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The purpose of this study is to assess the safety and effectiveness of the SJM Portico Transcatheter Heart Valve and the SJM TAVI Transfemoral Transcatheter delivery system in subjects with severe symptomatic aortic stenosis (AS).
Data will be collected at baseline, procedure, discharge, 30 days post implant, 3 months post implant, 6 months post implant, and 12 months post implant.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Transfemoral Access | Experimental | Transfemoral Access for transcatheter aortic valve implant |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transcatheter Aortic Valve Implantation | Device | Placement of the SJM Portico aortic valve with a transfemoral delivery system |
|
| Measure | Description | Time Frame |
|---|---|---|
| All Cause Mortality | Number of participants that reported all cause mortality | 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Select Cardiovascular Adverse Events | Number of participants with select cardiovascular adverse events | 30 days |
| Participant NYHA Classification at Day 30 | The New York Heart Association (NYHA) functional classification system relates symptoms to everyday activities and the patient's quality of life. Class I. Patients with cardiac disease but without resulting limitation of physical activity. Class II. Patients with cardiac disease resulting in slight limitation of physical activity. They are comfortable at rest. Class III. Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Class IV. Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of heart failure or the anginal syndrome may be present even at rest. The Criteria Committee of the New York Heart Association. Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels. 9th ed. Boston, Mass: Little, Brown & Co; 1994:253-256. |
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Inclusion Criteria:
Exclusion Criteria:
Subject has a history of a cerebral vascular accident (CVA) or transient ischemic attack (TIA) within the past 6 months (≤180 days) of the index procedure.
Subject has carotid artery disease requiring intervention.
Subject has evidence of a myocardial infarction (MI) within the past 6 months (≤180 days) of the index procedure.
Subject has hypertrophic cardiomyopathy.
Subject has a native aortic valve that is congenitally unicuspid, bicuspid, quadricuspid or non-calcified as seen by echocardiography.
Subject has mitral or tricuspid valvular regurgitation (>grade III) or moderate to severe mitral stenosis.
Subject has aortic root angulation >70 degrees (horizontal aorta).
Subject has a pre-existing prosthetic valve or prosthetic ring in any position.
Subject refuses blood transfusion or surgical valve replacement.
Subject has left ventricular ejection fraction (LVEF) < 20%.
The subject has documented, untreated coronary artery disease (CAD) requiring revascularization.
Subject has severe basal septal hypertrophy.
Subject has had a percutaneous interventional or other invasive cardiac or peripheral procedure ≤ 14 days of the index procedure.
Subject has a history of or has active endocarditis.
Subject has echocardiographic evidence of intracardiac mass, thrombus, or vegetation.
Subject has hemodynamic instability (requiring inotropic support or mechanical heart assistance).
Subject is in acute pulmonary edema or requiring intravenous diuretic therapy to stabilize heart failure.
Subject with significant pulmonary disease.
Subject has significant chronic steroid use.
Subject has a known hypersensitivity or contraindication to anticoagulant or antiplatelet medication.
Subject has renal insufficiency as evidenced by a serum creatinine > 3.0 mg/dL (265µmol/L) or end-stage renal disease requiring chronic dialysis.
Subject has morbid obesity defined as BMI ≥ 40.
Subject's iliac arteries have severe calcification, tortuosity (>two 90 degree bends), diameter <6mm, or subject has had an aorto-femoral bypass.
Subject has ongoing infection or sepsis.
Subject has blood dyscrasias (leukopenia, acute anemia, thrombocytopenia, history of bleeding diathesis, or coagulopathy).
Subject has a current autoimmune disease that, in the opinion of the Principal Investigator precludes the subject from study participation.
Subject has significant aortic disease, including:
Subject has a pre-existing endovascular stent graft in the supra- or infrarenal aorta or pre-existing stent grafts in the ileo-femoral arteries.
Subject has an active peptic ulcer or has had gastrointestinal (GI) bleeding within the past 90 days prior to the index procedure.
Subject is currently participating in another investigational drug or device study.
Subject requires emergency surgery for any reason.
Subject has a life expectancy < 12 months.
Subject has other medical, social or psychological conditions that, in the opinion of the Subject Selection Committee, preclude the subject from study participation.
Subject is suffering from dementia or admitted to a chronic care facility which would fundamentally complicate rehabilitation from the procedure or compliance with follow-up visits.
Subject has a known allergy to contrast media, nitinol alloys, porcine tissue, or bovine tissue.
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| Name | Affiliation | Role |
|---|---|---|
| Ganesh Manoharan, MD | Royal Victoria Hospital, Belfast | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Adelaide Royal Hospital | Adelaide | Australia | ||||
| Rigshospitalet Copenhagen |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29534170 | Derived | Walther T, Manoharan G, Linke A, Mollmann H, Holzhey D, Worthley SG, Kim WK, Schafer U. Incidence of new-onset left bundle branch block and predictors of new permanent pacemaker following transcatheter aortic valve replacement with the Portico valve. Eur J Cardiothorac Surg. 2018 Sep 1;54(3):467-474. doi: 10.1093/ejcts/ezy078. | |
| 29444998 |
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| ID | Title | Description |
|---|---|---|
| FG000 | Transfemoral | Transfemoral access |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Transfemoral | Transfemoral access |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | All Cause Mortality | Number of participants that reported all cause mortality | Posted | Count of Participants | Participants | 30 days |
|
|
1-year
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Transfemoral | Transfemoral access | 29 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| All-cause death | General disorders | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hypertension | Cardiac disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Sr Clinical Scientist | St Jude Medical | 4159179696 | alicia.kimber@abbott.com |
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| ID | Term |
|---|---|
| D001024 | Aortic Valve Stenosis |
| D006349 | Heart Valve Diseases |
| ID | Term |
|---|---|
| D000082862 | Aortic Valve Disease |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014694 | Ventricular Outflow Obstruction |
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| ID | Term |
|---|---|
| D065467 | Transcatheter Aortic Valve Replacement |
| ID | Term |
|---|---|
| D019918 | Heart Valve Prosthesis Implantation |
| D006348 | Cardiac Surgical Procedures |
| D013504 | Cardiovascular Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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| day 30 |
| Number of Participants With Acute Device Success |
| 7 days |
| Copenhagen |
| Denmark |
| Kerckhoff Klinik | Bad Nauheim | Germany |
| Heart Center Bernau | Bernau | Germany |
| Asklepios Klinik-St. Georg | Hamburg | Germany |
| Klinikum der Universität Jena | Jena | Germany |
| Klinik fur Herzhirurgie Karlruhe GmbH | Karlsruhe | Germany |
| Herzzentrum Leipzig | Leipzig | Germany |
| Medical Center Leeuwarden | Leeuwarden | Netherlands |
| Royal Victoria Hospital | Belfast | Northern Ireland | BT12 6BA | United Kingdom |
| Glenfield Hospital | Leicester | United Kingdom |
| Kings College | London | United Kingdom |
| St. Thomas' Hospital | London | United Kingdom |
| Derriford Hospital, Plymouth | Plymouth | United Kingdom |
| Linke A, Holzhey D, Mollmann H, Manoharan G, Schafer U, Frerker C, Worthley SG, van Boven AJ, Redwood S, Kovac J, Butter C, Sondergaard L, Lauten A, Schymik G, Walther T. Treatment of Aortic Stenosis With a Self-Expanding, Resheathable Transcatheter Valve: One-Year Results of the International Multicenter Portico Transcatheter Aortic Valve Implantation System Study. Circ Cardiovasc Interv. 2018 Feb;11(2):e005206. doi: 10.1161/CIRCINTERVENTIONS.117.005206. |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| STS risk score of mortality | The Society of Thoracic Surgeons (STS) score measures patient risk of operative mortality and morbidity after adult cardiac surgery on a scale that ranges from 0% to 100%, with higher numbers indicating greater risk. | Mean | Standard Deviation | Percentage |
|
| NYHA class III/IV | NYHA Class I: Subjects with cardiac disease but without resulting limitations of physical activity. NYHA Class II: Subjects with cardiac disease resulting in slight limitation of physical activity. NYHA Class III: Subjects with cardiac disease resulting in marked limitation of physical activity. NYHA Class IV: Subjects with cardiac disease resulting in inability to carry on any physical activity without discomfort. | Count of Participants | Participants |
|
| History of pulmonary hypertension | Count of Participants | Participants |
|
| Porcelain aorta | Count of Participants | Participants |
|
| History of atrial fibrillation | Count of Participants | Participants |
|
| Renal failure/insufficiency | Count of Participants | Participants |
|
|
| Secondary | Number of Select Cardiovascular Adverse Events | Number of participants with select cardiovascular adverse events | Posted | Number | participants | 30 days |
|
|
|
| Secondary | Participant NYHA Classification at Day 30 | The New York Heart Association (NYHA) functional classification system relates symptoms to everyday activities and the patient's quality of life. Class I. Patients with cardiac disease but without resulting limitation of physical activity. Class II. Patients with cardiac disease resulting in slight limitation of physical activity. They are comfortable at rest. Class III. Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Class IV. Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of heart failure or the anginal syndrome may be present even at rest. The Criteria Committee of the New York Heart Association. Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels. 9th ed. Boston, Mass: Little, Brown & Co; 1994:253-256. | Analysis for participants that completed visit and assessment | Posted | Count of Participants | Participants | day 30 |
|
|
|
| Secondary | Number of Participants With Acute Device Success |
| Successful vascular access, delivery and deployment of the device | Posted | Count of Participants | Participants | 7 days |
|
|
|
| 222 |
| 102 |
| 222 |
| 18 |
| 222 |
| Cardiovascular Death | Cardiac disorders | Systematic Assessment |
|
| Myocardial infarction | Cardiac disorders | Systematic Assessment |
|
| Stage 3 acute kidney injury | Renal and urinary disorders | Systematic Assessment |
|
| Life-threatening or disabling bleeding | Vascular disorders | Systematic Assessment |
|
| Disabling stroke | Renal and urinary disorders | Systematic Assessment |
|
| Major vascular complications | Vascular disorders | Systematic Assessment |
|
| Stage 1 acute kidney injury | Renal and urinary disorders | Systematic Assessment |
|
| Stage 2 acute kidney injury | Renal and urinary disorders | Systematic Assessment |
|
| Non-disabling stroke | Renal and urinary disorders | Systematic Assessment |
|
| Pacemaker implantation | Cardiac disorders | Systematic Assessment |
|
| Heart failure | Cardiac disorders | Systematic Assessment |
|
| Coronary obstruction | Cardiac disorders | Systematic Assessment |
|
| Hyponatremia | Investigations | Systematic Assessment |
|
| Urinary tract infection | Infections and infestations | Systematic Assessment |
|
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| D019919 | Prosthesis Implantation |
| D019616 | Thoracic Surgical Procedures |
| NYHA IV |
|