- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05531578
Transfemoral Implant of Inovare® Transcatheter Valve
January 9, 2024 updated by: Braile Biomedica Ind. Com. e Repr. Ltda.
Transfemoral Implant of Inovare® Transcatheter Valve - Clinical Trial of Feasibility and Safety and Efficacy Verification
Clinical trial to evaluate the early safety and efficacy of the transfemoral implant of Inovare® Transcatheter Valve for the treatment of patients with severe degenerative aortic stenosis and high surgical risk.
Study Overview
Status
Active, not recruiting
Conditions
Detailed Description
The Inovare® transcatheter valve was developed and has been market ed since 2011 for replacement, via transapical or transaortic route, of calcified native aortic valves and degenerated bioprostheses (aortic and mitral) with satisfactory medium-long-term results.
The present study aims to evaluate the safety and clinical performance of the new navigation and delivery system of this device using the transfemoral route.
The new device has as its main feature the drivable control of the curvature of the delivery system, the which allows better navigability in regions of more complex anatomy, especially with accentuated tortuosities.
Study Type
Interventional
Enrollment (Actual)
60
Phase
- 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
- Name: Glaucia Basso Frazzato
- Phone Number: +55 (17) 2136-7005
- Email: glaucia.basso@braile.com.br
Study Locations
-
-
-
São José Do Rio Preto, Brazil
- Fundação Faculdade Regional de Medicina de São José do Rio Preto
-
São Paulo, Brazil
- Instituto Dante Pazzanese de Cardiologia
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São Paulo, Brazil
- Universidade Federal de São Paulo
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São Paulo, Brazil
- INCOR - Instituto do Coração do Hospital das Clínicas da FMUSP
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-
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
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Calcified degenerative aortic stenosis with valve area < 1.0 cm2 (or valve area index < 0.6 cm2/m2) and mean transvalvular gradient > 40 mmHg or aortic jet velocity > 4 m/s by echocardiogram.
Multidisciplinary evaluation by the "Heart Team", composed of a cardiovascular surgeon, clinical cardiologist and hemodynamicist, which concludes that the patient has:
- High surgical risk for aortic valve replacement, typically with an STS score of ≥ 8% (or logistic EuroSCORE ≥ 20%) or intermediate risk (STS of ≥ 3% and < 8%);
- Presence of porcelain aorta or hostile chest, as well as global clinical condition and comorbidities not fully addressed by the score STS
- Presence of extreme frailty (5-meter walk test [5MWT], grip strength, activities of daily living (ADL), and albumin laboratory exam);
- Considerable chance of clinical benefit with the transcatheter procedure.
- Heart failure symptoms NYHA functional ≥ II.
- Aortic valve annulus with a mean diameter between 17.3 and 28.6 mm, documented by imaging method, suitable for positioning and accommodation of the Inovare® prosthesis, according to the judgment of an experienced hemodynamicist.
- Height of coronary ostia > 10 mm or presence of a coronary graft that prevents the occurrence of acute myocardial ischemia due to coronary occlusion after valve release.
- Femoral arterial access route considered adequate for the progression of the vascular introducer and prosthesis-balloon system, typically evaluated through multi-imaging methods that include, for example, conventional angiography and computed tomography.
- Patient has provided written informed consent to participate in the trial.
Exclusion Criteria:
Clinic
- Hemodynamic instability requiring vasoactive drugs or circulatory support;
- Valve procedure with clinical need to be performed in a time of urgency or emergency (non-elective);
- Left ventricular ejection fraction < 30%;
- Chronic renal failure on dialysis or with serum creatinine levels > 3.0 mg/dL (265 µmol/L);
- Acute renal failure with serum creatinine that has not yet returned to baseline levels;
- Clinical or biological signs of infection with systemic repercussions;
- Endocarditis < 12 months;
- Coronary artery disease requiring elective revascularization during or after the valve procedure;
- Evidence of myocardial infarction in an interval of less than one month;
- Recent stroke or transient ischemic attack (within the last 6 months);
- Hypersensitivity or contraindication to the administration of heparin, ticlopidine or clopidogrel or to radiopaque contrast;
- Anemia (hemoglobin < 10 g/dl), thrombocytopenia (< 100,000 cells/mm3) or hyperthrombocytosis (> 700,000 cells/mm3);
- Need for chronic anticoagulation for other causes;
- Active peptic disease, gastrointestinal bleeding < 3 months, or previously diagnosed bleeding diathesis;
- Life expectancy less than 12 months due to non-cardiac disease or other comorbidities.
Anatomical/morphological
- Valve ring diameter less than or equal to 17.2 mm or greater than or equal to 28.7 mm;
- Iliofemoral access route, with extreme tortuosity or calcification or reduced luminal diameter (typically < 7 mm), which prevents safe progression of the arterial introducer and delivery system with the prosthesis, according to the judgment of the responsible physician;
- Presence of sessile and unstable atheromas in the ascending aorta and/or aortic arch detected by imaging methods;
- Obstructive hypertrophic cardiomyopathy or severe left ventricular outflow tract obstruction, with no possibility of balloon dilation;
- Previous aortic or mitral valve procedure (surgical or by catheter, excluding aortic balloon valvuloplasty);
- Moderate or severe aortic, mitral or tricuspid regurgitation;
- Non-calcified native valve;
- Evidence of an intracardiac mass (tumor, thrombus, or vegetation).
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: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: TAVI TRANSFEMORAL
|
Transfemoral implantation of the INOVARE® transcatheter valve
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Device success
Time Frame: Procedure
|
Absence of mortality in the procedure AND correct positioning of a single bioprosthesis with the intended performance (mean gradient < 20 mmHg and regurgitation ≥ moderate).
|
Procedure
|
Death the first 30 days
Time Frame: 30 days
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Deaths from any cause within the first 30 days of the procedure or during hospital stay will be considered procedure-related deaths.
|
30 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Device success
Time Frame: 30 days or more
|
Absence of mortality in the procedure AND correct positioning of a single bioprosthesis with the intended performance (mean gradient < 20 mmHg and regurgitation ≥ moderate).
|
30 days or more
|
Incidence of serious adverse events
Time Frame: 30 days or more
|
Overall mortality; · Coronary obstruction requiring percutaneous intervention (PCI); · Stroke; · Stage 2-3 acute kidney injury requiring dialysis technique or increase in creatinine ≥ 300% or creatinine ≥4.0 mg/dl; · Life-threatening bleeding (or sequelae) or critical organ bleeding or hypovolemic shock or severe hypotension requiring vasopressors or surgery or packed red blood cells (RBCs) transfusion ≥4 units; · Major vascular complication; · Reintervention for valvular dysfunction; · Myocardial infarction; ·Permanent pacemaker implantation
|
30 days or more
|
Efficacy of the procedure
Time Frame: 30 days or more
|
Mortality, stroke, bioprosthesis dysfunction due to stenosis (mean gradient ≥ 20 mmHg) and regurgitation ≥ moderate, re-hospitalization with congestive heart failure or valvular symptoms, New York Heart Association (NYHA) functional class III or IV.
|
30 days or more
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: José Honório de Almeida Palma da Fonseca, Dr, InCor Heart Institute
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)
September 11, 2020
Primary Completion (Estimated)
February 20, 2024
Study Completion (Estimated)
December 30, 2028
Study Registration Dates
First Submitted
August 18, 2022
First Submitted That Met QC Criteria
September 2, 2022
First Posted (Actual)
September 8, 2022
Study Record Updates
Last Update Posted (Actual)
January 11, 2024
Last Update Submitted That Met QC Criteria
January 9, 2024
Last Verified
January 1, 2024
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- Inovare - Transfemoral
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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