The Investigational Device is the TricValve Transcatheter Bicaval Valve System (also referred to as the TricValve System). The bioprosthesis is available in two different diameters for each model (SVC and IVC) specifically designed to adapt to the anatomic features of the superior vena cava (SVC) and inferior vena cava (IVC). The SVC and IVC valves are single use, sterile devices provided in two sizes each, for a total of four valve sizes. The valves are designed for heterotopic caval implantation without perturbing the native tricuspid valve. The valves are made of bovine pericardium leaflets sutured on a nitinol self-expanding stent system. The SVC and IVC valves are provided pre-mounted in two separate TricValve Delivery Systems, and are individually packaged into two separate boxes, provided sterile and ready to use. The two TricValve Delivery Systems deliver the two valves percutaneously into the SVC and IVC via femoral vein access using a transvenous approach.
This is a prospective, multi-center, randomized controlled pivotal clinical trial to evaluate the safety and effectiveness of the TricValve System with Optimal Medical Therapy (OMT) compared to OMT alone in the treatment of patients with severe TR and caval reflux (CR). The TricValve System received Breakthrough Device Designation from the US FDA.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
600
TricValve® Device (Device) Group subjects will undergo TricValve® implantation and will continue to be managed with optimal medical therapies.
Optimal medical therapy
St. Joseph's Hospital and Medical Center
Phoenix, Arizona, United States
Scripps Memorial Hospital La Jolla
San Diego, California, United States
Tampa General Hospital
Tampa, Florida, United States
Northshore Evanston Hospital
Evanston, Illinois, United States
Ascension Medical Group St. Vincent The Heart Center of Indiana
Indianapolis, Indiana, United States
Cardiovascular Institute of the South
Houma, Louisiana, United States
Minneapolis Heart Institute Foundation
Minneapolis, Minnesota, United States
Columbia University Medical Center/ NewYork Presbyterian Hospital
Irving, New York, United States
Montefiore Medical Center
The Bronx, New York, United States
Cleveland Clinic
Cleveland, Ohio, United States
...and 5 more locations
Mortality
Number of Cardiovascular Deaths at 30 Days.
Time frame: 1 Month, 12 Months
Q-wave myocardial infarctions
Number of myocardial infarctions at 30 Days.
Time frame: 1 Month
Disabling stroke
Number of days until death.
Time frame: 1 Month
Life threatening bleeding
Number of days until death.
Time frame: 1 Month
Pulmonary embolism
Number of days until death.
Time frame: 1 Month
Renal failure requiring dialysis
Number of days until new renal replacement therapy.
Time frame: 1 Month
Major access-site, vascular, or cardiac structural complications
Number of days until death.
Time frame: 1 Month
Emergency surgery or intervention related to the device/procedure complications
Number of days until emergency surgery or intervention.
Time frame: 1 Month
Reduction in Caval Reflux (CR)
Reduction in CR, measured by echocardiography
Time frame: 6 Months
Kansas City Cardiomyopathy Questionnaire (KCCQ Score)
Change in KCCQ score (score ranges between 0 and 100)
Time frame: 6 Months, 12 Months
New York Heart Association (NYHA Class)
Change in NYHA class (range from I to IV)
Time frame: 6 Months, 12 Months
Six Minute Walking Test (6MWT)
Change in walking distance
Time frame: 6 Months, 12 Months
Right Ventricular Assist Device (RVAD) implantation or heart transplant
Number of days until Right Ventricular Assist Device (RVAD) implantation or heart transplant
Time frame: 12 Months
Tricuspid valve surgery or percutaneous tricuspid intervention
Number of days until tricuspid valve surgery or percutaneous tricuspid intervention
Time frame: 12 Months
Heart Failure Events
Number of heart failure episodes including hospitalization, or worsening heart failure
Time frame: 12 Months
Secondary Safety Endpoint (measured at 1 year)
The percentage of subjects with Device- and/or Procedure-related MAEs through 1 year.
Time frame: 12 Months
All-Cause mortality
Number of days until death.
Time frame: 3 Months, 6 Months, and 12 Months
Kansas City Cardiomyopathy Questionnaire (KCCQ Score)
Change in KCCQ score (score ranges between 0 and 100)
Time frame: 3 Months, 6 Months, and 12 Months
Right Ventricular Assist Device (RVAD) implantation or heart transplant
Number of days until Right Ventricular Assist Device (RVAD) implantation or heart transplant.
Time frame: 3 Months, 6 Months, and 12 Months
Six Minute Walking Test (6MWT)
Change in walking distance
Time frame: 3 Months, 6 Months, and 12 Months
Atrial Fibrillation
Days to new onset of atrial fibrillation.
Time frame: 3 Months, 6 Months, and 12 Months
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