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The China Mviv Registry

Primary Purpose

Bioprosthesis Failure, Mitral Stenosis With Insufficiency, Mitral Stenosis

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Transseptal Transcatheter Mitral valve-in-valve Replacement
Sponsored by
Xiamen Cardiovascular Hospital, Xiamen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Bioprosthesis Failure

Eligibility Criteria

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

Inclusion Criteria: Subject had a degenerated surgical mitral bioprosthesis with at least moderate to severe mitral regurgitation or severe stenosis with echocardiographically derived mitral valve area (MVA) of ≤1.5 cm2 Subjiect is symptomatic from mitral valve disease, as demonstrated by reported NYHA Functional Class II or greater. Subject is at least 18 years old. Heart team (including cardiac surgeon) agree on eligibility including assessment that transeptal, transcatheter mitral valve replacement (TsMVR) and redo surgical mitral valve replacement (rSMVR) are appropriate. The study patient or the study patient's legal representative informed of the nature of the study, agreed to its provisions and provided written informed consent as approved by the Institutional Review Board (IRB) center. The study Subject agreed to comply with all required post-procedure follow-up visits including annual visits through 5 years and analysis close date visits, which was conducted as a phone/clinic follow-up. Exclusion Criteria: Subject was operable with the assessment of experienced Heart Team Subject had evidence of an acute MI, percutaneous intervention, or a peripheral intervention ≤30 days prior to Portico ViV index procedure. Subject had uncontrolled blood dyscrasias defined as: leukopenia (WBC<3,000 mm3), acute anemia (Hb <9 g/dL), or thrombocytopenia (platelet count <50,000 cells/mm³). Subject was considered hemodynamically unstable at the time of the ViV procedure (requiring inotropic support or mechanical heart assistance) Subject had severe ventricular dysfunction with left ventricular ejection fraction (LVEF) <20% as measured by resting echocardiogram. Subject had imaging evidence of intracardiac mass, thrombus or vegetation. Subject had an active peptic ulcer or has/had upper gastrointestinal (GI) bleeding ≤3 months prior to ViV index procedure. Subject had a documented history of a cerebrovascular accident (CVA) or a transient ischemic attack (TIA) ≤6 months prior to index procedure. Subject had active bacterial endocarditis or ongoing sepsis ≤ 6 months prior to the index procedure. Subject was unable to tolerate antiplatelet or anticoagulant therapy

Sites / Locations

  • Yan WangRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Transcatheter mitral valve-in-valve implantation

Arm Description

Outcomes

Primary Outcome Measures

all-cause mortality
The rate in all-cause mortality will be calculated from 0 month to 12 months.
Rate of New hospitalization for heart failure
Hospitalization for valve-related symptoms or worsening congestive heart failure

Secondary Outcome Measures

Technical success
Technical success was the primary safety endpoint at the time of patient exit from the cardiac catheterization laboratory, which was defined as the delivery and retrieval of the transcatheter delivery system being successful, the deployment of a single valve in the proper position in the mitral annulus, no need for surgery or additional reintervention, and the patient leaving the procedure room alive
Procedure success
Procedure success defiened as adequate performance of the THV with residual MR grade < 2 and mean MV gradient (MVG) < 10 mm Hg.
all-cause mortality
The rate in all-cause mortality will be calculated from 0 month to 12 months.
Rate of New hospitalization for heart failure
Hospitalization for valve-related symptoms or worsening congestive heart failure
Rate of myocardial infarction
Rate of neurological events
All stroke, transient ischemic attack (TIA)
Rate of Structural Valve dysfunction
as assessed by transthoracic echocardiography with residual MR grade > 2 and mean MV gradient (MVG) ≥ 10 mm Hg.
Clinical Benefit Endpoint
Change in New York Heart Association (NYHA) functional classification from baseline

Full Information

First Posted
May 11, 2023
Last Updated
June 28, 2023
Sponsor
Xiamen Cardiovascular Hospital, Xiamen University
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1. Study Identification

Unique Protocol Identification Number
NCT05925335
Brief Title
The China Mviv Registry
Official Title
Evaluation of Clinical Outcomes of Transseptal Transcatheter Mitral Valve-in-Valve Replacement for Degenerated Bioprostheses - The China Mviv Registry
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 11, 2023 (Anticipated)
Primary Completion Date
July 11, 2024 (Anticipated)
Study Completion Date
June 11, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Xiamen Cardiovascular Hospital, Xiamen University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Mitral valve disease is the most common structure heart disease, and surgical valve replacement is an important treatment for severe mitral valve disease. There are 2 types of valve often been used, mechanical or biological protheses valves. Mechanical valve requires lifelong use of anticoagulants and take the risk of bleeding through all lifetime, but bioprotheses valve do not..
Detailed Description
Due to a massive shift from mechanical to bioprosthetic valves with finite longevity, increasing numbers of patients are presenting with bioprosthetic mitral valve degeneration. Mitral valve reoperation, the standard therapy for the bioprosthetic failure in the past, often entails high risk due to age, multiple comorbidities et al. TMVR is an emerging treatment for the patients with bioprosthetic failure at high risk for conventional mitral valve surgery. Recent studies from US and Europe have demonstrated the safety and efficacy of TMVR in this population. However, there are limited data regarding clinical outcomes after TMVR from Asia-Pacific region. To evaluate the safety and efficacy of TMVR using balloon-expandable valve among those patients with high risk for redo surgery and those who refuse redo surgery after shared decision making even they have less than high risk.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Bioprosthesis Failure, Mitral Stenosis With Insufficiency, Mitral Stenosis, Mitral Regurgitation, Heart Failure

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Transcatheter mitral valve-in-valve implantation
Arm Type
Experimental
Intervention Type
Device
Intervention Name(s)
Transseptal Transcatheter Mitral valve-in-valve Replacement
Intervention Description
Transcatheter transfemoral mitral valve-in-valve replacement is an alternative surgery in patients with severe dysfunction of a degenerated mitral bioprosthesis and high surgical risk for repeat operation. The procedure is performed via femoral vein access. All procedures were carried out using intra-procedural TEE guidance to aid in transseptal puncture. After balloon septostomy, the bioprosthetic valve is introduced through the degenerative valve into the left ventricle and expanded in the mitral position during rapid ventricle pacing.
Primary Outcome Measure Information:
Title
all-cause mortality
Description
The rate in all-cause mortality will be calculated from 0 month to 12 months.
Time Frame
12 months
Title
Rate of New hospitalization for heart failure
Description
Hospitalization for valve-related symptoms or worsening congestive heart failure
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Technical success
Description
Technical success was the primary safety endpoint at the time of patient exit from the cardiac catheterization laboratory, which was defined as the delivery and retrieval of the transcatheter delivery system being successful, the deployment of a single valve in the proper position in the mitral annulus, no need for surgery or additional reintervention, and the patient leaving the procedure room alive
Time Frame
24 hours
Title
Procedure success
Description
Procedure success defiened as adequate performance of the THV with residual MR grade < 2 and mean MV gradient (MVG) < 10 mm Hg.
Time Frame
12 months
Title
all-cause mortality
Description
The rate in all-cause mortality will be calculated from 0 month to 12 months.
Time Frame
annual for five years
Title
Rate of New hospitalization for heart failure
Description
Hospitalization for valve-related symptoms or worsening congestive heart failure
Time Frame
annual for five years
Title
Rate of myocardial infarction
Time Frame
annual for five years
Title
Rate of neurological events
Description
All stroke, transient ischemic attack (TIA)
Time Frame
annual for five years
Title
Rate of Structural Valve dysfunction
Description
as assessed by transthoracic echocardiography with residual MR grade > 2 and mean MV gradient (MVG) ≥ 10 mm Hg.
Time Frame
annual for five years
Title
Clinical Benefit Endpoint
Description
Change in New York Heart Association (NYHA) functional classification from baseline
Time Frame
30 days, 6 months, 12 months, annual for five years]

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject had a degenerated surgical mitral bioprosthesis with at least moderate to severe mitral regurgitation or severe stenosis with echocardiographically derived mitral valve area (MVA) of ≤1.5 cm2 Subjiect is symptomatic from mitral valve disease, as demonstrated by reported NYHA Functional Class II or greater. Subject is at least 18 years old. Heart team (including cardiac surgeon) agree on eligibility including assessment that transeptal, transcatheter mitral valve replacement (TsMVR) and redo surgical mitral valve replacement (rSMVR) are appropriate. The study patient or the study patient's legal representative informed of the nature of the study, agreed to its provisions and provided written informed consent as approved by the Institutional Review Board (IRB) center. The study Subject agreed to comply with all required post-procedure follow-up visits including annual visits through 5 years and analysis close date visits, which was conducted as a phone/clinic follow-up. Exclusion Criteria: Subject was operable with the assessment of experienced Heart Team Subject had evidence of an acute MI, percutaneous intervention, or a peripheral intervention ≤30 days prior to Portico ViV index procedure. Subject had uncontrolled blood dyscrasias defined as: leukopenia (WBC<3,000 mm3), acute anemia (Hb <9 g/dL), or thrombocytopenia (platelet count <50,000 cells/mm³). Subject was considered hemodynamically unstable at the time of the ViV procedure (requiring inotropic support or mechanical heart assistance) Subject had severe ventricular dysfunction with left ventricular ejection fraction (LVEF) <20% as measured by resting echocardiogram. Subject had imaging evidence of intracardiac mass, thrombus or vegetation. Subject had an active peptic ulcer or has/had upper gastrointestinal (GI) bleeding ≤3 months prior to ViV index procedure. Subject had a documented history of a cerebrovascular accident (CVA) or a transient ischemic attack (TIA) ≤6 months prior to index procedure. Subject had active bacterial endocarditis or ongoing sepsis ≤ 6 months prior to the index procedure. Subject was unable to tolerate antiplatelet or anticoagulant therapy
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xiang Chen, Dr
Phone
18033997788
Email
Seanchenx@126.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yan Wang, Dr
Email
wy@medmail.com.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yan Wang, Dr
Organizational Affiliation
Clinical Trial Center of Xiamen Cardiovascular Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Yan Wang
City
Xiamen
State/Province
Fujian
ZIP/Postal Code
361000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yan Wang, dr
Email
wy@medmail.com.cn

12. IPD Sharing Statement

Learn more about this trial

The China Mviv Registry

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