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HAART Model 300 Annuloplasty Ring

Primary Purpose

Aortic Regurgitation

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
HAART 300 Annuloplasty Device
Sponsored by
Biostable Science & Engineering
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Aortic Regurgitation focused on measuring Aortic Insufficiency, Aortic Regurgitation, Aortic Valve Repair

Eligibility Criteria

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

Inclusion Criteria:

  • The subject is 50 years old or older
  • The subject has a tricuspid aortic valve morphology
  • Patients with documented severe aortic insufficiency with aortic annular dilation without severe concomitant aortic stenosis
  • Patients referred to center for documented moderate to severe Chronic aortic regurgitation (AR) associated with annular dilatation with or without cusp prolapse of one, two, or all three leaflets
  • Patients with or without Sinotubular Junction (STJ) dilatation or aortic root aneurysms
  • Patients who are free of coronary disease or those with evidence of minor stable (1-2 vessel) coronary disease
  • Subject is willing to comply with specified follow-up evaluations, including transesophageal echocardiography if there are inadequate images by transthoracic echocardiography (TTE) to assess the aortic valve
  • The subject has signed the written informed consent
  • The subject agrees to return for all follow-up evaluations for the duration of the study (i.e. geographically stable
  • The subject is New York Hospital Association (NYHA) class II or III

Exclusion Criteria:

  • The subject has preexisting valve prosthesis in the atrial, the mitral, pulmonary, and/or tricuspid position
  • The subject requires an additional valve replacement
  • The subject's aortic valve morphology is not tricuspid
  • The subject has active endocarditis
  • Heavily calcified valves
  • Valvular retraction with severely reduced mobility
  • The subject has mixed stenosis and regurgitation of the aortic valve with predominant stenosis
  • The subject requires a repair of the mitral or tricuspid valve with the use of an annuloplasty device
  • Leukopenia
  • Acute anemia (Hb < 9mg%)
  • Platelet count <100,000 cell/mm3
  • Need for emergency surgery for any reason
  • History of bleeding diathesis or coagulopathy or the subject refuses blood transfusions
  • Active infection requiring antibiotic therapy (if temporary illness, subjects may enroll 4 weeks after discontinuation of antibiotics)
  • Subjects in whom transesophageal echocardiography (TEE) is contraindicated
  • Non elective presentation
  • Low Ejection Fraction (EF) EF < 40%
  • Life expectancy < 1 year
  • Rheumatic disease
  • The subject has severe leaflet fenestration or leaflets damaged by endocarditis
  • The subject is or will be participating in a concomitant research study of an investigational product or has participated in such a study within the 30 days prior to screening
  • The subject is a minor, an illicit drug user, alcohol abuser, prisoner, institutionalized, or is unable to give informed consent
  • The subject is pregnant or lactating
  • This patient will not agree to return to the implant center for the required number of follow-up visits or is geographically unavailable for follow-up
  • The subject has not signed and dated the study informed consent
  • Recent (within 6 months) cerebrovascular accident (CVA) or transient ischemic attack (TIA)
  • Myocardial infarction (MI) within one month of trial inclusion
  • Have a known intolerance to titanium or polyester
  • Sole therapy for correction for patients with aortic root aneurysm
  • Subjects requiring simultaneous cardiac procedures
  • The subject has asymptomatic AR and a left ventricular ejection fraction (LVEF) > 50%

Sites / Locations

  • University Hospital Gasthuisberg
  • Institut klinicke a experimantalni mediciny
  • German Heart Institute
  • German Heart Center Munich

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

HAART 300 Annuloplasty Device

Arm Description

Implantation of HAART 300 Annuloplasty Device for aortic valve repair

Outcomes

Primary Outcome Measures

Primary Safety Outcome Measure: Event-free Survival
Event-free survival is defined as survival free from device-related death
Primary Safety Outcome Measure: Event-free Survival
Event-free survival is defined as survival free from device-related death
Primary Efficacy Outcome Measure: Aortic Valvular Regurgitation at 6 Months Postprocedure
Aortic valvular regurgitation assessed by transthoracic echocardiography and graded as None/Trace (0), Mild (1+), Moderate (2+), Moderate-to-Severe (3+), or Severe (4+)
Primary Efficacy Outcome Measure: Aortic Valvular Regurgitation at 2 Years Postprocedure
Aortic valvular regurgitation assessed by transthoracic echocardiography and graded as None/Trace (0), Mild (1+), Moderate (2+), Moderate-to-Severe (3+), or Severe (4+)

Secondary Outcome Measures

Implant Procedure Success
Success is defined as the absence of specified adverse events evaluated through discharge or 14 days after the procedure: Aortic annular dissection, rupture, or leaflet damage Paravalvular leak > +2 or requiring intervention Mitral valve impingement due to implant implant dehiscence/migration into aorta implant dehiscence/migration into left ventricle Hemodynamics requiring intervention Other adverse event resulting in reoperation, explantation, or permanent disability.
Implant Procedure Success
Success is defined as the absence of specified adverse events evaluated through discharge or 14 days after the procedure: Aortic annular dissection, rupture, or leaflet damage Paravalvular leak > +2 or requiring intervention Mitral valve impingement due to implant implant dehiscence/migration into aorta implant dehiscence/migration into left ventricle Hemodynamics requiring intervention Other adverse event resulting in reoperation, explantation, or permanent disability.
Actuarial Freedom From Clinical Cardiovascular Events
Freedom from specified clinical cardiovascular events 1 month postprocedure: Device-related mortality Complete heart block Structural device failure Endocarditis Periprosthetic leak or dehiscence Thromboembolism Bleeding Event Native Valve Deterioration Valve Thrombosis Hemolysis Reoperation and explant at 1 month
Actuarial Freedom From Clinical Cardiovascular Events
Freedom from specified clinical cardiovascular events 2 years postprocedure: Device-related mortality Complete heart block Structural device failure Endocarditis Periprosthetic leak or dehiscence Thromboembolism Bleeding Event Native Valve Deterioration Valve Thrombosis Hemolysis Reoperation and explant at 2 years
Event-free Survival
Event-free survival is defined as survival free from device-related death
New York Heart Association (NYHA) Functional Capacity Classification
Four classes describing the effect of cardiac disease on physical activity: Class I - disease does not limit activity; Class II - slight limitation; Class III - marked limitation; Class IV - inability to carry out any physical activity without discomfort
New York Heart Association (NYHA) Functional Capacity Classification
Four classes describing the effect of cardiac disease on physical activity: Class I - disease does not limit activity; Class II - slight limitation; Class III - marked limitation; Class IV - inability to carry out any physical activity without discomfort
Peak Gradient - Change From Baseline
Transthoracic echocardiography parameter
Peak Gradient - Change From Baseline
Transthoracic echocardiography parameter
Mean Gradient - Change From Baseline
Transthoracic echocardiography parameter
Mean Gradient - Change From Baseline
Transthoracic echocardiography parameter
LV Mass - Change From Baseline
Left ventricular mass. Transthoracic echocardiography parameter.
LV Mass - Change From Baseline
Left ventricular mass. Transthoracic echocardiography parameter.
LVID Diastole - Change From Baseline
Left ventricular internal dimension. Transthoracic echocardiography parameter.
LVID Diastole - Change From Baseline
Left ventricular internal dimension. Transthoracic echocardiography parameter.
LVID Systole - Change From Baseline
Left ventricular internal dimension. Transthoracic echocardiography parameter.
LVID Systole - Change From Baseline
Left ventricular internal dimension. Transthoracic echocardiography parameter.
LV Diastolic Volume - Change From Baseline
Left ventricular diastolic volume. Transthoracic echocardiography parameter.
LV Diastolic Volume - Change From Baseline
Left ventricular diastolic volume. Transthoracic echocardiography parameter.
LV Systolic Volume - Change From Baseline
Left ventricular systolic volume. Transthoracic echocardiography parameter.
LV Systolic Volume - Change From Baseline
Left ventricular systolic volume. Transthoracic echocardiography parameter.
LVEF - Change From Baseline
Left ventricular ejection fraction. Transthoracic echocardiography parameter.
LVEF - Change From Baseline
Left ventricular ejection fraction. Transthoracic echocardiography parameter.
Cardiac Output - Change From Baseline
Stroke volume x heart rate. Transthoracic echocardiography parameter.
Cardiac Output - Change From Baseline
Stroke volume x heart rate. Transthoracic echocardiography parameter.
Cardiac Index - Change From Baseline
Hemodynamic parameter computed as cardiac output divided by body surface area
Cardiac Index - Change From Baseline
Hemodynamic parameter computed as cardiac output divided by body surface area

Full Information

First Posted
July 21, 2011
Last Updated
November 27, 2016
Sponsor
Biostable Science & Engineering
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1. Study Identification

Unique Protocol Identification Number
NCT01400841
Brief Title
HAART Model 300 Annuloplasty Ring
Official Title
A Prospective, Non-randomized, Multi-center Trial to Evaluate the Safety and Effectiveness of the HAART Model 300 Annuloplasty Ring When Used to Surgically Repair a Leaking Aortic Valve Using a 3-D Intra-annular Mounting Frame
Study Type
Interventional

2. Study Status

Record Verification Date
November 2016
Overall Recruitment Status
Completed
Study Start Date
January 2012 (undefined)
Primary Completion Date
April 2013 (Actual)
Study Completion Date
September 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Biostable Science & Engineering

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This investigation is a prospective, non-randomized, multi-center trial to evaluate the safety and effectiveness of the HAART model 300 annuloplasty ring when used to surgically repair a leaking aortic valve using a 3-D intra-annular mounting frame
Detailed Description
Aortic Regurgitation, (also known as Aortic Insufficiency; AI), is the failure of the aortic valve to close completely during diastole which causes blood to flow from the aorta back into the left ventricle. Aortic Regurgitation (AR) is a frequent cause of both disability and death due to congestive heart failure, primarily in individuals forty or older, but can also occur in younger populations. Traditionally management of aortic regurgitation has been by aortic valve replacement, however, as has been observed in patients who have had mitral valve repair, the option of maintaining ones native aortic valve versus a replacement, either bioprosthetic or mechanical, can have added multiple benefits. The advantage of repair is the avoidance of prosthetic valve-related complications with bioprosthetic valves over 10-15 years or the need for anticoagulation with mechanical valves and the related problems of this therapy. Therefore, potentially aortic valve repair is a good option for patients with AR or AI.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Aortic Regurgitation
Keywords
Aortic Insufficiency, Aortic Regurgitation, Aortic Valve Repair

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
HAART 300 Annuloplasty Device
Arm Type
Experimental
Arm Description
Implantation of HAART 300 Annuloplasty Device for aortic valve repair
Intervention Type
Device
Intervention Name(s)
HAART 300 Annuloplasty Device
Intervention Description
Implantation of device for aortic valve repair
Primary Outcome Measure Information:
Title
Primary Safety Outcome Measure: Event-free Survival
Description
Event-free survival is defined as survival free from device-related death
Time Frame
1 month postprocedure
Title
Primary Safety Outcome Measure: Event-free Survival
Description
Event-free survival is defined as survival free from device-related death
Time Frame
2 years postprocedure (extended follow-up)
Title
Primary Efficacy Outcome Measure: Aortic Valvular Regurgitation at 6 Months Postprocedure
Description
Aortic valvular regurgitation assessed by transthoracic echocardiography and graded as None/Trace (0), Mild (1+), Moderate (2+), Moderate-to-Severe (3+), or Severe (4+)
Time Frame
6 months postprocedure
Title
Primary Efficacy Outcome Measure: Aortic Valvular Regurgitation at 2 Years Postprocedure
Description
Aortic valvular regurgitation assessed by transthoracic echocardiography and graded as None/Trace (0), Mild (1+), Moderate (2+), Moderate-to-Severe (3+), or Severe (4+)
Time Frame
2 years postprocedure (extended follow-up)
Secondary Outcome Measure Information:
Title
Implant Procedure Success
Description
Success is defined as the absence of specified adverse events evaluated through discharge or 14 days after the procedure: Aortic annular dissection, rupture, or leaflet damage Paravalvular leak > +2 or requiring intervention Mitral valve impingement due to implant implant dehiscence/migration into aorta implant dehiscence/migration into left ventricle Hemodynamics requiring intervention Other adverse event resulting in reoperation, explantation, or permanent disability.
Time Frame
discharge or 14 days postprocedure, whichever comes first
Title
Implant Procedure Success
Description
Success is defined as the absence of specified adverse events evaluated through discharge or 14 days after the procedure: Aortic annular dissection, rupture, or leaflet damage Paravalvular leak > +2 or requiring intervention Mitral valve impingement due to implant implant dehiscence/migration into aorta implant dehiscence/migration into left ventricle Hemodynamics requiring intervention Other adverse event resulting in reoperation, explantation, or permanent disability.
Time Frame
2 years postprocedure (extended follow-up)
Title
Actuarial Freedom From Clinical Cardiovascular Events
Description
Freedom from specified clinical cardiovascular events 1 month postprocedure: Device-related mortality Complete heart block Structural device failure Endocarditis Periprosthetic leak or dehiscence Thromboembolism Bleeding Event Native Valve Deterioration Valve Thrombosis Hemolysis Reoperation and explant at 1 month
Time Frame
1 month postprocedure
Title
Actuarial Freedom From Clinical Cardiovascular Events
Description
Freedom from specified clinical cardiovascular events 2 years postprocedure: Device-related mortality Complete heart block Structural device failure Endocarditis Periprosthetic leak or dehiscence Thromboembolism Bleeding Event Native Valve Deterioration Valve Thrombosis Hemolysis Reoperation and explant at 2 years
Time Frame
2 years postprocedure
Title
Event-free Survival
Description
Event-free survival is defined as survival free from device-related death
Time Frame
6 months postprocedure
Title
New York Heart Association (NYHA) Functional Capacity Classification
Description
Four classes describing the effect of cardiac disease on physical activity: Class I - disease does not limit activity; Class II - slight limitation; Class III - marked limitation; Class IV - inability to carry out any physical activity without discomfort
Time Frame
6 months postprocedure
Title
New York Heart Association (NYHA) Functional Capacity Classification
Description
Four classes describing the effect of cardiac disease on physical activity: Class I - disease does not limit activity; Class II - slight limitation; Class III - marked limitation; Class IV - inability to carry out any physical activity without discomfort
Time Frame
2 years postprocedure (extended follow-up)
Title
Peak Gradient - Change From Baseline
Description
Transthoracic echocardiography parameter
Time Frame
Baseline, 6 months postprocedure
Title
Peak Gradient - Change From Baseline
Description
Transthoracic echocardiography parameter
Time Frame
Baseline, 2 years postprocedure (extended follow-up)
Title
Mean Gradient - Change From Baseline
Description
Transthoracic echocardiography parameter
Time Frame
Baseline, 6 months postprocedure
Title
Mean Gradient - Change From Baseline
Description
Transthoracic echocardiography parameter
Time Frame
Baseline, 2 years postprocedure (extended follow-up)
Title
LV Mass - Change From Baseline
Description
Left ventricular mass. Transthoracic echocardiography parameter.
Time Frame
Baseline, 6 months postprocedure
Title
LV Mass - Change From Baseline
Description
Left ventricular mass. Transthoracic echocardiography parameter.
Time Frame
Baseline, 2 years postprocedure (extended follow-up)
Title
LVID Diastole - Change From Baseline
Description
Left ventricular internal dimension. Transthoracic echocardiography parameter.
Time Frame
Baseline, 6 months postprocedure
Title
LVID Diastole - Change From Baseline
Description
Left ventricular internal dimension. Transthoracic echocardiography parameter.
Time Frame
Baseline, 2 years postprocedure (extended follow-up)
Title
LVID Systole - Change From Baseline
Description
Left ventricular internal dimension. Transthoracic echocardiography parameter.
Time Frame
Baseline, 6 months postprocedure
Title
LVID Systole - Change From Baseline
Description
Left ventricular internal dimension. Transthoracic echocardiography parameter.
Time Frame
Baseline, 2 years postprocedure (extended follow-up)
Title
LV Diastolic Volume - Change From Baseline
Description
Left ventricular diastolic volume. Transthoracic echocardiography parameter.
Time Frame
Baseline, 6 months postprocedure
Title
LV Diastolic Volume - Change From Baseline
Description
Left ventricular diastolic volume. Transthoracic echocardiography parameter.
Time Frame
Baseline, 2 years postprocedure (extended follow-up)
Title
LV Systolic Volume - Change From Baseline
Description
Left ventricular systolic volume. Transthoracic echocardiography parameter.
Time Frame
Baseline, 6 months postprocedure
Title
LV Systolic Volume - Change From Baseline
Description
Left ventricular systolic volume. Transthoracic echocardiography parameter.
Time Frame
Baseline, 2 years postprocedure (extended follow-up)
Title
LVEF - Change From Baseline
Description
Left ventricular ejection fraction. Transthoracic echocardiography parameter.
Time Frame
Baseline, 6 months postprocedure
Title
LVEF - Change From Baseline
Description
Left ventricular ejection fraction. Transthoracic echocardiography parameter.
Time Frame
Baseline, 2 years postprocedure (extended follow-up)
Title
Cardiac Output - Change From Baseline
Description
Stroke volume x heart rate. Transthoracic echocardiography parameter.
Time Frame
Baseline, 6 months postprocedure
Title
Cardiac Output - Change From Baseline
Description
Stroke volume x heart rate. Transthoracic echocardiography parameter.
Time Frame
Baseline, 2 years postprocedure (extended follow-up)
Title
Cardiac Index - Change From Baseline
Description
Hemodynamic parameter computed as cardiac output divided by body surface area
Time Frame
Baseline, 6 months postprocedure
Title
Cardiac Index - Change From Baseline
Description
Hemodynamic parameter computed as cardiac output divided by body surface area
Time Frame
Baseline, 2 years postprocedure (extended follow-up)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject is 50 years old or older The subject has a tricuspid aortic valve morphology Patients with documented severe aortic insufficiency with aortic annular dilation without severe concomitant aortic stenosis Patients referred to center for documented moderate to severe Chronic aortic regurgitation (AR) associated with annular dilatation with or without cusp prolapse of one, two, or all three leaflets Patients with or without Sinotubular Junction (STJ) dilatation or aortic root aneurysms Patients who are free of coronary disease or those with evidence of minor stable (1-2 vessel) coronary disease Subject is willing to comply with specified follow-up evaluations, including transesophageal echocardiography if there are inadequate images by transthoracic echocardiography (TTE) to assess the aortic valve The subject has signed the written informed consent The subject agrees to return for all follow-up evaluations for the duration of the study (i.e. geographically stable The subject is New York Hospital Association (NYHA) class II or III Exclusion Criteria: The subject has preexisting valve prosthesis in the atrial, the mitral, pulmonary, and/or tricuspid position The subject requires an additional valve replacement The subject's aortic valve morphology is not tricuspid The subject has active endocarditis Heavily calcified valves Valvular retraction with severely reduced mobility The subject has mixed stenosis and regurgitation of the aortic valve with predominant stenosis The subject requires a repair of the mitral or tricuspid valve with the use of an annuloplasty device Leukopenia Acute anemia (Hb < 9mg%) Platelet count <100,000 cell/mm3 Need for emergency surgery for any reason History of bleeding diathesis or coagulopathy or the subject refuses blood transfusions Active infection requiring antibiotic therapy (if temporary illness, subjects may enroll 4 weeks after discontinuation of antibiotics) Subjects in whom transesophageal echocardiography (TEE) is contraindicated Non elective presentation Low Ejection Fraction (EF) EF < 40% Life expectancy < 1 year Rheumatic disease The subject has severe leaflet fenestration or leaflets damaged by endocarditis The subject is or will be participating in a concomitant research study of an investigational product or has participated in such a study within the 30 days prior to screening The subject is a minor, an illicit drug user, alcohol abuser, prisoner, institutionalized, or is unable to give informed consent The subject is pregnant or lactating This patient will not agree to return to the implant center for the required number of follow-up visits or is geographically unavailable for follow-up The subject has not signed and dated the study informed consent Recent (within 6 months) cerebrovascular accident (CVA) or transient ischemic attack (TIA) Myocardial infarction (MI) within one month of trial inclusion Have a known intolerance to titanium or polyester Sole therapy for correction for patients with aortic root aneurysm Subjects requiring simultaneous cardiac procedures The subject has asymptomatic AR and a left ventricular ejection fraction (LVEF) > 50%
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christof Stamm, M.D.
Organizational Affiliation
German Heart Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital Gasthuisberg
City
Leuven
ZIP/Postal Code
B-3000
Country
Belgium
Facility Name
Institut klinicke a experimantalni mediciny
City
Prague
ZIP/Postal Code
1958/9
Country
Czech Republic
Facility Name
German Heart Institute
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
German Heart Center Munich
City
Munich
ZIP/Postal Code
80636
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
26156945
Citation
Mazzitelli D, Fischlein T, Rankin JS, Choi YH, Stamm C, Pfeiffer S, Pirk J, Detter C, Kroll J, Beyersdorf F, Griffin CD, Shrestha M, Nobauer C, Crooke PS, Schreiber C, Lange R. Geometric ring annuloplasty as an adjunct to aortic valve repair: clinical investigation of the HAART 300 device. Eur J Cardiothorac Surg. 2016 Mar;49(3):987-93. doi: 10.1093/ejcts/ezv234. Epub 2015 Jul 8.
Results Reference
derived
PubMed Identifier
25468084
Citation
Mazzitelli D, Stamm C, Rankin JS, Pfeiffer S, Fischlein T, Pirk J, Choi YH, Detter C, Kroll J, Beyersdorf F, Shrestha M, Schreiber C, Lange R. Leaflet reconstructive techniques for aortic valve repair. Ann Thorac Surg. 2014 Dec;98(6):2053-60. doi: 10.1016/j.athoracsur.2014.06.052. Epub 2014 Dec 1.
Results Reference
derived
PubMed Identifier
24113022
Citation
Mazzitelli D, Stamm C, Rankin JS, Nobauer C, Pirk J, Meuris B, Crooke PS, Wagner A, Beavan LA, Griffin CD, Powers D, Nasseri B, Schreiber C, Hetzer R, Lange R. Hemodynamic outcomes of geometric ring annuloplasty for aortic valve repair: a 4-center pilot trial. J Thorac Cardiovasc Surg. 2014 Jul;148(1):168-75. doi: 10.1016/j.jtcvs.2013.08.031. Epub 2013 Oct 8.
Results Reference
derived
PubMed Identifier
23959743
Citation
Mazzitelli D, Nobauer C, Rankin JS, Badiu CC, Dorfmeister M, Crooke PS, Wagner A, Schreiber C, Lange R. Early results of a novel technique for ring-reinforced aortic valve and root restoration. Eur J Cardiothorac Surg. 2014 Mar;45(3):426-30. doi: 10.1093/ejcts/ezt407. Epub 2013 Aug 19.
Results Reference
derived

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HAART Model 300 Annuloplasty Ring

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