Aortic Aneurysm Clinical Trial
Official title:
Conservative Aortic Valve Surgery for Aortic Insufficiency and Aneurysms of the Aortic Root
The primary objective of the CAVIAAR study is to prove that aortic valve sparing for
patients with aortic root aneurysms and/or dystrophic aortic insufficiency is associated
with a 45% increase of 3 years-survival rate without increased mortality or serious
increased morbidity events when compared to mechanical valve replacement.
The main hypothesis of this study is that a standardized procedure of valve sparing based on
external aortic annuloplasty in patients with dystrophic aortic insufficiency and/or aortic
root aneurysm increases survival rate without increased mortality or serious increased
morbidity events when compared with patients undergoing mechanical aortic valve replacement.
The CAVIAAR trial is a multicenter, prospective open trial. Target recruitment is 260 adults
with aortic root aneurysms and/or dystrophic aortic insufficiency, enrolled in 19 french
centers. Patients will undergo a standardized aortic valve sparing procedure based on aortic
annuloplasty or a mechanical valve replacement (130 patients in each arm). In case of valve
sparing, per-operative transoesophageal echocardiography will evaluate residual aortic
insufficiency after valve repair. A conversion towards a valve replacement will be performed
if residual aortic insufficiency is superior or equal to grade II.
Analysis will be on an intention-to-treat basis, completed with a per-protocol analysis.
Primary endpoint will be 3-years survival free of morbidity or mortality, evaluated on a
composite criterion, associating mortality; structural and non-structural valvular
dysfunction, valve thrombosis, embolism, bleeding event, endocarditis, reoperations and
permanent valve-related impairment. In the valve sparing group, we expect less than 5% rate
of operative conversion and a significant improvement of primary endpoint. As secondary
goals, quality of life and criteria of valvular coaptation will be compared between the 2
groups.
Standardization is the prerequisite for evaluation of valve sparing procedure. Aim of
CAVIAAR trial is to provide evidence based medicine data for the best surgical management of
patients with aortic root aneurysms and/or dystrophic aortic insufficiency.
;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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