Transcatheter Aortic Valve Replacement (TAVR) Double Balloon Valvuloplasty
In this study, the investigators evaluate whether routine double inflation of the valve could have a lasting impact. The investigators hypothesize that a routine second reinflation of the balloon, or "double tap", will improve flow across the valve when compared to a single inflation. The investigators hypothesize that "double tap" (1) will decrease mean gradient between first and second inflation during the procedure, (2) will decrease mean gradient on immediate post procedure and 30 day postprocedure echocardiograms when compared to mean gradient gradient after single inflation. Less obstruction indicated by lower mean gradient early after deployment may translate to improved 5 and 10 year outcomes. Furthermore, the investigators hypothesize that this small change in technique will have no effect on procedure time or complications and the change will not result in any increase in perioperative vascular complications, or new permanent pacemaker insertion.
The primary objective of this study is to determine if double valve inflation during a TAVR procedure improves valve area and mean gradients as measured by echocardiogram immediately following the procedure and at 30 days follow up.
調査の概要
研究の種類
入学 (予想される)
連絡先と場所
研究連絡先
- 名前：Erin Ross
- 電話番号：8059488278
- メール：eross1@cmhshealth.org
研究場所
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California
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Ventura、California、アメリカ、93003
- 募集
- Community Memorial Hospital
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コンタクト：
- Erin Ross
- 電話番号：805-948-8278
- メール：eross1@cmhshealth.org
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Male or female ≥18 years of age
- Diagnosis of severe native valve aortic stenosis
- Meets the standard of care indications to undergo TAVR procedure (aortic valve area <1.0 cm2 or mean pressure gradient >40 mmHg or peak velocity >4.0 m/s or aortic valve area index <0.6).
- Provided informed consent.
Exclusion Criteria:
- History of prior aortic valve replacement
- Pre-existing moderate to severe aortic regurgitation
- Lacking pre-procedure echocardiogram
- Patients planning to undergo multiple valve replacements simultaneously
- Intraoperative arrhythmia
- Intraoperative hemodynamic instability
- Intraoperative complication during initial inflation (such as: aortic dissection, coronary artery occlusion, coronary artery dissection)
- At the discretion of the principal investigator, any reason that the potential subject may be unfit for participation, such as frailty.
研究計画
研究はどのように設計されていますか？
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
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Prospective
The prospective phase will enroll patients planning to undergo TAVR, at the discretion of Drs.
Wan and Fatemi, and if they meet all of the inclusion criteria and none of the exclusion criteria.
All patients who provide consent will undergo the TAVR procedure where the valve will be double inflated.
Echocardiogram results and procedure details will be collected as data.
At the patient's 30-day follow-up clinic visit, as per standard of care, they will be re-evaluated with an echocardiogram.
Details from that follow-up visit and the echocardiogram results will be collected as data.
Prospective enrollment will begin upon IRB approval and we plan to continue enrollment until December 31, 2023, or once 200 participants are reached, whichever comes first.
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The prospective phase will enroll patients planning to undergo TAVR, at the discretion of Drs.
Wan and Fatemi, and if they meet all of the inclusion criteria and none of the exclusion criteria.
All patients who provide consent will undergo the TAVR procedure where the valve will be double inflated.
Echocardiogram results and procedure details will be collected as data.
At the patient's 30-day follow-up clinic visit, as per standard of care, they will be re-evaluated with an echocardiogram.
Details from that follow-up visit and the echocardiogram results will be collected as data.
Prospective enrollment will begin upon IRB approval and we plan to continue enrollment until December 31, 2023, or once 200 participants are reached, whichever comes first.
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Retrospective
The retrospective phase will collect data from previous TAVR procedures completed between February 2019 and October 1, 2021.
Data from up to 200 patient charts will be collected using the Society of Thoracic Surgeons/American College of Cardiology that is maintained by the CMH Cardiology Department.
The population will be de-identified as the purpose is to obtain descriptive information from the medical records to utilize for propensity match scoring.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Valve area
時間枠：Immediately following the procedure
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Valve area as measured by echocardiogram
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Immediately following the procedure
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Valve area
時間枠：At 30 days follow up
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Valve area as measured by echocardiogram
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At 30 days follow up
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Mean gradient
時間枠：Immediately following the procedure
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Mean gradient as measured by echocardiogram
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Immediately following the procedure
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Mean gradient
時間枠：At 30 days follow up
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Mean gradient as measured by echocardiogram
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At 30 days follow up
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協力者と研究者
捜査官
- 主任研究者：Jennifer Wan, MD、Community Memorial HealthCenter
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。