Early Feasibility EXperience of Posterior Leaflet RestOration to REduce Degenerative Mitral Regurgitation (EXPLORE DMR)
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Degenerative Mitral Valve Disease
- Sponsor
- Polares Medical SA
- Enrollment
- 1
- Locations
- 1
- Primary Endpoint
- Incidence of change from baseline to moderate or less mitral regurgitation (Grade 2+ or less) as evaluated by 2D TTE
- Status
- Terminated
- Last Updated
- 2 years ago
Overview
Brief Summary
An early feasibility study to evaluate the safety and feasibility of the PLAR Implant and Delivery System to treat severe degenerative mitral regurgitation and to gather preliminary data on its performance thereby providing guidance for future clinical development. The study is a single-arm registry with the last follow-up visit at 5 years post-intervention. The study will enroll up to 10 patients at up to 4 centers in North America.
Detailed Description
Percutaneous approaches to treat MR promise to provide a sufficient reduction in MR without the risks typically associated with open heart surgery. Furthermore there is an unmet clinical need for patients with severe MR who are refused or denied surgery due to high risk. Percutaneous therapy provides a novel alternative treatment option for these patients with the aim of reducing morbidity and mortality over and above current medical therapy. The Polares Medical PLAR Implant and Delivery System is a catheter-based technology designed to permanently implant a prosthesis using a transvenous / transseptal approach to augment the posterior mitral valve leaflet and improve coapatation of the mitral valve. Approved edge-to-edge repair has already been shown to be a viable alternative for high risk MR patients. However treatment with these devices is limited to specific anatomies and often requires multiple devices which increases clinical risk, adds to procedural time, and can result in residual MR. The PLAR Implant and Delivery System has been designed to overcome and mitigate some of these shortfalls.
Investigators
Eligibility Criteria
Inclusion Criteria
- •18 years of age or older
- •Greater than moderate degenerative mitral regurgitation (Grade 3+ or higher) as confirmed by transesophageal echocardiography (TEE) within 90 days prior to study procedure
- •Patient must present with an STS Score less than 10%
- •High surgical risk for conventional mitral repair or replacement due to morphological criteria (e.g. leaflet or annulus calcifications), but operable, as assessed by the local heart team comprised of a cardiac surgeon experienced in mitral valve surgery and a cardiologist experienced in treating mitral valve disease and heart failure
- •Patient is approved by an independent Patient Eligibility Committee
- •New York Heart Association (NYHA) Functional Class III or IV
- •Patient willing to participate in study and provide signed IRB/EC-approved informed consent
- •Treating physician and patient agree that patient is able to return for all required post-procedure follow-up visits
- •Women of child-bearing potential have a negative pregnancy test
Exclusion Criteria
- •Severe tricuspid regurgitation
- •Severe aortic stenosis or insufficiency
- •Severe mitral annulus calcification
- •Diseased mitral anterior leaflet such as flail / prolapse/ heavy calcification
- •Implanted vena cava filter
- •Femoral veins with severe angulation and calcification
- •Contraindication for transesophageal echocardiography (TEE) or MDCT scan.
- •Active infection or endocarditis
- •Previous mitral valve surgery
- •Prior orthotopic heart transplantation
Outcomes
Primary Outcomes
Incidence of change from baseline to moderate or less mitral regurgitation (Grade 2+ or less) as evaluated by 2D TTE
Time Frame: 30-days
Primary performance endpoint
Incidence of all-cause mortality
Time Frame: 30-days
Primary safety outcome
Secondary Outcomes
- Patient success rate per MVARC2 definitions (all must be present for success)(Patient success is measured at 12 months post-intervention)
- Procedure success per MVARC2 definitions(Procedure success is measured at 30 days post-intervention)
- Rate of major safety events as defined by MVARC2(30 days, at 6 and 12 months, and at 2 - 5 years post-intervention)
- Technical success per MVARC2 definitions(Technical success is measured at exit from OR)
- Device success rate per MVARC2 definitions (all must be present for success)(Device success is measured at 30 days, at 6 and 12 months, and at 2 - 5 years post-intervention)