HLT transfemOral Replacement of aortIc Valve Via transcatherteriZatiON
Last updated on April 2022Recruitment
- Recruitment Status
- Completed
- Estimated Enrollment
- 20
Inclusion Criteria
- Geographically available, willing to comply with follow up and able to provide written informed consent
- Symptomatology due to aortic stenosis resulting in a New York Heart Association (NYHA) Functional Classification of II or greater
- 75 years of age or older
- ...
- Geographically available, willing to comply with follow up and able to provide written informed consent
- Symptomatology due to aortic stenosis resulting in a New York Heart Association (NYHA) Functional Classification of II or greater
- 75 years of age or older
- Aortic valve annular diameter ≥ 21 and ≤23mm measured by MSCT
- 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%.
Exclusion Criteria
- 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.
- 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
- Pre-existing prosthetic heart valve in any position, or prosthetic ring
- ...
- 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.
- 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
- Pre-existing prosthetic heart valve in any position, or prosthetic ring
- Moderate to severe mitral stenosis
- Life expectancy < 1 year due to non-cardiac co-morbid conditions
- Echocardiographic evidence of intracardiac mass, thrombus or vegetation
- History of any cognitive or mental health status that would interfere with study participation
- Currently participating in any investigational drug or device studies that may confound the results of this study
- Untreated clinically significant coronary artery disease requiring revascularization
- Patient ineligible for or refuses blood transfusions
- Blood dyscrasias defined as: acute leukopenia, acute anemia, acute thrombocytopenia, history of bleeding diathesis or coagulopathy
- Need for emergent surgery or intervention other than the investigational procedure
- Renal insufficiency as demonstrated by a serum creatinine > 2.5 mg/dL or end stage renal disease requiring chronic dialysis
- Severe (Grade 3 to 4) aortic, mitral or tricuspid valve regurgitation
- LVEF < 30%
- Myocardial infarction within the past 30 days*
- Active infection requiring ongoing treatment
- Hemodynamic instability requiring inotropic drug therapy within the past 14 days or mechanical support within the past 6 months*
- Presence of significant aortic disease such as atheroma, thrombus, or aneurysm which, in the opinion of the investigator, precludes safe implant delivery
- Hypersensitivity or contraindication to procedural medication and device materials (e.g. titanium, nickel, pork) which cannot be adequately pre-medicated
- 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)*
- Uncontrolled hypertension (i.e. blood pressure at baseline > 140 mmHg systolic; or in the opinion of the investigator cannot be controlled by medical therapy).
- Stroke or transient ischemic attack within past 6 months*
- Active peptic ulcer or gastrointestinal bleeding within the past 90 days*
- Severe pulmonary hypertension with pulmonary systolic pressure greater than two-thirds of systemic pressure
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
- Geographically available, willing to comply with follow up and able to provide written informed consent
- Symptomatology due to aortic stenosis resulting in a New York Heart Association (NYHA) Functional Classification of II or greater
- 75 years of age or older
- ...
- Geographically available, willing to comply with follow up and able to provide written informed consent
- Symptomatology due to aortic stenosis resulting in a New York Heart Association (NYHA) Functional Classification of II or greater
- 75 years of age or older
- Aortic valve annular diameter ≥ 21 and ≤23mm measured by MSCT
- 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%.
Exclusion Criteria
- 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.
- 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
- Pre-existing prosthetic heart valve in any position, or prosthetic ring
- ...
- 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.
- 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
- Pre-existing prosthetic heart valve in any position, or prosthetic ring
- Moderate to severe mitral stenosis
- Life expectancy < 1 year due to non-cardiac co-morbid conditions
- Echocardiographic evidence of intracardiac mass, thrombus or vegetation
- History of any cognitive or mental health status that would interfere with study participation
- Currently participating in any investigational drug or device studies that may confound the results of this study
- Untreated clinically significant coronary artery disease requiring revascularization
- Patient ineligible for or refuses blood transfusions
- Blood dyscrasias defined as: acute leukopenia, acute anemia, acute thrombocytopenia, history of bleeding diathesis or coagulopathy
- Need for emergent surgery or intervention other than the investigational procedure
- Renal insufficiency as demonstrated by a serum creatinine > 2.5 mg/dL or end stage renal disease requiring chronic dialysis
- Severe (Grade 3 to 4) aortic, mitral or tricuspid valve regurgitation
- LVEF < 30%
- Myocardial infarction within the past 30 days*
- Active infection requiring ongoing treatment
- Hemodynamic instability requiring inotropic drug therapy within the past 14 days or mechanical support within the past 6 months*
- Presence of significant aortic disease such as atheroma, thrombus, or aneurysm which, in the opinion of the investigator, precludes safe implant delivery
- Hypersensitivity or contraindication to procedural medication and device materials (e.g. titanium, nickel, pork) which cannot be adequately pre-medicated
- 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)*
- Uncontrolled hypertension (i.e. blood pressure at baseline > 140 mmHg systolic; or in the opinion of the investigator cannot be controlled by medical therapy).
- Stroke or transient ischemic attack within past 6 months*
- Active peptic ulcer or gastrointestinal bleeding within the past 90 days*
- Severe pulmonary hypertension with pulmonary systolic pressure greater than two-thirds of systemic pressure
Tracking Information
- NCT #
- NCT02157142
- Collaborators
- Not Provided
- Investigators
- Principal Investigator: Axel Linke, MD University of Leipzig - Herzzcntrum
- Axel Linke, MD University of Leipzig - Herzzcntrum