The goal of this study is to learn what effects the ABC Bicuspid Sizing Algorithm has on the clinical outcomes of patients with bicuspid aortic stenosis after having a transcatheter aortic valve replacement (TAVR) using the Sapien 3 valve. The main questions the study aims to answer are: 1. Does the ABC Bicuspid Sizing Algorithm increase the technical success at exit from the procedure room? 2. Does the ABC Bicuspid Sizing Algorithm increase the device success at 30 days after the procedure? Participants already being evaluated for a TAVR as part of their regular medical care for bicuspid aortic stenosis will have their diagnostic images assessed using the ABC Bicuspid Sizing Algorithm to help determine their procedure type and valve size. They will have visits 30 days and one year after their procedure.
This is a multi-centre, international, prospective cohort study. Approximately 290 patients who are clinically eligible for transcatheter aortic valve replacement (TAVR) will be enrolled. Using information collected with the ABC Bicuspid Sizing Algorithm, physicians will make a treatment allocation between TAVR and surgical aortic valve replacement (SAVR), and determine valve sizing and deployment for TAVR-treated patients. Included in the algorithm use is the utilization of gated computed tomography evaluation or artificial intelligence-based simulation models in select cases with borderline feasibility. The findings of these additional assessments will be shared with the treating physicians for consideration in the final treatment decision. Of the 290 patients, an estimated 230 will be recommended to have TAVR. Data will be collected from TAVR-treated patients at baseline, procedure, hospital discharge, and 30 days and one year after the procedure. Data will only be collected from SAVR-treated patients at baseline and procedure. Sites in Canada, Latin America, the Middle East, and Asia Pacific will participate.
Study Type
OBSERVATIONAL
Enrollment
290
The ABC Bicuspid Sizing Algorithm is a valve sizing algorithm. It guides operators' evaluations of CT scans, helping inform (1) treatment allocation between TAVR and surgical aortic valve replacement, and (2) valve choice for patients undergoing TAVR. In select cases, the algorithm will suggest gated CT evaluation or artificial intelligence-based simulation models be used to further evaluate the risk of the planned valve size and deployment volume. The operators will consider the findings of the ABC Bicuspid Sizing Algorithm as well as other clinical factors when making their final treatment decisions.
John Hunter Hospital
New Lambton Heights, New South Wales, Australia
NOT_YET_RECRUITINGNorth Shore Private Hospital
St Leonards, New South Wales, Australia
NOT_YET_RECRUITINGRoyal North Shore Hospital
St Leonards, New South Wales, Australia
RECRUITINGThe Prince Charles Hospital
Chermside, Queensland, Australia
NOT_YET_RECRUITINGSt Andrew's War Memorial Hospital
Spring Hill, Queensland, Australia
NOT_YET_RECRUITINGThe Alfred
Melbourne, Victoria, Australia
RECRUITINGFiona Stanley Hospital
Murdoch, Western Australia, Australia
NOT_YET_RECRUITINGFoothills Medical Centre
Calgary, Alberta, Canada
NOT_YET_RECRUITINGNovaScotia Health Authority- Halifax Infimary
Halifax, NovaScotia, Canada
NOT_YET_RECRUITINGHamilton General Hospital
Hamilton, Ontario, Canada
RECRUITING...and 11 more locations
Proportion of cases achieving technical success
Freedom from mortality, successful access, delivery of the device, and retrieval of the delivery system, correct positioning of a single prosthetic heart valve into the proper anatomical location, and freedom from surgery or intervention related to the device or cardiac structural complication
Time frame: At exit from procedure room after procedure completion
Proportion of cases achieving device success
Technical success and intended performance of the valve (mean gradient less than 20 mmHg, peak velocity less than 3 m/s, Doppler velocity index greater than 0.35, and less than moderate aortic regurgitation)
Time frame: At 30 days after the procedure
Proportion of cases in which the use of gated computed tomography evaluation or artificial intelligence-based simulation models altered the treatment plan or operator confidence in the treatment plan compared to the ABC Bicuspid Sizing Algorithm alone
Time frame: At baseline
New conduction disturbance and permanent pacemaker implantation
Time frame: At 30 days and 1 year after the procedure
Stroke or transient ischemic attack
Time frame: At 30 days and 1 year after the procedure
Major vascular complication
Time frame: At 30 days after the procedure
Moderate or severe paravalvular regurgitation
Time frame: At 30 days and 1 year after the procedure
Death
Time frame: At 30 days and 1 year after the procedure
Acute valve complication
Time frame: At 30 days and 1 year after the procedure
Need for cardiac surgery
Time frame: At 30 days and 1 year after the procedure
Delayed valve dysfunction
Time frame: At 1 year after the procedure
Proportion of cases in which evaluation of anatomy above or below the annulus altered the valve sizing and deployment decision compared to the calculated valve sizing and deployment decision considering the annulus size only
Time frame: At baseline
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