A Study to Evaluate the Safety and Performance of LuX-Valve Plus System for Tricuspid Replacement
- Conditions
- Tricuspid Regurgitation
- Interventions
- Device: Transcatheter Tricuspid Valve Intervention
- Registration Number
- NCT05436028
- Lead Sponsor
- Jenscare Scientific
- Brief Summary
This is a prospective, single-arm, multi-center trial to evaluate the LuX-Valve Plus system for treating symptomatic at least severe TR in patients who are deemed high risk for tricuspid surgery.
Treatment with the LuX-Valve Plus system may enable patients with tricuspid regurgitation to have a complete tricuspid valve replacement with a minimally invasive approach.
Up to 150 subjects will be implanted at up to 24 institutions worldwide. No single institution will be allowed to register more than 25% of total subjects. There is no minimum number of subjects to be registered at any site.
Up to3 per site, may be implanted by operators without prior experience using the LuX-Valve Plus device to gain hands-on experience.Each site has a maximum of 3 roll-in cases. The data of roll-in subjects will not count towards the overall enrollment cap. Safety and performance results of roll-in subjects will be analyzed in subgroups.
All subjects will be evaluated at baseline, procedure, discharge, 30 days, 6 months, 1 year, 2 years, 3 years, 4 years, and 5 years post-procedure.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 161
- Age≥50 years at time of consent
- Severe or greater TR (≥3+) assessed on transthoracic echocardiography by Echo Core Lab (ECL) using a 5-grade classification
- New York Heart Association (NYHA) Class II-IV
- In the judgment of the Site Heart Team, the subject has been adequately treated per applicable standards, including optimal medical therapy with diuretics
- The Site Heart Team concur the benefit-risk analysis supports transcatheter tricuspid valve replacement per current guidelines for the management of valvular heart disease, and the subject is at high risk for tricuspid valve surgery.
- Patient must be able to fully understand all aspects of the investigation that are relevant to the decision to participate, and provide a written informed consent
- In France, patient is affiliated to a health social security regimen or equivalent
- Pulmonary arterial systolic pressure (PASP) > 60 mmHg by echo Doppler (unless right heart catheterization [RHC] demonstrates PASP ≤60 mmHg) or R heart catheterization OR PASP > 2/3 systemic BP with PVR > 5 Wood units after vasodilator challenge, in the absence of symptomatic hypotension or systolic BP < 90 mmHg.
- Left Ventricular Ejection Fraction (LVEF) <35%
- Evidence of intracardiac mass, thrombus or vegetation
- Anatomical structures precluding proper device deployment or device vascular access, evaluated by echo or CT
- Ebstein Anomaly or congenital right ventricular dysplasia
- Surgical correction is indicated for other concomitant valvular disease (e.g., severe aortic, mitral and/or pulmonic valve stenosis and/or regurgitation) Subjects with concomitant valvular disease may treat their respective valve first, and wait 2 months before being reassessed for the trial.
- Patients with valve prostheses implanted in the tricuspid valve
- Pre-existing prosthetic valve(s) (other than tricuspid ones) with clinically significant prosthetic dysfunction
- Sepsis or active endocarditis within 3 months, or infections requiring antibiotic therapy within 2 weeks prior to the planned procedure
- Untreated clinically significant coronary artery disease requiring revascularization
- Acute myocardial infarction or unstable ischemia-related angina within 30 days prior to the planned procedure
- Any percutaneous coronary, intracardiac or carotid intervention within 30 days prior to the planned procedure
- Cerebrovascular stroke (ischemic or bleeding) within prior 3 months to enrollment
- Active peptic ulcer or active gastrointestinal (GI) bleeding within prior 3 months to enrollment
- Inability to tolerate anticoagulation or antiplatelet therapy
- Cardiogenic shock manifested by low cardiac output, vasopressor dependence, or mechanical hemodynamic support
- Renal insufficiency (eGFR < 30 ml/min per the Cockcroft-Gault formula) and/or renal replacement therapy at the time of screening
- Chronic liver failure or cirrhosis with MELD-Albumin Score ≥ 12
- Severe lung disease or patient dependent on home oxygen and deemed unsuitable by the local heart team or eligibility committee for the study.
- Futility with estimated life expectancy<12 months.
- Subjects currently participating in another clinical trial of an investigational drug or device that has not yet completed its primary endpoint.
- Pregnant or lactating; or female of childbearing potential with a positive pregnancy test within 14 days prior to intervention (contraceptive requirement is shown in Appendix XI)
- Allergic to one or more of the substances contained in the implant and/or delivery system, including nitinol, tantalum, PET, PTFE, bovine pericardium, Pebax, PA, Polyurethane, Stainless steel.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description LuX-Valve Plus transvenous tricuspid valve and delivery system(LuX-Valve Plus System) Transcatheter Tricuspid Valve Intervention The LuX-Valve Plus System is intended for the treatment of patients with at least severe TR who are determined by a Heart Team to be at high risk of traditional open-heart surgery.
- Primary Outcome Measures
Name Time Method A composite endpoint of Major Adverse Event (MAE) at 30 days post procedure 30 days post procedure A composite endpoint of Major Adverse Event (MAE) at 30 days post procedure, as listed below:
Cardiovascular Mortality Myocardial Infarction (MI) Stroke New onset renal failure requiring unplanned dialysis or renal replacement therapy Severe Bleeding (includes fatal, life-threatening and extensive bleeding as defined by MVARC) Non-selective tricuspid valve surgery or transcatheter re-intervention post procedure Major cardiac structural complications Major access site and vascular complications Device-related pulmonary embolism New pacemaker implantation due to AV block
- Secondary Outcome Measures
Name Time Method Acute Secondary Endpoints-Procedural Success Rate 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure Device success without clinically significant PVL, as determined by the Echo Core Lab (ECL) assessment of a discharge TTE. Subjects who die or undergo tricuspid valve surgery before discharge are procedure failures.
Clinical and Functional Endpoints-All-cause mortality at 30 days, 6 months, 12 months and annually until 5 years post-procedure All-cause mortality
Clinical and Functional Endpoints-NYHA Functional Class at 30 days, 6 months, 12 months and annually until 5 years post-procedure NYHA Functional Class
Echocardiographic Endpoints-TR Severity Grade at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure TR Severity Grade
Echocardiographic Endpoints-Regurgitant Volume at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Regurgitant Volume
Echocardiographic Endpoints-Mean Tricuspid valve inflow gradient at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Mean Tricuspid valve inflow gradient
Echocardiographic Endpoints-Right Atrial Volume at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Right Atrial Volume
Echocardiographic Endpoints-Right ventricular functions assessments:fractional area change(FAC) at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Right ventricular functions assessments:fractional area change(FAC)
Acute Secondary Endpoints-Clinical Success Rate at 30 days at 30 days Procedural success without MAEs at 30 days.
Clinical and Functional Endpoints-Heart failure hospitalization at 30 days, 6 months, 12 months and annually until 5 years post-procedure Heart failure hospitalization
Clinical and Functional Endpoints-Distance of 6-Minute Walk Test (6MWT) at 30 days, 6 months, 12 months and annually until 5 years post-procedure Distance of 6-Minute Walk Test (6MWT)
Echocardiographic Endpoints-Vena Contracta Width at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Vena Contracta Width
Echocardiographic Endpoints-Effective Regurgitant Orifice Area (EROA) at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Effective Regurgitant Orifice Area (EROA)
Acute Secondary Endpoints-Device Success Rate From the first skin incision for the investigational device to the time patient's exist from OR/Cath lab,assessed up to 24 hours post procedure. Device success is defined as successful deployment of the device and removal of the delivery system as planned, with no unplanned surgery related to the device or access procedure.
Clinical and Functional Endpoints-Cardiovascular mortality at 30 days, 6 months, 12 months and annually until 5 years post-procedure Cardiovascular mortality
Echocardiographic Endpoints-Regurgitation Jet Area at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Regurgitation Jet Area
Echocardiographic Endpoints-Right ventricular functions assessments:TAPSE at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Right ventricular functions assessments:TAPSE
Echocardiographic Endpoints-Right ventricular functions assessments:systolic tricuspid lateral annular tissue velocity S' at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Right ventricular functions assessments:systolic tricuspid lateral annular tissue velocity S'
Echocardiographic Endpoints-Left Ventricular Ejection Fraction (LVEF) at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Left Ventricular Ejection Fraction (LVEF)
Clinical and Functional Endpoints-Tricuspid valve surgery or transcatheter re-intervention at 30 days, 6 months, 12 months and annually until 5 years post-procedure Tricuspid valve surgery or transcatheter re-intervention
Clinical and Functional Endpoints-Kansas City Cardiomyopathy Questionnaire (KCCQ) at 30 days, 6 months, 12 months and annually until 5 years post-procedure Kansas City Cardiomyopathy Questionnaire (KCCQ):Scores are transformed to a range of 0-100,in which higher scores reflect better health status.
Clinical and Functional Endpoints-Edema assessment at 30 days, 6 months, 12 months and annually until 5 years post-procedure Edema assessment (1+ to 4+)
Echocardiographic Endpoints-Right ventricular functions assessments:Hepatic vein flow reversal at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Right ventricular functions assessments:Hepatic vein flow reversal
Echocardiographic Endpoints-Cardiac Output at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Cardiac Output
Echocardiographic Endpoints-Paravalvular leak severity at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Paravalvular leak severity
Echocardiographic Endpoints-Systolic pulmonary artery pressure at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Systolic pulmonary artery pressure
Echocardiographic Endpoints-Right ventricular functions assessments:Inferior Cava Vein Diameter/respiratory variations at baseline, 7-day post procedure, or at discharge if the subjects are discharged within 7 days after the procedure, 30 days, 6 months, 12 months and annually until 5 years post-procedure Right ventricular functions assessments:Inferior Cava Vein Diameter/respiratory variations
Trial Locations
- Locations (1)
Unité Médico-Chirurgicale, Hôpital Haut Lévêque, CHU de Bordeaux
🇫🇷Bordeaux, Gironde, France