Treatment of Pulmonary Arterial Hypertension Using the Aria CV Pulmonary Hypertension System (ASPIRE PH)
Pulmonary Arterial Hypertension, Pulmonary Hypertension, Right Heart Dysfunction
About this trial
This is an interventional treatment trial for Pulmonary Arterial Hypertension focused on measuring Pulmonary Disease, Pulmonary Artery, Pulmonary Hypertension, Lung Disease, Right Heart Dysfunction
Eligibility Criteria
Inclusion Criteria:
- 18 years or older.
Diagnosis of WHO Group 1 PH (Pulmonary Arterial Hypertension, PAH) evidenced by all the following parameters measured at rest:
- Mean pulmonary artery pressure (mPAP) ≥25 mmHg;
- Pulmonary capillary wedge pressure (PCWP) or left ventricular end diastolic pressure (LVEDP) ≤15 mmHg;
- Pulmonary vascular resistance (PVR) >3 Wood units.
- Patient remains symptomatic despite being on a stable drug regimen of at least two PH specific medications for at least 90 days prior to planned index procedure.
- Patient with a current assessment of WHO Functional Class (FC) III or ambulatory IV.
- Main pulmonary artery (MPA) diameter and anatomy suitable for placement of the device as defined in the Instructions For Use (IFU) and as assessed by multi-slice computed tomography (MSCT).
- Patient is deemed appropriate for Aria CV device by the Patient Care Team at the investigation site and approved by the Central Screening Committee (CSC).
- Patient understands the study requirements, is willing and able to provide appropriate informed consent and is committed and able to attend all required follow-up visits and undergo all required tests at the clinic.
Exclusion Criteria:
- Diagnosis of WHO PH Groups 2, 3, 4 or 5.
Patient with recent clinical events of any of the following:
- Myocardial infarction or stroke within 6 months prior to the index procedure;
- Sustained tachyarrhythmia (documented heart rate >110/min) within 2 months prior to the index procedure.
- Any pre-existing or requirement of emergent surgery/ intervention, or implantation of prosthetic cardiac device that may interfere with Aria CV device placement or function (e.g. pulmonary or tricuspid valve repair or replacement, pacemaker, defibrillator, inferior vena cava filters, neurostimulators, drug infusion devices, etc.).
Patient with any of the following medical history or comorbidities:
- History of endocarditis;
- Current renal insufficiency as demonstrated by an eGFR <30 mL/min/1.73 m^2 or end stage renal disease requiring chronic dialysis;
- Current diagnosis of scleroderma associated with:
i. Any history of GI bleeding or receiving iron infusions within 2 years prior to enrollment;
ii. Significant skin involvement that could compromise daily activities or the ability to receive IV medications, or sclerodactyly that causes surface ulcerations, digital ulcerations, or ulcerating calcinosis lesions.
d. History of receiving immunosuppressant therapy as follows:
i. Excluded if receiving Mycophenolate mofetil within 30 days prior to enrollment, or Rituximab within 6 months prior to enrollment, or currently receiving Prednisone at a dose > 12 mg per day at time of enrollment.
ii. Excluded if any immunosuppressant other than Mycophenolate mofetil, Rituximab, or Prednisone, per above.
e. Current pulmonary veno-occlusive disease (PVOD);
f. Current pulmonary capillary hemangiomatosis (PCH);
g. History of clinically significant patent foramen ovale or other inter-atrial or inter-ventricular shunt;
h. History of gastric antral vascular ectasia (GAVE), gastrointestinal or intracranial bleeding which, in the opinion of the investigator, will predispose subject to major bleeding events following Aria CV device placement and warfarin anticoagulation regimen;
i. Current active systemic infection requiring antibiotic therapy;
j. Blood dyscrasias that may, in the opinion of investigator(s), expose patient to unacceptable procedural risks such as severe or worsening leukopenia, anemia, thrombocytopenia, untreated iron deficiency or history of bleeding diathesis or coagulopathy.
Anatomy not suitable for placement of Aria CV device, including
- No suitable subcutaneous implantation location for the reservoir;
- Contraindication to 22 Fr venous access via a subclavian vein;
- Body habitus that precludes safe placement of any components of the Aria CV device.
Right heart valve regurgitation:
- Moderate to severe (Grade 3 or 4) pulmonary valve regurgitation;
- Severe (Grade 4) tricuspid valve regurgitation.
Hypersensitivity or contraindication to
- Required medications (e.g. contrast agents, warfarin, heparin) which cannot be adequately managed;
- Materials in device including polyurethane, silicone, nickel, and titanium.
- Patient ineligible for or refuses blood transfusion.
- Pregnant or lactating female or planning a pregnancy during participation in the study.
- Patient with life expectancy of less than two years.
- Currently participating in or planning to participate in other investigational drug or device trials that may interfere with the outcome of this study
Sites / Locations
- University of California - San Diego
- University of California-Los Angeles
- St. Vincent HealthRecruiting
- Brigham and Women's Hospital
- Beaumont HospitalRecruiting
- University of Minnesota
- Mayo Clinic
- Cornell UniversityRecruiting
- University of Rochester
- The Christ HospitalRecruiting
- The Ohio State University
- Ohio HealthRecruiting
- Medical University of South Carolina
- Aurora St Luke's Medical CenterRecruiting
Arms of the Study
Arm 1
Experimental
Aria CV Pulmonary Hypertension System
Treatment with the Aria CV Pulmonary Hypertension System