BioVentrix Revivent TC™ System Clinical Study
Primary Purpose
Ventricular Dysfunction, Left
Status
Active
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Revivent TC
Sponsored by
About this trial
This is an interventional treatment trial for Ventricular Dysfunction, Left
Eligibility Criteria
Inclusion Criteria:
- 18 years old or older
- LV Aneurysm or Scar Presence: Defined by presence of a contiguous acontractile (akinetic and/or dyskinetic) scar;
- LV Aneurysm/Scar Location: Defined as a scar involving septum and/or anterior, apical or anterolateral regions of the left ventricle as evidenced by cardiac imaging and referred for surgical management;
- Viability of myocardium in regions remote from area of intended scar exclusion as evidenced by cardiac imaging;
- Left Ventricular Ejection Fraction < 45%;
- Left ventricular end-systolic volume index ≥50 mL/m2;
- Suffering from heart failure symptoms as defined by NYHA Classification > 2 not responsive to medical therapy;
- Patient completed 6 Minute Walk Test and MLHF Quality of Life Questionnaire (can be performed at baseline visit);
- Patient is on adequate Guideline Directed Medical Therapy (GDMT);
- Subject or a legally authorized representative must provide written informed consent;
- Agree to required follow-up visits; and
- Female subject of childbearing potential does not plan pregnancy for at least one year following the index procedure. For a female of childbearing potential, a pregnancy test must be performed with negative results known within seven days prior to index procedure Candidates for the study group must meet ALL of the inclusion criteria.
Candidates allocated to active concurrent control pool of patients must meet all inclusion criteria (including LV Aneurysm/Scar Presence), WITH THE EXCEPTION OF ONE OF THE FOLLOWING:
- They have undergone previous pericardiotomy, left thoracotomy, or open heart surgery, or
- The LV Aneurysm/Scar location does not permit treatment with the study device, or
- The patient elects to be enrolled in the control group
Exclusion Criteria:
Candidates will be excluded from the study and active concurrent control group if ANY of the following conditions are present:
- Cardiac Resynchronization Therapy (CRT) or ICD pacing lead placement ≤ 60 days prior to enrollment;
- Valvular heart disease, which in the opinion of the investigator, will require surgery;
- Functional Mitral Regurgitation greater than moderate (i.e. EROA>20mm sq.) and degenerative MR (including MR due to papillary muscle rupture);
- Need for coronary revascularization, in the opinion of the site investigator;
- Peak Systolic Pulmonary Arterial Pressure > 60 mm Hg via echo or right heart catheterization and/or evidence of cor pulmonale;
- Myocardial Infarction within 90 days prior to enrollment;
- Within the last six months, a prior CVA or TIA, or any intracranial hemorrhage, or any permanent neurologic deficit, or any known intracranial pathology;
- Co-morbid disease process with life expectancy of less than one year or active malignancy not in remission;
- Any solid organ transplant or is on waiting list for any solid organ transplant other than cardiac;
- Chronic renal failure with a serum creatinine >2.5 mg/dL and/or GFR<30ml/min;
- Subject is currently participating in another clinical trial that has not yet completed its primary endpoint;
- Presence of significant ventricular arrhythmias
The following exclusion criteria apply only to the treatment group and do not apply to the concurrent control cohort:
- Contraindication or inability to adhere to systemic anticoagulation;
- Known hypersensitivity or contraindication to device materials;
- Previous pericardiotomy or left thoracotomy;
- Pathology/previous surgery/radiation therapy of the right neck that would interfere with placement of a 14F delivery catheter;
- Prior open heart surgery or significant pericarditis;
- Calcified ventricular wall in the area of intended anchor implants as verified by cardiac imaging;
- Thrombus or intra-ventricular mass in the left atrium or ventricle as verified by cardiac imaging that has not been adequately treated with anticoagulant.
- Functioning pacemaker leads in antero-apical RV, which, in the opinion of the investigator, would interfere with anchor placement;
Sites / Locations
- University of Arizona College of Medicine - Phoenix Banner University Medicine Heart Institute
- Ronald Regan UCLA Medical Center
- University of California, San Francisco
- Los Robles Hospital & Medical Center
- Baptist Hospital of Maimi
- Emory University Hospital Midtown
- WellStar Health System
- Memorial Medical Center
- Terrebonne General Medical Center
- University of Michigan
- University of Minnesota Medical Center
- Saint Luke's Hospital of Kansas City
- Hackensack University Medical Center
- Mount Sinai Hospital
- New York Presbyterian Hospital
- Wake Forest Baptist Hospital
- Cleveland Clinic
- Oklahoma Heart Hospital
- UPMC Pinnacle
- Penn State Health Milton S. Hershey Medical Center
- Hospital of the University of Pennsylvania
- Medical University of South Carolina
- CHI St. Luke's Health-Baylor St. Luke's Medical Center
- Houston Methodist Hospital
- Winchester Medical Center
- Nemocnice Na Homolce
- Hygeia Hospital
- Interbalkan Medical Center
- Papworth Hospital NHS Foundation Trust
- Freeman Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
No Intervention
Arm Label
Treatment
Control Pool
Arm Description
Treatment with the Revivent TC System
Treatment with Guideline Directed Medical Therapy for Heart Failure Symptoms Only
Outcomes
Primary Outcome Measures
Incidence of all cause death, mechanical support, emergent cardiac surgery, prolonged mechanical ventilation, renal failure and clinically important stroke compared to data from the STS database for surgical LV aneurysm repair.
Composite primary safety endpoint of all cause death, placement of a mechanical support device intra or post-op (IABP, VAD, ECMO or catheter based), emergent cardiac surgery including reoperation for bleeding or tamponade, prolonged mechanical ventilation, renal failure and clinically important stroke (Rankin Score of 4 or higher) through 30-days post procedure. Data from the patients treated with the Revivent TC System will be compared to surgical outcomes data from the Society for Thoracic Surgery database for surgical LV aneurysm repair.
The rate of all cause of death, mechanical support, and operation (or re-operation) for HF, bleeding or tamponade from 1 through 12 months post procedure compared to untreated patients who remain on Guideline Directed Medical Therapy (GDMT).
A composite of all cause of death, placement of a mechanical support device and operation (or re-operation) for HF, bleeding or tamponade from 1 through 12 months (day 31 through 365) post procedure. Data from patients treated with the Revivent TC System will be compared to data from a control pool of patients who comply with all aspects of the protocol except scar (aneurysm) location and are not treated with the investigational devices remain on Guideline Directed Medical Therapy (GDMT). Patients in the GDMT group will be evaluated from day 31 through 365 after the date of enrollment into the study.
Secondary Outcome Measures
The rate of re-hospitalization and improvement of HF Symptoms in patients treated with the test device compared to patients who are maintained on Guideline Directed Medical Therapy.
Composite primary effectiveness endpoint consisting of:
No hospital readmission for new or worsening heart failure, and
Improvement in MLHF Quality of Life score by >10 points, and
Improvement in 6 Minute Walk Distance by >25 meters, and
Improvement in NYHA Classification > 1 grade.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02931240
Brief Title
BioVentrix Revivent TC™ System Clinical Study
Official Title
Clinical Study of the BioVentrix Revivent TC™ System for Treatment of Left Ventricular Aneurysms (ALIVE)
Study Type
Interventional
2. Study Status
Record Verification Date
August 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
August 29, 2017 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
June 30, 2027 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioVentrix
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
A prospective, multi-center, dual-arm pivotal study of the BioVentrix Revivent TC System, with 2:1 study vs. active concurrent control group allocation ratio. This study will include 126 patients of which 84 patients will be treated with the investigational device and 42 patients will be included in an active control group.
Detailed Description
The Revivent TC System is indicated for patients referred for surgical treatment of left ventricular scar that is contiguous, and includes both anterior and septal components. Primary and Secondary Effectiveness Endpoints will compare data from the patients treated with the Revivent TC System to a control pool of patients who comply with all aspects of the protocol except scar location and are not treated with the investigational devices but remain on Guideline Directed Medical Therapy (GDMT). The primary safety and effectiveness endpoints will be evaluated at 12 months post procedure. The study will be conducted at a maximum of 20 clinical centers.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ventricular Dysfunction, Left
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
126 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Treatment
Arm Type
Experimental
Arm Description
Treatment with the Revivent TC System
Arm Title
Control Pool
Arm Type
No Intervention
Arm Description
Treatment with Guideline Directed Medical Therapy for Heart Failure Symptoms Only
Intervention Type
Device
Intervention Name(s)
Revivent TC
Intervention Description
Treatment of LV scar
Primary Outcome Measure Information:
Title
Incidence of all cause death, mechanical support, emergent cardiac surgery, prolonged mechanical ventilation, renal failure and clinically important stroke compared to data from the STS database for surgical LV aneurysm repair.
Description
Composite primary safety endpoint of all cause death, placement of a mechanical support device intra or post-op (IABP, VAD, ECMO or catheter based), emergent cardiac surgery including reoperation for bleeding or tamponade, prolonged mechanical ventilation, renal failure and clinically important stroke (Rankin Score of 4 or higher) through 30-days post procedure. Data from the patients treated with the Revivent TC System will be compared to surgical outcomes data from the Society for Thoracic Surgery database for surgical LV aneurysm repair.
Time Frame
1 Month
Title
The rate of all cause of death, mechanical support, and operation (or re-operation) for HF, bleeding or tamponade from 1 through 12 months post procedure compared to untreated patients who remain on Guideline Directed Medical Therapy (GDMT).
Description
A composite of all cause of death, placement of a mechanical support device and operation (or re-operation) for HF, bleeding or tamponade from 1 through 12 months (day 31 through 365) post procedure. Data from patients treated with the Revivent TC System will be compared to data from a control pool of patients who comply with all aspects of the protocol except scar (aneurysm) location and are not treated with the investigational devices remain on Guideline Directed Medical Therapy (GDMT). Patients in the GDMT group will be evaluated from day 31 through 365 after the date of enrollment into the study.
Time Frame
1 Year
Secondary Outcome Measure Information:
Title
The rate of re-hospitalization and improvement of HF Symptoms in patients treated with the test device compared to patients who are maintained on Guideline Directed Medical Therapy.
Description
Composite primary effectiveness endpoint consisting of:
No hospital readmission for new or worsening heart failure, and
Improvement in MLHF Quality of Life score by >10 points, and
Improvement in 6 Minute Walk Distance by >25 meters, and
Improvement in NYHA Classification > 1 grade.
Time Frame
1 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
100 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
18 years old or older
LV Aneurysm or Scar Presence: Defined by presence of a contiguous acontractile (akinetic and/or dyskinetic) scar;
LV Aneurysm/Scar Location: Defined as a scar involving septum and/or anterior, apical or anterolateral regions of the left ventricle as evidenced by cardiac imaging and referred for surgical management;
Viability of myocardium in regions remote from area of intended scar exclusion as evidenced by cardiac imaging;
Left Ventricular Ejection Fraction < 45%;
Left ventricular end-systolic volume index ≥50 mL/m2;
Suffering from heart failure symptoms as defined by NYHA Classification > 2 not responsive to medical therapy;
Patient completed 6 Minute Walk Test and MLHF Quality of Life Questionnaire (can be performed at baseline visit);
Patient is on adequate Guideline Directed Medical Therapy (GDMT);
Subject or a legally authorized representative must provide written informed consent;
Agree to required follow-up visits; and
Female subject of childbearing potential does not plan pregnancy for at least one year following the index procedure. For a female of childbearing potential, a pregnancy test must be performed with negative results known within seven days prior to index procedure Candidates for the study group must meet ALL of the inclusion criteria.
Candidates allocated to active concurrent control pool of patients must meet all inclusion criteria (including LV Aneurysm/Scar Presence), WITH THE EXCEPTION OF ONE OF THE FOLLOWING:
They have undergone previous pericardiotomy, left thoracotomy, or open heart surgery, or
The LV Aneurysm/Scar location does not permit treatment with the study device, or
The patient elects to be enrolled in the control group
Exclusion Criteria:
Candidates will be excluded from the study and active concurrent control group if ANY of the following conditions are present:
Cardiac Resynchronization Therapy (CRT) or ICD pacing lead placement ≤ 60 days prior to enrollment;
Valvular heart disease, which in the opinion of the investigator, will require surgery;
Functional Mitral Regurgitation greater than moderate (i.e. EROA>20mm sq.) and degenerative MR (including MR due to papillary muscle rupture);
Need for coronary revascularization, in the opinion of the site investigator;
Peak Systolic Pulmonary Arterial Pressure > 60 mm Hg via echo or right heart catheterization and/or evidence of cor pulmonale;
Myocardial Infarction within 90 days prior to enrollment;
Within the last six months, a prior CVA or TIA, or any intracranial hemorrhage, or any permanent neurologic deficit, or any known intracranial pathology;
Co-morbid disease process with life expectancy of less than one year or active malignancy not in remission;
Any solid organ transplant or is on waiting list for any solid organ transplant other than cardiac;
Chronic renal failure with a serum creatinine >2.5 mg/dL and/or GFR<30ml/min;
Subject is currently participating in another clinical trial that has not yet completed its primary endpoint;
Presence of significant ventricular arrhythmias
The following exclusion criteria apply only to the treatment group and do not apply to the concurrent control cohort:
Contraindication or inability to adhere to systemic anticoagulation;
Known hypersensitivity or contraindication to device materials;
Previous pericardiotomy or left thoracotomy;
Pathology/previous surgery/radiation therapy of the right neck that would interfere with placement of a 14F delivery catheter;
Prior open heart surgery or significant pericarditis;
Calcified ventricular wall in the area of intended anchor implants as verified by cardiac imaging;
Thrombus or intra-ventricular mass in the left atrium or ventricle as verified by cardiac imaging that has not been adequately treated with anticoagulant.
Functioning pacemaker leads in antero-apical RV, which, in the opinion of the investigator, would interfere with anchor placement;
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Andrew S Wechsler, MD
Organizational Affiliation
Drexel University College of Medicine
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Gregg W Stone, MD
Organizational Affiliation
Icahn School of Medicine at Mount Sinai
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jerry D Estep, MD
Organizational Affiliation
The Cleveland Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Arizona College of Medicine - Phoenix Banner University Medicine Heart Institute
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85004
Country
United States
Facility Name
Ronald Regan UCLA Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90024
Country
United States
Facility Name
University of California, San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Los Robles Hospital & Medical Center
City
Thousand Oaks
State/Province
California
ZIP/Postal Code
91360
Country
United States
Facility Name
Baptist Hospital of Maimi
City
Miami
State/Province
Florida
ZIP/Postal Code
33176
Country
United States
Facility Name
Emory University Hospital Midtown
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30308
Country
United States
Facility Name
WellStar Health System
City
Marietta
State/Province
Georgia
ZIP/Postal Code
30060
Country
United States
Facility Name
Memorial Medical Center
City
Springfield
State/Province
Illinois
ZIP/Postal Code
62781
Country
United States
Facility Name
Terrebonne General Medical Center
City
Houma
State/Province
Louisiana
ZIP/Postal Code
70360
Country
United States
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109-5856
Country
United States
Facility Name
University of Minnesota Medical Center
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
Saint Luke's Hospital of Kansas City
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Facility Name
Hackensack University Medical Center
City
Hackensack
State/Province
New Jersey
ZIP/Postal Code
07601
Country
United States
Facility Name
Mount Sinai Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
New York Presbyterian Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Wake Forest Baptist Hospital
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Oklahoma Heart Hospital
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73120
Country
United States
Facility Name
UPMC Pinnacle
City
Harrisburg
State/Province
Pennsylvania
ZIP/Postal Code
17101
Country
United States
Facility Name
Penn State Health Milton S. Hershey Medical Center
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States
Facility Name
Hospital of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
CHI St. Luke's Health-Baylor St. Luke's Medical Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Houston Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Winchester Medical Center
City
Winchester
State/Province
Virginia
ZIP/Postal Code
22601
Country
United States
Facility Name
Nemocnice Na Homolce
City
Prague
ZIP/Postal Code
150 30
Country
Czechia
Facility Name
Hygeia Hospital
City
Athens
ZIP/Postal Code
151 23
Country
Greece
Facility Name
Interbalkan Medical Center
City
Thessaloniki
Country
Greece
Facility Name
Papworth Hospital NHS Foundation Trust
City
Cambridge
ZIP/Postal Code
CB23 3RE
Country
United Kingdom
Facility Name
Freeman Hospital
City
Newcastle Upon Tyne
ZIP/Postal Code
NE7 7DN
Country
United Kingdom
12. IPD Sharing Statement
Plan to Share IPD
No
Links:
URL
http://www.bioventrix.com
Description
Sponsor Web Site
Learn more about this trial
BioVentrix Revivent TC™ System Clinical Study
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