MedPath

REdo tranScatheter Aortic Valve Replacement for Transcatheter aOrtic Valve failuRE

Recruiting
Conditions
Aortic Stenosis
Registration Number
NCT06777368
Lead Sponsor
Medtronic Cardiovascular
Brief Summary

The purpose of this study is to generate clinical evidence on valve safety and performance in subjects treated by redo Transcatheter Aortic Valve Replacement (TAVR).

Detailed Description

Primary Objectives:

* To determine the acute and long-term outcomes of redo TAVR for the treatment of BVF affecting TAVs

* To determine the factors which are associated with the acute and long-term outcomes of redo TAVR

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
225
Inclusion Criteria
  • BVF of a TAV (either Medtronic or Edwards) requiring redo TAVR
Exclusion Criteria
  • BVF due solely to paravalvular regurgitation
  • Active endocarditis
  • Untreated acute valve thrombosis
  • Life-expectancy less than 1-year
  • Subject is less than legal age of consent, legally incompetent, or otherwise vulnerable
  • Participating in another study that may influence the outcome of this study

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Primary Outcome MeasureLate (1-year)

a composite endpoint of 1-year freedom from all-cause mortality, all stroke, or any re-hospitalization for valve or redo TAVR procedure-related causes

Secondary Outcome Measures
NameTimeMethod
VARC 3 30-day device success30-Day

30-day device success

Peak and mean invasive gradient post-procedureTime of procedure

Peak and mean invasive gradient will be measured in mmHg

Bioprosthetic Valve Dysfunction (BVD) at the final required follow-up visit5 year

Intrinsic permanent changes to the prosthetic valve, including wear and tear, leaflet disruption, flail leaflet, leaflet fibrosis and/or calcification, or strut fracture or deformation

Evaluate coronary accessibility (e.g., commissural alignment, valve to valve alignment, etc.) based on Computed Tomography (CT) at either pre-discharge or 30 daysUp to 30 days

Evaluate coronary accessibility

Valve Academic Research Consortium (VARC) 3 technical success (at exit from procedure room)Time of procedure

(VARC) 3 technical success (at exit from procedure room)

VARC 3 30-day early safety30-Day

30-day early safety

In-hospital clinical outcomesTreatment up to 7 days (or until patient is discharged from the hospital if later than 7 days)

Percentage of all participants with all-cause mortality, all stroke, Myocardial infarction (MI), Coronary artery obstruction, Unplanned Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Grafting (CABG), Bleeding (VARC 3 type 1-4), Major and Minor vascular and access-related complications, Cardiac structural complications, Permanent pacemaker implantation (PPI), Acute Kidney Injury (AKI) stage 1-4, Endocarditis, and Valve Thrombosis.

Clinical outcomes at 30 days, 1-year, and annually thereafter30 days, at 1 year, at 2 years, at 3 years, at 4 years, and at 5 years.

All-cause mortality, All stroke, Myocardial infarction (MI), Coronary artery obstruction, Bleeding (VARC 3 type 1-4), Major and Minor vascular and access-related complications, Cardiac structural complications, Permanent pacemaker implantation (PPI), Acute Kidney Injury (AKI) stage 1-4, Endocarditis, Valve Thrombosis, Any rehospitalization and re-intervention.

Bioprosthetic Valve Failure (BVF) at the final required follow-up visitThrough study completion or Up to 5-years

Any bioprosthetic valve dysfunction associated with clinically expressive criteria (new-onset or worsening symptoms, left ventricle dilation/hypertrophy/dysfunction, or pulmonary hypertension) or irreversible Stage 3 Hemodynamic Valve Deterioration (HVD) or Aortic valve reoperation or re-intervention, or Valve-related death.

KCCQ Quality of life (QoL) assessments at 30 days, 1-year, and annually thereafterAt 30 days, at 1 year, at 2 years, at 3 years, at 4 years, and at 5 years.

QoL: KCCQ assessment

EQ5D Quality of life (QoL) assessments at 30 days, 1-year, and annually thereafterAt 30 days, at 1 year, at 2 years, at 3 years, at 4 years, and at 5 years.

QoL: EQ5D assessment

Echocardiographic assessment pre-discharge or at 30 days, 1-year, and annually thereafterAfter the procedure and prior to discharge from the hospital, at 30 days, at 1 year, at 2 years, at 3 years, at 4 years, and at 5 years.

Left ventricular ejection fraction, mean gradient across aortic valve, effective orifice area, effective orifice area index, patient-prosthesis mismatch, Doppler Velocity Index, total aortic regurgitation, paravalvular aortic regurgitation, and transvalvular aortic regurgitation.

New York Heart Association (NYHA) classification at pre-discharge, 30 days, 1-year, and annually thereafterAfter the procedure and prior to discharge from the hospital, at 30 days, at 1 year, at 2 years, at 3 years, at 4 years, and at 5 years.

New York Heart Association (NYHA) classification

Trial Locations

Locations (41)

Sutter Heatlh

🇺🇸

Sacramento, California, United States

Yale New Haven Hospital

🇺🇸

New Haven, Connecticut, United States

MedStar Washington Medical Center

🇺🇸

Washington, District of Columbia, United States

MercyOne Iowa Heart Center

🇺🇸

Des Moines, Iowa, United States

University of Michigan Health

🇺🇸

Ann Arbor, Michigan, United States

Henry Ford Hospital

🇺🇸

Detroit, Michigan, United States

The Valley Hospital

🇺🇸

Paramus, New Jersey, United States

Montefiore Medical Center

🇺🇸

Bronx, New York, United States

Astrium Health Wake Forest Baptist Medical Center

🇺🇸

Winston-Salem, North Carolina, United States

University of Texas Health Science Center at Houston

🇺🇸

Houston, Texas, United States

Providence Heart Institute (Providence Sacred Heart)

🇺🇸

Spokane, Washington, United States

Abrazo Arizona Heart Hospital

🇺🇸

Phoenix, Arizona, United States

Kaiser Permanente Los Angeles Medical Center

🇺🇸

Los Angeles, California, United States

Los Robles Regional Medical Center

🇺🇸

Thousand Oaks, California, United States

Hartford Hospital

🇺🇸

Hartford, Connecticut, United States

Morton Plant Hospital

🇺🇸

Clearwater, Florida, United States

HealthPark Medical Center, Lee Memorial Health

🇺🇸

Fort Myers, Florida, United States

Orlando Health/Orlando Regional Medical Center

🇺🇸

Orlando, Florida, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Abbott Northwestern/Minneapolis Heart

🇺🇸

Minneapolis, Minnesota, United States

Providence Saint Patrick Hospital

🇺🇸

Missoula, Montana, United States

Buffalo General Medical Center

🇺🇸

Buffalo, New York, United States

Northwell Health

🇺🇸

Manhasset, New York, United States

Saint Francis Hospital

🇺🇸

Roslyn, New York, United States

Maine Medical Center

🇺🇸

Portland, Maine, United States

Medstar Union Memorial Hospital

🇺🇸

Baltimore, Maryland, United States

Brigham and Women's Hospital

🇺🇸

Boston, Massachusetts, United States

The Christ Hospital

🇺🇸

Cincinnati, Ohio, United States

University Hospitals of Cleveland Medical Center

🇺🇸

Cleveland, Ohio, United States

Lehigh Valley Hospital

🇺🇸

Allentown, Pennsylvania, United States

UPMC Pinnacle

🇺🇸

Mechanicsburg, Pennsylvania, United States

Allegheny General Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

Lankenau Medical Center

🇺🇸

Wynnewood, Pennsylvania, United States

Heart Hospital of Austin

🇺🇸

Austin, Texas, United States

Houston Methodist Hospital

🇺🇸

Houston, Texas, United States

Methodist Hospital

🇺🇸

San Antonio, Texas, United States

University of Vermont Medical Center

🇺🇸

Burlington, Vermont, United States

University of Virginia Medical Center

🇺🇸

Charlottesville, Virginia, United States

Inova Fairfax Hospital

🇺🇸

Falls Church, Virginia, United States

Sentara Norfolk General Hospital

🇺🇸

Norfolk, Virginia, United States

Aurora St. Lukes Medical Center

🇺🇸

Milwaukee, Wisconsin, United States

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