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Use of DurAVR™ THV System in Subjects With Severe Aortic Stenosis: Early Feasibility Study (DurAVR™ EFS)

Primary Purpose

Aortic Stenosis, Symptomatic Aortic Stenosis, Severe Aortic Valve Stenosis

Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
DurAVRTM THV System
Sponsored by
Anteris Technologies Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional device feasibility trial for Aortic Stenosis focused on measuring TAVI, TAVR, Transcatheter Valve, Transcatheter Aortic Valve Implantation

Eligibility Criteria

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

Inclusion Criteria: Subjects are eligible for entry in this study if ALL the following conditions are met: Symptomatic, severe native aortic stenosis in subjects 65 years or older Requires aortic valve replacement and is indicated for TAVR as determined by the Heart Team (composed of an experienced interventional cardiologist and an experienced cardiac surgeon) Eligible for transfemoral delivery of the DurAVR™ THV Anatomy appropriate to accommodate safe placement of DurAVR™ THV (Preprocedural measurements by TTE and CT required: aortic annulus diameter 21-23 mm by CT) Understands the study requirements and the treatment procedures and provides written informed consent Subject agrees to complete all required scheduled follow-up visits. Exclusion Criteria: Subjects are eligible for entry in this study if NONE of the following conditions are met: Anatomical Anatomy precluding safe placement of DurAVR™ THV Pre-existing prosthetic heart valve in any position Unicuspid or bicuspid aortic valve Severe aortic regurgitation Severe mitral or severe tricuspid regurgitation requiring intervention. Moderate to severe mitral stenosis. Hypertrophic obstructive cardiomyopathy Echocardiographic evidence of intracardiac mass, thrombus or vegetation requiring treatment. Severe basal septal hypertrophy with outflow gradient Clinical Evidence of an acute myocardial infarction ≤ 30 days before the intended treatment. Determined inoperable/ineligible for surgery by the Heart Team Any percutaneous coronary or peripheral interventional procedure performed within 30 days prior to the index procedure Blood dyscrasias as defined: leukopenia (WBC < 1000 mm3), thrombocytopenia (platelet count < 50,000 cells/mm3), history of bleeding diathesis or coagulopathy, or hypercoagulable states Untreated clinically significant Coronary Artery Disease (CAD) requiring revascularization Cardiogenic shock manifested by low cardiac output, vasopressor dependence, or mechanical hemodynamic support Need for emergency surgery for any reason Ventricular dysfunction with left ventricular ejection fraction (LVEF) < 30% as measured by resting echocardiogram Recent (within 6 months) cerebrovascular accident (CVA) or transient ischemic attack (TIA). Symptomatic carotid or vertebral artery disease End stage renal disease requiring chronic dialysis or creatinine clearance < 20 cc/min. GI bleeding within the past 3 months A known hypersensitivity or contraindication to any of the following which cannot be adequately pre-medicated: aspirin, heparin, nitinol (titanium or nickel), ticlopidine and clopidogrel, contrast media Ongoing sepsis, including active endocarditis (Duke Criteria) [49] Subject refuses a blood transfusion Life expectancy < 12 months due to associated non-cardiac co-morbid conditions Other medical, social, or psychological conditions that in the opinion of an Investigator precludes the subject from appropriate consent Severe dementia (resulting in either inability to provide informed consent for the trial/procedure, prevents independent lifestyle outside of a chronic care facility, or will fundamentally complicate rehabilitation from the procedure or compliance with follow-up visits) Currently participating in an investigational drug or another investigational device trial Subject is contraindicated for MDCT or MRI Scans. Subject belongs to a vulnerable population (Vulnerable subject populations are defined as individuals with mental disability, persons in nursing homes, children, impoverished persons, homeless persons, nomads, refugees, and those permanently incapable of giving informed consent. Vulnerable populations also may include members of a group with a hierarchical structure such as university students, subordinate hospital and laboratory personnel, employees of the Sponsor, members of the armed forces, and persons kept in detention).

Sites / Locations

  • Tucson Medical Center
  • University of Michigan
  • Montefiore Medical Center
  • Columbia University Medical Center/NYPH
  • Cleveland Clinic Foundation

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

DurAVR™ THV System

Arm Description

TAVR procedure

Outcomes

Primary Outcome Measures

All-cause mortality or disabling stroke
Mortality would be reported as rate of death/mortality at 30 days. Disabling stroke would be reported according to VARC-3 Guidelines
Technical success
Freedom from mortality, successful device implant, and freedom from surgery or intervention related to the device.

Secondary Outcome Measures

All-cause mortality
Mortality would be reported as rate of death/mortality at 30days.
Disabling stroke
Rate of disabling stroke according to VARC-3 Guidelines
Major vascular, access-related, or cardiac structural complication
complications according to VARC-3 Guidelines
VARC-3 Type 2-4 bleeding
Rates of Type 2, 3, and 4 bleeding according to VARC-3 guidelines
Acute Kidney Injury stage 3 or 4
AKI stage 3-4 according to VARC-3 guidelines
Moderate or severe aortic regurgitation
aortic regurgitation according to VARC-3 guidelines
New permanent pacemaker due to procedure related conduction abnormalities
Rate of pacemaker interventions in subjects experiencing conduction abnormalities
Surgery or intervention related to the device, including aortic valve reintervention.
Device related interventions

Full Information

First Posted
January 13, 2023
Last Updated
October 18, 2023
Sponsor
Anteris Technologies Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05712161
Brief Title
Use of DurAVR™ THV System in Subjects With Severe Aortic Stenosis: Early Feasibility Study
Acronym
DurAVR™ EFS
Official Title
Use of DurAVR™ THV System in Subjects With Severe Aortic Stenosis: Early Feasibility Study
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
August 7, 2023 (Actual)
Primary Completion Date
November 2023 (Anticipated)
Study Completion Date
December 2033 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Anteris Technologies 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
To evaluate the safety and feasibility of DurAVR™ THV System in the treatment of subjects with symptomatic severe native aortic stenosis.
Detailed Description
The primary objective is to assess the acute and long-term safety and feasibility of the DurAVR™ device in adult subjects with symptomatic, severe native aortic stenosis eligible for the transcatheter aortic valve replacement as assessed by the Heart Team at the enrolling institutions. This is a prospective, non-randomized, single-arm, multi-center Study. Subjects will be consented for follow-up to 10 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Aortic Stenosis, Symptomatic Aortic Stenosis, Severe Aortic Valve Stenosis, Aortic Valve Calcification
Keywords
TAVI, TAVR, Transcatheter Valve, Transcatheter Aortic Valve Implantation

7. Study Design

Primary Purpose
Device Feasibility
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
A prospective, non-randomized, single-arm, multi-center study
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
DurAVR™ THV System
Arm Type
Experimental
Arm Description
TAVR procedure
Intervention Type
Device
Intervention Name(s)
DurAVRTM THV System
Intervention Description
The DurAVR™ Transcatheter Heart Valve (THV) is a balloon expandable transcatheter aortic valve
Primary Outcome Measure Information:
Title
All-cause mortality or disabling stroke
Description
Mortality would be reported as rate of death/mortality at 30 days. Disabling stroke would be reported according to VARC-3 Guidelines
Time Frame
30days
Title
Technical success
Description
Freedom from mortality, successful device implant, and freedom from surgery or intervention related to the device.
Time Frame
Immediate post procedure
Secondary Outcome Measure Information:
Title
All-cause mortality
Description
Mortality would be reported as rate of death/mortality at 30days.
Time Frame
30days
Title
Disabling stroke
Description
Rate of disabling stroke according to VARC-3 Guidelines
Time Frame
30days
Title
Major vascular, access-related, or cardiac structural complication
Description
complications according to VARC-3 Guidelines
Time Frame
30days
Title
VARC-3 Type 2-4 bleeding
Description
Rates of Type 2, 3, and 4 bleeding according to VARC-3 guidelines
Time Frame
30days
Title
Acute Kidney Injury stage 3 or 4
Description
AKI stage 3-4 according to VARC-3 guidelines
Time Frame
30days
Title
Moderate or severe aortic regurgitation
Description
aortic regurgitation according to VARC-3 guidelines
Time Frame
30days
Title
New permanent pacemaker due to procedure related conduction abnormalities
Description
Rate of pacemaker interventions in subjects experiencing conduction abnormalities
Time Frame
30days
Title
Surgery or intervention related to the device, including aortic valve reintervention.
Description
Device related interventions
Time Frame
30days
Other Pre-specified Outcome Measures:
Title
Hospitalization (or re-hospitalization)
Description
Hospitalization (or re-hospitalization). Any admission after the index hospitalization or study enrolment to an inpatient unit or hospital ward for ≥24 h, including an emergency department stay. Hospitalizations planned for pre-existing conditions are excluded unless there is worsening of the baseline condition.
Time Frame
1 year
Title
Leaflet thickening and reduced motion
Description
Assessing causes of valve leaflet thickening and reduced leaflet motion such as leaflet thrombosis, endocarditis, leaflet deterioration, and valve frame expansion issues.
Time Frame
1year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects are eligible for entry in this study if ALL the following conditions are met: Symptomatic, severe native aortic stenosis in subjects 65 years or older Requires aortic valve replacement and is indicated for TAVR as determined by the Heart Team (composed of an experienced interventional cardiologist and an experienced cardiac surgeon) Eligible for transfemoral delivery of the DurAVR™ THV Anatomy appropriate to accommodate safe placement of DurAVR™ THV (Preprocedural measurements by TTE and CT required: aortic annulus diameter 21-23 mm by CT) Understands the study requirements and the treatment procedures and provides written informed consent Subject agrees to complete all required scheduled follow-up visits. Exclusion Criteria: Subjects are eligible for entry in this study if NONE of the following conditions are met: Anatomical Anatomy precluding safe placement of DurAVR™ THV Pre-existing prosthetic heart valve in any position Unicuspid or bicuspid aortic valve Severe aortic regurgitation Severe mitral or severe tricuspid regurgitation requiring intervention. Moderate to severe mitral stenosis. Hypertrophic obstructive cardiomyopathy Echocardiographic evidence of intracardiac mass, thrombus or vegetation requiring treatment. Severe basal septal hypertrophy with outflow gradient Clinical Evidence of an acute myocardial infarction ≤ 30 days before the intended treatment. Determined inoperable/ineligible for surgery by the Heart Team Any percutaneous coronary or peripheral interventional procedure performed within 30 days prior to the index procedure Blood dyscrasias as defined: leukopenia (WBC < 1000 mm3), thrombocytopenia (platelet count < 50,000 cells/mm3), history of bleeding diathesis or coagulopathy, or hypercoagulable states Untreated clinically significant Coronary Artery Disease (CAD) requiring revascularization Cardiogenic shock manifested by low cardiac output, vasopressor dependence, or mechanical hemodynamic support Need for emergency surgery for any reason Ventricular dysfunction with left ventricular ejection fraction (LVEF) < 30% as measured by resting echocardiogram Recent (within 6 months) cerebrovascular accident (CVA) or transient ischemic attack (TIA). Symptomatic carotid or vertebral artery disease End stage renal disease requiring chronic dialysis or creatinine clearance < 20 cc/min. GI bleeding within the past 3 months A known hypersensitivity or contraindication to any of the following which cannot be adequately pre-medicated: aspirin, heparin, nitinol (titanium or nickel), ticlopidine and clopidogrel, contrast media Ongoing sepsis, including active endocarditis (Duke Criteria) [49] Subject refuses a blood transfusion Life expectancy < 12 months due to associated non-cardiac co-morbid conditions Other medical, social, or psychological conditions that in the opinion of an Investigator precludes the subject from appropriate consent Severe dementia (resulting in either inability to provide informed consent for the trial/procedure, prevents independent lifestyle outside of a chronic care facility, or will fundamentally complicate rehabilitation from the procedure or compliance with follow-up visits) Currently participating in an investigational drug or another investigational device trial Subject is contraindicated for MDCT or MRI Scans. Subject belongs to a vulnerable population (Vulnerable subject populations are defined as individuals with mental disability, persons in nursing homes, children, impoverished persons, homeless persons, nomads, refugees, and those permanently incapable of giving informed consent. Vulnerable populations also may include members of a group with a hierarchical structure such as university students, subordinate hospital and laboratory personnel, employees of the Sponsor, members of the armed forces, and persons kept in detention).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Reardon, MD
Organizational Affiliation
Methodist DeBakey Hospital
Official's Role
Study Chair
Facility Information:
Facility Name
Tucson Medical Center
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85712
Country
United States
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Montefiore Medical Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Facility Name
Columbia University Medical Center/NYPH
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Cleveland Clinic Foundation
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Use of DurAVR™ THV System in Subjects With Severe Aortic Stenosis: Early Feasibility Study

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