PARADIGM: Amplatzer Valvular Plug for PVL Closure
- Conditions
- Paravalvular Aortic Regurgitation
- Interventions
- Device: AVP III
- Registration Number
- NCT04489823
- Lead Sponsor
- Abbott Medical Devices
- Brief Summary
The Paradigm study is a prospective, multicenter, single arm study to demonstrate the safety and effectiveness of the Amplatzer Valvular Plug III (AVP III) as a treatment for clinically significant PVLs following surgical implant of a mechanical or biological heart valve implanted in the aortic or mitral position.
- Detailed Description
PARADIGM is a prospective, international, multi-center, single arm study to demonstrate the safety and effectiveness of the AVP III for percutaneous, transcatheter closure of paravalvular leak (PVL) occurring after aortic or mitral valve replacement with a surgically-implanted mechanical or bioprosthetic valve. The study will be conducted at approximately 25 clinical sites in the US, Europe, and Canada. A total of 200 subjects with a clinically significant PVL will undergo an AVP III implant procedure for PVL closure. Pre-procedural Baseline and follow-up assessments at Discharge, 30 days, 6 months and 1 year will include echocardiography, physical examinations, lab measurements and questionnaires to assess PVL severity, prosthetic valve function, hemolytic anemia, heart failure symptoms, and quality of life. Adverse events will be recorded throughout the study.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 200
- Subject is implanted with a mechanical or biological surgical valve in the aortic or mitral position
- Note: Subjects in European countries can only be implanted with a mechanical valve in the aortic or mitral position
- Subject has a clinically significant paravalvular leak with a severity grade of moderate or higher, associated with signs of heart failure and/or hemolysis necessitating recurring blood transfusions.
- Subject has one clinically significant PVL defect that can be closed with a single AVP III as assessed pre-procedurally
- Subject has provided written informed consent
- Subject is ≥18 years old
- Subject has a rocking valve or extreme dehiscence of the prosthetic valve involving more than 40% of the sewing ring
- Subject's PVL(s) originates from a transcatheter aortic or mitral valve replacement, or from rapid deployment or sutureless surgical replacement valves
- Subject has a prosthetic aortic valve and prosthetic mitral valve which both have a clinically significant paravalvular leak.
- Subject who is hemodynamically unstable or who cannot undergo an elective procedure
- Subject with active endocarditis or other active infection
- Subject has within the last 6 months a previously documented intracardiac mass, vegetation, tumor, or thrombus which would interfere with placement of the AVP III
- Subject has inadequate vasculature for delivery of the AVP III
- Subject has unsuitable anatomy for PVL closure using the AVP III (such as a PVL associated with an abscess cavity or a pseudoaneurysmal sac) or anatomy where the AVP III would interfere with other intracardiac or intravascular structures (such coronary ostia)
- Subjects who are unable to receive intraprocedural anticoagulant therapy
- Pregnant or nursing subjects or subjects who plan pregnancy during the clinical investigation follow-up period.
- Presence of other anatomic or comorbid conditions, or other medical, social, or psychological conditions that, in the investigator's opinion, could limit the subject's ability to participate in the clinical investigation or to comply with follow-up requirements, or impact the scientific soundness of the clinical investigation results.
- Life expectancy is less than 1 year in the opinion of the Investigator
- Incapacitated individuals, defined as persons with mental illnesses or handicaps that impair their ability to provide informed consent, or individuals without legal authority to provide informed consent.
- Individual who are currently participating in an investigational drug or device study that has not reached the primary endpoint or that may confound the results of this study
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Paravalvular Leak Closure AVP III Includes all eligible subjects who undergo an AVP III implant attempt for treatment of significant paravalvular leakage with an echocardiographic severity grade of moderate or higher. This is a single arm study.
- Primary Outcome Measures
Name Time Method Paravalvular leak closure success rate (percent of subjects) 30 Days * Successful transcatheter placement in the intended location without interference
* Reduction in paravalvular regurgitation severity by ≥ two grades
* Freedom from intra-procedural death
* Freedom from unplanned transcatheter or surgical re-intervention through 30 days post-implant.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (29)
University Hospital - Univ. of Alabama at Birmingham (UAB)
🇺🇸Birmingham, Alabama, United States
Emory University Hospital
🇺🇸Atlanta, Georgia, United States
St. Vincent Hospital
🇺🇸Indianapolis, Indiana, United States
Ochsner Medical Center
🇺🇸New Orleans, Louisiana, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
Henry Ford Hospital
🇺🇸Detroit, Michigan, United States
Minneapolis Heart Institute
🇺🇸Minneapolis, Minnesota, United States
Mayo Clinic
🇺🇸Rochester, Minnesota, United States
St. Luke's Hospital
🇺🇸Kansas City, Missouri, United States
University of Nebraska Medical Center
🇺🇸Omaha, Nebraska, United States
Hackensack University Medical Center
🇺🇸Hackensack, New Jersey, United States
Lenox Hill Hospital
🇺🇸New York, New York, United States
New York Presbyterian Hospital/Cornell University
🇺🇸New York, New York, United States
The Cleveland Clinic Foundation
🇺🇸Cleveland, Ohio, United States
Baptist Memorial Hospital
🇺🇸Memphis, Tennessee, United States
Intermountain Medical Center
🇺🇸Murray, Utah, United States
Carilion Roanoke Memorial Hospital
🇺🇸Roanoke, Virginia, United States
Providence Sacred Heart Medical Center
🇺🇸Spokane, Washington, United States
Institut de Cardiologie de Montreal (Montreal Heart Inst.)
🇨🇦Montréal, Quebec, Canada
Institut de Cardiologie de Quebec (Hôpital Laval)
🇨🇦Quebec City, Quebec, Canada
St. Paul's Hospital
🇨🇦Vancouver, Canada
Ospedale San Raffaele
🇮🇹Milano, Lombard, Italy
St. Antonius Ziekenhuis
🇳🇱Nieuwegein, Utrecht, Netherlands
Gornoslaskie Centrum Medyczne im.prof. Leszka Gieca
🇵🇱Katowice, Silesia, Poland
Hospital Ramón y Cajal
🇪🇸Madrid, Spain
Hospital Universitario de Salamanca
🇪🇸Salamanca, Spain
Edinburgh Heart Centre
🇬🇧Edinburgh, Lothian, United Kingdom
The Royal Sussex County Hospital
🇬🇧Brighton, Soeast, United Kingdom
Papworth Hospital NHS Foundation Trust
🇬🇧Cambridge, United Kingdom