A prospective, non-randomized multi-center clinical investigation of the Venus P-Valve™ for the treatment of pulmonary regurgitation with or without stenosis in patient with native outflow tracts.
This study evaluates the implantation of the Venus P-Valve™ for the treatment of patients with an incompetent pulmonic valve, which causes blood to flow back from the pulmonary artery into the right heart ventricle during pumping of the heart (pulmonary regurgitation). Patients with and without narrowing (stenosis) of the right ventricular outflow tract will be included. The purpose of this protocol is to assess the safety and performance of Venus P-Valve™ implantation. Post-procedure, a clinical visit will be scheduled at 30 days, 6 month, 12 months, and annually thereafter to 3 years. Population: Patients≥12 years with a body weight of ≥30kg, with significant pulmonary regurgitation (≥3+) with or without right ventricular outflow tract (RVOT) stenosis (mean Doppler gradient ≥35mmHg) with native right ventricular outflow tracts.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
84
trans catheter heart valve replacement
Safety of Venus P-Valve™ measured as probability of death/reoperation
Occurrence of death or reoperation (Valve and/or procedure related) calculated as a composite freedom-of-death and -reoperation probability at 12 months. The acceptance criterion for mortality and reoperation is 16% (or equivalently 84% freedom from death and reoperation). If the lower 95% confidence limit for survival and freedom from reoperation at 12 months is greater than 84%, the acceptance criterion for safety will have been met.
Time frame: month 12 follow-up
Safety of Venus P-Valve™ measured as probability of Major Adverse Cardiac and Cerebro-vascular Event (MACCE)
Occurrence of MACCE (defined as death, myocardial infarction, reoperation, vascular injury resulting in the need for an unplanned vascular grafting intervention, stroke, and pulmonary embolism) calculated as freedom-from-MACCE probability at month-1, calculated using the Kaplan Meier method
Time frame: month 1 follow-up
Performance of Venus P-Valve™ measured as Success rate of valve placement and implantation
The device success is defined as the percentage of subjects with successful implant of the P-Valve assessed at the earliest evaluable echocardiogram. Linearized rates will be presented.
Time frame: up to 30 days
Hemodynamic Performance of Venus P-Valve™ measured as the mean transvalvular pressure (mmHg)
Hemodynamic performance, measured as the mean transvalvular pressure gradient measured by transthoracic echocardiogram at month-1
Time frame: 1 month
Performance of Venus P-Valve™ measured as change of pulmonary regurgitation (regurgitation classification by MRI)
Improvement or abolition of pulmonary regurgitation assessed by MRI at baseline and month 6, with grading of pulmonary stenosis defined as: mild \<2, moderate: 2-4; severe \>4
Time frame: baseline and month 6
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Performance of Venus P-Valve™ measured as change of pulmonary regurgitation (regurgitation classification by transthoracic echocardiogram)
Improvement or abolition of pulmonary regurgitation assessed by transthoracic echocardiogram at baseline, day 1, month 1, 6, 12 and annually thereafter to 3 years post procedure, with grading of pulmonary stenosis defined as: mild \<2, moderate: 2-4; severe \>4
Time frame: baseline, day 1, month 1, 6, 12 and annually thereafter to 3 years post procedure
Performance of Venus P-Valve™ measured as percentage of subjects with structural valve deterioration
Structural valve deterioration assessment includes stent fracture, leaflet mobility, thickening and calcification
Time frame: month 6
Safety measured as percentage of subjects experiencing serious adverse events
Within the duration of the study of the percentage of patients experiencing the following events is measured: * Device migration/embolization * Valvar thrombosis * Thromboembolism * Bleeding * Paravalvar leak * Endocarditis * Nonstructural dysfunction * Explant * Hemolysis * Arrhythmias * all other serious adverse events as defined in protocol section 6.2
Time frame: up to third year of follow-up
Functional improvement measured as decreased pulmonary regurgitation (regurgitation classification by transthoracic echocardiogram )
Improved valve function demonstrated by a decrease in pulmonary regurgitation (PR) to mild or less (≤ 2) by transthoracic echocardiogram (TTE) at month-1
Time frame: 1 month
Functional improvement measured as decreased pulmonary regurgitation (regurgitation classification by MRI)
Improved valve function demonstrated by a decrease in pulmonary regurgitation (PR) to mild or less (≤ 2) by MRI at month-6
Time frame: month 6