Quantification of Debris Captured Using TCEP During VIV TAVR With BVF
Primary Purpose
Aortic Valve Disease
Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
VIV TAVR with BVF using TCEP
Sponsored by
About this trial
This is an interventional treatment trial for Aortic Valve Disease
Eligibility Criteria
Inclusion Criteria:
- Men and Women ≥ 18 years of age
- The patient has severe bioprosthetic aortic valve degeneration (stenosis, insufficiency, or mixed valve disease) and a clinical indication for VIV TAVR
- The bioprosthetic valve can be fractured with high pressure balloon inflation.
- The patient is deemed at prohibitive or high mortality risk related to surgical aortic valve replacement as assessed by the Heart Team
- For procedural planning, all patients must have a CT angiogram of the chest, abdomen and pelvis to confirm:
A. Adequate femoral access for the TAVR procedure B. Appropriate right subclavian, carotid and brachiocephalic as well as left carotid artery anatomy for the SENTINEL device deployment.
- The patient or legal representative is able to understand and willing to provide written informed consent to participate in the trial
- The patient is able and willing to return for required follow-up visits and examinations
- The patient is evaluated by the multidisciplinary heart-valve team and found to be a suitable for the procedure.
Exclusion Criteria:
- Patients with low or moderate mortality risk from surgical aortic valve replacement
- Patients with bioprosthetic valves that cannot be fractured with standard non-compliant valvuloplasty balloons (Table 1)
- Patients with evidence of significant carotid artery stenosis (i.e., carotid stenosis ≥ 50%), noted on ultrasound duplex imaging or CT angiography.
- Patients with evidence of right subclavian/brachiocephalic artery stenosis
- Patients with right arm/forearm dialysis fistula or graft.
- Patients with harvested right radial artery for a previous coronary bypass surgery.
- Patients with prohibitive aortic arch anomalies for SENTINEL device implantation.
- The patient with history of cerebrovascular event (CVA) within within 6 months.
- Patient with incidental left atrial appendage thrombus noted on TEE or CT imaging.
- The patient is actively enrolled in another trial of a cardiovascular device or an investigational drug (post-market study participation and registries are acceptable)
- The patient is pregnant, or pregnancy is planned during the course of the investigation if patient is of child-bearing potential
- Any clinically significant medical condition or presence of any laboratory abnormality performed prior to randomization that is considered by the investigator to be clinically important and could interfere with the conduct of the study or not meeting procedure guidelines for TAVR or SENTINEL
- The patient has a life expectancy of less than one year
Sites / Locations
- Saint Luke's Hospital of Kansas CityRecruiting
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
VIV TAVR with BVF using TCEP
Arm Description
All subjects will receive the intervention.
Outcomes
Primary Outcome Measures
Quantity of debris
Amount of debris captured by the SENTINEL TCEP device in VIV TAVR with BVF patients compared to historical data
Complication rate
In-hospital stroke, device embolization rate, procedure-related major bleeding
Secondary Outcome Measures
Mortality
Deaths from all causes
MACCE
Major adverse cardiac and cerebrovascular events
Full Information
NCT ID
NCT05093764
First Posted
September 28, 2021
Last Updated
April 11, 2023
Sponsor
Saint Luke's Health System
Collaborators
Boston Scientific Corporation
1. Study Identification
Unique Protocol Identification Number
NCT05093764
Brief Title
Quantification of Debris Captured Using TCEP During VIV TAVR With BVF
Official Title
Quantification of Debris Captured Using Transcatheter Cerebral Embolic Protection (TCEP) During Valve in Valve Transcatheter Aortic Valve Replacement (VIV TAVR) With Bioprosthetic Valvular Fracture (BVF)
Study Type
Interventional
2. Study Status
Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 2, 2022 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
July 31, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Saint Luke's Health System
Collaborators
Boston Scientific Corporation
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No
5. Study Description
Brief Summary
The objective of this study is to quantify the amount of debris captured by the SENTINEL transcatheter cerebral embolic protection (TCEP) device in patients undergoing valve in valve transcatheter aortic valve replacement (VIV TAVR) with bioprosthetic valvular fracture (BVF)
Detailed Description
SENTINEL VIV-TAVR is a prospective, single-center, single-arm, unblinded pilot trial. A total of 20 subjects with severe symptomatic bioprosthetic aortic valve degeneration, who are deemed to be at high or prohibitive mortality risk related to surgical aortic valve replacement, and are undergoing VIV-TAVR and BVF, will be enrolled at the Mid-America Heart Institute, St-Luke's Hospital of Kansas City. Subjects will initially have an aortic arch angiogram done to confirm appropriate anatomy, followed by the SENTINEL device implanted through right radial artery approach. After that, patients will undergo VIV TAVR, using a commercially available transcatheter heart valve, followed by bioprosthetic valve fracture (BVF) as indicated.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Aortic Valve Disease
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
VIV TAVR with BVF using TCEP
Arm Type
Other
Arm Description
All subjects will receive the intervention.
Intervention Type
Device
Intervention Name(s)
VIV TAVR with BVF using TCEP
Intervention Description
The insertion and retrieval of the SENTINEL device is performed at the time of the patients TAVR procedure in the same setting while they are sedated under moderate sedation or general anesthesia depending on the case. The device is inserted at the initiation of the procedure through 6F right radial artery access and the filters are positioned in the left common carotid artery and brachiocephalic artery. After deployment, the usual TAVR procedure is performed. At the conclusion of the procedure, the SENTINEL device is extracted and hemostasis is achieved at the radial access site in the usual fashion with patent hemostasis.
Primary Outcome Measure Information:
Title
Quantity of debris
Description
Amount of debris captured by the SENTINEL TCEP device in VIV TAVR with BVF patients compared to historical data
Time Frame
During surgical procedure
Title
Complication rate
Description
In-hospital stroke, device embolization rate, procedure-related major bleeding
Time Frame
Through hospital discharge, an average of 2.5 days
Secondary Outcome Measure Information:
Title
Mortality
Description
Deaths from all causes
Time Frame
Through hospital discharge, an average of 2.5 days
Title
MACCE
Description
Major adverse cardiac and cerebrovascular events
Time Frame
Through hospital discharge, an average of 2.5 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Men and Women ≥ 18 years of age
The patient has severe bioprosthetic aortic valve degeneration (stenosis, insufficiency, or mixed valve disease) and a clinical indication for VIV TAVR
The bioprosthetic valve can be fractured with high pressure balloon inflation.
The patient is deemed at prohibitive or high mortality risk related to surgical aortic valve replacement as assessed by the Heart Team
For procedural planning, all patients must have a CT angiogram of the chest, abdomen and pelvis to confirm:
A. Adequate femoral access for the TAVR procedure B. Appropriate right subclavian, carotid and brachiocephalic as well as left carotid artery anatomy for the SENTINEL device deployment.
The patient or legal representative is able to understand and willing to provide written informed consent to participate in the trial
The patient is able and willing to return for required follow-up visits and examinations
The patient is evaluated by the multidisciplinary heart-valve team and found to be a suitable for the procedure.
Exclusion Criteria:
Patients with low or moderate mortality risk from surgical aortic valve replacement
Patients with bioprosthetic valves that cannot be fractured with standard non-compliant valvuloplasty balloons (Table 1)
Patients with evidence of significant carotid artery stenosis (i.e., carotid stenosis ≥ 50%), noted on ultrasound duplex imaging or CT angiography.
Patients with evidence of right subclavian/brachiocephalic artery stenosis
Patients with right arm/forearm dialysis fistula or graft.
Patients with harvested right radial artery for a previous coronary bypass surgery.
Patients with prohibitive aortic arch anomalies for SENTINEL device implantation.
The patient with history of cerebrovascular event (CVA) within within 6 months.
Patient with incidental left atrial appendage thrombus noted on TEE or CT imaging.
The patient is actively enrolled in another trial of a cardiovascular device or an investigational drug (post-market study participation and registries are acceptable)
The patient is pregnant, or pregnancy is planned during the course of the investigation if patient is of child-bearing potential
Any clinically significant medical condition or presence of any laboratory abnormality performed prior to randomization that is considered by the investigator to be clinically important and could interfere with the conduct of the study or not meeting procedure guidelines for TAVR or SENTINEL
The patient has a life expectancy of less than one year
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sheila Erwin, RN
Phone
816-932-7996
Email
serwin@saintlukeskc.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Adnan Chhatriwalla, MD
Organizational Affiliation
Saint Luke's Health System
Official's Role
Principal Investigator
Facility Information:
Facility Name
Saint Luke's Hospital of Kansas City
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sheila Erwin, RN
Phone
816-932-7996
Email
serwin@saintlukeskc.org
First Name & Middle Initial & Last Name & Degree
Adnan Chhatriwalla, MD
12. IPD Sharing Statement
Plan to Share IPD
No
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Quantification of Debris Captured Using TCEP During VIV TAVR With BVF
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