VenTouch OUS Feasibility Study
Functional Mitral Regurgitation
About this trial
This is an interventional treatment trial for Functional Mitral Regurgitation
Eligibility Criteria
Inclusion Criteria:
- Adults ≥18 years of age
- Symptomatic FMR of grade moderately severe to severe (3 to 4) due to either ischemic or non-ischemic dilated cardiomyopathy with structurally normal leaflets determined by echocardiography (preferably with echocardiographic evidence of EROA ≥ 0.20 cm2)
- NYHA Class II to IV
- Left Ventricular Ejection Fraction (LVEF) 20%-50% determined by echocardiography
- Treatment and compliance with optimal guideline-directed medical therapy for heart failure for at least 30 days
- Subjects with a Class I indication for CRT implant according to current guidelines should have CRT implant prior to entry into the study. Subjects who have existing CRT implants may be included in the study if the implant has been in place for at least 90 days; reprogramming of an implanted CRT that results in increased biventricular pacing (from <92% to ≥92%) must be in place for at least 30 days.
- Left Ventricular End Diastolic Diameter (LVEDD) of 55 to 80 mm as determined by echocardiography
- Indexed Left Ventricular End Diastolic Diameter (LVEDDi) of 30 to 40 mm/m2 (where LVEDDi is calculated by LVEDD/Body Surface Area (BSA))
- Subject is willing and available to return for study follow-up
- Subject or legal representative understands and provides signed informed consent for participation in study
- Acceptance of subject for trial enrollment after review of all subject baseline data by Study Selection Committee
Exclusion Criteria:
- Life expectancy of less than 12 months due to conditions other than cardiac status
- Anticipated need for LVAD or transplant within 12 months
- Chronic Obstructive Pulmonary Disease (COPD) requiring continuous home oxygen therapy or chronic outpatient oral steroid use
- American College of Cardiology / American Heart Association (ACC/AHA) Stage D heart failure
- Six-minute walk distance < 150 meters
- Identified need for any cardiovascular surgery
- STS score that suggests prohibitive surgical risk as determined by Subject Selection Committee
- Untreated clinically significant coronary artery disease
- Any procedure, condition or cardiac anatomy that may impact or compromise the pericardial space (e.g. prior mitral valve surgery, CABG, epicardial pacing leads, pericarditis, or other procedure involving pericardial access)
- Percutaneous coronary intervention, acute coronary syndrome (e.g. STEMI or non-STEMI myocardial infarction, unstable angina) or clinically significant cardiac events (e.g. hypotension, syncope, arrhythmias, embolism, heart failure exacerbation or any hospitalization) within 30 days of enrollment
- Thoracic or cardiac surgery contraindication (e.g., acute respiratory distress, endocarditis, myocarditis, pericarditis)
- Significant structural abnormality of the mitral valve (e.g. flail leaflets, ruptured or elongated chordae, prolapsed valve, perforated valve leaflets, significant calcification in the annulus, or calcification in the leaflets that restricts motion)
- Severe symptomatic carotid stenosis
- Severe or sustained pulmonary hypertension, defined by resting pulmonary artery systolic (PAS) pressure ≥70 mmHg determined by echocardiography or right heart catheterization
- Physical evidence of right-sided congestive heart failure with echocardiographic evidence of moderate or severe right ventricular dysfunction or moderate to severe TR
- Hypotension (systolic pressure <90 mmHg)
- Hemodynamic instability requiring inotropic support or mechanical heart assistance within 30 days
- Hypertrophic cardiomyopathy, restrictive cardiomyopathy, or any other structural heart disease causing heart failure other than dilated cardiomyopathy
- UNOS status 1 heart transplantation
- Creatinine > 2.5 mg/dL (221 µmol/L) and/or renal failure requiring dialysis
- Stroke (cerebrovascular accident) or transient ischemic event (TIA) within 30 days of enrollment
- Active systemic infection or bleeding
- Autoimmune disorders and/or the use of immune suppression therapy
- Females who are pregnant (as documented by HCG beta pregnancy test in females of child-bearing age) or lactating
- Currently enrolled in another investigational drug or device study
Intra-Operative Exclusion Criteria:
- Significant structural abnormality of the mitral valve (e.g. flail leaflets, ruptured or elongated chordae, prolapsed valve, perforated valve leaflets, significant calcification in the annulus, or calcification in the leaflets that restricts motion)
- Signs/indications of ischemia
- Intra-operative coronary angiography demonstrates that there is compression of the coronary arteries or reduction in coronary blood flow due to the VenTouch implant
Sites / Locations
- Libin Cardiovascular Institute, University of Calgary
- University of British Columbia, St. Paul's Hospital
- London Health Sciences Centre, University Hospital
- Toronto General HospitalRecruiting
- Montreal Heart InstituteRecruiting
- Institut Universitaire de Cardiologie et de Pneumologie De Québec (IUCPQ)Recruiting
- Bordeaux Heart University Hospital
- CardioVasculäres Centrum
- Semmelweis University Heart and Vascular CenterRecruiting
- Leiden University Medical Center
- Pacifica Salud Hospital Punta PacificaRecruiting
- Centralny Szpital Kliniczny MSWiA w Warszawia
Arms of the Study
Arm 1
Experimental
VenTouch System Implant
The VenTouch System is intended for use in the treatment of functional MR (FMR) in adults who are symptomatic despite optimal medical management. It is indicated for subjects with FMR with essentially normal leaflet anatomy and motion, with mitral valve regurgitation attributable to annular and/or ventricular dilation. It is not intended to treat structural defects/degeneration of the mitral valve. The VenTouch System is intended to provide ventricular support that will encourage beneficial remodeling of the heart and, with adjustable inflatable chambers, it is intended to reduce annular dilation, correct papillary muscle displacement, and restore mitral valve leaflet coaptation, allowing proper closure of the valve, and reducing or eliminating MR. The VenTouch System is indicated for patients who have "moderately severe" or "severe" mitral regurgitation (grade 3 or 4 MR).