跳至主要内容
临床试验/NCT06461676
NCT06461676尚未招募1 期

Study of Intramyocardial Injection of Ventrix Bio Extracellular Matrix (VentriGel) to Assess the Safety and Feasibility in Pediatric Patients with Hypoplastic Left Heart Syndrome (HLHS)

Emory University1 个研究点 分布在 1 个国家目标入组 12 人开始时间: 2025年8月最近更新:
适应症
干预措施
相关药物

试验速览

阶段
1 期
状态
尚未招募
入组人数
12
试验地点
1
主要终点
Number of Cardiogenic shock events

研究概览

简要总结

The goal of this Phase I Open-Label study is to demonstrate the safety and feasibility of VentriGel injection in children with Hypoplastic Left Heart Syndrome (HLHS).

The main questions it aims to answer are:

  • Whether VentriGel is safe in treating patients with HLHS
  • Whether there are any preliminary improvements in measures of cardiac function following Ventrigel injection

详细描述

HLHS, a type of congenital heart disease, presents a unique challenge where the left ventricle fails to develop, necessitating the right ventricle to manage both systemic and pulmonary blood flow. This condition, once fatal, has become manageable due to advancements in surgical techniques, with reported 5-year survival rates of 70-90%. However, these staged procedures, while lifesaving, can strain the right ventricle, leading to long-term issues such as weakened muscle and reduced cardiac function. Additionally, even with surgical intervention, patients often face a diminished quality of life.

Addressing these challenges, ongoing clinical trials explore regenerative therapies, particularly stem cell injections, aiming to improve heart function. Yet, concerns persist regarding the practicality and efficacy of these treatments, including issues with cell survival and coordination of injections within narrow timeframes.

Innovatively, the investigator and the team propose an alternative approach using VentriGel, an injectable hydrogel derived from decellularized porcine myocardium. Originally designed for treating heart failure post-myocardial infarction in adults, VentriGel has shown promising results in animal models, demonstrating significant improvements in cardiac function. Notably, its shelf-stable nature and flexible timing for administration offer advantages over traditional stem cell therapies.

Moreover, VentriGel's effectiveness in addressing right-ventricular failure, as demonstrated in recent studies, highlights its potential as a solution for HLHS patients. Leveraging approved extracellular matrix devices, such as Alloderm and SurgiSIS, further underscores the feasibility and safety of this approach, paving the way for potentially transformative treatments in congenital heart diseases.

研究设计

研究类型
Interventional
分配方式
Na
干预模型
Single Group
主要目的
Treatment
盲法
None

入排标准

年龄范围
— 至 1 Year(Child)
性别
All
接受健康志愿者

入选标准

  • Subjects with Hypoplastic Left Heart Syndrome (HLHS) requiring Stage II Glenn operation under one year of age

排除标准

  • Subjects undergoing the Stage II Glenn operations who do not have HLHS
  • Subjects requiring mechanical circulatory support within 5 days pre pre-surgical intervention
  • Parent or guardian unwilling or unable to comply with necessary follow-up(s)
  • Immunosuppressive diseases or subjects who require treatment with interventions that cause immunosuppression
  • A history of tumor or malignancy
  • Coagulation disorders
  • Chromosomal abnormalities that limit expected survival to < 1 year
  • Abnormal lab values that may increase the risk of the study procedure (WBC >20,000 cells/ul or < 1,000 cells/ul; platelet count < 50,000 cells/ul; Hgb < 8.0 gm/dl; LFTs > 2x reference lab upper limit of normal) at the time of screening
  • Subjects with conduction abnormalities, including atrioventricular block and bundle branch blocks
  • Ventricular arrhythmias due to antiarrhythmic pharmacological therapy

研究组 & 干预措施

Ventrix Bio Extracellular Matrix

Experimental

Treatment intervention of a total of 8 injections into the right ventricle of the heart will occur before the patient comes off of the heart-lung bypass machine used during the Stage II Glenn Operation. The treatment will be conducted according to clinical guidelines set in place while the patient is undergoing a surgical intervention before the patient comes off the heart/lung bypass machine required for the stage II Glenn Procedure.

干预措施: Ventrix Bio Extracellular Matrix (Drug)

结局指标

主要结局

Number of Cardiogenic shock events

时间窗: Day 1, 30 days post operation

Cardiogenic shock (i.e. tissue hypoperfusion presented by hypotension due to decreased cardiac output, determined by rising lactate levels (5x normal levels in first 24 hours, 2.5x normal levels in first 30 days)

Number of ventricular tachycardia events

时间窗: upto 30 days post operation

Number of sustained/symptomatic ventricular tachycardia incidences requiring intervention with inotropic support or anti-arrhythmics

Number of Adverse Events

时间窗: upto 30 days post operation

Number of adverse events occurring post op

Number of deaths

时间窗: upto 30 days post operation

Number of deaths occurring post op

Number of VentriGel products manufactured and delivered to subjects

时间窗: 12 months

Number of patients receiving Cardiac MRIs

时间窗: Baseline, 6 months, 12 months

Number of unplanned cardiovascular operation events

时间窗: 30 days post operation

Unplanned cardiovascular operation due to right ventricular intramyocardial injection site bleeding in the first 5 days after Stage II operation decreased cardiac output, determined by rising lactate levels (5x normal levels in first 24 hours, 2.5x normal levels in first 30 days)

Number of patients requiring new permanent pacemaker

时间窗: upto 30 days post operation

Number of patients requiring new permanent pacemaker

Stroke or embolic event

时间窗: upto 30 days post operation

Stroke or embolic event to the brain determined by CT scan

次要结局

  • Change in right ventricular global circumferential strain(Baseline, 6 months,12 months post operation)
  • Change in right ventricular end diastolic volume(Baseline, 6 months, 12 months post operation)
  • Change in tricuspid regurgitation(Baseline, 6 months,12 months post operation)
  • Change in right ventricular global longitudinal strain(Baseline, 6 months,12 months post operation)
  • Change in right ventricular Tricuspid Annular Plane Systolic Excursion (TAPSE)(Baseline, 6 months,12 months post operation)
  • Change in right ventricular ejection fraction(Baseline, 6 months, 12 months post operation)
  • Change in right ventricular function Fractional Area Change(Baseline, 6 months,12 months post operation)
  • Change in right ventricular end systolic volume(Baseline, 6 months, 12 months post operation)
  • Change in right atrial volume indexed(Baseline, 6 months,12 months post operation)

研究者

申办方类型
Other
责任方
Principal Investigator
主要研究者

William T. Mahle

Professor

Emory University

研究点 (1)

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