- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05683067
Microcirculation and Vascular Function After Fontan Surgery (MICROFON)
Fontan Surgery is done for children with only one working lower chamber of the heart called the 'Single Ventricle'. This surgery involves making connections between the two big veins that drain oxygen deficient blood to the heart and the lung artery directly. Fontan patients may develop long-term complications such as reduced heart function or oxygen levels, increased pressure in the veins, liver or kidney problems etc. The reasons for these complications are poorly understood. The small blood vessels in the body or 'microcirculation' are tiny (can be seen only by microscope) and they supply food and oxygen to the tissues. Very little is known about what happens to the microcirculation in adult Fontan survivors . In this study the investigator want to understand why these adult Fontan survivors develop complications by looking at their microcirculation and comparing them with healthy people and those who were operated for other congenital heart diseases. The study will be conducted in East Midlands Congenital Heart Centre, Glenfield Hospital.
Leicester.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
In normal heart, there are two working lower chambers where one chamber pumps the blood to the lungs and other chamber pumps the blood to the body. However, some congenital heart conditions have only one working lower chamber of the heart called the 'Single Ventricle'. This condition is often associated with hole between the heart chambers with increased or decreased blood flow to the lungs. This can lead to mixing of blood in the heart with low oxygen levels in the body. The surgery for single ventricle is usually performed in stages starting from the infancy. Fontan surgery is the last stage where the two big veins that return the blood to the heart is connected to the lung artery directly. This surgery improves the oxygen levels in the blood and lessens the burden on the single ventricle. The blood is not pumped to the lungs by the heart but rather enters passively to the lungs through this new surgical connection. Some people operated for Fontan surgery have many short-term and long-term complications such as increased pressure in veins , poor heart function and low oxygen levels in the blood. In particular, the organs below the chest such as kidney, liver and gut are affected, and all of these predict poor outcomes. The reason for these complications are poorly understood.
The small blood vessels in the body or 'microcirculation' are very tiny and are less than 150 microns in diameter. These includes arterioles, capillaries, and venules. Very little is known about the microcirculation in adult Fontan survivors and its association with aortic stiffness, late complications, and quality of life. In this study, The investigators want to look at the blood vessels in adult Fontan survivors, people operated for other congenital heart diseases, and healthy volunteers using a special microscope called Hand Held Capillary Microscopy. The investigators will visualize their blood vessel appearance, number, and size they have in their hands, feet, and under the tongue. This procedure is non-invasive and will not cause any pain. The aortic stiffness will be measured non-invasively using a special blood pressure monitor called Mobile 'O' Graph, which is about size of a pocket diary. 24 hour blood pressure monitoring is optional. The investigator will also collect the information about the quality of life using questionnaires as few studies have shown that the quality of life is affected in adult Fontan survivors and it was associated with poor vascular function. Age matched healthy controls and adults survivors of other congenital heart surgeries will also undergo these tests for comparison purpose. This study will be conducted at East Midlands Congenital Heart Centre, Glenfield Hospital, Leicester.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Locations
-
-
Leicestershire
-
Leicester, Leicestershire, United Kingdom, LE3 9QP
- Recruiting
- Glenfield Hospital Leicester
-
Contact:
- Rajendra Raghuraman, MSc
- Phone Number: 07838025043
- Email: rpr4@le.ac.uk
-
Contact:
- Frances Bu'Lock, MD
- Phone Number: 0116 256 3904
- Email: frances.bulock@uhl-tr.nhs.uk
-
Sub-Investigator:
- Frances Bu'Lock, MD FRCP
-
Principal Investigator:
- Iain Squire, MD FESC
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients operated for Fontan procedure or other congenital heart conditions
- Patients ≥ 16 - 50 years of age
- Participant/Parents/Guardian or legal representative willing and able to give Informed Consent for participation in the study
- Able (in the Investigators opinion) and willing to comply with all study requirements
Exclusion Criteria:
- Low blood pressure (90/60 mmHg with symptoms or on intravenous inotropes for maintenance of blood pressure)
- Raynaud's disease
- Autoimmune diseases
- Down's syndrome as they have lower risk for vascular anomalies compared with the general population and may have different microvasculature
- Treatment with sympathomimetic drugs
- Atrial fibrillation or any other arrhythmia which might interfere with vascular function assessments.
- Documented peripheral vascular disease
- Skin disorders such as psoriasis or significant eczema
- Any other significant disease or disorder which, in the opinion of the Investigator, may either put the participants at risk because of participation in the study, or may influence the result of the study, or the participant's ability to participate in the study.
- Tremor or Inability to keep the hand still for 20 minutes.
Note: Patients treated with angiotensin converting enzyme inhibitors or angiotensin receptor inhibitors, beta blockers, vasodilators, diuretics and digoxin will be included in the study as the majority of Fontan survivors are taking one or more of these drugs for optimization of their circulation or for symptom management. Patients treated with anticoagulants and antiplatelets will be included in the study.
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Fontan Survivors
The investigator will include Fontan survivors between 16-50 years of age for the study.
|
The investigator will visualize the blood vessel appearance, number, and size they have in their hands, feet, and under the tongue.
This procedure is non-invasive and will not cause any pain.
The aortic stiffness will be measured non-invasively using a special blood pressure monitor called Mobile 'O' Graph, which is about size of a pocket diary.
24 hour blood pressure monitoring is optional.
The investigator will evaluate the quality of life using questionnaires such as EQ-5D-5L questionnaire and the Minnesota Living with Heart Failure Questionnaire (MLHFQ)
|
People operated for congenital heart diseases
The investigator will include people operated for other types of congenital heart diseases such as tetralogy of Fallot, transposition of great arteries between 16 and 50 years of age
|
The investigator will visualize the blood vessel appearance, number, and size they have in their hands, feet, and under the tongue.
This procedure is non-invasive and will not cause any pain.
The aortic stiffness will be measured non-invasively using a special blood pressure monitor called Mobile 'O' Graph, which is about size of a pocket diary.
24 hour blood pressure monitoring is optional.
The investigator will evaluate the quality of life using questionnaires such as EQ-5D-5L questionnaire and the Minnesota Living with Heart Failure Questionnaire (MLHFQ)
|
Healthy volunteers
The investigator will include healthy volunteers between 16 to 50 years of age for comparison purpose.
|
The investigator will visualize the blood vessel appearance, number, and size they have in their hands, feet, and under the tongue.
This procedure is non-invasive and will not cause any pain.
The aortic stiffness will be measured non-invasively using a special blood pressure monitor called Mobile 'O' Graph, which is about size of a pocket diary.
24 hour blood pressure monitoring is optional.
The investigator will evaluate the quality of life using questionnaires such as EQ-5D-5L questionnaire and the Minnesota Living with Heart Failure Questionnaire (MLHFQ)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
In this study, the investigator want to look at the microcirculation using hand held capillary microscopy in the young and adult Fontan survivors compared to the age matched healthy people and the people operated for other congenital heart surgeries.
Time Frame: One year
|
The microcirculation will be studied in the skin of the hands, feet, and the mouth using handheld capillary microscopy
|
One year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The investigator want to measure the central blood pressure in the young and adult Fontan survivors compared to the age matched healthy people and the people operated for other congenital heart surgeries.
Time Frame: One year
|
The central blood pressure, pulse wave velocity, and the augmentation index will be assessed by Mobile O Graph blood pressure monitor
|
One year
|
The investigator will measure the functional outcomes in young and adult Fontan survivors using questionnaires and study its relationship with microvascular assessments and vascular function.
Time Frame: One Year
|
The functional status will be assessed by Minnesota living with heart failure questionnaire
|
One Year
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 0860
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Congenital Heart Disease
-
University of UlsterBelfast Health and Social Care TrustCompletedCongenital Heart Disease | Congenital Heart Defect | Adult Congenital Heart DiseaseUnited Kingdom
-
Children's Hospital Medical Center, CincinnatiNational Heart, Lung, and Blood Institute (NHLBI)CompletedHeart Disease CongenitalUnited States
-
Vanderbilt University Medical CenterEnrolling by invitationCongenital Heart Disease | Congenital Heart Defect | Congenital Heart MalformationsUnited States
-
YHAlattarNot yet recruitingCritical Congenital Heart Disease
-
University Hospital TuebingenCompletedComplex Congenital Heart DiseaseGermany
-
The Hospital for Sick ChildrenCompletedCongenital Heart Disease (CHD)Canada
-
University College, LondonSociety for Cardiothoracic Surgery in Great Britain & Ireland; British Congenital...Unknown
-
University of California, DavisCompletedCyanotic Congenital Heart DiseaseUnited States
-
Assistance Publique Hopitaux De MarseilleRecruitingComplex Congenital Heart DiseaseFrance
-
University of PittsburghNational Heart, Lung, and Blood Institute (NHLBI); Boston Children's HospitalEnrolling by invitation
Clinical Trials on Hand Held Capillary Microscopy
-
The University of Texas Medical Branch, GalvestonWithdrawn
-
NYU Langone HealthCompletedNeurofibromatosis 1 and 2 (NF1 and NF2)United States
-
City, University of LondonKing's College Hospital NHS TrustCompleted
-
University of East AngliaClinical Research and Trials Unit (Norfolk & Norwich University Hospital,...UnknownHead and Neck CancerUnited Kingdom
-
Mayo ClinicRecruitingBrain Tumor | Brain Tumor Adult | Brain LesionUnited States
-
King's College LondonCompletedPrimary Lung Cancer or Secondary Lung Metastases | COPD III/IVUnited Kingdom
-
Aysegul CelikEnrolling by invitation
-
Washington University School of MedicineNational Cancer Institute (NCI)RecruitingBreast BiopsyUnited States
-
Assistance Publique - Hôpitaux de ParisCentre National de la Recherche Scientifique, FranceCompleted
-
Deutsches Herzzentrum MuenchenCompletedElectromagnetic InterferenceGermany, Greece