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Early Feasibility Study for the Foldax Tria Aortic Heart Valve

Primary Purpose

Aortic Valve Disease, Aortic Valve Stenosis

Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Foldax Tria Aortic Valve
Sponsored by
Foldax, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Aortic Valve Disease

Eligibility Criteria

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

Inclusion Criteria:

  1. Is 18 years or older
  2. Provide written informed consent prior to trial procedures after standard of care studies and tests indicate that the patient needs aortic valve replacement
  3. Agrees to attend all follow-up assessments for up to 5 years and is willing to comply with specified follow-up evaluations for the FOLDAX Clinical trial
  4. Diagnosed with symptomatic aortic valve disease (stenosis and/or regurgitation) where aortic valve replacement is recommended based on pre-operative evaluations

Exclusion Criteria:

  1. Requires multiple valve replacement / repair
  2. Requires emergency surgery
  3. Has had prior valve surgery
  4. Requires a surgical procedure outside of the cardiac area
  5. Requires a cardiac procedure other than a CABG or root enlargement
  6. Requires or are planning another unrelated surgery within 12 months of undergoing implantation of the study device
  7. Has active endocarditis/myocarditis or within 3 months to the scheduled surgery
  8. Has renal insufficiency as determined by creatinine (S-Cr) level as ≥ 1.5 mg/dl or endstage renal disease requiring chronic dialysis at screening visit
  9. Has MRI or CT scan confirmed stroke, cerebrovascular accident (CVA) or transient ischemic attack (TIA) within 3 months (90 days) prior to planned valve surgery
  10. Has acute myocardial infarction (Ml) within 30 days prior to planned valve surgery
  11. Has life expectancy to less than 12 months
  12. Diagnosed with hypertrophic obstructive cardiomyopathy (HOCM), except patients who have isolated subaortic muscular hypertrophy diagnosed at the time of surgery
  13. Diagnosed with abnormal calcium metabolism and/or hyperparathyroidism
  14. Echocardiographic left ventricular ejection fraction <25%
  15. Echocardiographic evidence of an intra-cardiac thrombus or vegetation
  16. Hemodynamic or respiratory instability requiring inotropic support, mechanical circulatory support, or mechanical ventilation within 30 days prior to planned valve surgery
  17. Documented leukopenia (WBC < 4.0 x 103/µL), acute anemia (Hgb < 10.0 gm/dl or 6 mmol/L), thrombocytopenia (platelet count < 100 x103/µL) or history of bleeding diathesis or coagulopathy
  18. Has prior organ transplant or is currently an organ transplant candidate
  19. Current or recent participation (within 6 weeks prior to surgery) in another drug or device trial
  20. Pregnant, lactating or planning to become pregnant during the duration of participation in trial
  21. Currently incarcerated or unable to give voluntary informed consent
  22. Documented history of substance (drug or alcohol) abuse within the last 5 years prior to implant
  23. Requires concomitant left ventricular assist device (LVAD) placement, Impella placement, and/or intra-aortic balloon pump
  24. Tests positive for an active infection with SARS-CoV-2 (COVID-19)

Sites / Locations

  • St. Vincent Hospital
  • Ascension Via Christi St. Francis Hospital
  • William Beaumont Hospital
  • The Christ Hospital
  • OhioHealth Riverside

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Tria Aortic Valve

Arm Description

Patients receiving the Foldax Tria Aortic Valve

Outcomes

Primary Outcome Measures

Primary Safety Endpoints: Objective Performance Criteria for Flexible Heart Valve Events Assessments
The adverse events consistent with the Objective Performance Criteria (OPC), for flexible heart valves will be compared to those rates defined as acceptable levels in the standard. a. Thromboembolism b. Valve Thrombosis c. Major Paravalvular leak d. Major Hemorrhage e. Endocarditis
Primary Safety Endpoints: Surgical Valve Events Rate Assessment
The rates of other events will be compared to clinical outcomes for surgically implanted heart valves reported in the literature. a. All-caused death b. Valve related death c. Valve-related reoperation d. Valve explant e. Hemorrhage f. All-cause reoperation g. Valve-related death
Primary Effectiveness Endpoint: Hemodynamic Performance Assessment
Hemodynamic performance parameters are mmHG mean gradient and derived Effective Orifice Area (EOA). Success is defined as clinically significant improvement in hemodynamic performance (Effective Orifice Area (EOA)) at one year based on literature reports for surgical aortic valve replacement.
Primary Effectiveness Endpoint: New York Heart Association Improvement Assessment
Clinically significant improvement (one grade) in the New York Heart Association (NYHA) functional classification status at 365 days compared to baseline. a. Class I - No symptoms and no limitations in ordinary physical activity, e.g. shortness of breath when walking, climbing stairs etc. b. Class II - Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity. c. Class III - Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20-100m). Comfortable only at rest. d. Class IV - Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients.

Secondary Outcome Measures

Secondary Endpoints: Stroke
Assessment of patient experiencing a stroke verified by imaging and or physical exam
Secondary Endpoint: Transient Ischemic Attack
Assessment of patient having a TIA verified by imaging and or physical exam
Secondary Endpoint: ICU Duration of Stay
Length of stay in the ICU post valve implantation defined as arrival time/date in hours and minutes to transfer to floor time/date in hours and minutes.
Secondary Endpoint: Ventilation Time
Ventilation time in hours defined as arrival time/date in recovery in hours and minutes to date and time extubated in hours and minutes
Secondary Endpoint: New Onset Atrial Fibrillation
New/post-operative atrial fibrillation - confirmed on ECG after closure during initial or subsequent admission or at one-year review
Secondary Endpoint: Length of Stay in Hospital
Post procedure length of stay defined as the date and time in hours and minutes documented for arrival in the recovery unit to date and time in hours and minutes of discharge in hours and minutes.
Secondary Endpoint: Readmission
Patient readmission to the hospital post discharge measured by date/time
Secondary Endpoint: Hemolysis screen
Hemolysis screen is measured by blood tests including hemoglobin and liver enzyme assessments
Secondary Endpoint: Change in Quality of Life (QOL)
Change in QOL as measured by the Kansas City Cardiomyopathy Questionnaire

Full Information

First Posted
February 14, 2019
Last Updated
September 11, 2023
Sponsor
Foldax, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT03851068
Brief Title
Early Feasibility Study for the Foldax Tria Aortic Heart Valve
Official Title
Early Feasibility Study for the Foldax Tria Aortic Heart Valve
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
June 18, 2019 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Foldax, Inc

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to conduct the initial clinical investigation of the Foldax Polymer Aortic Valve to collect evidence on the device's safety and performance. The study is anticipated to confirm successful clinical safety and clinical effectiveness with significant improvements in clinical hemodynamic performance.
Detailed Description
The Foldax Polymer Aortic Valve is indicated as a replacement for a diseased, damaged, or malfunctioning native aortic heart valve via open heart surgery. This is a first in human study conducted under US FDA's Early Feasibility Investigational Device Exemption and will enroll up to 40 patients. These patients will be followed up to 5 years after implantation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Aortic Valve Disease, Aortic Valve Stenosis

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Tria Aortic Valve
Arm Type
Experimental
Arm Description
Patients receiving the Foldax Tria Aortic Valve
Intervention Type
Device
Intervention Name(s)
Foldax Tria Aortic Valve
Intervention Description
Aortic Valve Replacement
Primary Outcome Measure Information:
Title
Primary Safety Endpoints: Objective Performance Criteria for Flexible Heart Valve Events Assessments
Description
The adverse events consistent with the Objective Performance Criteria (OPC), for flexible heart valves will be compared to those rates defined as acceptable levels in the standard. a. Thromboembolism b. Valve Thrombosis c. Major Paravalvular leak d. Major Hemorrhage e. Endocarditis
Time Frame
12 months following patient enrollment completion
Title
Primary Safety Endpoints: Surgical Valve Events Rate Assessment
Description
The rates of other events will be compared to clinical outcomes for surgically implanted heart valves reported in the literature. a. All-caused death b. Valve related death c. Valve-related reoperation d. Valve explant e. Hemorrhage f. All-cause reoperation g. Valve-related death
Time Frame
12 months following patient enrollment completion
Title
Primary Effectiveness Endpoint: Hemodynamic Performance Assessment
Description
Hemodynamic performance parameters are mmHG mean gradient and derived Effective Orifice Area (EOA). Success is defined as clinically significant improvement in hemodynamic performance (Effective Orifice Area (EOA)) at one year based on literature reports for surgical aortic valve replacement.
Time Frame
12 months following patient enrollment completion
Title
Primary Effectiveness Endpoint: New York Heart Association Improvement Assessment
Description
Clinically significant improvement (one grade) in the New York Heart Association (NYHA) functional classification status at 365 days compared to baseline. a. Class I - No symptoms and no limitations in ordinary physical activity, e.g. shortness of breath when walking, climbing stairs etc. b. Class II - Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity. c. Class III - Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20-100m). Comfortable only at rest. d. Class IV - Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients.
Time Frame
12 months following patient enrollment completion
Secondary Outcome Measure Information:
Title
Secondary Endpoints: Stroke
Description
Assessment of patient experiencing a stroke verified by imaging and or physical exam
Time Frame
5 years following patient enrollment
Title
Secondary Endpoint: Transient Ischemic Attack
Description
Assessment of patient having a TIA verified by imaging and or physical exam
Time Frame
5 Years following patient enrollment
Title
Secondary Endpoint: ICU Duration of Stay
Description
Length of stay in the ICU post valve implantation defined as arrival time/date in hours and minutes to transfer to floor time/date in hours and minutes.
Time Frame
30 days post procedure
Title
Secondary Endpoint: Ventilation Time
Description
Ventilation time in hours defined as arrival time/date in recovery in hours and minutes to date and time extubated in hours and minutes
Time Frame
30 Days post procedure
Title
Secondary Endpoint: New Onset Atrial Fibrillation
Description
New/post-operative atrial fibrillation - confirmed on ECG after closure during initial or subsequent admission or at one-year review
Time Frame
12 Months post procedure
Title
Secondary Endpoint: Length of Stay in Hospital
Description
Post procedure length of stay defined as the date and time in hours and minutes documented for arrival in the recovery unit to date and time in hours and minutes of discharge in hours and minutes.
Time Frame
30 days post procedure
Title
Secondary Endpoint: Readmission
Description
Patient readmission to the hospital post discharge measured by date/time
Time Frame
30 days post discharge
Title
Secondary Endpoint: Hemolysis screen
Description
Hemolysis screen is measured by blood tests including hemoglobin and liver enzyme assessments
Time Frame
12 months post procedure
Title
Secondary Endpoint: Change in Quality of Life (QOL)
Description
Change in QOL as measured by the Kansas City Cardiomyopathy Questionnaire
Time Frame
12 months post procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Is 18 years or older Provide written informed consent prior to trial procedures after standard of care studies and tests indicate that the patient needs aortic valve replacement Agrees to attend all follow-up assessments for up to 5 years and is willing to comply with specified follow-up evaluations for the FOLDAX Clinical trial Diagnosed with symptomatic aortic valve disease (stenosis and/or regurgitation) where aortic valve replacement is recommended based on pre-operative evaluations Exclusion Criteria: Requires multiple valve replacement / repair Requires emergency surgery Has had prior valve surgery Requires a surgical procedure outside of the cardiac area Requires a cardiac procedure other than a CABG or root enlargement Requires or are planning another unrelated surgery within 12 months of undergoing implantation of the study device Has active endocarditis/myocarditis or within 3 months to the scheduled surgery Has renal insufficiency as determined by creatinine (S-Cr) level as ≥ 1.5 mg/dl or endstage renal disease requiring chronic dialysis at screening visit Has MRI or CT scan confirmed stroke, cerebrovascular accident (CVA) or transient ischemic attack (TIA) within 3 months (90 days) prior to planned valve surgery Has acute myocardial infarction (Ml) within 30 days prior to planned valve surgery Has life expectancy to less than 12 months Diagnosed with hypertrophic obstructive cardiomyopathy (HOCM), except patients who have isolated subaortic muscular hypertrophy diagnosed at the time of surgery Diagnosed with abnormal calcium metabolism and/or hyperparathyroidism Echocardiographic left ventricular ejection fraction <25% Echocardiographic evidence of an intra-cardiac thrombus or vegetation Hemodynamic or respiratory instability requiring inotropic support, mechanical circulatory support, or mechanical ventilation within 30 days prior to planned valve surgery Documented leukopenia (WBC < 4.0 x 103/µL), acute anemia (Hgb < 10.0 gm/dl or 6 mmol/L), thrombocytopenia (platelet count < 100 x103/µL) or history of bleeding diathesis or coagulopathy Has prior organ transplant or is currently an organ transplant candidate Current or recent participation (within 6 weeks prior to surgery) in another drug or device trial Pregnant, lactating or planning to become pregnant during the duration of participation in trial Currently incarcerated or unable to give voluntary informed consent Documented history of substance (drug or alcohol) abuse within the last 5 years prior to implant Requires concomitant left ventricular assist device (LVAD) placement, Impella placement, and/or intra-aortic balloon pump Tests positive for an active infection with SARS-CoV-2 (COVID-19)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Frank Shannon, MD
Organizational Affiliation
Beaumont Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
St. Vincent Hospital
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46290
Country
United States
Facility Name
Ascension Via Christi St. Francis Hospital
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67214
Country
United States
Facility Name
William Beaumont Hospital
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48073
Country
United States
Facility Name
The Christ Hospital
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
84219
Country
United States
Facility Name
OhioHealth Riverside
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43214
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Early Feasibility Study for the Foldax Tria Aortic Heart Valve

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