Clinical Trials Logo

Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT06381271
Other study ID # TRUST TAVR Registry
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date October 30, 2018
Est. completion date October 2034

Study information

Verified date April 2024
Source Xijing Hospital
Contact Rutao Wang, M.D, Ph.D
Phone +86-15091095796
Email rutaowang@qq.com
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

The purpose of this multicenter, prospective and observational registry is to evaluate the safety and efficacy of TAVR for treatment of pure severe aortic valve regurgitation. Baseline characteristics, procedural and clinical data will be collected


Description:

Pure native aortic valve regurgitation (NAVR) is a multifactorial valvular disease, with a prevalence of moderate or severe NAVR ranging from 0.5% to 2.7%. Patients with severe NAVR have a poor prognosis, conservative management has a 1-year mortality rate of more than 20%. Currently, surgical aortic valve replacement (SAVR) is the recommended treatment strategy for patients with NAVR. However, data showed that only 20% of patients with severe NAVR and left-ventricular ejection fraction (LVEF) of 30-50% undergo SAVR, while only 3% of those with an LVEF below 30% receive SAVR. Therefore, a less invasive surgical alternative therapy is needed for high surgical-risk patients from SAVR. Transcatheter aortic valve replacement (TAVR) is now considered the first-choice treatment for elderly patients with aortic stenosis, regardless of surgical risk. Recently, it has also been used to treat patients with NAVR in an "off-label" setting. The latest European guidelines suggest that TAVR may be considered in experienced centers for selected patients with AR who are not eligible for SAVR. However, the role of TAVR in patients with severe NAVR is still debatable. Current studies on this topic are limited by their retrospective design and small sample sizes. Dedicated devices for aortic regurgitation, such as the JenaValve, have shown promising results in terms of technical success and short-term outcomes. However, TAVR for patients with NAVR using on-label devices has a relatively high rate of pacemaker implantation. Additionally, the dedicated device was designed only for tricuspid valve anatomy, making TAVR with off-label devices the main invasive strategy for high-surgical risk patients with bicuspid valves. It's worth noting that the dedicated device is not yet commercially available worldwide. Therefore, further investigation into TAVR using off-label devices for NAVR patients, including those with bicuspid and tricuspid valves, is necessary. The objective of this study was to evaluate the safety and efficacy of TAVR in patients with NAVR in a real-world setting.


Recruitment information / eligibility

Status Recruiting
Enrollment 500
Est. completion date October 2034
Est. primary completion date October 2034
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - 1. Patients diagnosed with severe aortic valve regurgitation undergo evaluation by the Heart team and are eligible for TAVR therapy. - 2. Patients who understand the purpose of this study, agree to participate in the trial and sign the informed consent form Exclusion Criteria: - 1. Patients who cannot provide informed consent - 2. Patients who are treated with TAVR for aortic stenosis - 3. Patients who are participating in other clinical trials

Study Design


Related Conditions & MeSH terms


Intervention

Procedure:
Transcatheter aortic valve replacement
A total of 500 consecutive patients with NAVR undergoing TAVR will be enrolled at 3-5 centers. Clinical follow-up will be conducted in the periprocedural and after aortic valve implantation at 1 month, 1 year, 2 years, 3 years, 4 years, 5 years, and 10 years

Locations

Country Name City State
China Xijing Hospital Xi'an Shannxi

Sponsors (1)

Lead Sponsor Collaborator
Xijing Hospital

Country where clinical trial is conducted

China, 

Outcome

Type Measure Description Time frame Safety issue
Primary Combined clinical efficacy outcomes Combined clinical efficacy outcomes as composed by all-cause mortality, all strokes, any hospitalization 1 year
Secondary Combined early safety and clinical efficacy outcomes Composed by all-cause mortality, all strokes, life-threatening or fatal 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, conduction block and arrhythmia, surgery or intervention related to the device, any hospitalization, myocardial infarction, any other adverse events 30 days
Secondary Rate of technical success Freedom from mortality
Successful access, delivery of the device, and retrieval of the delivery system
Correct positioning of a single prosthetic heart valve into the proper anatomical location
Freedom from surgery or intervention related to the device or to a major vascular or access-related, or cardiac structural complication
at exit from procedure room
Secondary Rate of device success Technical success
Freedom from mortality
Freedom from surgery or intervention related to the device or to a major vascular or access-related or cardiac structural complication
Intended performance of the valve (mean gradient<20mmHg, and less than moderate aortic regurgitation)
discharge or 30 days
Secondary Combined clinical efficacy outcomes Combined clinical efficacy outcomes as composed by all-cause mortality, all strokes, any hospitalization 2 years, 3 years, 4 years
Secondary Rate of all-cause mortality 5years and 10years
Secondary Valve-related long-term clinical efficacy Freedom from bioprosthetic Valve Failure (defined as: Valve-related mortality OR Aortic valve re-operation/re-intervention OR Stage 3 hemodynamic valve deterioration)
Freedom from stroke or peripheral embolism (presumably valve-related, after ruling out other non-valve aetiologies)
Freedom from VARC Type 2-4 bleeding secondary to or exacerbated by antiplatelet or anticoagulant agents, used specifically for valve-related concerns (e.g. clinically apparent leaflet thrombosis)
5 years and 10 years
See also
  Status Clinical Trial Phase
Recruiting NCT05438862 - Early Aortic vaLve surgEry Versus wAtchful waitiNg Strategy in Severe Asymptomatic aOrtic reguRgitation N/A
Completed NCT03644784 - Protocoled Quantitative Assessment of Aortic Regurgitation Using Videodensitometry in a Multicontinental Trial in Rotterdam, Montreal, Yamaguchi, Segeberg, Amsterdam.
Recruiting NCT04797572 - Clinical Evaluation of the Free Margin Cusp Sizer (CALIBRATE) N/A
Not yet recruiting NCT05536310 - TAVIS Registry - Trilogy Heart Valve System for Management of Patients With Aortic Valve Disease
Completed NCT02375282 - Physical and Functional Recovery From Cardiac Surgery in Hospitalized Patients: A Feasibility Pilot Study N/A
Completed NCT04548726 - Hemodynamic Matched Comparison of the Balloon-Expandable Transcatheter Heart Valves Myval and Sapien-3 for the Treatment of Aortic Stenosis
Not yet recruiting NCT06455787 - J-Valve Transfemoral Pivotal Study N/A
Completed NCT01593917 - Trifectaâ„¢ Long Term Follow-Up (LTFU) Study
Recruiting NCT05459233 - Valve Hemodynamic Optimization Based on Doppler-Echocardiography vs Catheterization Measurements Following ViV TAVR N/A
Recruiting NCT05902897 - Aortic or Mitral Valve Replacement With the Braile Biomédica® Bovine Pericardium Valvular Bioprosthesis
Completed NCT03807921 - Anticoagulation for Aortic Bioprosthesis (ANTIPRO) Phase 4
Recruiting NCT04464655 - A 10-Minute Cardiovascular Magnetic Resonance Protocol for Cardiac Disease
Recruiting NCT05799573 - CT Scan Sizing for Perceval Sutureless Valve
Completed NCT00636987 - Aortic or Mitral Valve Replacement With the Biocor and Biocor Supra N/A