This pilot study is a prospective, randomized, open-label trial that aims to assess the feasibility of comparing a primary Computed tomography/Cardiac computed tomography angiography (CT/CCTA) strategy (test arm) to a strategy combining routine use of CT/CCTA and invasive CA (control arm) prior to a Transcatheter aortic valve implantation (TAVI) procedure. The study will also estimate the rate of composite coronary adverse events (myocardial infarction, post procedural coronary revascularization and cardiovascular mortality) between the two arms at 90 days follow-up. The primary endpoint will be the feasibility of recruitment and compliance with the study protocol at 2 sites in Canada and 1 site in Denmark. Additional clinical endpoints including: all-cause death at 90 days post procedure, myocardial infarction at 90 days post procedure, unplanned PCI or CABG at 90 days post procedure, stroke at 90 days post procedure, CA and PCI related cumulative vascular complications events. This information will be used to inform the design of the definitive efficacy trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
200
St. Paul's Hospital
Vancouver, British Columbia, Canada
RECRUITINGNumber of patients enrolled in the study of all those that are eligible
This is the primary outcome for this pilot study to assess feasibility of a larger trial.
Time frame: 18 months
All-cause mortality
Time frame: 90 days
Myocardial Infarction
According to Valvular Academic Research Consortium-2 (VARC-2) criteria. * Periprocedural MI (≤72h post procedure). * Spontaneous MI.
Time frame: Peri-procedural (≤72h post procedure) and 90 days
Unplanned revascularization
Any unplanned coronary revascularization either with Percutaneous Coronary Intervention( PCI) or Coronary Artery Bypass Graft (CABG) post TAVI procedure.
Time frame: 90 days
Bleeding complication
According to VARC-2 criteria. * TAVI related ≤ 72h post TAVI * Coronary procedure related ≤ 72h post CA or PCI (if staged TAVI-PCI)
Time frame: Peri-procedural (≤72h post procedure) and 90 days
Device success
According to VARC-2 criteria.
Time frame: 90 days
Acute Kidney Injury
According to VARC-2 criteria.
Time frame: 90 days
Stroke
An acute episode of focal or global neurological dysfunction caused by the brain, spinal cord, or retinal vascular injury as assessed by a clinician and confirmed by at least one cerebral imaging study (CT or MRI). Stroke may be classified as ischaemic or haemorrhagic
Time frame: 90 days
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