Confronto tra le valvole aortiche transcatetere Allegra e Sapien nell'indicazione Valve-In-Valve
Sperimentazione clinica dei risultati delle valvole aortiche transcatetere Allegra vs Sapien nell'indicazione Valve-In-Valve
The VIVALL-2 study is a randomized trial to compare the self-expandable supra-annular Allegra and the balloon-expandable intra-annular Edwards transcatheter valve systems in patients with degenerated biological aortic surgical valve.
Panoramica dello studio
Stato
Intervento / Trattamento
Descrizione dettagliata
In the VIVALL.2 study, 104 patients with severely degenerated biological aortic surgical valve accepted for vave-in-valve procedure (transcatheter aortic valve implantation) will be randomized to be treated with the self-expandable supra-annular Allegra or the balloon-expandable intra-annular Edwards systems. The primary end-point will be trans-aortic mean gradient determined by trans-thoracic echocardiography at 30 days. The proportion of patients with moderate or severe prosthesis mismatch at 30 days will be a secondary end-.point. Different countries will participate in the study.
Tipo di studio
Iscrizione (Stimato)
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
- Nome: FUNDACION EPIC
- Numero di telefono: 0034987876135
- Email: iepic@fundacionepic.org
Backup dei contatti dello studio
- Nome: RAÚL MORENO GÓMEZ, MD, PhD
- Numero di telefono: 0034917277000
- Email: raulmorenog@hotmail.com
Luoghi di studio
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Alessandria, Italia
- Reclutamento
- Azienda Ospedaliero- Universitaria di Alessandria
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Brescia, Italia, 25123
- Reclutamento
- ASST Spedali Civili di Brescia
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Perugia, Italia
- Reclutamento
- Azienda Ospedaliera di Perugia
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Manchester, Regno Unito
- Reclutamento
- Manchester University NHS Foundation Trust
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Newcastle, Regno Unito
- Reclutamento
- Freeman Hospital
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Swansea, Regno Unito
- Reclutamento
- Morriston Hospital, Swansea
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L'Hospitalet de Llobregat, Spagna, 08907
- Reclutamento
- Hospital Universitari de Bellvitge
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Madrid, Spagna, 28040
- Reclutamento
- Hospital Clinico San Carlos
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Madrid, Spagna, 28046
- Reclutamento
- Hospital Universitario de La Paz
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Majadahonda, Spagna, 28222
- Reclutamento
- Hospital Universitario Puerta De Hierro
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Salamanca, Spagna, 37007
- Reclutamento
- Hospital Clínico Universitario de Salamanca
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Valencia, Spagna, 46026
- Reclutamento
- Hospital Universitari I Politècnic de La Fe
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
Patients meeting ALL the following criteria will be included:
- Patients aged ≥ 18 years.
- Severe haemodynamical valve deterioration of a biological aortic valve implanted surgically, including severe valve stenosis (effective aortic valve area < 1.0 cm2) and/or severe valve regurgitation.
- The patient has cardiac symptoms and/or deterioration of left ventricular ejection fraction attributable to the aortic valve disease.
- Heart team decision of VIV procedure.
- Patient is willing to return at 30 days for TTE and to be clinically contacted at 1 year.
Exclusion Criteria:
Patients meeting, at least, 1 of the following criteria will be excluded:
- Patients who openly express their refusal to participate in the study.
- Female patients in gestational age.
- Presence or suspicious of biological aortic valve thrombosis.
- Known hypersensitivity or contraindication to antithrombotic therapy (or inability to be anticoagulated during the procedure), nitinol, or sensitivity to contrast media which cannot be adequately pre-medicated.
- Ongoing sepsis and/or suspicious or diagnosis of endocarditis.
- Patients whose life expectancy is < 1 year due to non-cardiac comorbid conditions.
- Medical, social, or psychological conditions that preclude the subject from appropriate consent or adherence to the protocol required follow-up exams.
- True inner diameter of the prosthetic valve > 27 mm.
- Transfemoral access inadequate to accommodate an 18F sheath.
- Patients included in other clinical trials (excluding registries).
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
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Comparatore attivo: NVT ALLEGRA System TF
NVT ALLEGRA System TF |
Transcatheter aortic valve implantation of a NVT ALLEGRA TAVI System TF in patients with severe haemodynamical valve deterioration of a biological aortic valve implanted surgically |
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Sperimentale: EDWARDS SAPIEN 3 or SAPIEN ULTRA SYSTEM
EDWARDS SAPIEN 3 or SAPIEN ULTRA SYSTEM |
Transcatheter aortic valve implantation of an EDWARDS SAPIEN 3 SYSTEM in patients with severe haemodynamical valve deterioration of a biological aortic valve implanted surgically |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Trans-aortic mean gradient after Valve-in-Valve procedure, measured by transthoracic echocardiography (TTE).
Lasso di tempo: 30 days
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Trans-aortic mean gradient after Valve-in-Valve procedure, measured by transthoracic echocardiography (TTE). |
30 days
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Proportion of patients with device success after the Valve In Valve (VIV) procedure
Lasso di tempo: 30 days
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Device success after the VIV procedure to the VARC-3 criteria |
30 days
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Proportion of patients with a trans-aortic mean gradient higher than 20 mmHg after the VIV procedure
Lasso di tempo: 30 days
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Proportion of patients with a trans-aortic mean gradient higher than 20 mmHg after the VIV procedure |
30 days
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Proportion of patients with moderate or severe prosthesis mismatch 30 days after the VIV intervention.
Lasso di tempo: 30 days
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Proportion of patients with moderate or severe prosthesis mismatch 30 days after the VIV intervention. |
30 days
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Early safety at 30 days as defined by Valve Academic Research Consortium 3 (VARC-3) criteria
Lasso di tempo: 30 days
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freedom from: all-cause mortality, all stroke, VARC type 2-4 bleeding, major vascular, access-related, or cardiac structural complication, acute kidney injury stage 3 or 4, moderate or severe aortic regurgitation, new permanent pacemaker due to procedure related conduction abnormalities, surgery or intervention related to the device. |
30 days
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Clinical efficacy at 1 year as defined by VARC-3 criteria
Lasso di tempo: 1 year
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freedom from: all-cause mortality, all stroke, hospitalization for procedure- or valve related causes, KCCQ Overall Summary Score <45 or decline from baseline of >10 point. |
1 year
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Trans-aortic mean gradient
Lasso di tempo: 1 year
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Trans-aortic mean gradient 1 year after TAVR procedure |
1 year
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Death
Lasso di tempo: 1 year
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Incidence of Death |
1 year
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Stroke
Lasso di tempo: 1 year
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Incidence of Stroke |
1 year
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Collaboratori e investigatori
Sponsor
Pubblicazioni e link utili
Pubblicazioni generali
- Bleiziffer S, Simonato M, Webb JG, Rodes-Cabau J, Pibarot P, Kornowski R, Windecker S, Erlebach M, Duncan A, Seiffert M, Unbehaun A, Frerker C, Conzelmann L, Wijeysundera H, Kim WK, Montorfano M, Latib A, Tchetche D, Allali A, Abdel-Wahab M, Orvin K, Stortecky S, Nissen H, Holzamer A, Urena M, Testa L, Agrifoglio M, Whisenant B, Sathananthan J, Napodano M, Landi A, Fiorina C, Zittermann A, Veulemans V, Sinning JM, Saia F, Brecker S, Presbitero P, De Backer O, Sondergaard L, Bruschi G, Franco LN, Petronio AS, Barbanti M, Cerillo A, Spargias K, Schofer J, Cohen M, Munoz-Garcia A, Finkelstein A, Adam M, Serra V, Teles RC, Champagnac D, Iadanza A, Chodor P, Eggebrecht H, Welsh R, Caixeta A, Salizzoni S, Dager A, Auffret V, Cheema A, Ubben T, Ancona M, Rudolph T, Gummert J, Tseng E, Noble S, Bunc M, Roberts D, Kass M, Gupta A, Leon MB, Dvir D. Long-term outcomes after transcatheter aortic valve implantation in failed bioprosthetic valves. Eur Heart J. 2020 Aug 1;41(29):2731-2742. doi: 10.1093/eurheartj/ehaa544.
- Moreno R, Baz JA, Moreu J, Berenguer A, Gonzalvez-Garcia A, Galeote G, Hernandez U, Canton T, Jimenez-Valero S, Jurado-Roman A, Moya H, Lazaro E. Transcatheter aortic valve implantation for degenerated aortic valves: Experience with a new supra-annular device. The Spanish Allegra valve-in-valve (SAVIV) registry. Catheter Cardiovasc Interv. 2021 Aug 1;98(2):365-370. doi: 10.1002/ccd.29742. Epub 2021 Apr 23.
- Hirji SA, Percy ED, Zogg CK, Malarczyk A, Harloff MT, Yazdchi F, Kaneko T. Comparison of in-hospital outcomes and readmissions for valve-in-valve transcatheter aortic valve replacement vs. reoperative surgical aortic valve replacement: a contemporary assessment of real-world outcomes. Eur Heart J. 2020 Aug 1;41(29):2747-2755. doi: 10.1093/eurheartj/ehaa252.
- Hahn RT, Webb J, Pibarot P, Ternacle J, Herrmann HC, Suri RM, Dvir D, Leipsic J, Blanke P, Jaber WA, Kodali S, Kapadia S, Makkar R, Thourani V, Williams M, Salaun E, Vincent F, Xu K, Leon MB, Mack M. 5-Year Follow-Up From the PARTNER 2 Aortic Valve-in-Valve Registry for Degenerated Aortic Surgical Bioprostheses. JACC Cardiovasc Interv. 2022 Apr 11;15(7):698-708. doi: 10.1016/j.jcin.2022.02.014.
- Landes U, Sathananthan J, Witberg G, De Backer O, Sondergaard L, Abdel-Wahab M, Holzhey D, Kim WK, Hamm C, Buzzatti N, Montorfano M, Ludwig S, Conradi L, Seiffert M, Guerrero M, El Sabbagh A, Rodes-Cabau J, Guimaraes L, Codner P, Okuno T, Pilgrim T, Fiorina C, Colombo A, Mangieri A, Eltchaninoff H, Nombela-Franco L, Van Wiechen MPH, Van Mieghem NM, Tchetche D, Schoels WH, Kullmer M, Tamburino C, Sinning JM, Al-Kassou B, Perlman GY, Danenberg H, Ielasi A, Fraccaro C, Tarantini G, De Marco F, Redwood SR, Lisko JC, Babaliaros VC, Laine M, Nerla R, Castriota F, Finkelstein A, Loewenstein I, Eitan A, Jaffe R, Ruile P, Neumann FJ, Piazza N, Alosaimi H, Sievert H, Sievert K, Russo M, Andreas M, Bunc M, Latib A, Godfrey R, Hildick-Smith D, Chuang MA, Blanke P, Leipsic J, Wood DA, Nazif TM, Kodali S, Barbanti M, Kornowski R, Leon MB, Webb JG. Transcatheter Replacement of Transcatheter Versus Surgically Implanted Aortic Valve Bioprostheses. J Am Coll Cardiol. 2021 Jan 5;77(1):1-14. doi: 10.1016/j.jacc.2020.10.053.
- Rodes-Cabau J, Abbas AE, Serra V, Vilalta V, Nombela-Franco L, Regueiro A, Al-Azizi KM, Iskander A, Conradi L, Forcillo J, Lilly S, Calabuig A, Fernandez-Nofrerias E, Mohammadi S, Panagides V, Pelletier-Beaumont E, Pibarot P. Balloon- vs Self-Expanding Valve Systems for Failed Small Surgical Aortic Valve Bioprostheses. J Am Coll Cardiol. 2022 Aug 16;80(7):681-693. doi: 10.1016/j.jacc.2022.05.005. Epub 2022 May 18.
- Sa MPBO, Van den Eynde J, Simonato M, Cavalcanti LRP, Doulamis IP, Weixler V, Kampaktsis PN, Gallo M, Laforgia PL, Zhigalov K, Ruhparwar A, Weymann A, Pibarot P, Clavel MA. Valve-in-Valve Transcatheter Aortic Valve Replacement Versus Redo Surgical Aortic Valve Replacement: An Updated Meta-Analysis. JACC Cardiovasc Interv. 2021 Jan 25;14(2):211-220. doi: 10.1016/j.jcin.2020.10.020.
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Termini relativi a questo studio
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Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
- EPIC34-VIVALL 2 TRIAL
Informazioni su farmaci e dispositivi, documenti di studio
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