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Feasibility Study of the DragonFly-T System for Severe Tricuspid Regurgitation

Primary Purpose

Tricuspid Regurgitation

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
DragonFly-T Transcatheter Tricuspid Valve Repair System
Sponsored by
Hangzhou Valgen Medtech Co., Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Tricuspid Regurgitation focused on measuring Tricuspid Regurgitation

Eligibility Criteria

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

Inclusion Criteria: Age ≥ 18 years In the judgment of the local cardiac team, the patient has been adequately treated according to applicable standards (including medical management), including: Optimal pharmacological therapy for TR (e.g. diuretics); Drug and/or interventional treatment of mitral regurgitation, atrial fibrillation, coronary artery disease, and heart failure; The Eligibility Committee confirms that the patient has received adequate medical treatment. Despite the drug optimization treatment according to the above method, patients still have symptoms of TR (TR grade≥3+). New York Heart Association (NYHA) Cardiac function Class II-IVa. The patient is suitable for transcatheter tricuspid valve repair, suitable for the use of the study device, and the femoral vein access is feasible and can accommodate a 24F catheter. Patient must provide written informed consent before any steps related to the study. Exclusion Criteria: Tricuspid valve leaflet anatomy, which may preclude clip implantation or proper clip positioning on the leaflets, including but not limited to the following: Evidence of calcification in the grasping area; Presence of a severe coaptation defect of the tricuspid leaflets; Severe leaflet defect(s) and cleft preventing proper device placement determined by ECL; Epstein anomaly. Previous tricuspid valve surgery or transcatheter therapy. Echocardiography suggested intracardiac thrombus, tumor, or mass. Transthoracic Echocardiogram and Transesophageal Echocardiography are unable to evaluate tricuspid valve anatomy. Refractory heart failure requiring intervention (e.g., left ventricular assist device, heart transplantation) (ACC/AHA Stage D heart failure). Severe and uncontrolled hypertension: systolic blood pressure ≥ 180mmHg and/or diastolic blood pressure ≥ 110mmHg. Active endocarditis, active rheumatic heart disease, or rheumatic heart valvular disease leading to tricuspid valve leaf lesions (poor valve leaf compliance, perforation, etc.). Had myocardial infarction or unstable angina within 4 weeks; Untreated severe coronary artery stenosis requiring revascularization. Percutaneous coronary intervention was performed within 30 days before surgery, except for coronary angiography. Hemodynamic instability, defined as systolic blood pressure < 90mmHg, with or without cardiogenic shock, or requiring intra-aortic balloon counterpulsation or other hemodynamic support devices. Bleeding diseases or coagulation disorders, or antithrombotic drug therapy contraindications. Acute peptic ulcer or gastrointestinal bleeding within 3 months before surgery. Severe cirrhosis (Child's grade C). Allergy to the device material. Life expectancy of fewer than 12 months. Women who are pregnant, breastfeeding, or planning to become pregnant. Participated in any drug and/or medical device clinical trials within 1 month prior to the trial. The researchers do not consider it appropriate to be enrolled in the study.

Sites / Locations

  • The Second Affiliated Hospital Zhejiang University School of MedicineRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

DragonFly-T Transcatheter Tricuspid Valve Repair System

Arm Description

The experimental group is allocated to use a novel tricuspid valve repair system for edge-to-edge repair manufactured by Hangzhou Valgen Medtech Co., Ltd.

Outcomes

Primary Outcome Measures

Incidence of major adverse events (MAEs)
MAEs include stroke, cardiovascular death, new renal failure, endocarditis requiring surgery, and non-elective cardiovascular interventions due to device-related adverse events

Secondary Outcome Measures

Acute procedural success
Successful in DragonFly-T implantation, and residual TR of 2+ or less at discharge. An echocardiography echocardiogram at 30 days can be accepted if the discharge image was not available or hard to interpret. A death before discharge or a re-operation of tricuspid valve prior to 30 days is defined as acute procedure failure
Acute device success
One or more DragonFly-T devices are successfully delivered and released, edge-to-edge leaflet repair confirmed by echocardiogram, and successfully withdrawal of the delivery catheter
Incidence of all-cause mortality and/or heart failure rehospitalization
Incidence of all-cause mortality and/or heart failure rehospitalization
Tricuspid regurgitation severity
Percentage of patients with tricuspid regurgitation of 2+ or less
Tricuspid regurgitation severity change
Percentage of patients with tricuspid regurgitation reduced by at least one grade
Change in 6 Minutes Walk Test
Improvement in 6 Minute Walk Test
Change in NYHA class
Improvement in New York Heart Association (NYHA) Function Class
Quality of life improvement
Improvement in quality of life (QoL) , as measured by the Kansas City Cardiomyopathy Questionnaire
Change in edema grading
Improvement in grading of edema,1-4 grade scale,higher scores mean worse outcome

Full Information

First Posted
December 20, 2022
Last Updated
January 2, 2023
Sponsor
Hangzhou Valgen Medtech Co., Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT05671640
Brief Title
Feasibility Study of the DragonFly-T System for Severe Tricuspid Regurgitation
Official Title
Feasibility Study of the DragonFly-T Transcatheter Tricuspid Valve Repair System for the Treatment of Tricuspid Regurgitation
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 27, 2022 (Actual)
Primary Completion Date
February 10, 2023 (Anticipated)
Study Completion Date
January 10, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hangzhou Valgen Medtech Co., Ltd

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
This study is a prospective design. Patients are severe tricuspid regurgitation (TR) (≥ 3+) who remained clinically symptomatic after guideline-directed medical treatment. After signing an informed consent form, subjects are enrolled and treated with the DragonFly-T Transcatheter Tricuspid Valve Repair System. All subjects receive clinical follow-up immediately after the procedure, before discharge, 30 days after the procedure, 6 months after the procedure, 12 months, and 2, 3, 4, and 5 years after the procedure. The incidence of MAEs (Major Adverse Events) at 30 days is used as the safety endpoint. The MAEs include stroke, cardiovascular death, new renal failure, endocarditis requiring surgery, and non-elective cardiovascular interventions due to device-related adverse events. The efficacy endpoints include acute procedural success, acute device success, the incidence of all-cause mortality and/or heart failure rehospitalization at 12 months after the procedure, the percentage of patients with tricuspid regurgitation of 2+ or less, the percentage of patients with tricuspid regurgitation reduced by at least one grade, the improvement in 6 minutes walk test, New York Heart Association (NYHA) class, quality of life change as assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ) score and change in edema scale grading.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tricuspid Regurgitation
Keywords
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
10 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
DragonFly-T Transcatheter Tricuspid Valve Repair System
Arm Type
Experimental
Arm Description
The experimental group is allocated to use a novel tricuspid valve repair system for edge-to-edge repair manufactured by Hangzhou Valgen Medtech Co., Ltd.
Intervention Type
Device
Intervention Name(s)
DragonFly-T Transcatheter Tricuspid Valve Repair System
Intervention Description
To conduct edge-to-edge repair with DragonFly-T System under the guidance of transesophageal echocardiography.
Primary Outcome Measure Information:
Title
Incidence of major adverse events (MAEs)
Description
MAEs include stroke, cardiovascular death, new renal failure, endocarditis requiring surgery, and non-elective cardiovascular interventions due to device-related adverse events
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Acute procedural success
Description
Successful in DragonFly-T implantation, and residual TR of 2+ or less at discharge. An echocardiography echocardiogram at 30 days can be accepted if the discharge image was not available or hard to interpret. A death before discharge or a re-operation of tricuspid valve prior to 30 days is defined as acute procedure failure
Time Frame
Immediately after procedure
Title
Acute device success
Description
One or more DragonFly-T devices are successfully delivered and released, edge-to-edge leaflet repair confirmed by echocardiogram, and successfully withdrawal of the delivery catheter
Time Frame
Immediately after procedure
Title
Incidence of all-cause mortality and/or heart failure rehospitalization
Description
Incidence of all-cause mortality and/or heart failure rehospitalization
Time Frame
12 months
Title
Tricuspid regurgitation severity
Description
Percentage of patients with tricuspid regurgitation of 2+ or less
Time Frame
30 days, 6 months, 12 months
Title
Tricuspid regurgitation severity change
Description
Percentage of patients with tricuspid regurgitation reduced by at least one grade
Time Frame
30 days, 6 months, 12 months
Title
Change in 6 Minutes Walk Test
Description
Improvement in 6 Minute Walk Test
Time Frame
30 days, 6 months, 12 months
Title
Change in NYHA class
Description
Improvement in New York Heart Association (NYHA) Function Class
Time Frame
30 days, 6 months, 12 months
Title
Quality of life improvement
Description
Improvement in quality of life (QoL) , as measured by the Kansas City Cardiomyopathy Questionnaire
Time Frame
30 days, 6 months, 12 months
Title
Change in edema grading
Description
Improvement in grading of edema,1-4 grade scale,higher scores mean worse outcome
Time Frame
30 days, 6 months, 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years In the judgment of the local cardiac team, the patient has been adequately treated according to applicable standards (including medical management), including: Optimal pharmacological therapy for TR (e.g. diuretics); Drug and/or interventional treatment of mitral regurgitation, atrial fibrillation, coronary artery disease, and heart failure; The Eligibility Committee confirms that the patient has received adequate medical treatment. Despite the drug optimization treatment according to the above method, patients still have symptoms of TR (TR grade≥3+). New York Heart Association (NYHA) Cardiac function Class II-IVa. The patient is suitable for transcatheter tricuspid valve repair, suitable for the use of the study device, and the femoral vein access is feasible and can accommodate a 24F catheter. Patient must provide written informed consent before any steps related to the study. Exclusion Criteria: Tricuspid valve leaflet anatomy, which may preclude clip implantation or proper clip positioning on the leaflets, including but not limited to the following: Evidence of calcification in the grasping area; Presence of a severe coaptation defect of the tricuspid leaflets; Severe leaflet defect(s) and cleft preventing proper device placement determined by ECL; Epstein anomaly. Previous tricuspid valve surgery or transcatheter therapy. Echocardiography suggested intracardiac thrombus, tumor, or mass. Transthoracic Echocardiogram and Transesophageal Echocardiography are unable to evaluate tricuspid valve anatomy. Refractory heart failure requiring intervention (e.g., left ventricular assist device, heart transplantation) (ACC/AHA Stage D heart failure). Severe and uncontrolled hypertension: systolic blood pressure ≥ 180mmHg and/or diastolic blood pressure ≥ 110mmHg. Active endocarditis, active rheumatic heart disease, or rheumatic heart valvular disease leading to tricuspid valve leaf lesions (poor valve leaf compliance, perforation, etc.). Had myocardial infarction or unstable angina within 4 weeks; Untreated severe coronary artery stenosis requiring revascularization. Percutaneous coronary intervention was performed within 30 days before surgery, except for coronary angiography. Hemodynamic instability, defined as systolic blood pressure < 90mmHg, with or without cardiogenic shock, or requiring intra-aortic balloon counterpulsation or other hemodynamic support devices. Bleeding diseases or coagulation disorders, or antithrombotic drug therapy contraindications. Acute peptic ulcer or gastrointestinal bleeding within 3 months before surgery. Severe cirrhosis (Child's grade C). Allergy to the device material. Life expectancy of fewer than 12 months. Women who are pregnant, breastfeeding, or planning to become pregnant. Participated in any drug and/or medical device clinical trials within 1 month prior to the trial. The researchers do not consider it appropriate to be enrolled in the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Kangmu Ma
Phone
+8613341773508
Email
makangmu@valgenmed.com
First Name & Middle Initial & Last Name or Official Title & Degree
Shuangjie Li
Phone
+8617756106609
Email
shuangjie.li@valgenmed.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jian'an Wang, MD,Phd
Organizational Affiliation
Second Affiliated Hospital, School of Medicine, Zhejiang University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Second Affiliated Hospital Zhejiang University School of Medicine
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jian'an Wang, MD,Phd
Phone
+8613805786328
Email
wja@zju.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Feasibility Study of the DragonFly-T System for Severe Tricuspid Regurgitation

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