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TRICUS STUDY - Safety and Efficacy of the TricValve® Device

Primary Purpose

Severe Tricuspid Regurgitation

Status
Completed
Phase
Not Applicable
Locations
Lithuania
Study Type
Interventional
Intervention
TricValve® System
Sponsored by
P+F Products + Features GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Severe Tricuspid Regurgitation focused on measuring Tricuspid Valve Insufficiency, Heart Valve Diseases, Heart Diseases, Cardiovascular Diseases

Eligibility Criteria

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

Inclusion Criteria:

  1. The subject must be 18 years of age or older
  2. The subject must be a patient with severe symptomatic tricuspid regurgitation demonstrated by echocardiography with significant backflow in the lower (IVC) and/or upper (SVC) vena cava and with a v-wave ≥ 25 mmHg as demonstrated by right heart catheterization (measured in the IVC and/or SVC 2-4 cm above/ below right atrium (RA) inflow) within 8 weeks prior to the implantation
  3. Suitable for TricValve® Transcatheter Bicaval Valves System implantation according to anatomic criteria by computed tomography
  4. The subjects must have severe, tricuspid regurgitation leading to New York Heart Association (NYHA) class III or IV
  5. The subject has left ventricular ejection fraction (LVEF) ≥ 40%
  6. Distance covert in 6-minute walk test (6MWT) ≥ 60m
  7. The patient shall be screened by a "Heart Team" - including an interventional cardiologist, cardiothoracic surgeon, and agreed as a candidate for the TricValve® Transcatheter Bicaval Valves System implantation
  8. Patient/authorized legal guardian understands the nature of the procedure, is willing to comply with associated follow-up evaluations, and provides written informed consent Patient/patient's authorized legal guardian is geographically stable (or willing to return for required study follow-up) and understands and is willing to fulfil all of the expected requirements of the clinical protocol

Exclusion Criteria:

  1. Known significant intracardiac shunt (e.g. ventricular septal defect) or congenital structural heart disease based on heart teams decision
  2. Requirement for other elective cardiac procedures e.g. Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft (CABG) up to 90 days after the procedure or 30 days before the procedure
  3. Right ventricular failure (TAPSE ≤13mmHg)
  4. Systolic pulmonary arterial pressure > 65 mmHg as assessed by Doppler echocardiography
  5. Presence of any known life threatening (noncardiac major or progressive disease), non-cardiac disease that will limit the subject's life expectancy to less than one year
  6. Cerebro-vascular event within the past 3 months
  7. History of mitral/tricuspid endocarditis within the last 12 months
  8. Patient has untreated significant left sided valvular heart disease which requires treatment (e.g. mitral regurgitation or stenosis, and aortic regurgitation or stenosis)
  9. Documented primary coagulopathy or platelet disorder, including thrombocytopenia (absolute platelet count <90k)
  10. Documented evidence of significant renal dysfunction (serum creatinine > 3.0mg/dl) or on any form of dialysis at time of screening within the last 4 weeks
  11. Contraindication or known allergy to device's components, anti-coagulation therapy with vitamin K antagonists or contrast media that cannot be adequately premedicated
  12. Patients unsuitable for implantation because of thrombosis of the lower venous system or vena cava filter
  13. The patient has contraindication against a transesophageal echo (TEE) during the procedure
  14. Evidence of an acute myocardial infarction (AMI) ≤ 1 month (30 days)
  15. Liver cirrhosis Child C (see appendix)
  16. Female patient of child-bearing potential
  17. Psychiatric or behavioural disease including known alcohol or drug abuser that is likely to impair compliance with protocol
  18. Currently participating in another study of an investigational drug or device that would directly impact the treatment or outcome of the current study
  19. Requirement for Antibiotic Treatment within the last 48 hours

Sites / Locations

  • LSMUH Kauno Kliniko

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TricValve® System Single-Arm

Arm Description

Minimally invasive catheter-supported, bicaval tricuspid valve (self-expanding) replacement

Outcomes

Primary Outcome Measures

Percentage of participants with major adverse events
The percentage of participants with major adverse events (death, myocardial infarction, cardiac tamponade, cardiac surgery for failed TricValve® implantation, stroke. Major bleeding according to Valve Academic Research Consortium (VARC) criteria)
Change of New York Heart Association (NYHA) functional class
Change of New York Heart Association (NYHA) functional class from III or IV to a lower one

Secondary Outcome Measures

Successful implantation
The percentage of surviving participants with successful access, delivery and retrieval of the device delivery system, and deployment and correct positioning of the intended device(s), and no need for additional unplanned or emergency surgery or re-intervention related to the device or access procedure.
Unrestricted movement of cusps
The percentage of medical devices with unrestricted movement of cusps after implantation as assessed with echocardiography (nominal)
Cusp insufficiency
The change of the degree of cusp insufficiency as assessed with echocardiography (ordinal) from a higher to a lower value
Device success
Device success as measured by number of patients who are alive with intended device in place with no additional surgical or interventional procedures related to the TricValve®.
NYHA functional class
Number of Patients with improvement of NYHA functional class
6 Minute Walk Test
Improvement in distance (m) in the 6 Minute Walk Test
Kansas City Cardiomyopathy Questionnaire (KCCQ)
Number of Patients with improvement in quality of life as assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ, 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. Range of 0-100, in which higher scores reflect better health status.)

Full Information

First Posted
October 25, 2018
Last Updated
April 19, 2022
Sponsor
P+F Products + Features GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT03723239
Brief Title
TRICUS STUDY - Safety and Efficacy of the TricValve® Device
Official Title
TRICUS STUDY - Safety and Efficacy of the TricValve® Transcatheter Bicaval Valves System in the Superior and Inferior Vena Cava in Patients With Severe Tricuspid Regurgitation.
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
September 12, 2018 (Actual)
Primary Completion Date
September 4, 2020 (Actual)
Study Completion Date
November 15, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
P+F Products + Features GmbH

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
The TricValve® Transcatheter Bicaval Valves System is indicated for relief of tricuspid insufficiency in patients with symptomatic heart disease who are judged by a heart team, including a cardiac surgeon, to be at extreme risk or inoperable for open surgical therapy.
Detailed Description
TricValve® Transcatheter Bicaval Valves is a system of two self-expanding biological valves for the treatment of patients with hemodynamically relevant tricuspid insufficiency and caval reflux. The prostheses are implanted percutaneously into the inferior and superior vena cava without disturbing the native tricuspid valve. It is especially intended for use for patients at extreme risk or who are inoperable for open surgical therapy. Pre-Clinical and Clinical preliminary studies have shown an acceptable safety and performance profile of the TricValve® Transcatheter Bicaval Valves System. Given that the medical device is a potential long-term treatment for patients with tricuspid insufficiency, clinical data for long-term treatment periods is necessary. Thus, the current study is designed to investigate the safety and performance for at least 30 days and up to 6 months. The study has been approved by the Kaunas Regional Biomedical Research Ethics Committee.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Severe Tricuspid Regurgitation
Keywords
Tricuspid Valve Insufficiency, Heart Valve Diseases, Heart Diseases, Cardiovascular Diseases

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
TricValve® System Single-Arm
Arm Type
Experimental
Arm Description
Minimally invasive catheter-supported, bicaval tricuspid valve (self-expanding) replacement
Intervention Type
Device
Intervention Name(s)
TricValve® System
Intervention Description
The TricValve® Delivery System is inserted from the femoral vein to access the inferior vena cava (IVC) and superior vena cava (SVC) of the heart under fluoroscopy guidance. The appropriately sized TricValve® is unsheathed at the implantation site and positions itself as per the anatomy - self expanding frame.
Primary Outcome Measure Information:
Title
Percentage of participants with major adverse events
Description
The percentage of participants with major adverse events (death, myocardial infarction, cardiac tamponade, cardiac surgery for failed TricValve® implantation, stroke. Major bleeding according to Valve Academic Research Consortium (VARC) criteria)
Time Frame
30 days
Title
Change of New York Heart Association (NYHA) functional class
Description
Change of New York Heart Association (NYHA) functional class from III or IV to a lower one
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Successful implantation
Description
The percentage of surviving participants with successful access, delivery and retrieval of the device delivery system, and deployment and correct positioning of the intended device(s), and no need for additional unplanned or emergency surgery or re-intervention related to the device or access procedure.
Time Frame
Up to Discharge (≤ 10 days post index procedure)
Title
Unrestricted movement of cusps
Description
The percentage of medical devices with unrestricted movement of cusps after implantation as assessed with echocardiography (nominal)
Time Frame
Up to 30 days, up to 6 months
Title
Cusp insufficiency
Description
The change of the degree of cusp insufficiency as assessed with echocardiography (ordinal) from a higher to a lower value
Time Frame
Up to 30 days, up to 6 months
Title
Device success
Description
Device success as measured by number of patients who are alive with intended device in place with no additional surgical or interventional procedures related to the TricValve®.
Time Frame
Up to 30 days, up to 6 months
Title
NYHA functional class
Description
Number of Patients with improvement of NYHA functional class
Time Frame
Up to 30 days
Title
6 Minute Walk Test
Description
Improvement in distance (m) in the 6 Minute Walk Test
Time Frame
Up to 30 days, up to 6 months
Title
Kansas City Cardiomyopathy Questionnaire (KCCQ)
Description
Number of Patients with improvement in quality of life as assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ, 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. Range of 0-100, in which higher scores reflect better health status.)
Time Frame
Up to 30 days, up to 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject must be 18 years of age or older The subject must be a patient with severe symptomatic tricuspid regurgitation demonstrated by echocardiography with significant backflow in the lower (IVC) and/or upper (SVC) vena cava and with a v-wave ≥ 25 mmHg as demonstrated by right heart catheterization (measured in the IVC and/or SVC 2-4 cm above/ below right atrium (RA) inflow) within 8 weeks prior to the implantation Suitable for TricValve® Transcatheter Bicaval Valves System implantation according to anatomic criteria by computed tomography The subjects must have severe, tricuspid regurgitation leading to New York Heart Association (NYHA) class III or IV The subject has left ventricular ejection fraction (LVEF) ≥ 40% Distance covert in 6-minute walk test (6MWT) ≥ 60m The patient shall be screened by a "Heart Team" - including an interventional cardiologist, cardiothoracic surgeon, and agreed as a candidate for the TricValve® Transcatheter Bicaval Valves System implantation Patient/authorized legal guardian understands the nature of the procedure, is willing to comply with associated follow-up evaluations, and provides written informed consent Patient/patient's authorized legal guardian is geographically stable (or willing to return for required study follow-up) and understands and is willing to fulfil all of the expected requirements of the clinical protocol Exclusion Criteria: Known significant intracardiac shunt (e.g. ventricular septal defect) or congenital structural heart disease based on heart teams decision Requirement for other elective cardiac procedures e.g. Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft (CABG) up to 90 days after the procedure or 30 days before the procedure Right ventricular failure (TAPSE ≤13mmHg) Systolic pulmonary arterial pressure > 65 mmHg as assessed by Doppler echocardiography Presence of any known life threatening (noncardiac major or progressive disease), non-cardiac disease that will limit the subject's life expectancy to less than one year Cerebro-vascular event within the past 3 months History of mitral/tricuspid endocarditis within the last 12 months Patient has untreated significant left sided valvular heart disease which requires treatment (e.g. mitral regurgitation or stenosis, and aortic regurgitation or stenosis) Documented primary coagulopathy or platelet disorder, including thrombocytopenia (absolute platelet count <90k) Documented evidence of significant renal dysfunction (serum creatinine > 3.0mg/dl) or on any form of dialysis at time of screening within the last 4 weeks Contraindication or known allergy to device's components, anti-coagulation therapy with vitamin K antagonists or contrast media that cannot be adequately premedicated Patients unsuitable for implantation because of thrombosis of the lower venous system or vena cava filter The patient has contraindication against a transesophageal echo (TEE) during the procedure Evidence of an acute myocardial infarction (AMI) ≤ 1 month (30 days) Liver cirrhosis Child C (see appendix) Female patient of child-bearing potential Psychiatric or behavioural disease including known alcohol or drug abuser that is likely to impair compliance with protocol Currently participating in another study of an investigational drug or device that would directly impact the treatment or outcome of the current study Requirement for Antibiotic Treatment within the last 48 hours
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alexander Lauten, Prof.Dr.med.
Organizational Affiliation
Charite University, Berlin, Germany
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Rimantas Benetis, Prof.
Organizational Affiliation
Hospital of Lithuanian University of Health Sciences Kauno Klinikos
Official's Role
Principal Investigator
Facility Information:
Facility Name
LSMUH Kauno Kliniko
City
Kaunas
Country
Lithuania

12. IPD Sharing Statement

Plan to Share IPD
No

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TRICUS STUDY - Safety and Efficacy of the TricValve® Device

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