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A Study to Evaluate the Safety and Performance of LuX-Valve Plus System for Tricuspid Replacement

Primary Purpose

Tricuspid Regurgitation

Status
Recruiting
Phase
Not Applicable
Locations
France
Study Type
Interventional
Intervention
Transcatheter Tricuspid Valve Intervention
Sponsored by
Jenscare Scientific
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Tricuspid Regurgitation

Eligibility Criteria

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

Inclusion Criteria:

  1. Age≥50 years at time of consent
  2. Severe or greater TR (≥3+) assessed on transthoracic echocardiography by Echo Core Lab (ECL) using a 5-grade classification
  3. New York Heart Association (NYHA) Class III or IV
  4. In the judgment of the Site Heart Team, the subject has been adequately treated per applicable standards, including optimal medical therapy with diuretics
  5. The Site Heart Team determined that the subject is appropriate for transcatheter tricuspid valve replacement, and the subject is at high risk for tricuspid valve surgery
  6. Subject must provide written informed consent prior to any trial related procedure

Exclusion Criteria:

  1. Systolic pulmonary artery pressure (sPAP) > 60 mmHg assessed by echocardiography
  2. Left Ventricular Ejection Fraction (LVEF) <40%
  3. Evidence of intracardiac mass, thrombus or vegetation
  4. Anatomical structures precluding proper device deployment or device vascular access, evaluated by echo or CT
  5. Ebstein Anomaly or congenital right ventricular dysplasia
  6. Surgical correction is indicated for other concomitant valvular disease (e.g., severe aortic, mitral and/or pulmonic valve stenosis and/or regurgitation) Subjects with concomitant valvular disease may treat their respective valve first, and wait 2 months before being reassessed for the trial.
  7. Pre-existing prosthetic valve(s) with clinically significant prosthetic dysfunction
  8. Sepsis or active endocarditis within 3 months, or infections requiring antibiotic therapy within 2 weeks prior to the planned procedure
  9. Untreated clinically significant coronary artery disease requiring revascularization
  10. Acute myocardial infarction or unstable ischemia-related angina within prior 30 days
  11. Any percutaneous coronary, intracardiac or carotid intervention within 30 days
  12. Cerebrovascular stroke (ischemic or bleeding) within prior 3 months to enrollment
  13. Active peptic ulcer or active gastrointestinal (GI) bleeding within prior 3 months to enrollment
  14. Inability to tolerate anticoagulation or antiplatelet therapy
  15. Cardiogenic shock manifested by low cardiac output, vasopressor dependence, or mechanical hemodynamic support
  16. Renal insufficiency (eGFR < 30 ml/min per the Cockcroft-Gault formula) and/or renal replacement therapy at the time of screening
  17. Chronic liver failure or cirrhosis with MELD-Albumin Score ≥ 12
  18. Severe lung disease or patient dependent on home oxygen and deemed unsuitable by the local heart team or eligibility committee for the study.
  19. Futility with estimated life expectancy<12 months.
  20. Subjects currently participating in another clinical trial of an investigational drug or device that has not yet completed its primary endpoint.

Sites / Locations

  • Unité Médico-Chirurgicale, Hôpital Haut Lévêque, CHU de BordeauxRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

LuX-Valve Plus transvenous tricuspid valve and delivery system(LuX-Valve Plus System)

Arm Description

The LuX-Valve Plus System is intended for the treatment of patients with severe TR who are determined by a Heart Team to be at high risk of traditional open-heart surgery.

Outcomes

Primary Outcome Measures

A composite endpoint of Major Adverse Event (MAE) at 30 days post procedure
A composite endpoint of Major Adverse Event (MAE) at 30 days post procedure, as listed below: Cardiovascular Mortality Myocardial Infarction (MI) Stroke New onset renal failure requiring unplanned dialysis or renal replacement therapy Severe Bleeding (includes fatal, life-threatening and extensive bleeding as defined by MVARC) Non-selective tricuspid valve surgery or transcatheter re-intervention post procedure Major cardiac structural complications Major access site and vascular complications New pacemaker implantation due to AV block

Secondary Outcome Measures

Acute Secondary Endpoints-Device Success Rate
Device success is defined as successful deployment of the device and removal of the delivery system as planned, with no unplanned surgery related to the device or access procedure.
Acute Secondary Endpoints-Procedural Success Rate
Device success without clinically significant PVL, as determined by the Echo Core Lab (ECL) assessment of a discharge TTE. Subjects who die or undergo tricuspid valve surgery before discharge are procedure failures.
Acute Secondary Endpoints-Clinical Success Rate at 30 days
Procedural success without MAEs at 30 days.
Clinical and Functional Endpoints-All-cause mortality
All-cause mortality
Clinical and Functional Endpoints-Cardiovascular mortality
Cardiovascular mortality
Clinical and Functional Endpoints-Heart failure hospitalization
Heart failure hospitalization
Clinical and Functional Endpoints-Tricuspid valve surgery or transcatheter re-intervention
Tricuspid valve surgery or transcatheter re-intervention
Clinical and Functional Endpoints-NYHA Functional Class
NYHA Functional Class
Clinical and Functional Endpoints-Distance of 6-Minute Walk Test (6MWT)
Distance of 6-Minute Walk Test (6MWT)
Clinical and Functional Endpoints-Kansas City Cardiomyopathy Questionnaire (KCCQ)
Kansas City Cardiomyopathy Questionnaire (KCCQ):Scores are transformed to a range of 0-100,in which higher scores reflect better health status.
Clinical and Functional Endpoints-Edema assessment
Edema assessment (1+ to 4+)
Echocardiographic Endpoints-TR Severity Grade
TR Severity Grade
Echocardiographic Endpoints-Vena Contracta Width
Vena Contracta Width
Echocardiographic Endpoints-Regurgitation Jet Area
Regurgitation Jet Area
Echocardiographic Endpoints-Effective Regurgitant Orifice Area (EROA)
Effective Regurgitant Orifice Area (EROA)
Echocardiographic Endpoints-Regurgitant Volume
Regurgitant Volume
Echocardiographic Endpoints-Mean Tricuspid valve inflow gradient
Mean Tricuspid valve inflow gradient
Echocardiographic Endpoints-Right Atrial Volume
Right Atrial Volume
Echocardiographic Endpoints-Right ventricular functions assessments:TAPSE
Right ventricular functions assessments:TAPSE
Echocardiographic Endpoints-Right ventricular functions assessments:fractional area change(FAC)
Right ventricular functions assessments:fractional area change(FAC)
Echocardiographic Endpoints-Right ventricular functions assessments:systolic tricuspid lateral annular tissue velocity S'
Right ventricular functions assessments:systolic tricuspid lateral annular tissue velocity S'
Echocardiographic Endpoints-Right ventricular functions assessments:Hepatic vein flow reversal
Right ventricular functions assessments:Hepatic vein flow reversal
Echocardiographic Endpoints-Right ventricular functions assessments:Inferior Cava Vein Diameter/respiratory variations
Right ventricular functions assessments:Inferior Cava Vein Diameter/respiratory variations
Echocardiographic Endpoints-Systolic pulmonary artery pressure
Systolic pulmonary artery pressure
Echocardiographic Endpoints-Cardiac Output
Cardiac Output
Echocardiographic Endpoints-Left Ventricular Ejection Fraction (LVEF)
Left Ventricular Ejection Fraction (LVEF)
Echocardiographic Endpoints-Paravalvular leak severity
Paravalvular leak severity

Full Information

First Posted
June 8, 2022
Last Updated
June 20, 2023
Sponsor
Jenscare Scientific
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1. Study Identification

Unique Protocol Identification Number
NCT05436028
Brief Title
A Study to Evaluate the Safety and Performance of LuX-Valve Plus System for Tricuspid Replacement
Official Title
TRIal to Evaluate TraNsvenous TrIcuspid Valve ReplacemenT With LuX-Valve Plus System in Patients With Severe or Greater Tricuspid Regurgitation -- SafetY and Clinical Performance
Study Type
Interventional

2. Study Status

Record Verification Date
June 2022
Overall Recruitment Status
Recruiting
Study Start Date
May 23, 2023 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Jenscare Scientific

4. Oversight

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

5. Study Description

Brief Summary
This is a prospective, single-arm, multi-center trial to evaluate the LuX-Valve Plus system for treating symptomatic severe or greater TR in patients who are deemed high risk for tricuspid surgery. Treatment with the LuX-Valve Plus system may enable patients with tricuspid regurgitation to have a complete tricuspid valve replacement with a minimally invasive approach. A total of 93 subjects will be enrolled at up to 20 institutions worldwide. No single institution will be allowed to register more than 25% of total subjects. There is no minimum number of subjects to be registered at any site. Up to an additional 42 roll-in subjects, up to 3 per site, may be enrolled by operators without prior experience with the LuX-Valve Plus system to gain hands-on experience. The data of roll-in subjects will not count towards the overall enrollment cap. Safety and effectiveness results of roll-in subjects will be reported separately. All subjects will be evaluated at baseline, discharge, 30 days, 6 months, 1 year, 2 years, 3 years, 4 years and 5 years post-procedure

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tricuspid Regurgitation

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
LuX-Valve Plus transvenous tricuspid valve and delivery system(LuX-Valve Plus System)
Arm Type
Experimental
Arm Description
The LuX-Valve Plus System is intended for the treatment of patients with severe TR who are determined by a Heart Team to be at high risk of traditional open-heart surgery.
Intervention Type
Device
Intervention Name(s)
Transcatheter Tricuspid Valve Intervention
Intervention Description
Due to unsustainable effect of medical therapy and high risks of surgical treatment, transcatheter tricuspid valve intervention (TTVI) has been a major field of study in the world in the last 10 years. TTVI could potentially reduce TR with lower periprocedural risk and improve the patient's clinical status and prognosis. Per the ESC guidelines for surgical and interventional treatment of tricuspid regurgitation (2021 ESC/EACTS Guidelines for the Management of Valvular Heart Disease), Transcatheter intervention for symptomatic secondary severe TR may be considered in inoperable patients at a Heart Valve Centre with expertise in the treatment of tricuspid valve disease (Class IIb). 20 Transcatheter tricuspid treatment options can be divided into categories based on their mechanism of action: coaptation enhancement (edge-to-edge repair and spacer device), annuloplasty devices, caval valve implantation and valve replacement.
Primary Outcome Measure Information:
Title
A composite endpoint of Major Adverse Event (MAE) at 30 days post procedure
Description
A composite endpoint of Major Adverse Event (MAE) at 30 days post procedure, as listed below: Cardiovascular Mortality Myocardial Infarction (MI) Stroke New onset renal failure requiring unplanned dialysis or renal replacement therapy Severe Bleeding (includes fatal, life-threatening and extensive bleeding as defined by MVARC) Non-selective tricuspid valve surgery or transcatheter re-intervention post procedure Major cardiac structural complications Major access site and vascular complications New pacemaker implantation due to AV block
Time Frame
30 days post procedure
Secondary Outcome Measure Information:
Title
Acute Secondary Endpoints-Device Success Rate
Description
Device success is defined as successful deployment of the device and removal of the delivery system as planned, with no unplanned surgery related to the device or access procedure.
Time Frame
From the first skin incision for the investigational device to the time patient's exist from OR/Cath lab,assessed up to 24 hours post procedure.
Title
Acute Secondary Endpoints-Procedural Success Rate
Description
Device success without clinically significant PVL, as determined by the Echo Core Lab (ECL) assessment of a discharge TTE. Subjects who die or undergo tricuspid valve surgery before discharge are procedure failures.
Time Frame
7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure
Title
Acute Secondary Endpoints-Clinical Success Rate at 30 days
Description
Procedural success without MAEs at 30 days.
Time Frame
at 30 days
Title
Clinical and Functional Endpoints-All-cause mortality
Description
All-cause mortality
Time Frame
at 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Clinical and Functional Endpoints-Cardiovascular mortality
Description
Cardiovascular mortality
Time Frame
at 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Clinical and Functional Endpoints-Heart failure hospitalization
Description
Heart failure hospitalization
Time Frame
at 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Clinical and Functional Endpoints-Tricuspid valve surgery or transcatheter re-intervention
Description
Tricuspid valve surgery or transcatheter re-intervention
Time Frame
at 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Clinical and Functional Endpoints-NYHA Functional Class
Description
NYHA Functional Class
Time Frame
at 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Clinical and Functional Endpoints-Distance of 6-Minute Walk Test (6MWT)
Description
Distance of 6-Minute Walk Test (6MWT)
Time Frame
at 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Clinical and Functional Endpoints-Kansas City Cardiomyopathy Questionnaire (KCCQ)
Description
Kansas City Cardiomyopathy Questionnaire (KCCQ):Scores are transformed to a range of 0-100,in which higher scores reflect better health status.
Time Frame
at 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Clinical and Functional Endpoints-Edema assessment
Description
Edema assessment (1+ to 4+)
Time Frame
at 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-TR Severity Grade
Description
TR Severity Grade
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Vena Contracta Width
Description
Vena Contracta Width
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Regurgitation Jet Area
Description
Regurgitation Jet Area
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Effective Regurgitant Orifice Area (EROA)
Description
Effective Regurgitant Orifice Area (EROA)
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Regurgitant Volume
Description
Regurgitant Volume
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Mean Tricuspid valve inflow gradient
Description
Mean Tricuspid valve inflow gradient
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Right Atrial Volume
Description
Right Atrial Volume
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Right ventricular functions assessments:TAPSE
Description
Right ventricular functions assessments:TAPSE
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Right ventricular functions assessments:fractional area change(FAC)
Description
Right ventricular functions assessments:fractional area change(FAC)
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Right ventricular functions assessments:systolic tricuspid lateral annular tissue velocity S'
Description
Right ventricular functions assessments:systolic tricuspid lateral annular tissue velocity S'
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Right ventricular functions assessments:Hepatic vein flow reversal
Description
Right ventricular functions assessments:Hepatic vein flow reversal
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Right ventricular functions assessments:Inferior Cava Vein Diameter/respiratory variations
Description
Right ventricular functions assessments:Inferior Cava Vein Diameter/respiratory variations
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Systolic pulmonary artery pressure
Description
Systolic pulmonary artery pressure
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Cardiac Output
Description
Cardiac Output
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Left Ventricular Ejection Fraction (LVEF)
Description
Left Ventricular Ejection Fraction (LVEF)
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure
Title
Echocardiographic Endpoints-Paravalvular leak severity
Description
Paravalvular leak severity
Time Frame
at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age≥50 years at time of consent Severe or greater TR (≥3+) assessed on transthoracic echocardiography by Echo Core Lab (ECL) using a 5-grade classification New York Heart Association (NYHA) Class III or IV In the judgment of the Site Heart Team, the subject has been adequately treated per applicable standards, including optimal medical therapy with diuretics The Site Heart Team determined that the subject is appropriate for transcatheter tricuspid valve replacement, and the subject is at high risk for tricuspid valve surgery Subject must provide written informed consent prior to any trial related procedure Exclusion Criteria: Systolic pulmonary artery pressure (sPAP) > 60 mmHg assessed by echocardiography Left Ventricular Ejection Fraction (LVEF) <40% Evidence of intracardiac mass, thrombus or vegetation Anatomical structures precluding proper device deployment or device vascular access, evaluated by echo or CT Ebstein Anomaly or congenital right ventricular dysplasia Surgical correction is indicated for other concomitant valvular disease (e.g., severe aortic, mitral and/or pulmonic valve stenosis and/or regurgitation) Subjects with concomitant valvular disease may treat their respective valve first, and wait 2 months before being reassessed for the trial. Pre-existing prosthetic valve(s) with clinically significant prosthetic dysfunction Sepsis or active endocarditis within 3 months, or infections requiring antibiotic therapy within 2 weeks prior to the planned procedure Untreated clinically significant coronary artery disease requiring revascularization Acute myocardial infarction or unstable ischemia-related angina within prior 30 days Any percutaneous coronary, intracardiac or carotid intervention within 30 days Cerebrovascular stroke (ischemic or bleeding) within prior 3 months to enrollment Active peptic ulcer or active gastrointestinal (GI) bleeding within prior 3 months to enrollment Inability to tolerate anticoagulation or antiplatelet therapy Cardiogenic shock manifested by low cardiac output, vasopressor dependence, or mechanical hemodynamic support Renal insufficiency (eGFR < 30 ml/min per the Cockcroft-Gault formula) and/or renal replacement therapy at the time of screening Chronic liver failure or cirrhosis with MELD-Albumin Score ≥ 12 Severe lung disease or patient dependent on home oxygen and deemed unsuitable by the local heart team or eligibility committee for the study. Futility with estimated life expectancy<12 months. Subjects currently participating in another clinical trial of an investigational drug or device that has not yet completed its primary endpoint.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lei Xia
Phone
+8618514254641
Email
xialei@jenscare.com
First Name & Middle Initial & Last Name or Official Title & Degree
Xing Li
Phone
+8615720625797
Email
lixing@jenscare.com
Facility Information:
Facility Name
Unité Médico-Chirurgicale, Hôpital Haut Lévêque, CHU de Bordeaux
City
Bordeaux
State/Province
Gironde
ZIP/Postal Code
33000
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
PASCUAL Zoé
Phone
05 24 54 93 70 (49370)
Email
zoe.pascual@chu-bordeaux.fr
First Name & Middle Initial & Last Name & Degree
Thomas Modine

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study to Evaluate the Safety and Performance of LuX-Valve Plus System for Tricuspid Replacement

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