Early Discharge After Mitral and Tricuspid Edge-to-edge Repair: an Assessment of Feasibility and Safety (EARLY-Edge)
Mitral regurgitation (MR) and tricuspid regurgitation (TR) are common causes of breathlessness, fluid retention and other heart failure symptoms, which lead to reduced quality of life and frequent hospitalisation. These conditions are particularly prevalent in older adults with many of these patients being at high risk for surgical intervention due to frailty and comorbidities, leaving them with few treatment alternatives.
Transcatheter edge-to-edge repair (TEER) procedures have increasingly been used to improve the severity of both MR and TR, offering patients symptomatic relief and reductions in heart failure hospitalisation at low procedural risk. There is considerable geographic variation in protocols to assess these patients prior to the procedure and also in length of hospital stay. The standard of care in the UK, and particularly in Oxford, emphasises fewer investigations before the TEER procedure and shorter length of hospital stay.
This prospective, observational cohort study will examine the safety and feasibility of this practice.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Sam Dawkins, MBBS MRCP BSc DPhil
- Phone Number: +443003047777
- Email: Sam.Dawkins@ouh.nhs.uk
Study Contact Backup
- Name: Cara Barnes, MBBS FRACGP FRACP MPhil
- Phone Number: +6192242244
- Email: Cara.Barnes@health.wa.gov.au
Study Locations
-
-
Oxfordshire
-
Oxford, Oxfordshire, United Kingdom, OX3 9DU
- John Radcliffe Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Aged ≥18 years
- Accepted by Heart Team for TEER (mitral and/or tricuspid)
- Willing and able to give informed consent for participation in the study.
- Regurgitation (mitral and/or tricuspid) grade ≥2+ as assessed by echocardiography
- Patient is willing and able to attend all follow-up visits
Exclusion Criteria:
- Patients in whom safety or clinical concerns preclude participation
- Patient declines to be involved in the study (unwilling to consent to enrolment or deemed by the patient advocate to be unwilling to consent)
- Patient in whom a TOE is contraindicated, or screening TOE is unsuccessful
- Pregnant or planning pregnancy within next 12 months
- Concurrent medical condition with a life expectancy of less than 12 months in the judgment of the Investigator
- Patients requiring emergency TEER
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Patients treated with either mitral TEER, tricuspid TEER or both
Patients treated with either mitral TEER, tricuspid TEER or both, at John Radcliffe Hospital, Oxford
|
Patients admitted for transcatheter edge-to-edge repair to either mitral or tricuspid valve and then discharged within 36 hours
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Proportion of patients discharged 'early' after edge -to-edge repair
Time Frame: up to 30 days
|
defined as < 36 hours after completion of procedure
|
up to 30 days
|
|
All - cause rehospitalisation after completion of procedure
Time Frame: 30 days, 1 year
|
Any hospital admission after discharge from the index procedure
|
30 days, 1 year
|
|
All cause death after completion of procedure
Time Frame: 30 days, 1 year
|
All patient death following discharge after the index procedure
|
30 days, 1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Hospital length of stay
Time Frame: Up to 3 months
|
Length of hospital stay from admission to discharge for outpatient procedures, or from procedure to discharge for inpatient procedures
|
Up to 3 months
|
|
Proportion of patients requiring intensive care unit care
Time Frame: Up to 3 months
|
The proportion of patients admitted to intensive care unit after their procedure
|
Up to 3 months
|
|
Safety outcomes a. Major adverse events at the time of the procedure b. Major adverse events (procedure/device related) up to 30 days
Time Frame: During index admission up to 30 days post procedure.
|
Evaluating safety a.
Major adverse events (procedure/device related) at the time of procedure b.
Major adverse events (procedure/device related) up to 30 days (including unplanned surgery relating to a device/procedural complication)
|
During index admission up to 30 days post procedure.
|
|
Symptomatic improvement
Time Frame: 3 months, 1 year
|
Change in Kansas City Cardiomyopathy Questionnaire (KCCQ) score from pre-procedure to post-procedure (validated score for assessing symptoms, physical and social limitations, and quality of life in patients with heart failure, score 0-100, where 100 = no symptoms).
|
3 months, 1 year
|
|
Heart failure hospitalisation
Time Frame: 30 days, 1 year
|
Any heart failure related hospitalisations after the index procedure
|
30 days, 1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Sam Dawkins, MBBS MRCP BSc DPhil, Oxford University Hospitals NHS Trust
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 318352
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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