Pilot Trial: Comparison of Flow Patterns
Pilot Trial: Comparison of Flow Patterns. Is There a Difference Between sewed-in and "Sutureless" Bioprosthetic Aortic Heart Valves?
The purpose of this study is to determine why sutureless aortic bioprostheses apparently offer better haemodynamic properties compared to sewed-in aortic bioprostheses in patients who underwent aortic valve replacement.
Our approach to address this question is the combination of clinical data with the application of specifically validated experimental and computer based analyses to compare the performance of these valves under patient-specific conditions.
Descripción general del estudio
Estado
Intervención / Tratamiento
Tipo de estudio
Inscripción (Anticipado)
Fase
- No aplica
Contactos y Ubicaciones
Ubicaciones de estudio
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Vienna, Austria, 1090
- Reclutamiento
- Medical University of Vienna
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Contacto:
- Claus Rath, MD
- Número de teléfono: 0043-1-40400-69660
- Correo electrónico: claus.rath@meduniwien.ac.at
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Contacto:
- Alfred Kocher, MD
- Número de teléfono: 0043-1-40400-69660
- Correo electrónico: alfred.kocher@meduniwien.ac.at
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Investigador principal:
- Alfred Kocher, MD
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Sub-Investigador:
- Claus Rath, MD
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Sub-Investigador:
- Martin Andreas, MD
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Sub-Investigador:
- Dominik Wiedemann, MD
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Sub-Investigador:
- Guenther Laufer, MD
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Sub-Investigador:
- Christian Loewe, MD
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Sub-Investigador:
- Raphael Rosenhek, MD
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- Patient underwent open aortic valve replacement with either an Edwards Magna Ease or an Edwards Intuity valve
- Implanted valve size 23mm
- Surgical access via full sternotomy or hemisternotomy
- Intuity Valve System implanted by one of the clinical investigators of the TRITON trial (http://clinicaltrials.gov/show/NCT01445171) at the Medical University of Vienna
- Post-operative ejection fraction ≥50%
- Sinus-Rhythm
- Ability to understand and comply with study procedures
- Signed informed consent
Exclusion Criteria:
- Under 18 years of age
- Emergency surgery
- Pregnancy
- Previous aortic root replacement
- Previous aortic valve replacement
- Previous or concomitant root enlargement
- Previous or concomitant repair of the ascending aorta
- Paravalvular leakage
- Ectasia of the ascending aorta
- Previous or concomitant myomectomy
- Concomitant replacement or repair of valves other than aortic
- Usage of more than 3 sutures for implantation of the Intuity Valve System
- Heavily calcified aortic root
- Glomerular filtration rate (GFR) < 30 ml/min
- Inability to understand or comply with study procedures
- Known allergic reaction to iodinated, non-ionic contrast agents
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Otro
- Asignación: No aleatorizado
- Modelo Intervencionista: Asignación de un solo grupo
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
|
Otro: "Sutureless" valve
Patients who underwent aortic valve replacement with a "sutureless" aortic valve. An echocardiogram and a cardiac CT-scan will be conducted. |
ECG gated CT angiography of the heart will be performed on a 128-slice dual-source and two Stellar detectors CT system with retrospective ECG-gating (Siemens/SOMATOM Definition Flash - Siemens, Germany, 100kV, 395.75 mAs). In details, multi-phase images will be acquired to reconstruct between 10 and 100% of the cardiac cycle (10% increments) with a slice thickness of 1 mm. Examination will include left ventricular outflow tract, aortic root, coronary sinus, ascending aorta together with the prosthetic valves. |
|
Otro: "Sewed-in" valve
Patients who underwent aortic valve replacement with a "sewed-in" aortic valve.
An echocardiogram and a cardiac CT-scan will be conducted.
|
ECG gated CT angiography of the heart will be performed on a 128-slice dual-source and two Stellar detectors CT system with retrospective ECG-gating (Siemens/SOMATOM Definition Flash - Siemens, Germany, 100kV, 395.75 mAs). In details, multi-phase images will be acquired to reconstruct between 10 and 100% of the cardiac cycle (10% increments) with a slice thickness of 1 mm. Examination will include left ventricular outflow tract, aortic root, coronary sinus, ascending aorta together with the prosthetic valves. |
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Periodo de tiempo |
|---|---|
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Comparison of maximum and minimum velocity under patient specific conditions
Periodo de tiempo: between 6 months and 4 years after aortic valve replacement
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between 6 months and 4 years after aortic valve replacement
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Comparison of the effective orifice area under patient specific conditions
Periodo de tiempo: between 6 months and 4 years after aortic valve replacement
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between 6 months and 4 years after aortic valve replacement
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Comparison of the percentage of turbulent flow under patient specific conditions
Periodo de tiempo: between 6 months and 4 years after aortic valve replacement
|
between 6 months and 4 years after aortic valve replacement
|
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Comparison of the pressure drop under patient specific conditions
Periodo de tiempo: between 6 months and 4 years after aortic valve replacement
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between 6 months and 4 years after aortic valve replacement
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Patient-specific, computer simulated pressure gradients compared to echocardiographically obtained pressure gradients.
Periodo de tiempo: between 6 months and 4 years after aortic valve replacement
|
The first secondary outcome measure is the comparison of -pressure gradients as computed by the model against the same data collected standardly with echocardiographic technique. Differences will be quantified. If positive (< 10%), this assessment would enhance the use of patient-specific models in clinics as a predictive tool for detailed haemodynamics." |
between 6 months and 4 years after aortic valve replacement
|
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Patient-specific, computer simulated peak velocity compared to echocardiographically obtained peak velocity.
Periodo de tiempo: between 6 months and 4 years after aortic valve replacement
|
The second secondary outcome measure is the comparison of -peak velocity as computed by the model against the same data collected standardly with echocardiographic technique. Differences will be quantified. If positive (< 10%), this assessment would enhance the use of patient-specific models in clinics as a predictive tool for detailed haemodynamics." |
between 6 months and 4 years after aortic valve replacement
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Alfred Kocher, MD, Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Anticipado)
Finalización del estudio (Anticipado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- 1790/2013-1
Información sobre medicamentos y dispositivos, documentos del estudio
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Estudia un producto de dispositivo regulado por la FDA de EE. UU.
producto fabricado y exportado desde los EE. UU.
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