Evolut™ EXPAND TAVR-II-Pivotal study
Zusammenfassung der Studie
The purpose of this clinical study is to collect information to compare the safety and efficacy of Medtronic's transcatheter aortic valve replacement (TAVR) system with the medication treatment typically provided for this condition, which follows guidelines. The treatment is determined in a manner similar to flipping a coin and is referred to as randomization. The patient is assigned to one of two groups. One group receives a medication treatment, also known as guideline-directed medical therapy (GDMT), and the other group receives the study device (Medtronic Evolut™ PRO+ or Medtronic Evolut™ FX) via transcatheter aortic valve replacement (TAVR) and GDMT (TAVR + GDMT).
(BASEC)
Untersuchte Intervention
The intervention consists of the implantation of the transcatheter aortic valve replacement system in the study patients assigned to this arm. The TAVR implantation procedure is considered experimental, as it is typically not performed in patients with moderate aortic stenosis (AS).
(BASEC)
Untersuchte Krankheit(en)
Moderate aortic stenosis (AS), a condition in which the opening of the aortic valve is narrowed. The valves affected by the stenosis restrict blood flow, causing the heart to work harder to push blood through the narrowed valve than when the valve opening is normal.
(BASEC)
- moderate aortic stenosis (BASEC)
Ausschlusskriterien
- Age < 65 - anatomical conditions are not suitable for a TAVR (BASEC)
Studienstandort
Bern
(BASEC)
Sponsor
Medtronic Schweiz AG Wolfgang Deutschmann Talstr. 9 39053 Münchenbuchsee wolfgang.deutschmann@medtronic.com
(BASEC)
Kontakt für weitere Auskünfte zur Studie
Kontaktperson Schweiz
Prof. Dr. med. Thomas Pilgrim
+41 316320827
thomas.pilgrim@clutterinsel.chInselspital-Universitätsspital Bern
(BASEC)
Allgemeine Auskünfte
Allina Health System,Fondation IUCPQ,Inselspital, Universit?tsspital Bern,
763-526-2832
thomas.pilgrim@clutterinsel.ch(ICTRP)
Allgemeine Auskünfte
Allina Health SystemFondation IUCPQInselspital, Universittsspital Bern
763-526-2832
thomas.pilgrim@clutterinsel.ch(ICTRP)
Wissenschaftliche Auskünfte
Allina Health System,Fondation IUCPQ,Inselspital, Universit?tsspital Bern,
763-526-2832
thomas.pilgrim@clutterinsel.ch(ICTRP)
Name der bewilligenden Ethikkommission (bei multizentrischen Studien nur die Leitkommission)
Ethikkommission Bern
(BASEC)
Datum der Bewilligung durch die Ethikkommission
22.08.2022
(BASEC)
ICTRP Studien-ID
NCT05149755 (ICTRP)
Offizieller Titel (Genehmigt von der Ethikkommission)
Evolut™ EXPAND TAVR II Pivotal Trial (BASEC)
Wissenschaftlicher Titel
Evolut EXPAND TAVR II Pivotal Trial (ICTRP)
Öffentlicher Titel
Evolut EXPAND TAVR II Pivotal Trial (ICTRP)
Untersuchte Krankheit(en)
Moderate Aortic Valve Stenosis (ICTRP)
Untersuchte Intervention
Device: Medtronic Evolut PRO+ TAVR System, or Evolut FX TAVR System, and guideline-directed management and therapy (GDMT) (ICTRP)
Studientyp
Interventional (ICTRP)
Studiendesign
Allocation: Randomized. Intervention model: Parallel Assignment. Primary purpose: Treatment. Masking: None (Open Label). (ICTRP)
Ein-/Ausschlusskriterien
Key Inclusion Criteria:
o Moderate AS, defined as follows by transthoracic echo (TTE) as assessed by the ECL:
- AVA >1.0 cm and <1.5cm or
- AVA = 1.0 cm with AVAI > 0.6cm/m if BMI < 30 kg/m: or
- AVA = 1.0 cm with AVAI > 0.5cm/m if BMI = 30 kg/m:
and
- Max aortic velocity = 3.0 m/sec. and < 4.0 m/sec. or
- Mean aortic gradient = 20mmHg and < 40.0 mmHg
Any of the following at-risk features:
- Symptoms of AS, defined as:
- NYHA = Class II, or
- Reduced functional capacity, defined as
- 6MWT < 300 meters, or
- < 85% of age-sex predicted METs on exercise tolerance testing (ETT)
- Documented heart failure event or hospitalization for heart failure within 1
calendar year prior to consent
- NT-proBNP = 600 pg/ml (or BNP = 80 pg/ml), or
- Persistent AF or Paroxysmal AF episode within 6 months prior to consent, or
- Elevated aortic valve calcium score (>1200 AU for females and > 2000 AU for males)
as assessed by the MDCT core lab, or
- Any of the following by the qualifying TTE as assessed by the ECL:
- Global longitudinal strain =16% (absolute value), or
- E/e' = 14.0 (average of medial and lateral velocities), or
- Diastolic dysfunction = Grade II, or
- LVEF < 60%
- Stroke Volume Index < 35 ml/m
- Anatomically suitable for transfemoral TAVR using the Medtronic Evolut PRO+ or
Evolut FX system
- The subject and the treating physician agree the subject will return for all
required follow-up visits
Key Exclusion Criteria:
- Age < 65 years
- LVEF = 20% by 2-D echo
- Class I indication for cardiac surgery
- Contraindication for placement of a bioprosthetic valve
- Documented history of cardiac amyloidosis (ICTRP)
nicht verfügbar
Primäre und sekundäre Endpunkte
Composite rate of all-cause mortality, all-stroke, life threatening or fatal bleeding, acute kidney injury, hospitalization due to device or procedure-related complication, or valve dysfunction requiring reintervention.;Composite rate of all-cause mortality, heart failure hospitalization or event, or medical instability leading to aortic valve replacement or re-intervention. (ICTRP)
Proportion of subjects alive and with moderately improved quality of life (= 10 points in KCCQ summary score from baseline);Composite of all-cause mortality and heart failure hospitalizations or events.;Composite of all-cause mortality, all-stroke, or unplanned CV hospitalizations;Heart failure hospitalizations or events.;All-cause mortality;Unplanned cardiovascular hospitalizations;Days alive and free of unplanned cardiovascular hospitalizations (ICTRP)
Registrierungsdatum
24.11.2021 (ICTRP)
Einschluss des ersten Teilnehmers
nicht verfügbar
Sekundäre Sponsoren
nicht verfügbar
Weitere Kontakte
Paul Sorajja, MD;Josep Rodes-Cabau, MD;Stephan Windecker, Prof.;Hang Nguyen, hang.t.nguyen@medtronic.com, 763-526-2832, Allina Health System,Fondation IUCPQ,Inselspital, Universit?tsspital Bern, (ICTRP)
Sekundäre IDs
D00411092 (ICTRP)
Angaben zur Verfügbarkeit von individuellen Teilnehmerdaten
nicht verfügbar
Weitere Informationen zur Studie
https://clinicaltrials.gov/ct2/show/NCT05149755 (ICTRP)
Ergebnisse der Studie
Zusammenfassung der Ergebnisse
nicht verfügbar
Link zu den Ergebnissen im Primärregister
nicht verfügbar