To confirm the effectiveness and safety of the GeminiOne Transcatheter Mitral Valve Repair System for the treatment of severe, symptomatic mitral regurgitation.
This study is a prospective, multi-center, non-randomized clinical trial. All enrolled subjects will receive the investigational GeminiOne TEER System in a single-arm design. The trial will be conducted at up to seven clinical centers located in the United States, Canada, and Europe. The GeminiOne TEER System is intended for use in adult patients with severe symptomatic mitral regurgitation (MR) who have suitable anatomy for both device implantation and transfemoral trans-septal access for left atrial delivery. Key Inclusion Criteria: Primary MR: Patients must be deemed high-risk for surgical intervention by the site's heart team. Secondary MR: Patients must have failed to respond to optimal guideline-directed medical therapy (GDMT) for at least one month, and must also have received appropriate coronary revascularization and cardiac resynchronization therapy (CRT), if indicated. Initially, up to 15 subjects will be treated. The total duration of the study is expected to be approximately 72 months. The enrollment period will span approximately 12 months. Subjects who receive the investigational device will be followed for 60 months post-implantation.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
The GeminiOne TEER System consists of a TEER clip implant, transcatheter delivery system and a guide sheath. The clip is made of cobalt-chromium-nickel alloy with a nickel-titanium alloy gripper, covered with a braided mesh of polyethylene terephthalate (PET) materials.
Safety: Absence of device or procedure related major adverse events at 30 days
MAE is defined as the occurrence of any of the following within 30 days: death, myocardial infarction (Ml) stroke, MVARC-defined Grade 3 Acute Kidney Injury (AKl), major access site and vascular complications, major cardiac structural complications or cardiac surgery due to GeminiOne device failure.
Time frame: 30 days
Effectiveness: Acute procedural success (APS)
APS is defined as the successful implantation of the GeminiOne device and achieving residual MR of 2+ or less at discharge. lf the discharge echocardiogram is unavailable or difficult to interpret, an echocardiogram taken at 30 days can be used instead. A death before discharge or a reoperation of the mitral valve within 30 days is considered an acute procedural failure.
Time frame: 30 days
All-cause mortality and stroke
Time frame: 30 days, 12 months and annually thereafter
Cardiovascular mortality
Time frame: 30 days, 12 months and annually thereafter
Rate of cardiovascular rehospitalization
Time frame: 30 days, 12 months and annually thereafter
Mitral valve surgery or re-intervention
Time frame: 30 days, 12 months and annually thereafter
Change in NYHA functional class
Time frame: 30 days, 12 months and annually thereafter
Mitral valve hemodynamics
Includes degree of residual mitral regurgitation and mean mitral valve gradient.
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Time frame: 30 days, 12 months and annually thereafter
Change in 6-Minute Walk Test (6MWT) performance
Time frame: 30 days, 12 months and annually thereafter
Change in Quality of Life as measured by Kansas City Cardiomyopathy Questionnaire (KCCQ)
Time frame: 30 days, 12 months and annually thereafter
Incidence of serious adverse events (SAEs)
A SAE is defined as any adverse event that meets one or more of the following criteria:\< 1. Death 2. life-threatening or results in serious illness or injury 3. Requires inpatient hospitalization or prolongation of existing hospitalization 4. Results in persistent or significant disability/incapacity 5. Results in a congenital anomaly/birth defect, fetal death, or fetal distress 6. Requires medical or surgical intervention to prevent permanent impairment to a body structure or body function 7. considered an important medical event that may jeopardize the patient or subject and/or may require intervention to prevent one of the outcomes listed above, based on appropriate medical judgment.
Time frame: 12 months