Early Feasibility Study of the PLAR Implant and Delivery System to Treat Degenerative Mitral Regurgitation (EXPLORE DMR)

December 13, 2023 updated by: Polares Medical SA

Early Feasibility EXperience of Posterior Leaflet RestOration to REduce Degenerative Mitral Regurgitation (EXPLORE DMR)

An early feasibility study to evaluate the safety and feasibility of the PLAR Implant and Delivery System to treat severe degenerative mitral regurgitation and to gather preliminary data on its performance thereby providing guidance for future clinical development. The study is a single-arm registry with the last follow-up visit at 5 years post-intervention. The study will enroll up to 10 patients at up to 4 centers in North America.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Terminated

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Percutaneous approaches to treat MR promise to provide a sufficient reduction in MR without the risks typically associated with open heart surgery. Furthermore there is an unmet clinical need for patients with severe MR who are refused or denied surgery due to high risk. Percutaneous therapy provides a novel alternative treatment option for these patients with the aim of reducing morbidity and mortality over and above current medical therapy. The Polares Medical PLAR Implant and Delivery System is a catheter-based technology designed to permanently implant a prosthesis using a transvenous / transseptal approach to augment the posterior mitral valve leaflet and improve coapatation of the mitral valve. Approved edge-to-edge repair has already been shown to be a viable alternative for high risk MR patients. However treatment with these devices is limited to specific anatomies and often requires multiple devices which increases clinical risk, adds to procedural time, and can result in residual MR. The PLAR Implant and Delivery System has been designed to overcome and mitigate some of these shortfalls.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
1

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • United States
    • Georgia
      • Atlanta, Georgia, United States, 30308
        • Emory Midtown

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. 18 years of age or older
  2. Greater than moderate degenerative mitral regurgitation (Grade 3+ or higher) as confirmed by transesophageal echocardiography (TEE) within 90 days prior to study procedure
  3. Patient must present with an STS Score less than 10%
  4. High surgical risk for conventional mitral repair or replacement due to morphological criteria (e.g. leaflet or annulus calcifications), but operable, as assessed by the local heart team comprised of a cardiac surgeon experienced in mitral valve surgery and a cardiologist experienced in treating mitral valve disease and heart failure
  5. Patient is approved by an independent Patient Eligibility Committee
  6. New York Heart Association (NYHA) Functional Class III or IV
  7. Patient willing to participate in study and provide signed IRB/EC-approved informed consent
  8. Treating physician and patient agree that patient is able to return for all required post-procedure follow-up visits
  9. Women of child-bearing potential have a negative pregnancy test

Exclusion Criteria:

  1. Severe tricuspid regurgitation
  2. Severe aortic stenosis or insufficiency
  3. Severe mitral annulus calcification
  4. Diseased mitral anterior leaflet such as flail / prolapse/ heavy calcification
  5. Implanted vena cava filter
  6. Femoral veins with severe angulation and calcification
  7. Contraindication for transesophageal echocardiography (TEE) or MDCT scan.
  8. Active infection or endocarditis
  9. Previous mitral valve surgery
  10. Prior orthotopic heart transplantation
  11. Pulmonary artery systolic hypertension > 70mmHg
  12. Evidence of intra-cardiac, inferior vena cava (IVC) or femoral venous thrombus
  13. Left ventricular ejection fraction (LVEF) < 30%
  14. Implant or revision of any pacing device < 30 days prior to intervention
  15. Symptomatic coronary artery disease treated < 30 days prior to study procedure
  16. Myocardial infarction requiring intervention < 30 days prior to study procedure
  17. Infiltrative cardiomyopathies (e.g., amyloidosis, hemochromatosis, sarcoidosis), hypertrophic or restrictive cardiomyopathies, and constrictive pericarditis
  18. Active peptic ulcer or upper gastrointestinal bleeding < 90 days prior to study procedure
  19. Stroke < 180 days prior to study procedure
  20. Severe renal insufficiency (creatinine > 3.0 mg/dL) or patient requiring dialysis
  21. Cardiogenic shock at time of enrolment
  22. Hemodynamic instability requiring inotropic support or mechanical heart assistance
  23. Concurrent medical condition with a life expectancy of less than 2 years
  24. Pregnancy at time of enrolment
  25. History of bleeding diathesis or coagulopathy or leukopenia (WBC < 3,000 mcL) or acute anemia (Hb < 9 g/dL) or thrombocytopenia (platelets < 50,000 cells mcL)
  26. Known hypersensitivity or contraindication to aspirin, heparin, ticlopidine or clopidogrel, nitinol, tantalum or allergy to contrast agents that cannot be pre-medicated
  27. Severe dementia or lack of capacity due to conditions that result in either inability to provide informed consent for the trial/procedure, prevent independent lifestyle outside of a chronic care facility, or will fundamentally complicate rehabilitation from the procedure or compliance with follow-up assessments
  28. Emergency situations
  29. Company employees or their immediate family members
  30. Patient is under guardianship
  31. Patient is participating in another clinical study for which follow-up is currently ongoing

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Device Feasibility
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Single-arm study of PLAR Implant and Delivery System
All enrolled patients will receive the study device
Device: Transcatheter mitral valve repair
Transvenous approach with a transeptal puncture to place the study device
Other Names:
  • TMVr

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Incidence of all-cause mortality
Time Frame: 30-days
Primary safety outcome
30-days
Incidence of change from baseline to moderate or less mitral regurgitation (Grade 2+ or less) as evaluated by 2D TTE
Time Frame: 30-days
Primary performance endpoint
30-days

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Rate of major safety events as defined by MVARC2
Time Frame: 30 days, at 6 and 12 months, and at 2 - 5 years post-intervention
Secondary safety endpoint
30 days, at 6 and 12 months, and at 2 - 5 years post-intervention
Technical success per MVARC2 definitions
Time Frame: Technical success is measured at exit from OR
  • Absence of procedure mortality
  • Successful access, delivery and retrieval of investigation delivery system
  • Successful deployment and correct positioning of intended implant(s)
  • Freedom from emergency surgery/re-intervention related to device or access procedure
Technical success is measured at exit from OR
Procedure success per MVARC2 definitions
Time Frame: Procedure success is measured at 30 days post-intervention
  • Device success

  • Absence of major device or procedure-related serious adverse events as below:

    • Death
    • Stroke
    • Life-threatening bleed
    • Major vascular complication
    • Major cardiac structural complication
    • Stage 2 or 3 AKI
    • MI or coronary ischemia requiring PCI or CABG
    • Shock, heart or respiratory failure requiring IV vasopressors, mechanical intervention or prolonged intubation
    • Valve-related dysfunction, migration, thrombosis, or other complication requiring surgery or repeat intervention
Procedure success is measured at 30 days post-intervention
Device success rate per MVARC2 definitions (all must be present for success)
Time Frame: Device success is measured at 30 days, at 6 and 12 months, and at 2 - 5 years post-intervention
  • Absence of procedure mortality or stroke
  • Proper placement and positioning of device
  • Freedom from unplanned re-intervention related to device or access procedure

  • Continued intended safety and performance of the device:

    • No evidence of structural or functional failure
    • No device technical failure issues/complications
    • MR reduction to moderate or less without stenosis
Device success is measured at 30 days, at 6 and 12 months, and at 2 - 5 years post-intervention
Patient success rate per MVARC2 definitions (all must be present for success)
Time Frame: Patient success is measured at 12 months post-intervention
  • Device success
  • Patient returned to pre-procedure setting
  • No rehospitalization or reintervention for mitral regurgitation or heart failure
  • Functional improvement from baseline by one or more NYHA class
  • 6MWT improvement from baseline by 50 metres or more
Patient success is measured at 12 months post-intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Polares Medical SA

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Director: Laura A Brenton, Polares Medical

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
April 30, 2021

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 31, 2022

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 31, 2022

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
December 1, 2020

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 7, 2020

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
December 14, 2020

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
December 20, 2023

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 13, 2023

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
December 1, 2023

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 202001

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Clinical trial results will be shared with investigators once study is enrolled and trial data is prepared for presentation at a medical conference or for publication in a medical journal.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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