CoreValve™ Evolut R™ FORWARD Study (FORWARD)

April 28, 2020 updated by: Medtronic Cardiovascular

The Medtronic CoreValve™ Evolut R™ FORWARD Study

Prospective, single arm, multi-center, observational, post market study to document the clinical and device performance outcomes of the Evolut R system used in routine hospital practice in a large patient cohort for the treatment of symptomatic native aortic valve stenosis or a stenosed, insufficient, or combined surgical bioprosthetic valve failure necessitating valve replacement.

Study Overview

Status

Completed

Detailed Description

The study objective is to document the clinical and device performance outcomes of the Evolut R system used in routine hospital practice in a large patient cohort for the treatment of symptomatic native aortic valve stenosis or a stenosed, insufficient, or combined surgical bioprosthetic valve failure necessitating valve replacement.

Prospective, single arm, multi-center, observational, post market study. In Australia and Canada it is a prospective, single arm, multi-center pre-market study.

Up to 60 centers worldwide. Geographies may include Europe, Australia, Middle East and Africa, Latin America and Canada.

Approximately 1000 implanted subjects, consented for follow-up through three years.

For each subject, data will be collected preoperatively, intra-operatively, at hospital discharge, 30 days, 1, 2 and 3 years.

Study Type

Observational

Enrollment (Actual)

1060

Contacts and Locations

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

Study Locations

      • Adelaide, Australia
        • Flinders Medical Centre
      • Melbourne, Australia
        • Monash Medical Centre
      • Melbourne, Australia
        • The Alfred Hospital
      • Perth, Australia
        • Fiona Stanley Hospital Perth
      • Antwerpen, Belgium
        • Universitair Ziekenhuis Antwerpen
      • London, Canada
        • London Health Sciences Centre - University Campus
      • Toronto, Canada
        • Sunnybrook Health Sciences Center
      • Vancouver, Canada
        • Saint Paul's Hospital
      • Cali, Colombia
        • Angiografia De Occidente S.A.
      • Trinec, Czechia
        • Nemocnice Podlesí a.s.
      • Creteil, France
        • Centre Hospitalier Universitaire - Hopital Henri Mondor
      • Lille, France
        • Centre Hospitalier Régional Universitaire de Lille
      • Massy, France
        • Institut Hospitalier Jacques Cartier
      • Paris, France
        • Hôpital Bichat - Claude Bernard
      • Toulouse, France
        • Clinique Pasteur
      • Bad Oeynhausen, Germany
        • Herz- und Diabeteszentrum NRW - Ruhr-Universitaet Bochum
      • Berlin, Germany
        • Deutsches Herzzentrum Berlin
      • Bonn, Germany
        • University of Bonn, Cardiology
      • Cottbus, Germany
        • Sana-Herzzentrum Cottbus GmbH
      • Dresden, Germany
        • Herzzentrum Dresden GmbH Universitaetsklinik
      • Duesseldorf, Germany
        • Universitaetsklinikum Düsseldorf
      • Essen, Germany
        • Universitätsklinikum Essen
      • Essen, Germany
        • Elisabeth-Krankenhaus Essen GmbH
      • Frankfurt, Germany
        • University of Frankfurt
      • Hamburg, Germany
        • Asklepios Klinik Sankt Georg
      • Karlsruhe, Germany
        • Städtisches Klinikum Karlsruhe GmbH
      • Leipzig, Germany
        • Herzzentrum Leipzig GmbH
      • Munich, Germany
        • Deutsches Herzzentrum Muenchen - Klinik an der TU Muenchen
      • Athens, Greece
        • Hygeia Hospital
      • Budapest, Hungary
        • Semmelweis Egyetem ÁOK
      • Tel-Aviv, Israel
        • Tel Aviv Sourasky Medical Center
      • Brescia, Italy
        • Azienda Ospedaliera Spedali Civili di Brescia
      • Catania, Italy
        • Presidio Ospedaliero Ferrarotto Alessi
      • Milan, Italy
        • IRCCS Policlinico San Donato
      • Milan, Italy
        • Ospedale San Raffaele - Milano
      • Pisa, Italy
        • Azienda Ospedaliero Universitaria Pisana - Stabilimento di Cisanello
      • Amsterdam, Netherlands
        • Onze Lieve Vrouwe Gasthuis - Locatie Oosterpark
      • Eindhoven, Netherlands
        • Catharina Ziekenhuis
      • Nieuwegein, Netherlands
        • St. Antonius Ziekenhuis
      • Rotterdam, Netherlands
        • Erasmus Medisch Centrum
      • Oslo, Norway
        • Oslo Universitetssykehus-Ullevål Universitetssykehus
      • Panama, Panama
        • Complejo Hospitalario Dr Arnulfo Arias Madrid
      • Warsaw, Poland
        • Instytut Kardiologii
      • Vila Nova de Gaia, Portugal
        • Centro Hospitalar de Vila Nova de Gaia/Espinho - Unidade I
      • Riyadh, Saudi Arabia
        • Prince Sultan Cardiac Center
      • Cape Town, South Africa
        • Mediclinic Panorama
      • Malaga, Spain
        • Hospital Universitario Virgen de la Victoria
      • Oviedo, Spain
        • Hospital Universitario Central de Asturias
      • Santiago de Compostela, Spain
        • Complejo Hospitalario Universitario de Santiago de Compostela
      • Uppsala, Sweden
        • Akademiska sjukhuset
      • Belfast, United Kingdom
        • Royal Victoria Hospital - Belfast Health and Social Care Trust
      • Brighton, United Kingdom
        • Royal Sussex County Hospital
      • Leeds, United Kingdom
        • The Leeds Teaching Hospitals NHS Trust - Leeds General Infirmary
      • Wolverhampton, United Kingdom
        • The Royal Wolverhampton Hospitals NHS - New Cross Hospital

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

Ages Eligible for Study

  • ADULT
  • OLDER_ADULT
  • CHILD

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

The study population includes patients with symptomatic native aortic valve stenosis or a stenosed, insufficient, or combined surgical bioprosthetic valve failure necessitating valve replacement who are scheduled for an elective transcatheter aortic valve implantation. Patients who will undergo an emergency procedure should not be included in this study.

Description

Inclusion Criteria:

  • Symptomatic native aortic valve stenosis or a stenosed, insufficient, or combined surgical bioprosthetic valve failure necessitating valve replacement
  • Acceptable candidate for elective treatment with the Evolut R System and in conformity with the local regulatory and medico economic context
  • Age ≥80 years OR considered to be at high or greater risk for surgical aortic valve replacement (AVR) where high risk is defined as:

    • Society of Thoracic Surgeons (STS) predicted risk of mortality ≥8% OR
    • Documented heart team agreement of risk for AVR due to frailty or comorbidities.
  • Geographically stable and willing to return to the implanting site for all follow-up visits
  • Of legal age to provide informed consent (patient Informed Consent or Data Release Form) in the country where they enroll in the trial
  • The patient has been informed of the nature of the study, is able and willing to provide consent without assistance from a legal representative and has consented to participate, and has authorized the collection and release of his/her medical information by signing a Patient Informed Consent or Data Release Form.

Exclusion Criteria:

  • Known hypersensitivity or contraindication to aspirin, heparin (HIT/HITTS) and bivalirudin, ticlopidine, clopidogrel, Nitinol (Titanium or Nickel), or sensitivity to contrast media, which cannot be adequately premedicated
  • Preexisting mechanical heart valve in aortic position
  • Ongoing sepsis, including active endocarditis
  • Anatomically not suitable for the Evolut R system
  • Estimated life expectancy of less than 1 year
  • Participating in another trial that may influence the outcome of this trial
  • Need for emergency surgery for any reason

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

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
All-cause mortality rate
Time Frame: 30 days post implant
All-cause mortality rate at 30 days post procedure
30 days post implant

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Device success according to VARC2
Time Frame: 24h to 7 days post implant

Device success rate at 24 hours to 7 days, defined according to the Valve Academic Research Consortium-2 (VARC-2) guidelines as:

  • Absence of procedural mortality, AND
  • Correct positioning of a single prosthetic heart valve into the proper anatomical location, AND
  • Intended performance of the prosthetic heart valve, defined as the absence of patient-prosthesis mismatch and mean gradient < 20 mmHg (or peak velocity < 3 m/sec), AND No moderate or severe prosthetic valve regurgitation.
24h to 7 days post implant
Hemodynamic performance
Time Frame: 24h to 7 days and 1 year post implant
Hemodynamic performance at 24 hours to 7 days (discharge) and 1 year post procedure, including the mean prosthetic valve gradient as measured by transthoracic echocardiography (TTE) and assessed by an independent core laboratory.
24h to 7 days and 1 year post implant
Hemodynamic performance
Time Frame: 24h to 7 days and 1 year post implant
Hemodynamic performance at 24 hours to 7 days (discharge) and 1 year post procedure, including the effective orifice area as measured by transthoracic echocardiography (TTE) and assessed by an independent core laboratory.
24h to 7 days and 1 year post implant
Hemodynamic performance
Time Frame: 24h to 7 days and 1 year post implant
Hemodynamic performance at 24 hours to 7 days (discharge) and 1 year post procedure, including the degree of prosthetic valve regurgitation (transvalvular, paravalvular, and total) as measured by transthoracic echocardiography (TTE) and assessed by an independent core laboratory.
24h to 7 days and 1 year post implant
Early safety composite endpoint according to VARC2
Time Frame: 30 days post implant

Early Safety composite endpoint at 30 days post procedure, defined according to the VARC-2 guidelines, defined as any of the following components:

  • All-cause mortality
  • All stroke (disabling and non-disabling)
  • Life-threatening bleeding
  • Acute kidney injury: stage 2 or 3 (including renal replacement therapy)
  • Coronary artery obstruction requiring intervention
  • Major vascular complication
  • Valve-related dysfunction requiring repeat procedure (BAV, TAVI, or SAVR)
30 days post implant
Event rates according to VARC2
Time Frame: 30 days post implant
Event rates of the individual components of the VARC-2 composite Early Safety endpoint at 30 days post procedure
30 days post implant
Rate of new permanent pacemaker implant
Time Frame: 30 days post implant
Rate of new permanent pacemaker implant at 30 days post procedure
30 days post implant

Collaborators and Investigators

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

Investigators

  • Principal Investigator: Eberhard Grube, Prof. Dr., University Hospital, Bonn
  • Principal Investigator: Stephan Windecker, Prof. Dr., Inselspital, Universitätsspital Bern

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

January 1, 2016

Primary Completion (Actual)

February 1, 2017

Study Completion (Actual)

February 6, 2020

Study Registration Dates

First Submitted

October 20, 2015

First Submitted That Met QC Criteria

October 28, 2015

First Posted (Estimate)

October 30, 2015

Study Record Updates

Last Update Posted (Actual)

April 30, 2020

Last Update Submitted That Met QC Criteria

April 28, 2020

Last Verified

April 1, 2020

More Information

Terms related to this study

Other Study ID Numbers

  • Evolut R™ FORWARD Study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

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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