Safety and Efficacy of SYM-SV/DS-002 in Patients with Severe Aortic Stenosis
To evaluate the safety and efficacy of Transfemoral Transcatheter Aortic Valve Implantation using SYM-SV-002 Aortic Bioprosthesis and SYM-DS-002 Transfemoral Delivery System in patients presenting with symptomatic severe aortic stenosis and with difficulty to safely undergo conventional surgical aortic valve replacement (AVR)
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
11
Transcatheter Aortic Valve Implantation via Transfemoral Approach
Kokura Memorial Hospital
Kitakyushu, Fukuoka, Japan
Osaka University Hospital
Suita, Osaka, Japan
Sakakibara Heart Institute
Fuchū, Tokyo, Japan
Keio University Hospital
Shinjuku, Tokyo, Japan
Survival rate
Time frame: at 12 months post-procedure
Occurrence rates of MACCE
MACCE is defined as a composite of: * All Cause Mortality * Myocardial infarction (MI) * All Stroke * Reintervention
Time frame: at 1 month, 6 months, 12 months, 2 years, 3 years, 4 years and 5 years post-procedure
Occurrence rates of individual MACCE components
Individual MACCE components include: * All Cause Mortality * Myocardial infarction (MI) * All Stroke * Reintervention
Time frame: at 1 month, 6 months, 12 months, 2 years, 3 years, 4 years and 5 years post-procedure
Occurrence rates of Major Adverse Events (MAEs)
MAEs include: * MACCE * Acute Kidney Injury (AKI) * Cardiac Tamponade * Prosthetic Valve Dysfunction (PVD) * Cardiogenic Shock * Prosthetic Valve Endocarditis * Life-Threatening, Disabling or Major Bleeding * Major Vascular Complications * Cardiac Perforation * Device Migration/Valve Embolism
Time frame: at 1 month, 6 months, 12 months, 2 years, 3 years, 4 years and 5 years post-procedure
Occurrence rate of conduction disturbance requiring Permanent Pacemaker Implantation(PPI)
Time frame: at 1 month, 6 month, 12 months, 2 years, 3 years, 4 years and 5 years post-procedure
Change in NYHA class from baseline
Time frame: at 1 month, 6 months, 12 months, 2 years, 3 years, 4 years and 5 years post-procedure
Change in distance walked during 6-Minute Walk Test (6MWT) from baseline
Time frame: at 1 month and 12 month post-procedure
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Teikyo University Hospital
tabashi City, Tokyo, Japan
Change in QOL from baseline
Kansas City Cardiomyopathy Questionnaire (KCCQ)
Time frame: at 1 month, 6 months, 12 months, 2 years, 3 years, 4 years and 5 years post-procedure
Change in QOL from baseline
SF-36
Time frame: at 1 month, 6 months, 12 months, 2 years, 3 years, 4 years and 5 years post-procedure
Echocardiographic assessment of valve performance
Effective Orifice Area Index (EOAI)
Time frame: at 1 month, 6 months, 12 months, 2 years, 3 years, 4 years and 5 years post-procedure
Echocardiographic assessment of valve performance
Mean gradient
Time frame: at 1 month, 6 months, 12 months, 2 years, 3 years, 4 years and 5 years post-procedure
Echocardiographic assessment of valve performance
Degree of Aortic valve Regurgitation (AR) (Transvalvular and Paravalvular)
Time frame: at 1 month, 6 months, 12 months, 2 years, 3 years, 4 years and 5 years post-procedure
Echocardiographic assessment of valve performance
Left ventricular ejection fraction (LVEF)
Time frame: at 1 month, 6 months, 12 months, 2 years, 3 years, 4 years and 5 years post-procedure
Device success
Device success is defined as that all of the following are achieved: * Successful vascular access * Successful delivery and deployment of the device * Successful retrieval of the delivery system * Correct position of the device in the proper anatomical location (placement in the aortic annulus with no impedance on device function) * Intended performance of the prosthetic heart valve is confirmed by echocardiography (defined as below): * No Patient-Prosthesis Mismatch (PPM) (EOAI \>0.85cm2/m2) * And mean aortic valve gradient \< 20 mmHg or peak velocity \< 3 m/sec, * And no moderate or severe prosthetic valve regurgitation * Only one valve implanted in the proper anatomical location
Time frame: Number of days from admission to discharge (estimated to be at 7 days post-procedure on average)
Procedural success
Procedural success is defined as that all of the following are achieved: * Achievement of the device success * Absence of in-hospital MACCE
Time frame: Number of days from admission to discharge (estimated to be at 7 days post-procedure on average)
Occurrence rate of Prosthetic Valve Dysfunction (PVD)
Prosthetic Valve Dysfunction (PVD) is defined as: * Aortic regurgitation (AR) reported as moderate or severe by echocardiography assessments * Significant aortic stenosis (AS) which meets one or more of the following by echocardiography assessments: * Peak velocity \> 4 m/s * Mean gradient \> 35 mmHg * Effective Orifice Area (EOA) \< 0.8 cm2 * TVIV1/TVIV2 \< 0.25
Time frame: at 1 month, 6 months, 12 months, 2 years, 3 years, 4 years and 5 years post-procedure
Occurrence rate of clinical endpoints per VARC 2
* Mortality * Stroke * Myocardial infarction (MI) * Bleeding complications * Acute kidney injury (AKI) * Vascular complications * Conduction disturbances and arrhythmia * Other TAVI-related complications
Time frame: at 1 month post-procedure