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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
Ventor Technologies
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Aortic Valve Disease

Eligibility Criteria

75 Years - undefined (Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patient understands the implications of participating in the study and provides informed consent
  2. Patient is willing to comply with specified follow-up evaluation and can be contacted by telephone
  3. Age >75 years
  4. 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)
  5. Symptoms related to the aortic valve disease, as demonstrated by NYHA Functional Class II or greater
  6. EuroSCORE scale of >9 points indicating a predicted risk for mortality of >11% according to the logistic EuroSCORE
  7. Echocardiographically determined anteroposterior aortic annulus diameter of >19 and <23 mm
  8. Echocardiographically determined sinotubular junction diameter of ≥23 mm

Exclusion Criteria:

  1. Congenital unicuspid or bicuspid aortic valve
  2. Fused commissures
  3. Severe eccentricity of calcification
  4. Echocardiographic evidence of intracardiac mass, thrombus, or vegetation.
  5. Severe left ventricular dysfunction (LVEF < 25%)
  6. More than mild right ventricular dysfunction
  7. Hypertrophic obstructive cardiomyopathy
  8. Moribund patients, or patients with a noncardiac disease limiting by itself life expectancy to less than 12 months
  9. Known hypersensitivity or contraindication to any study medication
  10. Known sensitivity to contrast medium that cannot be adequately controlled with pre-medication
  11. Known allergy or sensitivity to Nitinol
  12. Sepsis, or acute endocarditis
  13. Blood dyscrasia such as acute anemia, leucopenia, or thrombocytopenia; bleeding diathesis, or coagulopathy.
  14. Renal insufficiency and/or end stage renal disease requiring chronic dialysis
  15. 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).
  16. Significant lung disease (e.g. FEV1 < 1.2L or FEV1 < 50%).
  17. Active peptic ulcer or GI bleeding within 3 months from the planned index procedure
  18. Untreated clinically significant coronary artery disease requiring revascularisation
  19. Cardiogenic shock, suspected cardiogenic shock, or hemodynamic instability requiring inotropic support or mechanical heart assistance
  20. Peripheral vascular disease, including abdominal and thoracic aortic disease, which could pose a problem for eventual transarterial mechanical support (e.g. Intraaortic Balloon Pump)
  21. Need for emergency surgery, cardiac or noncardiac
  22. History of myocardial infarction in the last 6 weeks.
  23. History of TIA or stroke in the last 6 months.
  24. 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.
  25. Uncontrolled atrial fibrillation
  26. Pre-existing aortic valve replacement
  27. Severe (greater than 3+) mitral regurgitation
  28. Severe (greater than 3+) aortic regurgitation
  29. 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

First Posted
May 12, 2008
Last Updated
December 2, 2009
Sponsor
Ventor Technologies
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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
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Transapical Implantation of Ventor Embracer™ Valve in Patients With Severe Aortic Valve Disease

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