EDWARDS INTUITY Valve System CADENCE Study (CADENCE)
Primary Purpose
Aortic Valve Disease, Aortic Stenosis
Status
Completed
Phase
Not Applicable
Locations
France
Study Type
Interventional
Intervention
EDWARDS INTUITY
Stented aortic bioprostheses
Sponsored by
About this trial
This is an interventional treatment trial for Aortic Valve Disease focused on measuring Aortic Valve Replacement, Aortic Stenosis, EDWARDS INTUITY
Eligibility Criteria
Inclusion:
- ≥18 years of age
- aortic stenosis / mixed aortic stenosis and aortic insufficiency
- SAVR+CABG (1-4 distal anastomoses)
- Log. EuroSCORE ≥6
- NYHA Class ≥II
Exclusion (i.a.):
- pure aortic insufficiency
- pre-existing prosthetic heart valve or ring
- congenital true bicuspid / unicuspid aortic valve
- LVEF <20%
Sites / Locations
- CHU Bordeaux, Hôpital Haut-Lévêque
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
EDWARDS INTUITY
Stented aortic bioprostheses
Arm Description
EDWARDS INTUITY Valve System, Model 8300A
Stented aortic bioprostheses
Outcomes
Primary Outcome Measures
Average Subject Time Spent on Cardiopulmonary Cross Clamp
Cardiopulmonary cross clamp time is the amount of time that the patient's aorta (blood vessel) is clamped by a surgical instrument used in cardiac surgery. This allows the normal blood flow to be sent to an artificial heart and lung machine to keep it at a constant temperature and oxygen level.
Average Amount of Time Subject Spent on Cardiopulmonary Bypass
Cardiopulmonary bypass time is the amount of time that the patient's blood circulates through an artificial heart and lung machine during cardiac surgery.
Secondary Outcome Measures
Number of Participants With Change From Baseline in New York Heart Association (NYHA) Class at 2 Years.
The New York Heart Association (NYHA) functional classification system relates symptoms to everyday activities and the patient's quality of life. Class I. Patients with cardiac disease but without resulting limitation of physical activity.
Class II. Patients with cardiac disease resulting in slight limitation of physical activity. They are comfortable at rest.
Class III. Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest.
Class IV. Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort.
Symptoms of heart failure or the anginal syndrome may be present even at rest.
Subject's Average Mean Gradients (mmHg) Measurements Over Time.
Mean gradient is the average flow of blood through the aortic valve measured in millimeters of mercury. Gradients are evaluated by echocardiography over time. Mean gradient values depend on the size and type of valve.
Subject's Average Peak Gradients (mmHg) Measurements Over Time.
Peak gradient is the maximum value measured of flow of blood through the aortic valve as measured in millimeters of mercury. Gradients are evaluated by echocardiography over time.
Subject's Effective Orifice Area (EOA) Measurement Over Time.
Effective orifice area represents the cross-sectional area of the blood flow downstream of the aortic valve. Effective orifice area is evaluated by echocardiography over time.
Subject's Effective Orifice Area Index (EOAI) Measurement Over Time.
Effective orifice area index represents the minimal cross-sectional area of the blood flow downstream of the aortic valve divided by the person's body surface area. Effective orifice area index is evaluated by echocardiography over time.
Amount of Aortic Valvular Regurgitation Over Time.
Aortic valvular regurgitation occurs when the aortic valve in the heart does not close tightly allowing some of the blood that was pumped out of the heart to leak back into it. Aortic valvular regurgitation is evaluated by echocardiography over time. It is assessed on a scale from 0 to 4, where 0 represents no regurgitation and 4 represents severe regurgitation.
Conversion of Edwards INTUITY Surgical Aortic Valve to Control During Surgery.
Subjects randomized to the Edwards INTUITY group that were converted to the control group and received commercially available surgical aortic heart valves during surgery.
Subjects Who Required a Thoracic Resternotomy Over Time
Number of Subjects who had a surgical opening of their chest after their initial aortic heart valve surgery shown over various time points.
Subjects Who Received a Permanent Pacemaker Over Time.
Number of Subjects who received a Permanent Pacemaker shown over various time points.
Subjects With a Major Paravalvular Leak (OPC) Over Time
Number of subjects who experienced a Major Paravalvular Leak (OPC) shown over various time points.
Paravalvular leak refers to blood flowing through a channel between the implanted artificial valve and the cardiac tissue as a result of inappropriate sealing.
Paravalvular leak is evaluated by echocardiography over time. It is assessed on a scale from 0 to 4, where 0 = no leak, 1 = a trace leak, 2 = a mild leak, 3 = a moderate leak, and 4 = a severe leak. A major paravalvular leak (OPC)are any events of leak that required surgical intervention or were considered an serious adverse event.
Subjects Who Experienced Major Bleeding Over Time.
Number of subjects who experienced Major Bleeding shown over various time points.
Subjects Who Experienced Respiratory Failure Over Time
Number of subjects who experienced a Respiratory Failure shown over various time points. Respiratory failure happens when not enough oxygen passes from your lungs to your blood.
Subjects With a Cerebral Vascular Accident or Permanent Stroke Over Time
Number of subjects who experienced a Cerebral Vascular Accident or Permanent Stroke shown over various time points.
Subjects With Renal Failure Over Time
Number of subjects who experienced Renal (kidney) Failure shown over various time points.
Subjects With Endocarditis Over Time
Number of subjects who experienced Endocarditis shown over various time points. Endocarditis is an infection of the endocardium, which is the inner lining of your heart chambers and heart valves.
Subjects With a Deep Sternal Would Infection Over Time
Number of subjects who experienced a Deep Sternal Wound Infection shown over various time points.
Subjects With a Myocardial Infarction Over Time
Number of subjects who experienced a Myocardial Infarction shown over various time points. A Myocardial infarction, commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle.
Subjects With a Thromboembolism Over Time
Number of subjects who experienced a Thromboembolism shown over various time points. A thromboembolism is an obstruction of a blood vessel by a blood clot that has become dislodged from another site in the circulation.
Subjects With a Cardiac Tamponade Over Time
Number of subjects who experienced a Cardiac Tamponade shown over various time points. Cardiac tamponade is when fluid in the pericardium (the sac around the heart) builds up and results in compression (squeezing) of the heart.
Subjects With a Cardiac Reoperation for Any Reason Over Time
Number of subjects who experienced a Cardiac reoperation for any reason shown over various time points.
Subjects Who Died Intraoperatively
Number of subjects who died during surgery.
Subject's Average Score on the EQ-5D- Quality of Life Questionnaire Over Time
The EQ-5D is a standardized questionnaire that asks subjects to rate themselves (no problems, some problems, extreme problems) on mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The scale is indexed and ranges from a minimum of 0.275 and a maximum of 1.000. A lower number indicates the participants experiences more problems and a higher number indicates the participants experiences fewer problems.
Subject's Average Score SF-12 - Quality of Life Questionnaire Over Time
The Medical Outcomes Study Short-Form 12 (SF-12) - Physical Component Summary (PCS) and Mental Component Summary (MCS).
The SF-12 questionnaire scale ranges from 100, which reflects the best health status to 0, which reflects the worse health status.
Subject's Average Score at Baseline and at each follow-up interval until 2 year - SF-12.
Subject's Average Score on the KCCQ - Quality of Life Questionnaire Over Time
The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a 23-item, self-administered instrument that quantifies physical function, symptoms (frequency, severity and recent change), social function, self-efficacy and knowledge, and quality of life. Scores range from 0-100, in which higher scores reflect better health status. Subjects took this questionnaire at baseline, 30 days, 3 Months, 6 Months, 1 Year, and 2 Years.
Health Care Utilization
The average amount of time the subjects spent in the intensive care unit, the intermediate care length of stay, and the average total length of hospital stay after their heart valve replacement procedure.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02688153
Brief Title
EDWARDS INTUITY Valve System CADENCE Study
Acronym
CADENCE
Official Title
A Randomized Comparison of the EDWARDS INTUITY Valve System anD commErcially Available Aortic Bioprostheses in Subjects uNdergoing surgiCal Aortic Valve replacEment
Study Type
Interventional
2. Study Status
Record Verification Date
May 2018
Overall Recruitment Status
Completed
Study Start Date
October 2012 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
April 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Edwards Lifesciences
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 study purpose is to compare the EDWARDS INTUITY valve system with commercially available stented aortic bioprostheses, in patients requiring aortic valve replacement surgery with coronary artery bypass.
Detailed Description
This is a randomized study comparing the cross-clamp time (XCT) and cardiopulmonary bypass time (CPBT) of the EDWARDS INTUITY valve system with any commercially available stented aortic bioprosthesis, in patients with logistic EuroSCORE 1 ≥ 6 undergoing elective surgical aortic valve replacement surgery with concomitant coronary bypass grafts.
Additionally, the aim is to gather sufficient data to quantify the effect size of short term patient benefit outcomes previously identified from literature and finally to explore additional healthcare resource utilization or health economic endpoints.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Aortic Valve Disease, Aortic Stenosis
Keywords
Aortic Valve Replacement, Aortic Stenosis, EDWARDS INTUITY
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
120 (Actual)
8. Arms, Groups, and Interventions
Arm Title
EDWARDS INTUITY
Arm Type
Active Comparator
Arm Description
EDWARDS INTUITY Valve System, Model 8300A
Arm Title
Stented aortic bioprostheses
Arm Type
Active Comparator
Arm Description
Stented aortic bioprostheses
Intervention Type
Device
Intervention Name(s)
EDWARDS INTUITY
Other Intervention Name(s)
aortic stenosis, stenosis-based insufficiency, aortic valve replacement
Intervention Description
To evaluate cardiac performance characteristics and adverse events rates associated with the EDWARDS INTUITY Valve in patients undergoing AVR & CABG.
Intervention Type
Device
Intervention Name(s)
Stented aortic bioprostheses
Other Intervention Name(s)
aortic stenosis, stenosis-based insufficiency, aortic valve replacement
Intervention Description
In comparison to control valves available on the market.
Primary Outcome Measure Information:
Title
Average Subject Time Spent on Cardiopulmonary Cross Clamp
Description
Cardiopulmonary cross clamp time is the amount of time that the patient's aorta (blood vessel) is clamped by a surgical instrument used in cardiac surgery. This allows the normal blood flow to be sent to an artificial heart and lung machine to keep it at a constant temperature and oxygen level.
Time Frame
At time of surgery, an average of 1.5 hours
Title
Average Amount of Time Subject Spent on Cardiopulmonary Bypass
Description
Cardiopulmonary bypass time is the amount of time that the patient's blood circulates through an artificial heart and lung machine during cardiac surgery.
Time Frame
At time of surgery, an average of 2 hours
Secondary Outcome Measure Information:
Title
Number of Participants With Change From Baseline in New York Heart Association (NYHA) Class at 2 Years.
Description
The New York Heart Association (NYHA) functional classification system relates symptoms to everyday activities and the patient's quality of life. Class I. Patients with cardiac disease but without resulting limitation of physical activity.
Class II. Patients with cardiac disease resulting in slight limitation of physical activity. They are comfortable at rest.
Class III. Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest.
Class IV. Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort.
Symptoms of heart failure or the anginal syndrome may be present even at rest.
Time Frame
Baseline and 2 Years
Title
Subject's Average Mean Gradients (mmHg) Measurements Over Time.
Description
Mean gradient is the average flow of blood through the aortic valve measured in millimeters of mercury. Gradients are evaluated by echocardiography over time. Mean gradient values depend on the size and type of valve.
Time Frame
30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subject's Average Peak Gradients (mmHg) Measurements Over Time.
Description
Peak gradient is the maximum value measured of flow of blood through the aortic valve as measured in millimeters of mercury. Gradients are evaluated by echocardiography over time.
Time Frame
30 days, 3 months, 6 months, 1 year, 2 year
Title
Subject's Effective Orifice Area (EOA) Measurement Over Time.
Description
Effective orifice area represents the cross-sectional area of the blood flow downstream of the aortic valve. Effective orifice area is evaluated by echocardiography over time.
Time Frame
30 days, 3 months, 6 months, 1 year, 2 year
Title
Subject's Effective Orifice Area Index (EOAI) Measurement Over Time.
Description
Effective orifice area index represents the minimal cross-sectional area of the blood flow downstream of the aortic valve divided by the person's body surface area. Effective orifice area index is evaluated by echocardiography over time.
Time Frame
30 days, 3 months, 6 months, 1 year, 2 year
Title
Amount of Aortic Valvular Regurgitation Over Time.
Description
Aortic valvular regurgitation occurs when the aortic valve in the heart does not close tightly allowing some of the blood that was pumped out of the heart to leak back into it. Aortic valvular regurgitation is evaluated by echocardiography over time. It is assessed on a scale from 0 to 4, where 0 represents no regurgitation and 4 represents severe regurgitation.
Time Frame
30 days, 3 months, 6 months, 1 year, 2 year
Title
Conversion of Edwards INTUITY Surgical Aortic Valve to Control During Surgery.
Description
Subjects randomized to the Edwards INTUITY group that were converted to the control group and received commercially available surgical aortic heart valves during surgery.
Time Frame
Prior to Surgery
Title
Subjects Who Required a Thoracic Resternotomy Over Time
Description
Number of Subjects who had a surgical opening of their chest after their initial aortic heart valve surgery shown over various time points.
Time Frame
30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subjects Who Received a Permanent Pacemaker Over Time.
Description
Number of Subjects who received a Permanent Pacemaker shown over various time points.
Time Frame
30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subjects With a Major Paravalvular Leak (OPC) Over Time
Description
Number of subjects who experienced a Major Paravalvular Leak (OPC) shown over various time points.
Paravalvular leak refers to blood flowing through a channel between the implanted artificial valve and the cardiac tissue as a result of inappropriate sealing.
Paravalvular leak is evaluated by echocardiography over time. It is assessed on a scale from 0 to 4, where 0 = no leak, 1 = a trace leak, 2 = a mild leak, 3 = a moderate leak, and 4 = a severe leak. A major paravalvular leak (OPC)are any events of leak that required surgical intervention or were considered an serious adverse event.
Time Frame
30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subjects Who Experienced Major Bleeding Over Time.
Description
Number of subjects who experienced Major Bleeding shown over various time points.
Time Frame
30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subjects Who Experienced Respiratory Failure Over Time
Description
Number of subjects who experienced a Respiratory Failure shown over various time points. Respiratory failure happens when not enough oxygen passes from your lungs to your blood.
Time Frame
30 days, 3 Months , 6 Months, 1 Year, 2 Years.
Title
Subjects With a Cerebral Vascular Accident or Permanent Stroke Over Time
Description
Number of subjects who experienced a Cerebral Vascular Accident or Permanent Stroke shown over various time points.
Time Frame
30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subjects With Renal Failure Over Time
Description
Number of subjects who experienced Renal (kidney) Failure shown over various time points.
Time Frame
30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subjects With Endocarditis Over Time
Description
Number of subjects who experienced Endocarditis shown over various time points. Endocarditis is an infection of the endocardium, which is the inner lining of your heart chambers and heart valves.
Time Frame
30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subjects With a Deep Sternal Would Infection Over Time
Description
Number of subjects who experienced a Deep Sternal Wound Infection shown over various time points.
Time Frame
30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subjects With a Myocardial Infarction Over Time
Description
Number of subjects who experienced a Myocardial Infarction shown over various time points. A Myocardial infarction, commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle.
Time Frame
30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subjects With a Thromboembolism Over Time
Description
Number of subjects who experienced a Thromboembolism shown over various time points. A thromboembolism is an obstruction of a blood vessel by a blood clot that has become dislodged from another site in the circulation.
Time Frame
30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subjects With a Cardiac Tamponade Over Time
Description
Number of subjects who experienced a Cardiac Tamponade shown over various time points. Cardiac tamponade is when fluid in the pericardium (the sac around the heart) builds up and results in compression (squeezing) of the heart.
Time Frame
30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subjects With a Cardiac Reoperation for Any Reason Over Time
Description
Number of subjects who experienced a Cardiac reoperation for any reason shown over various time points.
Time Frame
30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subjects Who Died Intraoperatively
Description
Number of subjects who died during surgery.
Time Frame
Surgery
Title
Subject's Average Score on the EQ-5D- Quality of Life Questionnaire Over Time
Description
The EQ-5D is a standardized questionnaire that asks subjects to rate themselves (no problems, some problems, extreme problems) on mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The scale is indexed and ranges from a minimum of 0.275 and a maximum of 1.000. A lower number indicates the participants experiences more problems and a higher number indicates the participants experiences fewer problems.
Time Frame
Baseline, 30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subject's Average Score SF-12 - Quality of Life Questionnaire Over Time
Description
The Medical Outcomes Study Short-Form 12 (SF-12) - Physical Component Summary (PCS) and Mental Component Summary (MCS).
The SF-12 questionnaire scale ranges from 100, which reflects the best health status to 0, which reflects the worse health status.
Subject's Average Score at Baseline and at each follow-up interval until 2 year - SF-12.
Time Frame
Baseline, 30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Subject's Average Score on the KCCQ - Quality of Life Questionnaire Over Time
Description
The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a 23-item, self-administered instrument that quantifies physical function, symptoms (frequency, severity and recent change), social function, self-efficacy and knowledge, and quality of life. Scores range from 0-100, in which higher scores reflect better health status. Subjects took this questionnaire at baseline, 30 days, 3 Months, 6 Months, 1 Year, and 2 Years.
Time Frame
Baseline, 30 days, 3 Months, 6 Months, 1 Year, 2 Years.
Title
Health Care Utilization
Description
The average amount of time the subjects spent in the intensive care unit, the intermediate care length of stay, and the average total length of hospital stay after their heart valve replacement procedure.
Time Frame
Day of surgical procedure through discharge from the hospital, an average of 2 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion:
≥18 years of age
aortic stenosis / mixed aortic stenosis and aortic insufficiency
SAVR+CABG (1-4 distal anastomoses)
Log. EuroSCORE ≥6
NYHA Class ≥II
Exclusion (i.a.):
pure aortic insufficiency
pre-existing prosthetic heart valve or ring
congenital true bicuspid / unicuspid aortic valve
LVEF <20%
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Prof. Labrousse, MD
Organizational Affiliation
CHU Bordeaux - Hôpital Haut-Lévèque
Official's Role
Principal Investigator
Facility Information:
Facility Name
CHU Bordeaux, Hôpital Haut-Lévêque
City
Pessac
ZIP/Postal Code
33604
Country
France
12. IPD Sharing Statement
Links:
URL
https://euroqol.org/eq-5d-instruments/
Description
EuroQol Standardized Instrument (EQ-5D) developed to measure of health-related quality of life.
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EDWARDS INTUITY Valve System CADENCE Study
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