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FreeFlow Percutaneous Atrial Septal Shunt for IPAH

Not Applicable
Recruiting
Conditions
Pulmonary Arterial Hypertension
Interventions
Device: FreeFlow percutaneous atrial septal shunt
Registration Number
NCT06605794
Lead Sponsor
Shanghai Zhongshan Hospital
Brief Summary

The goal of this clinical trial is to explore the safety and efficacy of the FreeFlow percutaneous atrial septal shunt for treatment of idiopathic pulmonary arterial hypertension. The main questions it aims to answer are:

* Is the FreeFlow percutaneous atrial septal shunt safe to use in patients with idiopathic pulmonary arterial hypertension?

* Does the FreeFlow percutaneous atrial septal shunt reduce all-cause mortality and readmission in patients with idiopathic pulmonary arterial hypertension, and how effective is it? Thirty subjects who met the inclusion and exclusion criteria were selected for selective implantation of FreeFlow percutaneous atrial septal shunts after balloon atrial septostomy.

Participants will:

* underwent balloon atrial septostomy and FreeFlow percutaneous atrial septal shunt implantation.

* will be followed up at 24 hours after shunt implantation or before discharge, 1 month, 3 months, 6 months and 12 months.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • 18≤ age ≤70 years old, female or male;
  • 10 mmHg≤ mean right atrial pressure (mRAP) ≤20 mmHg;
  • The subjects had severe idiopathic pulmonary hypertension (mean pulmonary arterial pressure > 45 mmHg);
  • WHO grade III or IV;
  • NT-proBNP≥650 ng/L;
  • The subjects were informed of the nature of the study and agreed to all the requirements for participating in the study. They signed the informed consent form and agreed to complete the follow-up and the examinations required for the follow-up.
Exclusion Criteria
  • Local or systemic sepsis or other acute infection;
  • Severe coagulopathy;
  • Allergy to nickel and/or titanium and/or nickel/titanium-based materials;
  • Patients with contraindications to antiplatelet, coagulant or thrombotic therapy;
  • Intolerance to contrast media;
  • Have participated in other drug or device clinical trials during the same period;
  • Glomerular filtration rate (GFR) < 50 mL/min;
  • Patients with severe liver dysfunction (alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 3 times the upper limit of normal);
  • The patient had malignant arrhythmia;
  • The patient did not receive standardized drug therapy (triple sequential therapy) according to the Chinese guidelines for the diagnosis and treatment of pulmonary hypertension within 3 months;
  • Women who are pregnant, planning to become pregnant (within 12 months) or breastfeeding;
  • Severe restrictive or obstructive lung disease;
  • Implanted atrial septal defect (ASD)/ patent foramen ovale (PFO) closure device;
  • Left ventricular ejection fraction (LVEF) <50%;
  • SpO2 < 90% without oxygen inhalation (pulse measurement);
  • The anatomical structure of the heart is abnormal, and the shunt cannot be implanted on the atrial septum;
  • Other circumstances in which the patient was deemed by the investigator to be ineligible for inclusion in the trial.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Device-intervention GroupFreeFlow percutaneous atrial septal shuntFreeFlow percutaneous atrial septal shunt
Primary Outcome Measures
NameTimeMethod
All-cause mortality at 6 months6 months

All-cause mortality at 6 months

Rehospitalization rates associated with exacerbation of pulmonary arterial hypertension6 months

Rehospitalization rates associated with exacerbation of pulmonary arterial hypertension within 6 months

Secondary Outcome Measures
NameTimeMethod
Effective shunt rate at the end point12 months

Effective shunt was defined as the presence of intra-atrial shunt by echocardiography at 12 months after operation, and the diameter of the shunt was reduced by no more than 2mm compared with the diameter measured by echocardiography before discharge

Shunt Success rate12 months

Successful shunt operation was defined as successful shunt implantation, normal morphology and position, and basically the expected shunt size under fluoroscopy.

The WHO functional class was changed 12 months after operation12 months

The WHO functional class was changed 12 months after operation

Changes in NT-pro BNP at 12 months after surgery12 months

Changes in NT-pro BNP at 12 months after surgery

The change of exercise capacity (6min walking test) was observed 12 months after operation12 months

The change of exercise capacity (6min walking test) was observed 12 months after operation

The change of subjects' Kansas City Cardiomyopathy Quality of Life Questionnaire score at 12 months after surgery12 months

The change of subjects' Kansas City Cardiomyopathy Quality of Life Questionnaire score at 12 months after surgery

Cumulative number of readmissions associated with exacerbation of pulmonary hypertension at 12 months after surgery12 months

Cumulative number of readmissions associated with exacerbation of pulmonary hypertension at 12 months after surgery

Serious Adverse Event Rate (SAE)through study completion, an average of 1 year

Serious adverse event rate (SAE) refers to events occurring during the course of the clinical trial that lead to death or serious deterioration of health status, including fatal illness or injury, permanent defects in body structure or function, and the need for medical or surgical intervention to avoid permanent defects in body structure or function.

Device-related Adverse Event Rate (DSAE)through study completion, an average of 1 year

The device-related adverse event rate (DSAE) refers to the adverse medical events related to the use of the device that occurred during the course of the clinical trial.

Trial Locations

Locations (1)

180 Fenglin Road

🇨🇳

Shanghai, Shanghai, China

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