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Epicardial Mitral Repair Trial - ENRAPT-MR (ENRAPT-MR)

Primary Purpose

Mitral Regurgitation

Status
Recruiting
Phase
Not Applicable
Locations
Lithuania
Study Type
Interventional
Intervention
Mitral Touch Implant
Sponsored by
Mitre Medical Corp.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mitral Regurgitation

Eligibility Criteria

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

Inclusion Criteria:

  • Patient has moderate (2+), moderate-to-severe (3+) or severe (4+) ischemic or functional Mitral regurgitation per 2D or 3D echocardiography, symptomatic or asymptomatic
  • Patient is 18 years of age or older
  • Patient is willing and able to sign informed consent form

Exclusion Criteria:

  • History of endocarditis or current endocarditis
  • Structural abnormalities of the leaflets and papillary muscles*
  • Dysfunctional chordae*
  • Any prior cardiac surgery including but not limited to CABG, Mitral Valve repair surgery, mechanical prosthetic Valve, or ventricular assist device, prior sternotomy*
  • Ejection fraction <25%
  • New York Hheart Association (NYHA) class IV
  • MV diameters > 7cm
  • Myxomatous Mitral regurgitation
  • Renal insufficiency (eGFR &lt; 30 ml/min)
  • Severely calcified (posterior) Mitral Valve annulus
  • Women who are pregnant (by history of menstrual period or pregnancy test if history is considered unreliable)
  • Any coronary artery calcification at site of placement as determined by angiogram.
  • Abnormal cardiac anatomy discovered prior to surgery or during procedure.
  • Pericardial adhesions

    • NOTE: Patients with prior or concurrent mitral chordae repair (example: PTFE or Neochord) are potential candidates for the MitralTouch

Sites / Locations

  • Vilnius University Hospital Santariskiu KlinikosRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment

Arm Description

Treatment with the Mitral Touch Implant for Epicardial Annuloplasty.

Outcomes

Primary Outcome Measures

Safety - 30 - Day Major Adverse Event Rate
30 - Day Major Adverse Event Rate All-cause mortality Stroke Life-threatening bleeding (MVARC scale) Major vascular complications Major cardiac structural complications Stage 2 or 3 acute kidney injury (includes new dialysis) Severe hypotension, worsening of heart failure, or respiratory failure requiring intravenous pressors or invasive or mechanical heart failure treatments such as ultrafiltration or hemodynamic assist devices, including intra-aortic balloon pumps or left ventricular or biventricular assist devices, or prolonged intubation for >48 h Emergency surgery or re-intervention related to the device or access procedure

Secondary Outcome Measures

Technical Success - MR Reduction
MR assessment of MR Grade by TTE compared to baseline
Technical Success - Coaptation Length Increase
An increase of coaptation length compared to baseline
Technical Success - Septa-Lateral Reduction
Target of 15%-30% Reduction when compared to baseline
Technical Success - Improvement in NYHA Classification
Reduction in NYHA Classification compared to baseline

Full Information

First Posted
November 1, 2018
Last Updated
January 17, 2023
Sponsor
Mitre Medical Corp.
Collaborators
Meditrial Europe Ltd., Medical Metrics Diagnostics, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT03864848
Brief Title
Epicardial Mitral Repair Trial - ENRAPT-MR
Acronym
ENRAPT-MR
Official Title
ENRAPT-MR Trial: Epicardial Mitral Repair
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 18, 2017 (Actual)
Primary Completion Date
December 20, 2024 (Anticipated)
Study Completion Date
December 20, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mitre Medical Corp.
Collaborators
Meditrial Europe Ltd., Medical Metrics Diagnostics, Inc

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
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
Mitral Touch System This device is designed to epicardially reshape the mitral valve annulus without the need for cardiopulmonary bypass (CPB) and open heart access (atriotomy), in patients with left ventricular dilation and ischemic or functional MR (mitral regurgitation (MR)).
Detailed Description
Mitre Medical has developed an epicardial mitral annuloplasty device that can be implanted concomitant during planned coronary artery bypass surgery to help treat the MR patients. The Mitral Touch is designed to restore the S-L dimension and has the advantage of being placed without stopping the heart and placing the patient on a bypass pump.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Treatment
Arm Type
Experimental
Arm Description
Treatment with the Mitral Touch Implant for Epicardial Annuloplasty.
Intervention Type
Device
Intervention Name(s)
Mitral Touch Implant
Intervention Description
The study population for this study will be comprised of patients who are to undergo cardiac surgery with a sternotomy (e.g. CABG) and who present moderate to severe ischemic or functional MR. In order to be considered eligible for the study, each patient must meet the conditions listed in the inclusion and none of the exclusion criteria.
Primary Outcome Measure Information:
Title
Safety - 30 - Day Major Adverse Event Rate
Description
30 - Day Major Adverse Event Rate All-cause mortality Stroke Life-threatening bleeding (MVARC scale) Major vascular complications Major cardiac structural complications Stage 2 or 3 acute kidney injury (includes new dialysis) Severe hypotension, worsening of heart failure, or respiratory failure requiring intravenous pressors or invasive or mechanical heart failure treatments such as ultrafiltration or hemodynamic assist devices, including intra-aortic balloon pumps or left ventricular or biventricular assist devices, or prolonged intubation for >48 h Emergency surgery or re-intervention related to the device or access procedure
Time Frame
30-Days
Secondary Outcome Measure Information:
Title
Technical Success - MR Reduction
Description
MR assessment of MR Grade by TTE compared to baseline
Time Frame
30-Days, 6 Months, 12 Months
Title
Technical Success - Coaptation Length Increase
Description
An increase of coaptation length compared to baseline
Time Frame
30-Days, 6 Months, 12 Months
Title
Technical Success - Septa-Lateral Reduction
Description
Target of 15%-30% Reduction when compared to baseline
Time Frame
Implantation, 6 Months, 12 Months
Title
Technical Success - Improvement in NYHA Classification
Description
Reduction in NYHA Classification compared to baseline
Time Frame
6 & 12 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient has moderate (2+), moderate-to-severe (3+) or severe (4+) ischemic or functional Mitral regurgitation per 2D or 3D echocardiography, symptomatic or asymptomatic Patient is 18 years of age or older Patient is willing and able to sign informed consent form Exclusion Criteria: History of endocarditis or current endocarditis Structural abnormalities of the leaflets and papillary muscles* Dysfunctional chordae* Any prior cardiac surgery including but not limited to CABG, Mitral Valve repair surgery, mechanical prosthetic Valve, or ventricular assist device, prior sternotomy* Ejection fraction <25% New York Hheart Association (NYHA) class IV MV diameters > 7cm Myxomatous Mitral regurgitation Renal insufficiency (eGFR &lt; 30 ml/min) Severely calcified (posterior) Mitral Valve annulus Women who are pregnant (by history of menstrual period or pregnancy test if history is considered unreliable) Any coronary artery calcification at site of placement as determined by angiogram. Abnormal cardiac anatomy discovered prior to surgery or during procedure. Pericardial adhesions NOTE: Patients with prior or concurrent mitral chordae repair (example: PTFE or Neochord) are potential candidates for the MitralTouch
Facility Information:
Facility Name
Vilnius University Hospital Santariskiu Klinikos
City
Vilnius
Country
Lithuania
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Vilus Janusauskas, MD, PhD
Phone
+37061685712
Email
vilius.janusauskas@santa.lt

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
20137971
Citation
Takaseya T, Shiose A, Saraiva RM, Fumoto H, Arakawa Y, Juravic M, Lombardi P, Fukamachi K. Novel epicardial off-pump device for mitral regurgitation: acute evaluation. Eur J Cardiothorac Surg. 2010 Jun;37(6):1291-6. doi: 10.1016/j.ejcts.2009.11.054.
Results Reference
background
PubMed Identifier
22437273
Citation
Takaseya T, Fumoto H, Saraiva RM, Shiose A, Arakawa Y, Park M, Rao S, Dessoffy R, Kramer LD Jr, Juravic M, Lombardi P, Fukamachi K. Acute feasibility study of a novel device for the treatment of mitral regurgitation in a normal canine model. Innovations (Phila). 2010 Jan;5(1):28-32. doi: 10.1097/IMI.0b013e3181cdf735.
Results Reference
background
PubMed Identifier
33436291
Citation
Thourani VH, George I, Rucinskas K, Kalinauskas G, Janusauskas V, Zakarkaite D, Ailawadi G, Smith R, Mack MJ. First in human experience with an epicardial beating heart device for secondary mitral regurgitation. J Thorac Cardiovasc Surg. 2021 Mar;161(3):949-958.e4. doi: 10.1016/j.jtcvs.2020.11.169. Epub 2020 Dec 14.
Results Reference
result
Links:
URL
https://www.jtcvs.org/article/S0022-5223(20)33362-6/fulltext
Description
RESULTS: First in human experience with an epicardial beating heart device for secondary mitral regurgitation

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Epicardial Mitral Repair Trial - ENRAPT-MR

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