HLT transfemOral Replacement of aortIc Valve Via transcatherteriZatiON
Last updated on April 2022Recruitment
- Recruitment Status
- Completed
- Estimated Enrollment
- 20
Inclusion Criteria
- An STS score ≥10; or Logistic EuroScore I ≥ 15; or a determination by one cardiovascular surgeon and one cardiologist that the co-morbidities not captured by the STS or EuroScore expected to increase the operative mortality risk to > 15%.
- 75 years of age or older
- Echocardiographic or hemodynamic based evidence of calcific (senile) aortic stenosis with one of the following: aortic valve EOA <1.0 cm2 or 0.6 cm2/m2 , mean aortic valve gradient >40 mmHg or peak aortic valve velocity >4 m/sec
- ...
- An STS score ≥10; or Logistic EuroScore I ≥ 15; or a determination by one cardiovascular surgeon and one cardiologist that the co-morbidities not captured by the STS or EuroScore expected to increase the operative mortality risk to > 15%.
- 75 years of age or older
- Echocardiographic or hemodynamic based evidence of calcific (senile) aortic stenosis with one of the following: aortic valve EOA <1.0 cm2 or 0.6 cm2/m2 , mean aortic valve gradient >40 mmHg or peak aortic valve velocity >4 m/sec
- Aortic valve annular diameter ≥ 21 and ≤23mm measured by MSCT
- Symptomatology due to aortic stenosis resulting in a New York Heart Association (NYHA) Functional Classification of II or greater
- Geographically available, willing to comply with follow up and able to provide written informed consent
Exclusion Criteria
- Life expectancy < 1 year due to non-cardiac co-morbid conditions
- Hypersensitivity or contraindication to procedural medication and device materials (e.g. titanium, nickel, pork) which cannot be adequately pre-medicated
- Need for emergent surgery or intervention other than the investigational procedure
- ...
- Life expectancy < 1 year due to non-cardiac co-morbid conditions
- Hypersensitivity or contraindication to procedural medication and device materials (e.g. titanium, nickel, pork) which cannot be adequately pre-medicated
- Need for emergent surgery or intervention other than the investigational procedure
- Active peptic ulcer or gastrointestinal bleeding within the past 90 days*
- Echocardiographic evidence of intracardiac mass, thrombus or vegetation
- Severe (Grade 3 to 4) aortic, mitral or tricuspid valve regurgitation
- Blood dyscrasias defined as: acute leukopenia, acute anemia, acute thrombocytopenia, history of bleeding diathesis or coagulopathy
- Severe pulmonary hypertension with pulmonary systolic pressure greater than two-thirds of systemic pressure
- Renal insufficiency as demonstrated by a serum creatinine > 2.5 mg/dL or end stage renal disease requiring chronic dialysis
- Stroke or transient ischemic attack within past 6 months*
- Myocardial infarction within the past 30 days*
- Uncontrolled hypertension (i.e. blood pressure at baseline > 140 mmHg systolic; or in the opinion of the investigator cannot be controlled by medical therapy).
- Any therapeutic invasive cardiac procedure performed or planned to perform within 30 days of the index procedure, (or 6 months for drug eluting coronary stent or biventricular pacemaker implantation)*
- LVEF < 30%
- Patient ineligible for or refuses blood transfusions
- Hemodynamic instability requiring inotropic drug therapy within the past 14 days or mechanical support within the past 6 months*
- History of any cognitive or mental health status that would interfere with study participation
- Active infection requiring ongoing treatment
- Unfavorable peripheral vascular anatomy or disease (e.g. severe obstructive calcification, severe tortuosity or small vessels) that would preclude passage of catheters from the femoral arterial access to the aorta as evidenced by peripheral MSCT
- Congenital unicuspid or bicuspid aortic valve, or noncalcified aortic valve; or valve eccentricity (calcific or otherwise) that in the opinion of the investigator could compromise procedural success.
- Pre-existing prosthetic heart valve in any position, or prosthetic ring
- Moderate to severe mitral stenosis
- Presence of significant aortic disease such as atheroma, thrombus, or aneurysm which, in the opinion of the investigator, precludes safe implant delivery
- Untreated clinically significant coronary artery disease requiring revascularization
- Currently participating in any investigational drug or device studies that may confound the results of this study
Summary
- Conditions
- Aortic Valve Stenosis
- Severe Aortic Stenosis
- Type
- Interventional
- Design
- Allocation: N/A
- Intervention Model: Single Group Assignment
- Masking: None (Open Label)
- Primary Purpose: Treatment
Participation Requirements
- Age
- Between 75 years and 125 years
- Gender
- Both males and females
Inclusion Criteria
- An STS score ≥10; or Logistic EuroScore I ≥ 15; or a determination by one cardiovascular surgeon and one cardiologist that the co-morbidities not captured by the STS or EuroScore expected to increase the operative mortality risk to > 15%.
- 75 years of age or older
- Echocardiographic or hemodynamic based evidence of calcific (senile) aortic stenosis with one of the following: aortic valve EOA <1.0 cm2 or 0.6 cm2/m2 , mean aortic valve gradient >40 mmHg or peak aortic valve velocity >4 m/sec
- ...
- An STS score ≥10; or Logistic EuroScore I ≥ 15; or a determination by one cardiovascular surgeon and one cardiologist that the co-morbidities not captured by the STS or EuroScore expected to increase the operative mortality risk to > 15%.
- 75 years of age or older
- Echocardiographic or hemodynamic based evidence of calcific (senile) aortic stenosis with one of the following: aortic valve EOA <1.0 cm2 or 0.6 cm2/m2 , mean aortic valve gradient >40 mmHg or peak aortic valve velocity >4 m/sec
- Aortic valve annular diameter ≥ 21 and ≤23mm measured by MSCT
- Symptomatology due to aortic stenosis resulting in a New York Heart Association (NYHA) Functional Classification of II or greater
- Geographically available, willing to comply with follow up and able to provide written informed consent
Exclusion Criteria
- Life expectancy < 1 year due to non-cardiac co-morbid conditions
- Hypersensitivity or contraindication to procedural medication and device materials (e.g. titanium, nickel, pork) which cannot be adequately pre-medicated
- Need for emergent surgery or intervention other than the investigational procedure
- ...
- Life expectancy < 1 year due to non-cardiac co-morbid conditions
- Hypersensitivity or contraindication to procedural medication and device materials (e.g. titanium, nickel, pork) which cannot be adequately pre-medicated
- Need for emergent surgery or intervention other than the investigational procedure
- Active peptic ulcer or gastrointestinal bleeding within the past 90 days*
- Echocardiographic evidence of intracardiac mass, thrombus or vegetation
- Severe (Grade 3 to 4) aortic, mitral or tricuspid valve regurgitation
- Blood dyscrasias defined as: acute leukopenia, acute anemia, acute thrombocytopenia, history of bleeding diathesis or coagulopathy
- Severe pulmonary hypertension with pulmonary systolic pressure greater than two-thirds of systemic pressure
- Renal insufficiency as demonstrated by a serum creatinine > 2.5 mg/dL or end stage renal disease requiring chronic dialysis
- Stroke or transient ischemic attack within past 6 months*
- Myocardial infarction within the past 30 days*
- Uncontrolled hypertension (i.e. blood pressure at baseline > 140 mmHg systolic; or in the opinion of the investigator cannot be controlled by medical therapy).
- Any therapeutic invasive cardiac procedure performed or planned to perform within 30 days of the index procedure, (or 6 months for drug eluting coronary stent or biventricular pacemaker implantation)*
- LVEF < 30%
- Patient ineligible for or refuses blood transfusions
- Hemodynamic instability requiring inotropic drug therapy within the past 14 days or mechanical support within the past 6 months*
- History of any cognitive or mental health status that would interfere with study participation
- Active infection requiring ongoing treatment
- Unfavorable peripheral vascular anatomy or disease (e.g. severe obstructive calcification, severe tortuosity or small vessels) that would preclude passage of catheters from the femoral arterial access to the aorta as evidenced by peripheral MSCT
- Congenital unicuspid or bicuspid aortic valve, or noncalcified aortic valve; or valve eccentricity (calcific or otherwise) that in the opinion of the investigator could compromise procedural success.
- Pre-existing prosthetic heart valve in any position, or prosthetic ring
- Moderate to severe mitral stenosis
- Presence of significant aortic disease such as atheroma, thrombus, or aneurysm which, in the opinion of the investigator, precludes safe implant delivery
- Untreated clinically significant coronary artery disease requiring revascularization
- Currently participating in any investigational drug or device studies that may confound the results of this study
Tracking Information
- NCT #
- NCT02157142
- Collaborators
- Not Provided
- Investigators
- Principal Investigator: Axel Linke, MD University of Leipzig - Herzzcntrum
- Axel Linke, MD University of Leipzig - Herzzcntrum