This is a prospective, single arm, multicenter study in an cohort of up to 267 patients (up to 100 Roll-ins and 167 patients implanted per protocol) symptomatic patients with severe aortic stenosis who will be followed up for up to 5 years.
The purpose of this trial is to determine the safety and effectiveness of the Vienna Aortic Valve SE System, a new self-expanding transcatheter heart valve, in patients with symptomatic severe aortic stenosis (SSAS). This is a prospective, single arm, multicenter study in an expanding cohort of symptomatic patients with severe aortic stenosis following the FIH feasibility study. The clinical investigation comprises 11 visits (V1 to V11). After implantation of the IMD at visit 2, safety and effectiveness assessment of the device will be performed at 30 days (V4), 3 months (V5), 6 months (V6), 1 year (V7) and every year thereafter up to 5 years post-implantation (V8 to V11). In summary, the clinical investigation for the individual patient will end after 5 years with a full clinical evaluation. The primary study endpoints for safety and effectiveness will be reached at 30-day follow-up timepoint. The clinical trial is completed after all 267 patients, that are not prematurely withdrawn, have completed their 5-year follow-up visit involving all specified assessments.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
267
Vienna Aortic Valve SE system for TAVI.
All Cause Mortality (30 days)
All-cause mortality at 30 days from the index procedure.
Time frame: up to 30 days
All-cause, cardiovascular and non-cardiovascular mortality
All-cause, cardiovascular and non-cardiovascular mortality at 30 days, 3 months, 6 months, 1 year and every year thereafter up to 5 years post-implantation.
Time frame: up to 5 years
Periprocedural death
Incidence of peri-procedural death (to capture intra-procedural events that result in immediate or consequent death ≤72 h post-procedure)
Time frame: 72 hours
Incidence of TAVI-related complications
Incidence of TAVI-related complications: 1. Valve-related complication requiring repeat procedure 2. Vascular complications resulting in interventions 3. Ventricular septal perforation ≤7 days after IMD implantation 4. Acute kidney injury-Stage 2 or 3 ≤7 days post IMD implantation 5. Coronary artery obstruction requiring intervention 6. Atrio-ventricular block requiring pacemaker implantation 7. Mitral valve apparatus damage or dysfunction 8. Evidence of a new pericardial effusion/ tamponade related to the TAVI procedure 9. Prosthetic valve endocarditis 10. Prosthetic valve thrombosis 11. Prosthetic valve mispositioning 12. Prosthetic valve embolization 13. Valve-related dysfunction (mean aortic valve gradient ≥20 mmHg, EOA ≤0.9-1.1 cm2 and/or DVI peak velocity \>0.35 m/s, AND/OR moderate or severe prosthetic valve regurgitation)
Time frame: periprocedural and during index hospitalization
Cerebrovascular event
Cerebrovascular event (at 30 days, 3 months, 6 months, 1 year and every year thereafter up to 5 years post-implantation): 1. Stroke, defined as an acute episode of focal or global neurological dysfunction caused by the brain, spinal cord, or retinal vascular injury as a result of haemorrhage or infarction 2. Transient ischemic attack (TIA), defined as a transient episode of focal neurological dysfunction caused by the brain, spinal cord, or retinal ischemia, without acute infarction. The difference between TIA and ischemic stroke is the presence of tissue damage on neuro-imaging studies or new sensory-motor deficit persisting \>24 h. By definition, a TIA does not produce a lasting disability.
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Hospital Privado Sur (FUMEBA)
Bahía Blanca, Argentina
NOT_YET_RECRUITINGFundación Favaloro
Buenos Aires, Argentina
NOT_YET_RECRUITINGHospital Italiano De Buenos Aires
Buenos Aires, Argentina
NOT_YET_RECRUITINGInstituto Nacional de Cardiologia
Rio de Janeiro, Rio de Janeiro, Brazil
NOT_YET_RECRUITINGEscola Paulista de Medicina da UNIFESP
São Paulo, São Paulo, Brazil
NOT_YET_RECRUITINGInstituto Estadual De Cardiologia Aloysio De Castro
Rio de Janeiro, Brazil
RECRUITINGInstituto Dante Pazzanese De Cardiologia
São Paulo, Brazil
RECRUITINGInstituto Do Coração (InCor) De São Paulo
São Paulo, Brazil
RECRUITINGHospital Del Torax De Santiago
Santiago, Chile
RECRUITINGHospital Clínico San Borja Arriarán
Santiago, Chile
RECRUITING...and 21 more locations
Time frame: Up to 5 years
Life-threatening bleeding
Life-threatening bleeding (at 30 days, 3 months, 6 months and 1 year post-implantation).
Time frame: Up to 1 year
Conduction disturbances requiring permanent pacemaker implantation
Conduction disturbances requiring permanent pacemaker implantation (at 30 days, 3 months, 6 months, 1 year and every year thereafter up to 5 years post-implantation)
Time frame: Up to 5 years
Rehospitalization
Re-hospitalization for valve-related complications or worsening congestive heart failure (at 30 days, 3 months, 6 months, 1 year and every year thereafter up to 5 years post-implantation)
Time frame: Up to 5 years
Device Success
Device success defined as: a. correct positioning of a single prosthetic investigational heart valve in the proper anatomical location AND ability to provide appropriate hemodynamic AND absence of peri-procedural mortality within 72 hours after implantation
Time frame: 72 hours
Technical success
Technical success defined as 1. successful vascular access, delivery and deployment of the IMD and successful retrieval of the delivery system; and 2. correct positioning of a single prosthetic investigational heart valve in the proper anatomical location 3. in patients alive at 30 days with implanted Vienna valve: 1. Total aortic regurgitation of none/trace/mild/mild-moderate 2. Patient prosthesis mismatch (PPM) insignificant\* 3. Mean gradient \< 20 mmHg
Time frame: up to 30 days
Clinical Efficacy
Clinical efficacy (at 1 year and thereafter) 1. Freedom from all-cause mortality 2. Freedom from all stroke 3. Freedom from hospitalization for procedure- or valve-related causes 4. Freedom from KCCQ Overall Summary Score \<45 or decline from baseline of \>10 point (i.e. Unfavourable Outcome)
Time frame: 1 year
Valve-related clinical efficacy
Valve-related clinical efficacy 1. Freedom from bioprosthetic Valve Failure (defined as: Valve-related mortality OR Aortic valve re-operation/re-intervention OR Stage 3 haemodynamic valve deterioration) 2. Freedom from stroke or peripheral embolism (presumably valve-related, after ruling out other non-valve aetiologies) 3. Freedom from VARC Type 2-4 bleeding secondary to or exacerbated by antiplatelet or anticoagulant agents, used specifically for valve-related concerns (e.g. clinically apparent leaflet thrombosis)
Time frame: Up to 5 years
New York Heart Association (NYHA) classification
Change in heart failure symptoms from baseline as assessed by the New York Heart Association (NYHA) classification (at 30 days, 3 months, 6 months, 1 year and every year thereafter up to 5 years post-implantation)
Time frame: Up to 5 years
Change in quality of life as assessed by the Kansas City Cardiomyopathy
Scale from 0 to 100 and summarized in 25-point ranges, where scores represent health status as follows: 0 to 24: very poor to poor; 25 to 49: poor to fair; 50 to 74: fair to good; and 75 to 100: good to excellent
Time frame: 1 year
Change in exercise capacity measured as the 6-minute walk distance (6-MWD)
Change in exercise capacity from baseline measured as the 6-minute walk distance (6-MWD) (at 30 days, 3 months, 6 months and 1 year post-implantation)
Time frame: 1 year