TRICUS STUDY - Safety and Efficacy of the TricValve® Transcatheter Bicaval Valves System in the Superior and Inferior Vena Cava in Patients With Severe Tricuspid Regurgitation.
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Severe Tricuspid Regurgitation
- Sponsor
- P+F Products + Features GmbH
- Enrollment
- 9
- Locations
- 1
- Primary Endpoint
- Percentage of participants with major adverse events
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
The TricValve® Transcatheter Bicaval Valves System is indicated for relief of tricuspid insufficiency in patients with symptomatic heart disease who are judged by a heart team, including a cardiac surgeon, to be at extreme risk or inoperable for open surgical therapy.
Detailed Description
TricValve® Transcatheter Bicaval Valves is a system of two self-expanding biological valves for the treatment of patients with hemodynamically relevant tricuspid insufficiency and caval reflux. The prostheses are implanted percutaneously into the inferior and superior vena cava without disturbing the native tricuspid valve. It is especially intended for use for patients at extreme risk or who are inoperable for open surgical therapy. Pre-Clinical and Clinical preliminary studies have shown an acceptable safety and performance profile of the TricValve® Transcatheter Bicaval Valves System. Given that the medical device is a potential long-term treatment for patients with tricuspid insufficiency, clinical data for long-term treatment periods is necessary. Thus, the current study is designed to investigate the safety and performance for at least 30 days and up to 6 months. The study has been approved by the Kaunas Regional Biomedical Research Ethics Committee.
Investigators
Eligibility Criteria
Inclusion Criteria
- •The subject must be 18 years of age or older
- •The subject must be a patient with severe symptomatic tricuspid regurgitation demonstrated by echocardiography with significant backflow in the lower (IVC) and/or upper (SVC) vena cava and with a v-wave ≥ 25 mmHg as demonstrated by right heart catheterization (measured in the IVC and/or SVC 2-4 cm above/ below right atrium (RA) inflow) within 8 weeks prior to the implantation
- •Suitable for TricValve® Transcatheter Bicaval Valves System implantation according to anatomic criteria by computed tomography
- •The subjects must have severe, tricuspid regurgitation leading to New York Heart Association (NYHA) class III or IV
- •The subject has left ventricular ejection fraction (LVEF) ≥ 40%
- •Distance covert in 6-minute walk test (6MWT) ≥ 60m
- •The patient shall be screened by a "Heart Team" - including an interventional cardiologist, cardiothoracic surgeon, and agreed as a candidate for the TricValve® Transcatheter Bicaval Valves System implantation
- •Patient/authorized legal guardian understands the nature of the procedure, is willing to comply with associated follow-up evaluations, and provides written informed consent Patient/patient's authorized legal guardian is geographically stable (or willing to return for required study follow-up) and understands and is willing to fulfil all of the expected requirements of the clinical protocol
Exclusion Criteria
- •Known significant intracardiac shunt (e.g. ventricular septal defect) or congenital structural heart disease based on heart teams decision
- •Requirement for other elective cardiac procedures e.g. Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft (CABG) up to 90 days after the procedure or 30 days before the procedure
- •Right ventricular failure (TAPSE ≤13mmHg)
- •Systolic pulmonary arterial pressure \> 65 mmHg as assessed by Doppler echocardiography
- •Presence of any known life threatening (noncardiac major or progressive disease), non-cardiac disease that will limit the subject's life expectancy to less than one year
- •Cerebro-vascular event within the past 3 months
- •History of mitral/tricuspid endocarditis within the last 12 months
- •Patient has untreated significant left sided valvular heart disease which requires treatment (e.g. mitral regurgitation or stenosis, and aortic regurgitation or stenosis)
- •Documented primary coagulopathy or platelet disorder, including thrombocytopenia (absolute platelet count \<90k)
- •Documented evidence of significant renal dysfunction (serum creatinine \> 3.0mg/dl) or on any form of dialysis at time of screening within the last 4 weeks
Outcomes
Primary Outcomes
Percentage of participants with major adverse events
Time Frame: 30 days
The percentage of participants with major adverse events (death, myocardial infarction, cardiac tamponade, cardiac surgery for failed TricValve® implantation, stroke. Major bleeding according to Valve Academic Research Consortium (VARC) criteria)
Change of New York Heart Association (NYHA) functional class
Time Frame: 6 months
Change of New York Heart Association (NYHA) functional class from III or IV to a lower one
Secondary Outcomes
- Successful implantation(Up to Discharge (≤ 10 days post index procedure))
- Unrestricted movement of cusps(Up to 30 days, up to 6 months)
- Cusp insufficiency(Up to 30 days, up to 6 months)
- Device success(Up to 30 days, up to 6 months)
- NYHA functional class(Up to 30 days)
- 6 Minute Walk Test(Up to 30 days, up to 6 months)
- Kansas City Cardiomyopathy Questionnaire (KCCQ)(Up to 30 days, up to 6 months)