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Safety and Performance Study of the MitralStitch Repair System.

Primary Purpose

Mitral Regurgitation

Status
Unknown status
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
MitralStitch
Sponsored by
Hangzhou Valgen Medtech Co., Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mitral Regurgitation focused on measuring Mitral Regurgitation, Mitral Valve Repair, Transapical

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥18 yrs
  2. Moderate to severe (3+) or severe (4+) mitral valve regurgitation confirmed by echocardiography (defined as MR >2+);
  3. NYHA functional class II-V (Appendix 3);
  4. Anatomically suitable for mitral valve repair;
  5. 40mm ≤LVESD≤55 mm; 25% ≤LVEF ≤60%; tolerable for small incision thoracic surgery;
  6. Mitral valve diameter ≤45mm;
  7. The independent expert committee of this study determined that surgical operation was contraindicated or high-risk, and the recommended reference standard was: surgical valve replacement with STS score ≥ 8; or surgical valve repair with STS score ≥ 6; or other risk factors (e.g., There are at least two moderate to severe indicators of weakness; potential operational disorders; at least major organ dysfunction that cannot be improved after surgery, etc.)
  8. The subject or the subject's legal representative fully understand and agree to join to the clinic trial.

Exclusion Criteria:

  1. Echocardiographic evidence of intracardiac mass, thrombus or vegetation;
  2. Severe mitral valve calcification;
  3. Concomitant with greater than moderate aortic stenosis or regurgitation;
  4. Mitral regurgitation caused by special pathological mechanisms, such as leaflet perforation and leaflet fissure;
  5. Severe untreated coronary artery stenosis requiring revascularization; or with other cardiovascular disease requiring surgical treatment;
  6. Hypertrophic cardiomyopathy with or without obstruction, restrictive cardiomyopathy, constrictive pericarditis, or other structural heart diseases that cause heart failure in patients expect dilated cardiomyopathy;
  7. Myocardial infarction was performed within 4 weeks before the intervention;
  8. Any vascular intervention, cardiac surgery, cardiac resynchronization therapy (CRT, CRT-D), and an implantation of implantable cardioverter defibrillator (ICD) were performed within 30 days before the intervention;
  9. Any heart transplantation, mitral valve surgery or percutaneous mitral valve operation were performed before the intervention;
  10. Life expectancy is less than 12 months;
  11. History of, or active, rheumatic heart disease;
  12. Active phase of bacterial endocarditis;
  13. The active infections require concurrent antibiotic treatment;
  14. History of acute peptic ulcer or upper gastrointestinal bleeding within 3 months;
  15. Dysplasia of the blood system, including granulocytopenia (WBC < 3×109/L), acute anemia (HB < 90g/L), thrombocytopenia (PLT < 50×109/L), hemorrhagic constitution, and coagulopathy;
  16. Modified Rankin scale ≥4;
  17. Pregnant or lactating women;
  18. The subject is suffered from a disease which may cause difficulty in evaluating the treatment (e.g., cancer, infection, severe metabolic disease, psychosis, etc.); or special cases were evaluated by the local experimental center heart team as not suitable for the surgical application of this clinical trial instrument;
  19. Participants who have participated in clinical trials of any drug and/or medical device within 1 month before this study;
  20. In the judgment of the Investigator, patients were not compliant enough to complete the study as required.

Sites / Locations

  • Structural Heart Disease Center, Fuwai Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

MitralStitch repair system

Arm Description

Experimental group is allocated to use novel mitral vavle repair system manufactured by Hangzhou Valgen Medtech Co., Ltd

Outcomes

Primary Outcome Measures

The success rate
Combined incidence of freedom from: death, surgery for Valve Dysfunction, and MR > 2+ (moderate to severe (3+) or severe (4+) mitral regurgitation) at 12 months

Secondary Outcome Measures

The instant procedural success
Technical success is defined as the absence of death, the successful implantation of the device and complete retraction of the delivery system without any need for emergency surgery or secondary intervention (including device related and surgical approach related
The success of the repair system
The success rate of the device is defined as the successful delivery and implantation of the device, and the successful withdrawal of the implanted parts after the completion of the release, without any technical failure or complications related to the device.
The success of the surgery
Surgical success was defined as the success of the instrument, MR 2+, and no major adverse events related to the instrument or operation occurred during the follow-up period after the implantation of the instrument.
New York Heart Association (NYHA) class
NYHA grading was used to evaluate the cardiac function status of subjects
Living quality
Postoperative SF-12 was used to evaluate the quality of life of the subjects
Incidence of major adverse events(MAE)
MAE definition: Any complications related to devices or surgeries, including but not limited to: death, emergency surgery, severe cardiac tamponade requiring pericardiocentesis or operation, hemorrhage, stroke related to operation.

Full Information

First Posted
August 31, 2019
Last Updated
February 27, 2020
Sponsor
Hangzhou Valgen Medtech Co., Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT04080362
Brief Title
Safety and Performance Study of the MitralStitch Repair System.
Official Title
A Prospective, Multicenter, Single Group Assignment Study for Evaluating the Safety and Effectiveness of MitralStitch Mitral Valve Repair System in Patients With Moderate to Severe and Severe Mitral Regurgitation.
Study Type
Interventional

2. Study Status

Record Verification Date
May 2019
Overall Recruitment Status
Unknown status
Study Start Date
July 5, 2019 (Actual)
Primary Completion Date
June 1, 2021 (Anticipated)
Study Completion Date
June 1, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hangzhou Valgen Medtech Co., Ltd

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
The main objective is to assess the effectiveness and safety of the MitralStitch repair system in patients with moderate to severe and severe mitral regurgitation.
Detailed Description
The clinical trial was designed as a prospective, multicenter, single group assignment study. The participants with moderate to severe and severe mitral valve regurgitation will receive a transapical beating-heart mitral valve repair surgery using MitralStitch mitral valve repair system after signed the informed consent. The follow-up will be conducted after 30 days, 3 months, 6 months and 12 months of the operation. The following conditions evaluate the performance of the system and the safety and efficiency of using MitralStitch mitral valve repair system in treating patients with severe mitral regurgitation. The none occurrence of these conditions will be approved as the main validity index: death, mitral valve related surgery without mitral valve failure and moderate or severe mitral regurgitation (MR > 2+). The secondary validity index was technical success rate, instrument success rate, surgical success rate, cardiac function improvement and quality of life improvement. And the safety evaluation indicators were assessed by the incidence of major adverse events, adverse events, serious adverse events, and device defects.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
The clinical trial was designed as a single group assignment study. The participants with moderate to severe and severe mitral valve regurgitation will receive a transapical beating-heart mitral valve repair surgery using MitralStitchTM mitral valve repair system.
Masking
None (Open Label)
Masking Description
No masking
Allocation
N/A
Enrollment
150 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
MitralStitch repair system
Arm Type
Experimental
Arm Description
Experimental group is allocated to use novel mitral vavle repair system manufactured by Hangzhou Valgen Medtech Co., Ltd
Intervention Type
Device
Intervention Name(s)
MitralStitch
Intervention Description
With transesophageal echocardiographic guidance,implanting ePTFE sutures as artificial neochordae or ege-to-ege repair using MitralStitch System
Primary Outcome Measure Information:
Title
The success rate
Description
Combined incidence of freedom from: death, surgery for Valve Dysfunction, and MR > 2+ (moderate to severe (3+) or severe (4+) mitral regurgitation) at 12 months
Time Frame
1 year
Secondary Outcome Measure Information:
Title
The instant procedural success
Description
Technical success is defined as the absence of death, the successful implantation of the device and complete retraction of the delivery system without any need for emergency surgery or secondary intervention (including device related and surgical approach related
Time Frame
Immediately after repair
Title
The success of the repair system
Description
The success rate of the device is defined as the successful delivery and implantation of the device, and the successful withdrawal of the implanted parts after the completion of the release, without any technical failure or complications related to the device.
Time Frame
12 months
Title
The success of the surgery
Description
Surgical success was defined as the success of the instrument, MR 2+, and no major adverse events related to the instrument or operation occurred during the follow-up period after the implantation of the instrument.
Time Frame
1 month
Title
New York Heart Association (NYHA) class
Description
NYHA grading was used to evaluate the cardiac function status of subjects
Time Frame
12 months
Title
Living quality
Description
Postoperative SF-12 was used to evaluate the quality of life of the subjects
Time Frame
12 months
Title
Incidence of major adverse events(MAE)
Description
MAE definition: Any complications related to devices or surgeries, including but not limited to: death, emergency surgery, severe cardiac tamponade requiring pericardiocentesis or operation, hemorrhage, stroke related to operation.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 yrs Moderate to severe (3+) or severe (4+) mitral valve regurgitation confirmed by echocardiography (defined as MR >2+); NYHA functional class II-V (Appendix 3); Anatomically suitable for mitral valve repair; 40mm ≤LVESD≤55 mm; 25% ≤LVEF ≤60%; tolerable for small incision thoracic surgery; Mitral valve diameter ≤45mm; The independent expert committee of this study determined that surgical operation was contraindicated or high-risk, and the recommended reference standard was: surgical valve replacement with STS score ≥ 8; or surgical valve repair with STS score ≥ 6; or other risk factors (e.g., There are at least two moderate to severe indicators of weakness; potential operational disorders; at least major organ dysfunction that cannot be improved after surgery, etc.) The subject or the subject's legal representative fully understand and agree to join to the clinic trial. Exclusion Criteria: Echocardiographic evidence of intracardiac mass, thrombus or vegetation; Severe mitral valve calcification; Concomitant with greater than moderate aortic stenosis or regurgitation; Mitral regurgitation caused by special pathological mechanisms, such as leaflet perforation and leaflet fissure; Severe untreated coronary artery stenosis requiring revascularization; or with other cardiovascular disease requiring surgical treatment; Hypertrophic cardiomyopathy with or without obstruction, restrictive cardiomyopathy, constrictive pericarditis, or other structural heart diseases that cause heart failure in patients expect dilated cardiomyopathy; Myocardial infarction was performed within 4 weeks before the intervention; Any vascular intervention, cardiac surgery, cardiac resynchronization therapy (CRT, CRT-D), and an implantation of implantable cardioverter defibrillator (ICD) were performed within 30 days before the intervention; Any heart transplantation, mitral valve surgery or percutaneous mitral valve operation were performed before the intervention; Life expectancy is less than 12 months; History of, or active, rheumatic heart disease; Active phase of bacterial endocarditis; The active infections require concurrent antibiotic treatment; History of acute peptic ulcer or upper gastrointestinal bleeding within 3 months; Dysplasia of the blood system, including granulocytopenia (WBC < 3×109/L), acute anemia (HB < 90g/L), thrombocytopenia (PLT < 50×109/L), hemorrhagic constitution, and coagulopathy; Modified Rankin scale ≥4; Pregnant or lactating women; The subject is suffered from a disease which may cause difficulty in evaluating the treatment (e.g., cancer, infection, severe metabolic disease, psychosis, etc.); or special cases were evaluated by the local experimental center heart team as not suitable for the surgical application of this clinical trial instrument; Participants who have participated in clinical trials of any drug and/or medical device within 1 month before this study; In the judgment of the Investigator, patients were not compliant enough to complete the study as required.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shengshou Hu
Organizational Affiliation
Chinese Academy of Medical Science, Fuwai Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Structural Heart Disease Center, Fuwai Hospital
City
Beijing
State/Province
Beijing
Country
China

12. IPD Sharing Statement

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Safety and Performance Study of the MitralStitch Repair System.

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