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HighLife™ Transcatheter Mitral Valve Replacement System Study

Not Applicable
Completed
Conditions
Mitral Valve Insufficiency
Mitral Valve Regurgitation
Interventions
Device: Transcatheter Mitral Valve Replacement
Registration Number
NCT02974881
Lead Sponsor
HighLife SAS
Brief Summary

Multicenter feasibility study of the HighLife™ TMVR system.

Detailed Description

This is an exploratory clinical study designed to evaluate the feasibility, safety and performance of the Highlife TMVR System in a population of patients with severe symptomatic mitral regurgitation, who are not suitable for surgical or approved percutaneous treatments according to the judgement of the Heart Team. The data gathered in this study will allow to evaluate the feasibility of mitral replacement using the HighLife™ TMVR system and characterize the safety and performance profile of the HighLife™ TMVR System.

All patients will be followed periodically up to 12 months after the intervention and long term safety and performance will be collected annually up to 5 years.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
5
Inclusion Criteria
  • Age ≥ 18 years
  • Severe mitral regurgitation
  • New York Heart Association (NYHA) Functional Class II, III or ambulatory IV.
  • Patient is under maximally tolerated GDMT (incl. CRT) for at least 3 months
  • Multidisciplinary Heart Team consensus that the patient is inoperable or at high-risk for surgical repair/replacement due to significant co-morbid conditions
  • Multidisciplinary Heart Team consensus that the patient is not a suitable candidate for other approved percutaneous repair therapy due to anatomical or medical conditions
  • Patient meets the anatomical criteria for HighLife valve sizing as determined by CT and TEE

Main

Exclusion Criteria
  • Mitral stenosis
  • Rheumatic valve disease
  • Severe calcifications of the mitral annulus and/or mitral leaflets
  • Prior surgical or interventional treatment of the mitral valve
  • Unsuitable anatomy for the transapical access
  • Unsuitable anatomy of the aorta and ilio-femoral vessels for the transfemoral access
  • Untreated clinically significant coronary artery disease requiring revascularization
  • LVEF < 30%
  • LVEDD > 70mm
  • Echocardiographic evidence of intracardiac mass, thrombus or vegetation
  • Hypertrophic Obstructive Cardiomyopathy (HOCM)
  • Any surgical or interventional procedure (including PCI) done in the past 30 days prior to procedure

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
transcatheter mitral valve replacementTranscatheter Mitral Valve ReplacementHighLife TMVR System is a novel and innovative approach developed as an alternative treatment for severe MR when medical treatment is maximal and surgical interventions not possible or at high risk. The HighLife TMVR system is composed of a Transcatheter Mitral Valve (TMV), a sub-annular implant (SAI), and their delivery systems and loading tools. The HighLife Valve is a 31 mm mitral bioprosthesis made of a self-expanding Nitinol frame covered with polyester graft and supporting bovine pericardium leaflets. The bioprosthesis is used in conjunction with the Sub-Annular Implant (SAI).
Primary Outcome Measures
NameTimeMethod
Technical successimmediately after procedure

defined as alive patient at exit from procedure room, with all of the following:

* Successful access, delivery and retrieval of the HighLife delivery systems

* Deployment and correct positioning of the HighLife bioprosthesis

* Freedom of additional emergency surgery or re-intervention related to the device or access procedure

Freedom of major adverse eventsat 30 days post procedure

including:

* All-cause mortality

* Myocardial infarction or coronary ischemia requiring PCI or CABG

* Major stroke

* Life-threatening bleeding (MVARC scale)

* Major access and vascular complications

* Stage 2 or 3 acute kidney injury (includes dialysis)

* Any valve-related dysfunction, migration, thrombosis, or other complication requiring surgery or repeat intervention

* Severe hypotension, heart failure or respiratory failure requiring intravenous pressors or invasive or mechanical heart failure treatments such as ultrafiltration or hemodynamic assist devices, including intra-aortic balloon pumps or left ventricular or biventricular assist devices, or prolonged intubation for ≥ 48H

Continued intended performance of the HighLife™ bioprosthesisat 30 days post procedure

defined as the reduction of mitral regurgitation (MR) to either optimal (0+ to trace) or acceptable (reduced by at least 1 grade from baseline with no more than 2+ MR) without significant mitral stenosis (post-procedure EOA ≥ 1.5 cm2 with a transmitral gradient \< 5mmHg) and with no greater than mild (1+) paravalvular MR (and without associated hemolysis)

Secondary Outcome Measures
NameTimeMethod
Device Success (per MVARC definitions)At 30 days, 6 months and 12 months post procedure

per MVARC definition

Patient SuccessAt 30 days, 6 months and 12 months post procedure

per MVARC definition

Quality of Life Improvement vs. BaselineAt 6 months and 12 months

Kansas City Cardiomyopathy Questionnaire

Procedure SuccessAt 30 days, 6 months and 12 months post procedure

per MVARC definition

Hemodynamic Performance vs. BaselineAt 7 days, 30 days, at 6 months and 12 months and at 2, 3, 4 and 5 years

Echocardiographic evaluation

Functional Improvement vs. BaselineAt 30 days, 6 months and 12 months

New York Heart Association Class 6-Minute Walk Test

Trial Locations

Locations (10)

CHU Nantes

🇫🇷

Nantes, France

CHRU Lille

🇫🇷

Lille, France

CHU Rennes Pontchaillou

🇫🇷

Rennes, France

Universitäres Herzzentrum Hamburg GmbH (UHZ)

🇩🇪

Hamburg, Germany

Hôpital Privé Jacques Cartier

🇫🇷

Massy, France

Universitätsklinikum

🇩🇪

Bonn, Germany

Herzzentrum Leipzig

🇩🇪

Leipzig, Germany

Groupe Hospitalier Pitié-Salpétrière Institut de Cardiologie

🇫🇷

Paris, France

CHU Toulouse Rangueil

🇫🇷

Toulouse, France

Deutsches Herzzentrum München des Freistaates Bayern

🇩🇪

Munich, Germany

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