortic valve implantation with a self-expanding anatomically oriented valve. Eur Heart J. 2011 Apr;32(7):878-87. doi: 10.1093/eurheartj/ehq445. Epub 2010 Dec 9.
Results Reference
derived
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Transapical Implantation of Ventor Embracer™ Valve in Patients With Severe Aortic Valve Disease
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