Study of Intramyocardial Injection of Ventrix Bio Extracellular Matrix (VentriGel) to Assess the Safety and Feasibility in Pediatric Patients with Hypoplastic Left Heart Syndrome (HLHS)
试验速览
- 阶段
- 1 期
- 状态
- 尚未招募
- 入组人数
- 12
- 试验地点
- 1
- 主要终点
- Number of Cardiogenic shock events
研究概览
简要总结
The goal of this Phase I Open-Label study is to demonstrate the safety and feasibility of VentriGel injection in children with Hypoplastic Left Heart Syndrome (HLHS).
The main questions it aims to answer are:
- Whether VentriGel is safe in treating patients with HLHS
- Whether there are any preliminary improvements in measures of cardiac function following Ventrigel injection
详细描述
HLHS, a type of congenital heart disease, presents a unique challenge where the left ventricle fails to develop, necessitating the right ventricle to manage both systemic and pulmonary blood flow. This condition, once fatal, has become manageable due to advancements in surgical techniques, with reported 5-year survival rates of 70-90%. However, these staged procedures, while lifesaving, can strain the right ventricle, leading to long-term issues such as weakened muscle and reduced cardiac function. Additionally, even with surgical intervention, patients often face a diminished quality of life.
Addressing these challenges, ongoing clinical trials explore regenerative therapies, particularly stem cell injections, aiming to improve heart function. Yet, concerns persist regarding the practicality and efficacy of these treatments, including issues with cell survival and coordination of injections within narrow timeframes.
Innovatively, the investigator and the team propose an alternative approach using VentriGel, an injectable hydrogel derived from decellularized porcine myocardium. Originally designed for treating heart failure post-myocardial infarction in adults, VentriGel has shown promising results in animal models, demonstrating significant improvements in cardiac function. Notably, its shelf-stable nature and flexible timing for administration offer advantages over traditional stem cell therapies.
Moreover, VentriGel's effectiveness in addressing right-ventricular failure, as demonstrated in recent studies, highlights its potential as a solution for HLHS patients. Leveraging approved extracellular matrix devices, such as Alloderm and SurgiSIS, further underscores the feasibility and safety of this approach, paving the way for potentially transformative treatments in congenital heart diseases.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- — 至 1 Year(Child)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Subjects with Hypoplastic Left Heart Syndrome (HLHS) requiring Stage II Glenn operation under one year of age
排除标准
- •Subjects undergoing the Stage II Glenn operations who do not have HLHS
- •Subjects requiring mechanical circulatory support within 5 days pre pre-surgical intervention
- •Parent or guardian unwilling or unable to comply with necessary follow-up(s)
- •Immunosuppressive diseases or subjects who require treatment with interventions that cause immunosuppression
- •A history of tumor or malignancy
- •Coagulation disorders
- •Chromosomal abnormalities that limit expected survival to < 1 year
- •Abnormal lab values that may increase the risk of the study procedure (WBC >20,000 cells/ul or < 1,000 cells/ul; platelet count < 50,000 cells/ul; Hgb < 8.0 gm/dl; LFTs > 2x reference lab upper limit of normal) at the time of screening
- •Subjects with conduction abnormalities, including atrioventricular block and bundle branch blocks
- •Ventricular arrhythmias due to antiarrhythmic pharmacological therapy
研究组 & 干预措施
Ventrix Bio Extracellular Matrix
Treatment intervention of a total of 8 injections into the right ventricle of the heart will occur before the patient comes off of the heart-lung bypass machine used during the Stage II Glenn Operation. The treatment will be conducted according to clinical guidelines set in place while the patient is undergoing a surgical intervention before the patient comes off the heart/lung bypass machine required for the stage II Glenn Procedure.
干预措施: Ventrix Bio Extracellular Matrix (Drug)
结局指标
主要结局
Number of Cardiogenic shock events
时间窗: Day 1, 30 days post operation
Cardiogenic shock (i.e. tissue hypoperfusion presented by hypotension due to decreased cardiac output, determined by rising lactate levels (5x normal levels in first 24 hours, 2.5x normal levels in first 30 days)
Number of ventricular tachycardia events
时间窗: upto 30 days post operation
Number of sustained/symptomatic ventricular tachycardia incidences requiring intervention with inotropic support or anti-arrhythmics
Number of Adverse Events
时间窗: upto 30 days post operation
Number of adverse events occurring post op
Number of deaths
时间窗: upto 30 days post operation
Number of deaths occurring post op
Number of VentriGel products manufactured and delivered to subjects
时间窗: 12 months
Number of patients receiving Cardiac MRIs
时间窗: Baseline, 6 months, 12 months
Number of unplanned cardiovascular operation events
时间窗: 30 days post operation
Unplanned cardiovascular operation due to right ventricular intramyocardial injection site bleeding in the first 5 days after Stage II operation decreased cardiac output, determined by rising lactate levels (5x normal levels in first 24 hours, 2.5x normal levels in first 30 days)
Number of patients requiring new permanent pacemaker
时间窗: upto 30 days post operation
Number of patients requiring new permanent pacemaker
Stroke or embolic event
时间窗: upto 30 days post operation
Stroke or embolic event to the brain determined by CT scan
次要结局
- Change in right ventricular global circumferential strain(Baseline, 6 months,12 months post operation)
- Change in right ventricular end diastolic volume(Baseline, 6 months, 12 months post operation)
- Change in tricuspid regurgitation(Baseline, 6 months,12 months post operation)
- Change in right ventricular global longitudinal strain(Baseline, 6 months,12 months post operation)
- Change in right ventricular Tricuspid Annular Plane Systolic Excursion (TAPSE)(Baseline, 6 months,12 months post operation)
- Change in right ventricular ejection fraction(Baseline, 6 months, 12 months post operation)
- Change in right ventricular function Fractional Area Change(Baseline, 6 months,12 months post operation)
- Change in right ventricular end systolic volume(Baseline, 6 months, 12 months post operation)
- Change in right atrial volume indexed(Baseline, 6 months,12 months post operation)
研究者
William T. Mahle
Professor
Emory University
