BioGlue as an Adjunct for Structural Repair and Hemostasis in Chinese Acute Type A Aortic Dissections Patients

N/AActive Not RecruitingNCT03369977

CryoLife, Inc.202 enrolled

Overview

A multi-center, randomized, controlled clinical trial is designed to investigate the safety and efficacy of BioGlue as an adjunct for structural repair and hemostasis to traditional surgical repair in Chinese subject with Acute type A aortic dissections.

A multi-center, randomized, controlled clinical trial is designed to investigate the safety and efficacy of BioGlue as an adjunct for structural repair and hemostasis in Chinese subjects with acute type A aortic dissection. The trial consists of three phases: Phase One - A non-randomized, lead-in phase. During the lead-in phase, the first 2-3 eligible subjects at each center will receive BioGlue in open surgery. These subjects will be evaluated for safety separately from the randomized phase of the trial. Phase Two - A randomized, controlled phase. Type A aortic dissection subjects will be randomized into TSR group (control group) and surgical repair with BioGlue group (test group) with a ratio of 1:1, so that equal number of subjects in test and control groups can be ensured. Phase Three - A Follow-up of Late Safety Outcomes of using BioGlue in "The CHINA Trial" . Subjects enrolled in "The CHINA Trial," from both the BioGlue and the control (TSR) group, will be invited to participate. Clinical data evaluating mortality, adverse events, and re-operation rates will be collected from subject's medical charts.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

202

Conditions

Type A Aortic Dissection

Interventions

BioGlue Surgical AdhesiveDEVICE

BioGlue (produced by CryoLife in Kennesaw, GA) is a surgical adhesive with two components respectively purified bovine serum albumin (BSA) and Glutaraldehyde (their proportions are 4:1). Crosslinked bonds (covalent bonds) of Glutaraldehyde cross-link the protein on the surface of the tissue and the amino residue of the bovine serum albumin. BioGlue also adheres to the synthetic matrix material by a mechanical interlocking mechanism in the space of graft matrix.

Traditional Surgical RepairOTHER

Traditional surgical repair as determined by the surgeon

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Male or female subjects 18-70 years of age. * Subject has a confirmed diagnosis of acute type A aortic dissection with subtype A2. * Subject is willing and able to give written consent for the trial. If the subject is unconscious or under the influence of medications which render him or her unable to give fully informed consent, a guardian may provide informed consent for the subject regarding trial participation. Exclusion Criteria: * Subjects with known allergy to albumin, bovine products, or glutaraldehyde. * Subjects who have been treated with an investigational product who have not completed the entire follow-up period. * Subjects who do not meet the eligibility criteria, including those who do not wish to participate or give informed consent for trial participation, will not be enrolled into the trial, and will be offered equivalent, non-trial surgical or other treatment, as judged appropriate by the investigator. * Subjects with previous cardiac and aortic surgery. * End stage malperfusion syndromes (i.e. end-organ failure such as coma, paraplegia, hemiplegia, intestinal necrosis, or hepatic failure). * Subjects with Marfan syndrome or other connective tissue disorders. * Previous chronic dissections resulting from non-cardiac surgery and/or trauma. * Concomitant surgery of valve replacement (both in screening and intraoperative).

Locations (7)

Beijing Anzhen Hospital, Capital Medical University

Beijing, China

Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School

Nanjing, China

Nanjing First Hospital

Nanjing, China

Changhai Hospital,The Second Military Medical University

Shanghai, China

Outcomes

Primary Outcomes

Successful Closure of the False Lumen

Successful closure of the false lumen as determined by intraoperative TEE. With successful closure of the false lumen, a complete disappearance of the false lumen will be achieved.

Time frame: This success can be visually confirmed intraoperatively with a TEE (binary yes/no expression for each subject)

Secondary Outcomes

Successful closure of the false lumen by CTA or TTE at discharge

Successful closure of the false lumen at discharge or at 20 days (+/- 10 days) post-operatively confirmed by CTA scan or Transthoracic Echocardiogram (TTE) scan if the subject is unable to have a CTA.

Time frame: CTA or TTE scan at discharge or at 20 days (+/- 10 days) post-operatively for subjects with longer hospital stays.

Time to repair the sinuses of Valsalva

During the operation the time to repair the sinuses of Valsalva will be recorded.

Time frame: The time for repairing the sinuses of Valsalva will be documented intraoperatively.

Evaluate the successful hemostasis at the anastomotic site

Hemostasis is assessed visually (i.e. lack of any observable extravascular bleeding) and is monitored until hemostasis is achieved at each applied anastomotic site.

Time frame: The measurement begins intraoperatively after either BioGlue or Traditional Surgical Repair is applied to the anastomotic suture line(s) and the bypass cross clamp is released.

Treatment failure of the aortic dissection repair site identified in "The CHINA Trial" which leads to either post-discharge mortality or re-operation.

Post-operative mortality and re-operation(s) will be collected from the subjects' medical charts retrospectively and during informed consent telephone notification.

Time frame: The measurement begins at discharge and will end when the retrospective chart review is performed by the hospital (could be up to 3 years post-op)

Data from ClinicalTrials.gov

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