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Caisson Transcatheter Mitral Valve Replacement (TMVR) System Early Feasibility Study

Not Applicable
Conditions
Mitral Valve Regurgitation
Interventions
Device: Caisson TMVR System
Registration Number
NCT02768402
Lead Sponsor
Caisson Interventional LLC
Brief Summary

The purpose of this study is to assess the safety and performance of the Caisson Interventional Transcatheter MitralValve Replacement (TMVR) system for the treatment of severe symptomatic MitralValve Regurgitation (MR).

Detailed Description

The treatment guidelines for valvular heart disease indicate that surgical correction of primary mitral valve regurgitation (MR) is a Class I recommendation. Further, recent evidence indicates that valve replacement is at least as effective as repair in both primary and secondary MR patients. However, many patients are not referred for surgery as they are considered to be too high of a risk to undergo on pump, open-heart procedures. Percutaneous aortic valve replacement has made treatment of stenosed aortic valves available to high-risk surgical patients who would have otherwise been medically managed. Percutaneous mitral valve (MV) replacement offers similar advantages. Currently, the only approved percutaneous treatment for MR is MitraClip. MitraClip is limited to a specific population of high risk surgical patients with valvular prolapses that are amenable to repair by the edge to edge technique. The feasibility of percutaneous MV replacement has been shown in animal studies, the implantation of aortic valves at the mitral position, and early evaluations of purpose made transcatheter MVs in humans. To meet this medical need, Caisson Interventional has developed a percutaneous delivery system for a bioprosthetic mitral valve. As with patients with aortic valve (AV) deficiencies, this device can be used to provide needed therapy to patients who might not otherwise receive treatment beyond medical therapy. This study will provide initial information on the safety and performance of this system.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Has severe mitral regurgitation
  • New York Heart Association (NYHA) Class II, III, IVa or heart failure
  • High risk for cardiovascular surgery
Exclusion Criteria
  • Excessive calcification or thickening of mitral valve annulus, severe mitral stenosis, fused commissures, valvular vegetation or mass
  • Left ventricular end diastolic dimension > 7cm
  • Left ventricular outflow tract obstruction
  • Severe right ventricular dysfunction
  • Stroke within 90 days; transischemic attack or myocardial infarction within 30 days of the index procedure

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatment ArmCaisson TMVR SystemAll eligible patients will be in the treatment arm for the 'Caisson TMVR System' (transcatheter mitral valve replacement) procedure. No control or comparator in this study.
Primary Outcome Measures
NameTimeMethod
Number of patients without Major Adverse Events (MAEs)30 days

Freedom from major adverse events including death, stroke, myocardial infarction and surgical reintervention through 30 days

Secondary Outcome Measures
NameTimeMethod
Number of patients with successful delivery and implantation of the prosthetic valve (technical success)Intraoperative

Successful delivery and retrieval of the transcatheter mitral valve delivery system; deployment and correct positioning (via intraoperative imaging) in the appropriate anatomic location of prosthetic valve with no requirement for additional surgery

Number of living, stroke-free patients with prosthetic valve in place (device success)30 days

Patient is alive, stroke-free, original intended device in place (echo), no mitral valve surgical re-intervention required

Trial Locations

Locations (13)

University of Washington

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Seattle, Washington, United States

Cedars Sinai Medical Center

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Los Angeles, California, United States

MedStar Washington Hospital Center

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Washington, District of Columbia, United States

Abbott Northwestern Hospital

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Minneapolis, Minnesota, United States

Delray Medical Center

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Delray Beach, Florida, United States

Morristown Medical Center

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Morristown, New Jersey, United States

New York University Langone Medical Center

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New York, New York, United States

Cleveland Clinic Foundation

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Cleveland, Ohio, United States

OhioHealth

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Columbus, Ohio, United States

Saint Thomas Heart

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Nashville, Tennessee, United States

University of Virginia Health System

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Charlottesville, Virginia, United States

Swedish Health Services

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Seattle, Washington, United States

Mayo Clinic

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Rochester, Minnesota, United States

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