TRICAV-II Pivotal: TRIcvalve biCAVal ventilsystem til svær tricuspid regurgitation. (TRICAV-II)
Et prospektivt, multicenter, randomiseret, klinisk forsøg med TricValve Transcatheter Bicaval Valve System hos personer med svær tricuspid regurgitation (TR).
Undersøgelsesanordningen er TricValve Transcatheter Bicaval Valve System (også kaldet TricValve System).
Bioprotesen fås i to forskellige diametre for hver model (SVC og IVC), der er specielt designet til at tilpasse sig de anatomiske egenskaber i vena cava superior og inferior.
SVC- og IVC-ventilerne er sterile engangsenheder, der leveres i to størrelser hver, til i alt fire ventilstørrelser. Ventilerne er designet til heterotop kavaleimplantation uden at forstyrre den native trikuspidalklap. Ventilerne er lavet af bovine pericardium-blade syet på et nitinol selvekspanderende stentsystem.
SVC- og IVC-ventilerne leveres forudmonteret i to separate TricValve-leveringssystemer og er individuelt pakket i to separate æsker, leveret sterile og klar til brug. De to TricValve Delivery Systems leverer de to ventiler perkutant ind i SVC og IVC via femoral veneadgang ved hjælp af en transvenøs tilgang.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Dette er et prospektivt, multicenter, randomiseret kontrolleret pivotalt klinisk forsøg til at evaluere sikkerheden og effektiviteten af TricValve-systemet med OMT sammenlignet med OMT alene i behandlingen af patienter med svær TR og kaval refluks.
TricValve-systemet modtog banebrydende enhedsbetegnelse fra US FDA.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Thuy Olender
- Telefonnummer: +1 408-839-3809
- E-mail: tolender@productsandfeatures.com
Studiesteder
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Alabama
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Birmingham, Alabama, Forenede Stater, 35233
- University of Alabama
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Arizona
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Phoenix, Arizona, Forenede Stater, 85013
- St. Joseph's Hospital and Medical Center
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California
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Sacramento, California, Forenede Stater, 95817
- UC Davis Health
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San Diego, California, Forenede Stater, 92037
- Scripps Memorial Hospital La Jolla
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San Francisco, California, Forenede Stater, 94143
- UCSF
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San Jose, California, Forenede Stater, 94118
- Kaiser Permanente
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District of Columbia
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Washington D.C., District of Columbia, Forenede Stater, 20010
- MedStar Washington Hospital Center (MWHC)
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Kontakt:
- Erin Collins
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Ledende efterforsker:
- Toby Rogers, MD
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Florida
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Delray Beach, Florida, Forenede Stater, 33484
- Delray Medical Center
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Largo, Florida, Forenede Stater, 33770
- HCA Florida Largo Hospital
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Ledende efterforsker:
- Saurabh Sanon, MD
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Tampa, Florida, Forenede Stater, 33606
- Tampa General Hospital
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Illinois
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Glenview, Illinois, Forenede Stater, 60026
- Endeavor Health
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Indiana
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Indianapolis, Indiana, Forenede Stater, 46260
- Ascension Medical Group St. Vincent The Heart Center of Indiana
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Kansas
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Kansas City, Kansas, Forenede Stater, 66103
- University of Kansas Medical Center
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Louisiana
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Houma, Louisiana, Forenede Stater, 70360
- Cardiovascular Institute of the South
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Massachusetts
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Boston, Massachusetts, Forenede Stater, 02215
- Beth Israel Deaconess Medical Center
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Boston, Massachusetts, Forenede Stater, 02114
- Massachusetts General Hospital
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Burlington, Massachusetts, Forenede Stater, 01805
- Lahey Hospital & Medical Center
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Minnesota
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Minneapolis, Minnesota, Forenede Stater, 55407
- Minneapolis Heart Institute Foundation
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Missouri
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Kansas City, Missouri, Forenede Stater, 64111
- Saint Luke's Mid America Heart Institute
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St Louis, Missouri, Forenede Stater, 63110
- Washington University of St Louis
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New Jersey
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Hackensack, New Jersey, Forenede Stater, 07601
- Hackensack University Medical Center
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New York
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Manhasset, New York, Forenede Stater, 11030
- Northwell Hospital
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The Bronx, New York, Forenede Stater, 10467
- Montefiore Medical Center
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Ohio
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Cleveland, Ohio, Forenede Stater, 44106
- Cleveland Clinic
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Ledende efterforsker:
- Rishi Puri, MD
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Columbus, Ohio, Forenede Stater, 43214
- Riverside Methodist Hospital
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Oregon
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Portland, Oregon, Forenede Stater, 97239
- Oregon Health
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South Carolina
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Charleston, South Carolina, Forenede Stater, 29425
- MUSC
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Texas
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Houston, Texas, Forenede Stater, 77030
- Houston Methodist
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Houston, Texas, Forenede Stater, 77030
- University of Texas (Memorial Hermann)
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Plano, Texas, Forenede Stater, 75093
- Baylor Scott & White Medical
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Utah
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Murray, Utah, Forenede Stater, 84107
- Intermountain Heart Institute - Intermountain Medical Center
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Virginia
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Charlottesville, Virginia, Forenede Stater, 22903
- UVA School of Medicine
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Norfolk, Virginia, Forenede Stater, 23507
- Sentara Healthcare
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Roanoke, Virginia, Forenede Stater, 24014
- Carilion Clinic
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inklusionskriterier:
- Faget skal være 18 år eller ældre.
- Alvorlig tricuspid regurgitation (TR), som bestemt af Echo Core Lab.
- NYHA klasse III-IVa eller hjertesvigt (HF) indlæggelse inden for de seneste 6 måneder.
- Forsøgspersonen behandles med stabil OMT i mindst 30 dage.
- Det lokale hjerteteam og IEC afgør, at patienten er berettiget
- For kvinder i den fødedygtige alder, negativ graviditetstest.
- Kan og er villig til at give underskrevet informeret samtykke.
Ekskluderingskriterier:
- Nylig MI, slagtilfælde eller CVA; større kardiovaskulær operation inden for 90 dage.
- Forsøgspersonen kræver en anden planlagt større hjerteindgreb.
- LVEF ≤ 30 % ved ekkokardiografi.
- Tegn på intrakardial, inferior vena cava (IVC) eller femoral venøs masse, trombe eller vegetation.
- Tricuspid stenose.
- Alvorlig højre ventrikulær dysfunktion.
- Hjerte amyloidose.
- Pulmonalarteriesystolisk tryk (PASP) >65 mmHg.
- Venetrombose i nedre ekstremiteter og/eller tilstedeværelsen af et IVC-filter på tidspunktet for eller 6 måneder før TricValve-proceduren.
- Hæmodynamisk signifikant perikardiel effusion.
- Patient med refraktær hjertesvigt, der kræver avanceret intervention
- Enhver kendt allergi eller overfølsomhed over for nitinol, bovint væv eller kontrastmidler, som ikke kan behandles tilstrækkeligt med præmedicinering.
- Ude af stand til at tolerere antikoagulation/antiblodpladebehandling.
- Hæmodynamisk ustabilitet, kardiogent shock, inotropisk støtte, intra-aorta ballonpumpe eller akut hjertesvigt inden for 30 dage før TricValve-proceduren.
- Forventet levetid lavere end 12 måneder.
- Blodpladetal < 75.000/mm3.
- Child-Pugh sværhedsgradsklasse C (10-15 point).
- Svær nyreinsufficiens med eGFR) ≤ 25 ml/min/1,73 m2 eller dialyse.
- Endokarditis eller aktiv/igangværende infektion, der kræver antibiotika.
- Ude af stand til at gå mindst 60 meter i en 6 minutters gangtest.
- Kendte blødnings- eller koagulationsforstyrrelser eller patienten nægter blodtransfusion.
- Aktiv gastrointestinal (GI) blødning inden for 3 måneder efter TricValve-proceduren.
- Tilstedeværelse af signifikant medfødt hjertesygdom, herunder, men ikke begrænset til, hæmodynamisk signifikant atrial septumdefekt, RV-dysplasi og arytmogen RV.
- Deltagelse i andre undersøgelsesudstyr eller lægemiddelundersøgelse.
- Enhver anden betingelse, der ville udelukke evnen til at opfylde undersøgelseskravene efter investigators mening.
- Psykiatriske/adfærdsmæssige problemer eller andre medicinske eller sociale forhold, der udelukker gyldigt samtykke og opfølgning.
- Gravide eller ammende personer.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Eksperimentel: TricValve System + Optimal medical therapy (OMT)
Heterotopic Transcatheter Valve Replacement (TVR) with the TricValve System in conjunction with optimal medical therapy (OMT) in patients with caval reflux and tricuspid regurgitation.
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Optimal medicinsk terapi
Andre navne:
• Heterotopic Transcatheter Valve Replacement (TVR) with the TricValve System in conjunction with optimal medical therapy
Andre navne:
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Aktiv komparator: Optimal medical therapy (OMT) Alone
OMT alone in patients with caval reflux and tricuspid regurgitation
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Optimal medicinsk terapi
Andre navne:
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Eksperimentel: TricValve Single Arm Registry
Single-Arm Registry for Heterotopic Transcatheter Valve Replacement (TVR) with the TricValve System in conjunction with OMT in patients with caval reflux and tricuspid regurgitation who are not eligible for randomization
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Optimal medicinsk terapi
Andre navne:
• Heterotopic Transcatheter Valve Replacement (TVR) with the TricValve System in conjunction with optimal medical therapy
Andre navne:
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Randomized Cohort: Caval Reflux (CR) grade reduction
Tidsramme: 6 months
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Reduction in Caval Reflux (CR) assessed by the echocardiography core laboratory.
The CR will be assessed using the 3-grade scale: Grade 1 (no reflux, reflux extending for less than 1 cm below the diaphragm), Grade 2 ( reflux extending for less than 3 cm), Grade 3 (reflux of 3 cm or more).
Lower grades of CR are better.
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6 months
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Randomized Cohort: Hierarchical composite endpoint including: Kansas City Cardiomyopathy Questionnaire (KCCQ) improvement, New York Heart Association (NYHA) functional class improvement, and 6-minute walk test distance improvement
Tidsramme: 6 months
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Comparison of clinical outcomes using a single hierarchical analysis.
Treatment effect will be summarized using Win Ratio statistics, where a value greater than 1 indicates improved outcomes in the experimental group compared with the comparator arm.
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6 months
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Randomized Cohort: Rate of Major Adverse Events (MAE)
Tidsramme: 30 days
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Rate of Major Adverse Events (MAE) in experimental arm (TricValve + OMT)
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30 days
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Randomized Cohort: Hierarchical composite endpoint: all-cause mortality, RVAD implantation or heart transplant, tricuspid valve surgery or percutaneous tricuspid intervention, heart failure hospitalizations, KCCQ improvement, NYHA functional class improv
Tidsramme: 1 year
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Comparison of clinical outcomes using a single hierarchical analysis.
Treatment effect will be summarized using Win Ratio statistics, where a value greater than 1 indicates improved outcomes in the experimental group compared with the comparator arm.
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1 year
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Registry Cohort: Rate of Major Adverse Events (MAE)
Tidsramme: 30 days
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Rate of Major Adverse Events (MAE) in single arm registry
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30 days
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Randomized Cohort: Percentage of Device- and/or Procedure-related MAEs
Tidsramme: 1 year
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Rate of Major Adverse Events
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1 year
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Randomized Cohort: All-Cause mortality and Cardiovascular Mortality
Tidsramme: 6 months and 1 year
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Number of deaths from any cause as well as cardiovascular events
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6 months and 1 year
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Randomized Cohort: Heart Failure Hospitalizations (HFH)
Tidsramme: 6 months and 1 year
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Number of Heart Failure Hospitalizations and worsening HF events without hospitilization
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6 months and 1 year
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Randomized Cohort: RVAD Implantation or Heart Transplant
Tidsramme: 6 months and 1 year
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Number of patients requiring RVAD Implantation or Heart Transplant
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6 months and 1 year
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Randomized Cohort: Atrial Fibrillation
Tidsramme: 1 year
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New onset of atrial fibrillation
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1 year
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Randomized Cohort: Quality of life as measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ) .
Tidsramme: 6 months and 1 year
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Improvement of at least 10 points from baseline.
KCCQ overall summary score is a patient-reported measure of health status, ranging from 0 to 100, where higher scores reflect better Quality of Life (QOL)
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6 months and 1 year
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Randomized Cohort: Changes in symptom status New York Heart Association (NYHA class)
Tidsramme: 6 months and 1 year
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Reduction of at least 1 class from baseline.
The NYHA functional classification system categorizes heart failure patients into 4 classes based on physical activity limitation and symptom severity: class I (no symptoms and no limitation in ordinary physical activity), class II (mild symptoms and slight limitation during ordinary activity), class III (marked limitation in activity due to symptoms, even during less-than-ordinary activity; comfortable only at rest, and class IV (severe limitations; experiences symptoms even while at rest).
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6 months and 1 year
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Randomized Cohort: Changes in functional capacity (6-minute walk test, 6MWT).
Tidsramme: 6 months and 1 year
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Improvement of 6-minute walk distance of at least 30 meters from baseline.
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6 months and 1 year
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Registry Cohort: Heart Failure Hospitalization
Tidsramme: 1 year
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Comparison of the 12-month post-procedure HFH rate with the 12-month pre-procedure rate
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1 year
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Registry Cohort: Changes in Quality of life (by Kansas City Cardiomyopathy Questionnaire (KCCQ) overall summary score).
Tidsramme: 1 year
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Change from baseline to 12 months.
KCCQ overall summary score is a patient-reported measure of health status, ranging from 0 to 100, where higher scores reflect better Quality of Life (QOL)
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1 year
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Roll-In Cohort: Percentage of Device- and/or Procedure-related MAEs
Tidsramme: 1 year
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Rate of Major Adverse Events
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1 year
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Roll-In Cohort: All-Cause mortality and Cardiovascular Mortality
Tidsramme: 6 months and 1 year
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Number of deaths from any cause as well as cardiovascular events
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6 months and 1 year
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Roll-In Cohort: Heart Failure Hospitalizations (HFH)
Tidsramme: 6 months and 1 year
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Number of Heart Failure Hospitalizations and worsening HF events without hospitalization
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6 months and 1 year
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Roll-In Cohort: RVAD Implantation or Heart Transplant
Tidsramme: 6 months and 1 year
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Number of patients requiring RVAD Implantation or Heart Transplant
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6 months and 1 year
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Roll-In Cohort: Atrial Fibrillation
Tidsramme: 1 year
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New onset of atrial fibrillation
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1 year
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Roll-In Cohort: Quality of life as measured by Kansas City Cardiomyopathy Questionnaire (KCCQ).
Tidsramme: 6 months and 1 year
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Improvement of at least 10 points from baseline.
KCCQ overall summary score is a patient-reported measure of health status, ranging from 0 to 100, where higher scores reflect better Quality of Life
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6 months and 1 year
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Roll-In Cohort: New York Heart Association (NYHA) functional class
Tidsramme: 6 months and 1 year
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Reduction of at least 1 class from baseline.
NYHA functional classification system categorizes heart failure patients into 4 classes based on physical activity limitation and symptom severity: class I (no symptoms and no limitation in ordinary physical activity), class II (mild symptoms and slight limitation during ordinary activity), class III (marked limitation in activity due to symptoms, even during less-than-ordinary activity; comfortable only at rest, and class IV (severe limitations; experiences symptoms even while at rest).
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6 months and 1 year
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Roll-In Cohort: 6-minute walk test (6MWT).
Tidsramme: 6 months and 1 year
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Improvement of 6-minute walk distance of at least 30 meters from baseline.
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6 months and 1 year
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Publikationer og nyttige links
Generelle publikationer
- Amat-Santos IJ, Estevez-Loureiro R, Sanchez-Recalde A, Cruz-Gonzalez I, Pascual I, Mascherbauer J, Abdul-Jawad Altisent O, Nombela-Franco L, Pan M, Trillo R, Moreno R, Delle Karth G, Blasco-Turrion S, Sanchez-Luna JP, Revilla-Orodoea A, Redondo A, Zamorano JL, Puri R, Iniguez-Romo A, San Roman A. Right heart remodelling after bicaval TricValve implantation in patients with severe tricuspid regurgitation. EuroIntervention. 2023 Aug 7;19(5):e450-e452. doi: 10.4244/EIJ-D-23-00077. No abstract available.
- Blasco-Turrion S, Briedis K, Estevez-Loureiro R, Sanchez-Recalde A, Cruz-Gonzalez I, Pascual I, Mascherbauer J, Abdul-Jawad Altisent O, Nombela-Franco L, Pan M, Trillo R, Moreno R, Delle Karth G, Sanchez-Luna JP, Gonzalez-Gutierrez JC, Revilla-Orodoea A, Zamorano JL, Gomez-Salvador I, Puri R, San Roman JA, Amat-Santos IJ. Bicaval TricValve Implantation in Patients With Severe Symptomatic Tricuspid Regurgitation: 1-Year Follow-Up Outcomes. JACC Cardiovasc Interv. 2024 Jan 8;17(1):60-72. doi: 10.1016/j.jcin.2023.10.043. Epub 2023 Dec 6.
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- CTP-TRIC-005-II
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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