Dragonfly-M Transcatheter Mitral Valve Repair System Early Feasibility Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Mitral Regurgitation
- Sponsor
- Hangzhou Valgen Medtech Co., Ltd
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- Incidence of acute procedural success
- Last Updated
- 4 years ago
Overview
Brief Summary
To establish the safety and effectiveness of the DragonFly transcatheter mitral valve repair system in symptomatic patients with moderate to severe and severe mitral regurgitation who have been determined to be at an high risk of mortality with mitral valve surgery by the cardiac surgeon with concurrence by the local Heart Team
Detailed Description
The subjects with moderate-to-severe (3+) and severe (4+) mitral valve regurgitation (MR) at high or prohibitive surgical risk will be evaluated by the study sites, and study eligibility confirmed by the echocardiographic core laboratory and eligibility committee. Those qualifying will then be treated with Dragonfly transcatheter mitral valve repair system after signing the informed consent. The follow-up will be conducted at discharge, 30 days, 6 months and 12 months after the operation. The primary endpoints are the incidence of major adverse events (MAE) at 30 days, and acute procedural success. Acute procedural success is defined as placement of one or more Dragonfly devices on the mitral valve with reduction of MR to 2+ or less. The secondary endpoints include all-cause mortality, cardiovascular mortality, incidence of serious adverse event, cardiovascular rehospitalization, NYHA functional class, mitral valve hemodynamics, acute technical success rate and device success rate at 6 months. Acute technical success is defined as no procedural mortality, successful in access, delivery, and retrieval of the device delivery system, and no emergency surgery or reintervention related to the device or access procedure in the catheterization laboratory. Device success is defined as no procedural mortality, proper delivery and deployment of the device, no unplanned surgical or interventional procedures related to the device, no specific device-related technical failure and or complications, function improvement of MR without significant stenosis (MR ≤ 2+) and without associated hemolysis or thrombogenesis.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age ≥ 18 yrs
- •Moderate-to-severe (3+) or severe (4+) mitral valve regurgitation on transthoracic or transesophageal echocardiography, and confirmed by echocardiographic core laboratory
- •The patient is on optimal guideline directed medical therapy for heart failure and remains symptomatic.
- •High or prohibitive surgical risk as defined by either Society for Thoracic Surgery Risk Calculator score for valve replacement ≥ 8 points; or STS score for valve repair ≥ 6 points , prohibitive risk as determined by the clinical judgement of the site heart team, including a cardiac surgeon experienced in mitral valve surgery and a cardiologist experience in mitral valve disease, due to the presence of one or more documented surgical risk factors.
- •Anatomically suitable for mitral valve repair and can be treated by Dragonfly confirmed by both site investigators, echocardiographic core laboratory, and the eligibility committee.
- •Transseptal catheterization and femoral vein access is determined to be feasible
- •Life expectancy ≥ 12 months
- •The subject or the subject's legal representative has been informed of the nature of the trial, willing to accept the experimental tests and follow-ups, and has provided written informed consent
Exclusion Criteria
- •History of heart transplantation, prior mitral valve replacement surgery. or transcatheter mitral valve procedure;
- •Leaflet anatomy which may preclude Dragonfly-MTM implantation and position, as judged by the site investigators and confirmed by the echocardiographic core laboratory and eligibility committee
- •Evidence of calcification or significant cleft in the grasping area
- •LVEF \< 20%
- •LVESD≥ 60mm;
- •Mobile leaflet length\<10mm
- •Mitral valve effective orifice area (EOA) \< 3.5cm2 or in the opinion of site investigators and confirmed by the echocardiographic core laboratory and eligibility committee that mitral stenosis would result from implantation of the Dragonfly-MTM device.
- •Echocardiographic evidence of intracardiac mass, thrombus or vegetation;
- •Severe non-mitral valve disease requiring treatment .
- •Severe pulmonary artery hypertension (sPAP\>70mmHg)
Outcomes
Primary Outcomes
Incidence of acute procedural success
Time Frame: 1 month
The acute procedural success is defined as successful Dragonfly implantation, and residual MR of 2+ or less at discharge. An echocardiogram at 30 days can be accepted if the discharge image was not available or hard to interpret. A death before discharge or a re-operation of mitral valve prior to 30 days is defined as acute procedure failure
Incidence of major adverse event (MAE) at 30 days
Time Frame: 1 month
Major adverse event is defined as one of the following components: death, myocardial infarction (MI), stroke, renal failure requiring dialysis, and cardiac surgery for Dragonfly device failure.
Secondary Outcomes
- All-cause mortality(6 months)
- Incidence of serious adverse event (SAE）(6 months)
- Cardiovascular mortality(6 months)
- NYHA(6 months)
- Technical success(Immediately after procedure)
- Device success(6 months)