Safety and Efficacy of the Rivet Pulmonary-to-Venous Shunt (PVS) Therapy in Patients With Group 2 Pulmonary Hypertension (PH) Due to Heart Failure With Preserved Ejection Fraction (HFpEF)
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Heart Failure
- Sponsor
- NXT Biomedical
- Locations
- 3
- Primary Endpoint
- Rate of Technical Success of the Rivet Shunt Implantation Procedure
- Status
- Withdrawn
- Last Updated
- last year
Overview
Brief Summary
This clinical investigation is a prospective, multicenter, non-randomized, open-label, Early Feasibility Study to evaluate the safety, performance, and initial clinical efficacy of the Rivet PVS therapy in patients with symptomatic pulmonary hypertension.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age ≥ 18 years
- •Prior diagnosis of Group 2 PH due to HFpEF, with the following resting hemodynamic criteria confirmed in the past year by right heart catheterization
- •a. mPAP ≥ 25 mmHg at rest or mPAP/CO slope \> 3 mmHg/L/min during incremental exercise
- •Confirmation of the following hemodynamic criteria during supine exercise
- •a. PCWP ≥ 25 mmHg, or PCWP/CO slope \> 2 mmHg/L/min
- •Chronic symptomatic heart failure documented by the following:
- •NYHA HF Class II with history \> II, or Class III, or ambulatory Class IV
- •≥ 1 HF hospitalization, or healthcare facility with IV diuretics or intensification of oral diuresis for HF within 12 months, or NT-pro BNP value \> 400 pg/mL in normal sinus rhythm or \> 750 pg/mL in atrial fibrillation in past 6 months
- •Ongoing stable guideline directed medical therapy (GDMT) for HF and medically optimized per treating HF physician according to current ACCF/AHA guidelines that is expected to be maintained without change for 6 months (excluding diuretic dosage changes for HF optimization within 90 days of the Index Procedure)
- •6MWD ≥ 150 m
Exclusion Criteria
- •Any therapeutic intracardiac intervention within the last 30 days
- •PH Group 1, 3, 4 or 5
- •Mean RAP \>12 mmHg by RHC at rest on room air
- •Right ventricular dysfunction, defined as one or more of the following
- •Greater than moderate RV dysfunction as assessed by TTE and/or MRI
- •RV FAC \< 35%
- •TAPSE \< 14 mm via TTE
- •RV size severely enlarged compared to LV size as estimated by TTE and/or MRI
- •Severe tricuspid valve regurgitation
- •Peak systolic pulmonary arterial pressure \> 80 mmHg by RHC at rest while awake
Outcomes
Primary Outcomes
Rate of Technical Success of the Rivet Shunt Implantation Procedure
Time Frame: At time of procedure
Study device is implanted as intended and confirmation of a patent pulmonary-to-venous shunt between the RPA and SVC by qualitative assessment via angiography and/or echocardiography at implantation procedure.
Rate of Major Adverse Events
Time Frame: 1 month
Composite of major adverse cardiac, cerebrovascular, or renal events (MACCRE) and re-intervention for study device related complications at implantation procedure (Day 0) and up to 1-month post-procedure (Day 30)
Secondary Outcomes
- Change in Hemodynamics at 12 months - PCWP(12 Months)
- Change in Kansas City Cardiomyopathy Questionnaire(12 months)
- Change in RV Chamber Size at 12 months - Diameter(12 months)
- Adverse Events through 12 months(12 months)
- Change in Hemodynamics at 12 months - mPAP/CO Slope(12 months)
- Change in RV function at 12 months - RV Fractional Area Change (FAC)(12 months)