Evaluation of a Management Algorithm for TAVI Patients With Concomitant Mitral or Tricuspid Regurgitation (MASTER-TAVI II)
torstai 28. toukokuuta 2026 päivittänyt: Josep Rodes-Cabau
Evaluation of a Treatment Algorithm for the Management of TAVI Patients With Significant Concomitant Mitral or Tricuspid Regurgitation
Aortic stenosis is a condition in which the aortic valve becomes narrow and does not open properly, making it harder for the heart to pump blood to the body. Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure commonly used to treat this condition, especially in older patients or patients at high surgical risk.
Many patients undergoing TAVI also have leakage of the mitral valve and/or tricuspid valve. These valve problems can cause symptoms such as shortness of breath, fatigue, swelling, heart failure, and repeated hospitalizations. Patients with multiple valve diseases generally have worse outcomes and are more difficult to treat.
In some patients, mitral or tricuspid valve leakage improves after TAVI because the heart works better once the aortic valve has been treated. However, in other patients, the leakage remains severe and continues to affect their health and quality of life. New minimally invasive treatments are now available to repair or replace the mitral and tricuspid valves, but doctors still do not know the best order or timing for these procedures.
This study aims to evaluate a treatment algorithm for patients with severe aortic stenosis and significant mitral and/or tricuspid valve leakage. The proposed approach follows current clinical guidelines and uses a stepwise strategy. Patients will first undergo TAVI, followed by reassessment of the mitral and tricuspid valves. If important valve leakage persists after TAVI, additional minimally invasive procedures may be considered to treat the mitral or tricuspid valve.
The study will include patients with severe aortic stenosis and moderate-to-severe or severe mitral and/or tricuspid regurgitation. Researchers will collect information about patient symptoms, heart imaging results, procedures, hospitalizations, quality of life, and clinical outcomes during follow-up.
The main goal of the study is to evaluate whether this staged treatment approach is safe, feasible, and effective in improving patient outcomes. Researchers will also assess whether the strategy can reduce hospitalizations for heart failure and improve symptoms, daily functioning, and quality of life.
The results of this study may help doctors better manage patients with multiple valve diseases and provide a more personalized and structured treatment approach for this complex group of patients.
Tutkimuksen yleiskatsaus
Tila
Ei vielä rekrytointia
Opintotyyppi
Havainnollistava
Ilmoittautuminen (Arvioitu)
300
Yhteystiedot ja paikat
Tässä osiossa on tutkimuksen suorittajien yhteystiedot ja tiedot siitä, missä tämä tutkimus suoritetaan.
Opiskeluyhteys
- Nimi: Melanie Côté, MSc
- Puhelinnumero: 2646 4186568711
- Sähköposti: melanie.cote@criucpq.ulaval.ca
Tutki yhteystietojen varmuuskopiointi
- Nimi: Josep Rodes Cabau, MD PhD
- Puhelinnumero: 5593 14186568711
- Sähköposti: josep.rodes@criucpq.ulaval.ca
Osallistumiskriteerit
Tutkijat etsivät ihmisiä, jotka sopivat tiettyyn kuvaukseen, jota kutsutaan kelpoisuuskriteereiksi. Joitakin esimerkkejä näistä kriteereistä ovat henkilön yleinen terveydentila tai aiemmat hoidot.
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Ei
Näytteenottomenetelmä
Ei-todennäköisyysnäyte
Tutkimusväestö
The study population will consist of adult patients with severe symptomatic aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) who also present with significant concomitant mitral regurgitation and/or tricuspid regurgitation. The study will mainly include elderly patients and patients considered at intermediate, high, or prohibitive surgical risk for conventional open-heart surgery.
Eligible participants will have moderate-to-severe or severe mitral and/or tricuspid valve regurgitation identified by echocardiography before TAVI. Patients will be evaluated and treated according to a staged transcatheter treatment algorithm based on current clinical guidelines and the evolution of valve disease following TAVI.
Kuvaus
Inclusion Criteria:
- Age >18 years.
- Patients with severe AS undergoing transarterial TAVI.
- Concomitant significant MR and/or TR (≥3+).
Exclusion Criteria:
- Life expectancy <1 year due to noncardiac conditions.
- Any prior mitral or tricuspid valve surgery.
- Echocardiographic evidence of intracardiac mass, thrombus, or vegetation.
- Active endocarditis.
- Subjects in whom transesophageal echocardiography is contraindicated or high risk.
Opintosuunnitelma
Tässä osiossa on tietoja tutkimussuunnitelmasta, mukaan lukien kuinka tutkimus on suunniteltu ja mitä tutkimuksella mitataan.
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
Kohortit ja interventiot
Ryhmä/Kohortti |
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Concomitant isolated MR - 3+ or 4
Patients with severe aortic stenosis (AS) and significant mitral regurgitation (MR) undergoing TAVI followed, if needed, by mitral intervention (M-TEER).
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Concomitant isolated TR - 3+ to 5
Patients with severe AS and significant tricuspid regurgitation (TR) undergoing TAVI followed, if needed, by tricuspid intervention (T-TEER).
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Concomitant MR and TR
Patients with severe AS, MR, and TR undergoing staged triple-valve transcatheter therapy.
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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All-cause mortality or re-hospitalization for worsening heart failure
Aikaikkuna: Minimum of 1 year
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Composite of all-cause mortality or re-hospitalization for worsening heart failure at a minimum of 1 year following the TAVI procedure
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Minimum of 1 year
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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All-cause mortality or re-hospitalization for worsening heart failure
Aikaikkuna: 1 Year
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Composite of all-cause mortality or re-hospitalization for worsening heart failure at 1-year follow-up.
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1 Year
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All-cause mortality or re-hospitalization for worsening heart failure
Aikaikkuna: 2 year
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Composite of all-cause mortality or re-hospitalization for worsening heart failure at 2-year follow-up
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2 year
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All-cause mortality or re-hospitalization for worsening heart failure
Aikaikkuna: 3 year
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Composite of all-cause mortality or re-hospitalization for worsening heart failure at 3-year follow-up.
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3 year
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All-cause mortality or re-hospitalization for worsening heart failure
Aikaikkuna: 4 year
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Composite of all-cause mortality or re-hospitalization for worsening heart failure at 4-year follow-up.
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4 year
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All-cause mortality or re-hospitalization for worsening heart failure
Aikaikkuna: 5 year
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Composite of all-cause mortality or re-hospitalization for worsening heart failure at 5-year follow-up.
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5 year
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All-cause mortality
Aikaikkuna: 1 year
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All-cause mortality at 1 year
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1 year
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All-cause mortality
Aikaikkuna: 2 year
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All-cause mortality at 2 year
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2 year
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All-cause mortality
Aikaikkuna: 3 year
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All-cause mortality at 3 year
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3 year
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All-cause mortality
Aikaikkuna: 4 year
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All-cause mortality at 4 year
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4 year
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All-cause mortality
Aikaikkuna: 5 year
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All-cause mortality at 5 year
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5 year
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Heart failure re-hospitalization
Aikaikkuna: 1 year
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Heart failure re-hospitalization at 1 year
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1 year
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Heart failure re-hospitalization
Aikaikkuna: 2 year
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Heart failure re-hospitalization at 2 year
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2 year
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Heart failure re-hospitalization
Aikaikkuna: 3 year
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Heart failure re-hospitalization at 3 year
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3 year
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Heart failure re-hospitalization
Aikaikkuna: 4 year
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Heart failure re-hospitalization at 4 year
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4 year
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Heart failure re-hospitalization
Aikaikkuna: 5 year
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Heart failure re-hospitalization at 5 year
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5 year
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Cardiovascular mortality
Aikaikkuna: 1 year
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Cardiovascular mortality at 1 year
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1 year
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Cardiovascular mortality
Aikaikkuna: 2 year
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Cardiovascular mortality at 2 year
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2 year
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Cardiovascular mortality
Aikaikkuna: 3 year
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Cardiovascular mortality at 3 year
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3 year
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Cardiovascular mortality
Aikaikkuna: 4 year
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Cardiovascular mortality at 4 year
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4 year
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Cardiovascular mortality
Aikaikkuna: 5 year
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Cardiovascular mortality at 5 year
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5 year
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All-cause mortality or heart failure re-hospitalization
Aikaikkuna: 1 year
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Evaluation of the composite outcome (all-cause mortality or heart failure re-hospitalization) at 1-year follow-up compared with a historical cohort.
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1 year
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MR severity
Aikaikkuna: 1 year
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MR severity at 1 year
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1 year
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MR severity
Aikaikkuna: 2 year
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MR severity at 2 year
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2 year
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MR severity
Aikaikkuna: 3 year
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MR severity at 3 year
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3 year
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MR severity
Aikaikkuna: 4 year
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MR severity at 4 year
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4 year
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MR severity
Aikaikkuna: 5 year
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MR severity at 5 year
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5 year
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TR severity
Aikaikkuna: 1 year
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TR severity at 1 year
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1 year
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TR severity
Aikaikkuna: 2 year
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TR severity at 2 year
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2 year
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TR severity
Aikaikkuna: 3 year
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TR severity at 3 year
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3 year
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TR severity
Aikaikkuna: 4 year
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TR severity at 4 year
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4 year
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TR severity
Aikaikkuna: 5 year
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TR severity at 5 year
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5 year
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LVEF
Aikaikkuna: 1 year
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LVEF at 1 year
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1 year
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LVEF
Aikaikkuna: 2 year
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LVEF at 2 year
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2 year
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LVEF
Aikaikkuna: 3 year
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LVEF at 3 year
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3 year
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LVEF
Aikaikkuna: 4 year
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LVEF at 4 year
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4 year
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LVEF
Aikaikkuna: 5 year
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LVEF at 5 year
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5 year
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Yhteistyökumppanit ja tutkijat
Täältä löydät tähän tutkimukseen osallistuvat ihmiset ja organisaatiot.
Sponsori
Tutkijat
- Päätutkija: Josep Rodes Cabau, MD PhD, IUCPQ-UL
Julkaisuja ja hyödyllisiä linkkejä
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