MedPath

5 Year Observation of Patients With PORTICO Valves

Completed
Conditions
Aortic Valve Stenosis
Interventions
Device: St Jude Medical Portico replacement aortic valve
Procedure: Transcatheter Aortic Valve Implant
Registration Number
NCT01802788
Lead Sponsor
Abbott Medical Devices
Brief Summary

The purpose of this clinical investigation is to further assess the performance and safety profile of the commercially-available Portico™ TAVI System in patients with severe symptomatic aortic stenosis.

Detailed Description

This is an international multicenter, prospective, non-randomized clinical investigation without concurrent or matched control, designed to assess the mid-term safety and performance of the Portico valve in patients with severe symptomatic aortic stenosis whom are high risk for surgical valve replacement. The primary endpoint is 1 year all-cause mortality. In addition, the performance and safety profile of the Portico valve will be further evaluated at 30 days, 1 year, and annually through 5 years post-implant.

The investigation will be conducted at approximately 65 centers in approximately 15 countries in Europe, Middle-East, Africa, Canada, Australia and New Zealand.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1032
Inclusion Criteria
  • Patient has signed the Patient Informed Consent prior to participating in the clinical investigation.

  • Patient has been referred for a Portico Valve implant as per Heart Team decision or patient has received a Portico Valve as per participation in an SJM sponsored regulatory or first-in-human trial.

  • Patient has senile degenerative aortic valve stenosis confirmed by echocardiographically derived criteria*:

    • An initial aortic valve area (AVA) of less than or equal to (≤) 1.0 cm2 (or indexed EOA less than or equal to (≤) 0.6 cm2/m2) AND
    • A mean gradient greater than (>)40 mmHg or jet velocity greater than (>)4.0 m/s or Doppler Velocity Index less than (<)0.25. If the mean gradient is <40 mmHg and left ventricular ejection fraction (LVEF) <55%, then the site may as well perform a dobutamine stress echo to see if the mean gradient increases to >40 mmHg." (Baseline measurement taken by echo within 6 months of index procedure.)
  • Patient has a life expectancy more than (>) 12 months.

For patients enrolled in a French site:

  • Patient is at high risk for surgery as demonstrated by a Logistic EuroSCORE equal or more than (≥) 20 and/or a Society of Thoracic Surgeon (STS) mortality risk score of more than (>) 10% and/or by clinical judgment of the Heart Team based on the individual risk profile (comorbidities).

    • Not applicable for a patient who has received a Portico Valve as per participation in an SJM sponsored Regulatory or First-In-Human trial.
Exclusion Criteria
  • Any case in which the Portico Valve would not be indicated for the patient as per current instructions for use (i.e any "off-label" use).
  • Patient has any other aortic valve than tricuspid one.
  • Patient has a prosthetic valve or ring in the aortic position.
  • Patient needs a concomitant structural heart procedure..
  • Patient needs the usage of an embolic protection device.
  • Patient is unwilling or unable to comply with all clinical investigation-required follow-up evaluations.
  • Patient is pregnant

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Cohort ATranscatheter Aortic Valve ImplantPatients implanted with a Portico valve after CE mark
Cohort ASt Jude Medical Portico replacement aortic valvePatients implanted with a Portico valve after CE mark
Cohort BTranscatheter Aortic Valve ImplantPatients implanted in previous SJM-sponsored premarket studies
Cohort BSt Jude Medical Portico replacement aortic valvePatients implanted in previous SJM-sponsored premarket studies
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With All-cause Mortality1 year post implant

Percentage of participants that died for any reason at 1 year post implantation

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Vascular Access Site Complication as Defined by Valve Academic Research Consortium-2 (VARC-2) in Cohort A30 days post implant

Percentage of participants with vascular access site complication (major or minor) as defined by VARC-2 at 30 days post implantation

Mean Prosthetic Valve Function as Defined by Valve Academic Research Consortium-2 (VARC-2) (Aortic Valve Area)30 days through 5 years post implant

The aortic valve area as interpreted by an independent echocardiographic core laboratory at 30 days through 5 years post implantation

Mean Quality of Life Assessment in Cohort A30 days and 1 year post implant

EuroQuol-5 Dimensions (EQ5D) is a standardized instrument for use as a measure of health outcome applicable to a wide range of health conditions and treatments. A visual analog scale (VAS) for health is also included in the measure as a patient-reported estimate of overall health status. This scale ranges between 0-100, where 0 is 'the worst health you can imagine' and 100 is 'the best health you can imagine'.

Percentage of Participants With All Cause Mortality in Cohort A30 days through 5 years post implant

Percentage of participants that died for any reason at 30 days through 5 years post implantation

Number of Participants With Cardiovascular Mortality Occurring at Each Time Window (30 Days, 1 Year, 2 Years, 3 Years, 4 Years and 5 Years) in Cohort B30 days through 5 years post implant

Number of participants who died for any reason at different time points such as 30 days, 1 year, 2 years, 3 years, 4 years and 5 years.

Percentage of Participants With Myocardial Infarction as Defined by Valve Academic Research Consortium-2 (VARC-2) in Cohort A30 days through 5 years post implant

Percentage of participants with a myocardial infarction as defined by VARC-2 at 30 days through 5 years post implantation post implantation

Percentage of Participants With Non-Cardiovascular Mortality as Defined by the Valve Academic Research Consortium-2 (VARC-2) in Cohort A30 days through 5 years post implant

Percentage of participants that died for any reason at 30 days through 5 years post implantation

Percentage of Participants With Bleeding Events as Defined by Valve Academic Research Consortium-2 (VARC-2) in Cohort A30 days post implant

Percentage of participants with a bleeding events (life threatening, major or minor) as defined by VARC-2 at 30 days post implantation

Mean Six Minute Walk Test (6MWT)30 days through 5 years post implant

Distance in metres that the participant can walk in 6 minutes. The six-minute walking test (6MWT) is a commonly used objective measure of functional exercise capacity in individuals with moderately severe impairment.

Number of Participants With Transient Ischemic Attack in Cohort B30 days through 5 years post implantation

Number of participants with transient ischemic attack as defined by VARC-2 at 30 days through 5 years post implantation

Number of Participants With All-cause Mortality (30 Days, Annually From 1 Year Through 5 Years) in Cohort B30 days through 5 years post implant

Number of participants who died for any reason at different time points such as 30 days, 1 year, 2 years, 3 years, 4 years and 5 years.

Percentage of Participants With Cardiovascular Mortality as Defined by the Valve Academic Research Consortium-2 (VARC-2) in Cohort A30 days through 5 years post implant

Percentage of participants that died for cardiovascular or unknown reasons as defined by VARC-2 at 30 days through 5 years post implantation

Number of Participants With Non-Cardiovascular Mortality Occurring at Each Time Window (30 Days, 1 Year, 2 Years, 3 Years, 4 Years and 5 Years) in Cohort B30 days through 5 years post implant

Number of participants who died for any reason at different time points such as 30 days, 1 year, 2 years, 3 years, 4 years and 5 years.

Number of Participants With Myocardial Infarction as Defined by Valve Academic Research Consortium-2 (VARC-2) in Cohort B30 days through 5 years post implant

Number of participants with a myocardial infarction as defined by VARC-2 at 30 days through 5 years post implantation post implantation

Mean Prosthetic Valve Function as Defined by Valve Academic Research Consortium-2 (VARC-2) (Mean Transvalvular Gradient)30 days through 5 years post implant

The mean transvalvular gradient as interpreted by an independent echocardiographic core laboratory at 30 days through 5 years post implantation

Percentage of Participants With Stage 1, 2 and 3 Acute Kidney Injury as Defined by Valve Academic Research Consortium-2 (VARC-2) in Cohort A30 days post implant

Percentage of participants with a Stage 1, 2 or Stage 3 acute kidney injury as defined by VARC-2 at 30 days post implantation

Number of Participants With New York Heart Association (NYHA) Functional Classification of Heart Failure5 years post implant

The New York Heart Association (NYHA) Functional Classification provides a simple way of classifying the extent of heart failure. It classifies patients in one of four categories based on their limitations during physical activity:

Class I - No symptoms and no limitation in ordinary physical activity; Class II - Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity; Class III - Marked limitation in activity due to symptoms; Class IV - Severe limitations.

Percentage of Participants With Transient Ischemic Attack in Cohort A30 days through 5 years post implantation

Percentage of participants with transient ischemic attack as defined by VARC-2 at 30 days through 5 years post implantation

Percentage of Participants With Stroke as Defined by Valve Academic Research Consortium-2 (VARC-2) in Cohort A5 years post implant

Percentage of participants with a stroke (disabling and non-disabling) as defined by VARC-2 at 5 years post implantation

Number of Participants With Stroke as Defined by Valve Academic Research Consortium-2 (VARC-2) in Cohort B5 years post implant

Number of participants with a stroke (disabling and non-disabling) as defined by VARC-2 at 5 years post implantation

Percentage of Participants With Conduction Disturbances and Cardiac Arrythmias as Defined by Valve Academic Research Consortium-2 (VARC-2) in Cohort A5 years post implant

Percentage of participants with a conduction disturbances and cardiac arrhythmias as defined by VARC-2 at 5 years post implantation

Number of Participants With Conduction Disturbances and Cardiac Arrythmias as Defined by Valve Academic Research Consortium-2 (VARC-2) in Cohort B5 years post implant

Number of participants with a conduction disturbances and cardiac arrhythmias as defined by VARC-2 at 5 years post implantation

Percentage of Participants With Prosthetic Valve Function as Defined by Valve Academic Research Consortium-2 (VARC-2) (Paravalvular Aortic Regurgitation) in Cohort A1 year post implant

Percentage of participants with a paravalvular aortic regurgitation as defined by VARC-2 at 1 year post implantation

Percentage of Participants With Prosthetic Valve Function as Defined by Valve Academic Research Consortium-2 (VARC-2) (Paravalvular Aortic Regurgitation)5 years post implant

Percentage of participants with a paravalvular aortic regurgitation as defined by VARC-2 at 5 years post implantation

Trial Locations

Locations (60)

UKE Hamburg (Universitatsklinik Eppendorf)

🇩🇪

Hamburg, Germany

Asklepios Klinikum St Georg

🇩🇪

Hamburg, Germany

Azienda Ospedali V. Emanuele Ferrarotto E S. Bambino

🇮🇹

Catania, Italy

Istituto Sant'Ambrogio

🇮🇹

Milan, Italy

PoliclinicoSan Donato

🇮🇹

Milan, Italy

Rigshospitalet

🇩🇰

Copenhagen, Denmark

Saint John Regional Hospital - New Brunswick Heart Centre

🇨🇦

Saint John, Canada

Queen Elizabeth II Heath Sciences

🇨🇦

Halifax, Canada

St. Paul's Hospital

🇨🇦

Vancouver, Canada

Kaplan Medical Center

🇮🇱

Reẖovot, Israel

Ospedale San Raffaele

🇮🇹

Milan, Italy

Hospital de la Santa Creu I Sant Pau

🇪🇸

Barcelona, Spain

The Royal Sussex Country Hospital

🇬🇧

Brighton, United Kingdom

Kings College Hospital

🇬🇧

London, United Kingdom

Royal Victoria Hospital

🇬🇧

Belfast, United Kingdom

Vilnius University Hospital Santarisku KLinikos

🇱🇹

Vilnius, Lithuania

Medisch Centrum Leeuwarden

🇳🇱

Leeuwarden, Netherlands

Hospital Clinico Universitario Virgen de Arrixaca

🇪🇸

El Palmar, Spain

Universitatspital Spital Zurich

🇨🇭

Zurich, Switzerland

Hospital Universitario Virgen Macarena

🇪🇸

Sevilla, Spain

Morriston hospital-ABM University Health Board

🇬🇧

Morriston, United Kingdom

St Andrews Hospital

🇦🇺

Adelaide, Australia

Royal Adelaide Hospital

🇦🇺

Adelaide, Australia

Heart Care Partners-Wesley Hospital

🇦🇺

Auchenflower, Australia

The Prince Charles Hospital

🇦🇺

Chermside, Australia

The Alfred Hospital

🇦🇺

Melbourne, Australia

Royal North Shore hospital

🇦🇺

Leonards Hill, Australia

Royal Melbourne Hospital - City Campus

🇦🇺

Parkville, Australia

Fiona Stanley Hospital

🇦🇺

Perth, Australia

North Shore Private Hospital

🇦🇺

St Leonards, Australia

Princess Alexandra Hospital

🇦🇺

Woolloongabba, Australia

AZ Middelheim

🇧🇪

Antwerp, Belgium

CHR Citadelle

🇧🇪

Liege, Belgium

Cliniques Universitaires Saint-Luc

🇧🇪

Bruxelles, Belgium

Institut de Cardiologie de Quebec (Hospital Laval)

🇨🇦

Quebec, Canada

Foothills Medical Centre

🇨🇦

Calgary, Canada

Institut de Cardiologie de Montreal (Montreal Heart Inst.)

🇨🇦

Montreal, Canada

Ottawa Heart Institute

🇨🇦

Ottawa, Canada

Toronto General Hospital

🇨🇦

Toronto, Canada

CHU Rangueil Toulouse

🇫🇷

Toulouse, France

Clinique Pasteur Toulouse

🇫🇷

Toulouse, France

CHRU Hopital de Pontchaillou

🇫🇷

Rennes, France

Kerckhoff-Klinik gGmbH

🇩🇪

Bad Nauheim, Germany

Deutsches Herzzentrum Berlin

🇩🇪

Berlin, Germany

Immanuelklinikum Bernau und Herzzentrum Brandenburg

🇩🇪

Bernau, Germany

Universitatsmedizin Gottingen Georg-August-Universitat

🇩🇪

Göttingen, Germany

Herzzentrum Dresden GmbH Universitatsklinik

🇩🇪

Dresden, Germany

St Johannes Hospital

🇩🇪

Dortmund, Germany

Klinikum der Johann Wolfgang Goethe-Universitat Frankfurt

🇩🇪

Frankfurt, Germany

Universitatsmedizin Berlin - Campus Benjamin Franklin (CBF)

🇩🇪

Berlin, Germany

Stadtisches Klinikum Karlsruhe gGmbH Medizinischen Klinik I

🇩🇪

Karlsruhe, Germany

Herzzentrum Leipzig GmbH

🇩🇪

Leipzig, Germany

Universitatsklinikum Jena

🇩🇪

Jena, Germany

Deutsches Herzzentrum Munchen des Freistaates Bayern

🇩🇪

Munchen, Germany

Policlinico di Monza

🇮🇹

Monza, Italy

OLVG

🇳🇱

Amsterdam, Netherlands

Ospedale Niguarda Ca'Granda

🇮🇹

Milan, Italy

Clinica Citta di Alessandria

🇮🇹

Alessandria, Italy

Fondazione Toscana Gabriele Monasterio - Ospedale del Cuore

🇮🇹

Massa, Italy

Centro Cardiologico Monzino

🇮🇹

Milano, Italy

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