The EMPIRE study confirms the technical performance of the new IMPERIA Delivery System and evaluates the safety and efficacy of the entire ALLEGRA THV System. The primary endpoint is device success rate at 7 days (discharge from index procedure or 7 days post implant, whichever comes first), as defined by VARC 2. Based on the outcomes of a study with a similar device and considering a drop-out rate of 5%, 107 patients need to be enrolled in the study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
137
Implantation of the ALLEGRA Transcatheter Heart Valve in failing surgical bioprosthesis
Schüchtermann Klinik
Bad Rothenfelde, Lower Saxony, Germany
Hospital Alvaro Cunqueiro
Vigo, Spain
Device success at 7 days
* Absence of procedural mortality AND * Correct positioning of a single device in the proper anatomical location (site-reported) AND * Intended performance of the prosthetic heart valve (as determined by an independent Echo Core Lab at discharge from index procedure or 7 days post implant, whichever comes first) * Indexed Effective Orifice Area (iEOA) \> 0.85 cm2/m2 for BMI \< 30kg/m2 and iEOA \> 0.70 cm2/m2 for BMI ≥ 30kg/m2 * Mean aortic valve gradient \<20 mmHg or peak velocity \<3 m/s * No moderate or severe prosthetic valve regurgitation
Time frame: 7 day
All-cause mortality
Time frame: up to 12 months
Cardiovascular mortality
Time frame: up to 12 months
All stroke
Time frame: up to 12 months
TIA
Time frame: up to 12 months
Procedural success
* Successful vascular access, delivery and deployment of the ALLEGRA THV including re- positioning if required and successful retrieval of the IMPERIA Delivery System (site- reported) * Correct position of the ALLEGRA THV (site-reported) * Only one ALLEGRA THV implanted in proper anatomical position (site-reported)
Time frame: assessed immediately after the procedure
Effective orifice area (EOA) as assessed by transthoracic echocardiogram (TTE)
Time frame: up to 12 months
Transvalvular mean and peak pressure gradient as assessed by transthoracic echocardiogram (TTE)
Time frame: up to 12 months
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Trans- and paravalvular regurgitation as assessed by transthoracic echocardiogram (TTE)
Time frame: up to 12 months
NYHA classification
Time frame: 30 days, 6 months, and 12 months
Early safety
* All-cause mortality * All stroke (disabling and non-disabling) * Life-threatening bleeding * Acute kidney injury-Stage 2 or 3 (including renal replacement therapy) * Coronary artery obstruction requiring intervention * Major vascular complication * Valve-related dysfunction requiring repeat procedure (BAV, TAVI, or SAVR)
Time frame: up to 30 days
Time-related valve safety
* Structural valve deterioration * Valve-related dysfunction (mean aortic valve gradient * 20 mmHg, EOA ≤0.9-1.1 cm2c and/or DVI \<0.35 m/s, AND/OR moderate or severe prosthetic valve regurgitation) * Requiring repeat procedure (TAVI or SAVR) * Prosthetic valve endocarditis * Prosthetic valve thrombosis * Thrombo-embolic events (e.g. stroke) * VARC bleeding, unless clearly unrelated to valve therapy (e.g. trauma)
Time frame: up to 12 months
Quality of life as assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ-12)
Assessed with the Kansas City Cardiomyopathy Questionnaire (KCCQ-12). Patients are asked questions about physical limitation, symptom frequency, quality of life, and social limitation. Responses are given on a Likert scale that for each individual item is scored on a scale of 0-100 with higher scores indicating better health.
Time frame: up to 12 months
New pacemaker implantation
Time frame: up to 12 months
Delivery system related AEs
Time frame: discharge from index procedure or 7 days post implant, whichever comes first