Reducing Right Ventricular Failure in Pulmonary Arterial Hypertension (RELIEVE-PAH) (RELIEVE-PAH)
Primary Purpose
Pulmonary Arterial Hypertension
Status
Recruiting
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
V-Wave Interatrial Shunt
Sponsored by
About this trial
This is an interventional treatment trial for Pulmonary Arterial Hypertension focused on measuring Pulmonary Arterial Hypertension, PAH, Interatrial Shunt, Interatrial Shunting, Atrial Septostomy
Eligibility Criteria
Main Inclusion Criteria:
- Group 1 PAH (idiopathic, connective tissue disease, HIV, corrected congenital heart disease).
- WHO Functional Class III or IV symptoms. If WHO Class III, at least 1 High-Risk characteristic or 2 Intermediate-Risk characteristics from the 2015 ESC Guidelines.
- Receiving maximal available and tolerable pharmacological PAH therapy ≥3 months at a stable dose for ≥1 month.
Main Exclusion Criteria:
- Resting oxygen saturation <90 % without supplemental oxygen corrected for altitude.
- Mean Right Atrial Pressure >20 mmHg.
- Severe restrictive or obstructive lung disease.
- Evidence of organ dysfunction other than right heart failure.
- Left ventricular ejection fraction <40 %.
- Anatomical anomaly on transesophageal echocardiography or intracardiac echocardiography that precludes implantation of Shunt across fossa ovalis (FO) of the interatrial septum.
- Inadequate vascular access for implantation of shunt, e.g. femoral venous access for transseptal catheterization and inferior vena cava (IVC) is not patent.
- Hemodynamic heart rhythm, or respiratory instability at time of Final Exclusion Criteria.
Sites / Locations
- Keck Medical Center of USCRecruiting
- University of California, San FranciscoRecruiting
- The Ohio State University Wexner Medical Center - Davis Heart & Lung Research InstituteRecruiting
- Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval
- Instituto Nacional de Cardiologia
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Therapy: V-Wave Shunt
Arm Description
Treatment arm patients will undergo a diagnostic right heart catheterization and invasive echocardiography to determine study eligibility followed by transseptal catheterization and V-Wave Shunt implantation.
Outcomes
Primary Outcome Measures
Safety-Percentage of Treatment patients experiencing major device-related adverse events
Percentage of Treatment group patients experiencing any device-related Major Adverse Cardiovascular or Neurological Events (MACNE) during the first 90-days after implantation
Safety-Percentage of Treatment patients experiencing any major adverse event
Percentage of Treatment group patients experiencing any Major Adverse Cardiovascular or Neurological Events (MACNE) during the first 90-days after implantation
Procedure Success-Percentage of patients successfully implanted with study device
Percentage of patients successfully implanted with the study device at the intended location across the interatrial septum during the index procedure compared to patients with attempted implantations
Device Success-Percentage of patients implanted with right to left interatrial flow
Percentage of patients successfully implanted with the study device with right to left interatrial flow on echocardiography at 3 months
Secondary Outcome Measures
Freedom from device related MACNE at 1 and 12 months after implantation
Freedom from device related Major Adverse Cardiac and Neurologic Events at 1 and 12 months after implantation.
Improvement in Exercise Capacity between baseline and 12 months
Improvement in Exercise Capacity measured by the six minute hall walk test from baseline to 12 months
Improvement in WHO Functional Class between baseline and 12 months
Improvement in World Health Organization Functional Class between baseline and 12 months.
Improvement in Quality of Life between baseline and 12 months
Improvement in Quality of Life as measured by the SF-36 questionnaire
Improvement in Quality of Life between baseline and 12 months
Improvement in Quality of Life as measured by the CAMPHOR questionnaire
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03838445
Brief Title
Reducing Right Ventricular Failure in Pulmonary Arterial Hypertension (RELIEVE-PAH)
Acronym
RELIEVE-PAH
Official Title
RELIEVE-PAH TRIAL: REducing Right ventricuLar faIlure With thE V-waVe Shunt in Pulmonary Arterial Hypertension
Study Type
Interventional
2. Study Status
Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 14, 2020 (Actual)
Primary Completion Date
June 30, 2024 (Anticipated)
Study Completion Date
December 31, 2026 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
V-Wave Ltd
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The objectives of the RELIEVE-PAH study are to obtain first-in-human experience with the study device in patients with severe pulmonary arterial hypertension, including evidence of initial safety, device performance and possible signals of clinical effectiveness.
Detailed Description
This is a multi-national, multi-center, prospective, non-randomized, open label trial of patients implanted with the study device. A total of up to 20 patients will be implanted with the study device and followed at regular intervals for 1 year and then annually for a total of 5 years post implant.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pulmonary Arterial Hypertension
Keywords
Pulmonary Arterial Hypertension, PAH, Interatrial Shunt, Interatrial Shunting, Atrial Septostomy
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Therapy: V-Wave Shunt
Arm Type
Experimental
Arm Description
Treatment arm patients will undergo a diagnostic right heart catheterization and invasive echocardiography to determine study eligibility followed by transseptal catheterization and V-Wave Shunt implantation.
Intervention Type
Device
Intervention Name(s)
V-Wave Interatrial Shunt
Intervention Description
The V-Wave Interatrial Shunt System, includes a permanent implant placed during a minimally invasive cardiac catheterization procedure using its dedicated Delivery Catheter. The device is implanted through the fossa ovals and straddles the interatrial septum.
Primary Outcome Measure Information:
Title
Safety-Percentage of Treatment patients experiencing major device-related adverse events
Description
Percentage of Treatment group patients experiencing any device-related Major Adverse Cardiovascular or Neurological Events (MACNE) during the first 90-days after implantation
Time Frame
3 months
Title
Safety-Percentage of Treatment patients experiencing any major adverse event
Description
Percentage of Treatment group patients experiencing any Major Adverse Cardiovascular or Neurological Events (MACNE) during the first 90-days after implantation
Time Frame
3 months
Title
Procedure Success-Percentage of patients successfully implanted with study device
Description
Percentage of patients successfully implanted with the study device at the intended location across the interatrial septum during the index procedure compared to patients with attempted implantations
Time Frame
3 months
Title
Device Success-Percentage of patients implanted with right to left interatrial flow
Description
Percentage of patients successfully implanted with the study device with right to left interatrial flow on echocardiography at 3 months
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Freedom from device related MACNE at 1 and 12 months after implantation
Description
Freedom from device related Major Adverse Cardiac and Neurologic Events at 1 and 12 months after implantation.
Time Frame
1 and 12 months
Title
Improvement in Exercise Capacity between baseline and 12 months
Description
Improvement in Exercise Capacity measured by the six minute hall walk test from baseline to 12 months
Time Frame
12 months
Title
Improvement in WHO Functional Class between baseline and 12 months
Description
Improvement in World Health Organization Functional Class between baseline and 12 months.
Time Frame
12 months
Title
Improvement in Quality of Life between baseline and 12 months
Description
Improvement in Quality of Life as measured by the SF-36 questionnaire
Time Frame
12 months
Title
Improvement in Quality of Life between baseline and 12 months
Description
Improvement in Quality of Life as measured by the CAMPHOR questionnaire
Time Frame
12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Main Inclusion Criteria:
Group 1 PAH (idiopathic, connective tissue disease, HIV, corrected congenital heart disease).
WHO Functional Class III or IV symptoms. If WHO Class III, at least 1 High-Risk characteristic or 2 Intermediate-Risk characteristics from the 2015 ESC Guidelines.
Receiving maximal available and tolerable pharmacological PAH therapy ≥3 months at a stable dose for ≥1 month.
Main Exclusion Criteria:
Resting oxygen saturation <90 % without supplemental oxygen corrected for altitude.
Mean Right Atrial Pressure >20 mmHg.
Severe restrictive or obstructive lung disease.
Evidence of organ dysfunction other than right heart failure.
Left ventricular ejection fraction <40 %.
Anatomical anomaly on transesophageal echocardiography or intracardiac echocardiography that precludes implantation of Shunt across fossa ovalis (FO) of the interatrial septum.
Inadequate vascular access for implantation of shunt, e.g. femoral venous access for transseptal catheterization and inferior vena cava (IVC) is not patent.
Hemodynamic heart rhythm, or respiratory instability at time of Final Exclusion Criteria.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
William T. Abraham, M.D.
Phone
(818)629-2164
Email
bill@vwavemedical.com
First Name & Middle Initial & Last Name or Official Title & Degree
Beverly Walker, MSN, NP
Phone
(818)629-2164
Email
beverly@vwavemedical.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Victor Tapson, M.D.
Organizational Affiliation
Cedars-Sinai Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Keck Medical Center of USC
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sivagini Ganesh, MD
First Name & Middle Initial & Last Name & Degree
Sivagini Ganesh, MD
Facility Name
University of California, San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marc Simon, MD
First Name & Middle Initial & Last Name & Degree
Marc Simon, MD
Facility Name
The Ohio State University Wexner Medical Center - Davis Heart & Lung Research Institute
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Veronica Franco, MD
First Name & Middle Initial & Last Name & Degree
Veronica Franco, M.D.
Facility Name
Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval
City
Québec
Country
Canada
Individual Site Status
Withdrawn
Facility Name
Instituto Nacional de Cardiologia
City
Mexico City
Country
Mexico
Individual Site Status
Active, not recruiting
12. IPD Sharing Statement
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Reducing Right Ventricular Failure in Pulmonary Arterial Hypertension (RELIEVE-PAH)
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