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Study Sponsor closing study due to financial circumstances.
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The objective of this study is to evaluate the initial safety and performance of the transShield EPS used for embolic protection during Transcatheter Aortic Valve Replacement (TAVR).
Patients 18 years of age and older, with severe aortic valve stenosis scheduled for a Transcatheter Aortic Valve Replacement (TAVR) procedure will be screened to determine eligibility and interest in the study. Patients who pass pre-screen eligibility criteria and are willing to participate in the study will be asked to sign the study Informed Consent Form before any study-specific tests or procedures are performed or for any study specific evaluations not considered standard of care that need to be performed to assess eligibility. All subjects enrolled in the study will be followed from baseline through post procedure, prior to discharge and conclude with a 30-day followup visit. The investigator will perform the percutaneous TAVR using a commercial TAVR system according to their institution's standard practice. After completion of the procedure, the transShield EPS Filter will be collected and shipped to an independent Core Lab for histopathology assessment of the embolic debris captured in the filter. Post procedure treatment and safety monitoring shall be completed per the investigator's standard guidelines and patients discharged when clinically stable, at the investigator's discretion. Prior to discharge, functional status, physical exam/vital signs, medications, safety assessment and hospital stay information shall be collected. Patients will be asked to return to the investigational site 30 days post procedure for functional status, physical exam/vital signs, medications, and safety assessment. If the patient is not able to return to the investigational site, the visit may be completed via a tele-health visit with the investigator in combination with an in-office visit to the patient's local General Practitioner (GP) or Cardiologist. This visit will conclude the patient's participation in the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with severe aortic valve stenosis scheduled for TAVR | Experimental | transShield Embolic Protection System |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| transShield Embolic Protection System | Device | Patient undergoing TAVR procedure will receive the transShield EPS with the intent to capture and remove debris dislodged during the interventional procedure. |
| Measure | Description | Time Frame |
|---|---|---|
| Performance Objective: Technical Success defined as tranShield EPS ability to perform all the following functions without adjudicated device malfunctions: | Ability to successfully deploy the device in the correct anatomical position, in the ascending aorta without interference with TAVR procedure/devices, and ability to retrieve and remove the device intact, including no visual evidence of any filter damage. | During procedure |
| Safety Objective: MACCE at 30 Days | Defined as incidence of Major Adverse Cardiac and Cerebrovascular Events (MACCE) at 30 days according to VARC-3 including: All cause mortality, All stroke (disabling and non-disabling) and TIA, Acute kidney injury (stage 2 or 3), Major vascular and access-related complications, and Life-threatening or disabling bleeding (type 2-4). | 30 day post procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Embolic Debris Captured | Volume of debris captured defined as the average number of captured particles great than or equal to 150 µm in diameter, as assessed by independent pathologist. | Procedure |
| Incidence of Stroke |
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Inclusion Criteria:
Exclusion Criteria:
Patient not undergoing TAVR via the trans-femoral route
Carotid artery stenosis > 70% in either carotid artery
Severe vascular tortuosity or anatomy that would preclude the safe introduction of the device
Aortic valve is a congenital unicuspid valve or is non-calcified
Predominant aortic regurgitation >3+
A known contraindication or hypersensitivity to all anticoagulation regimens or an inability to undergo anticoagulation for the study procedure
History of bleeding diathesis or in whom anticoagulant and/or anti- platelet therapy is contraindicated, patients who will refuse transfusion, or have an active peptic ulcer or upper GI bleeding within the prior 3 months
Renal disease requiring chronic dialysis at time of treatment
History of stroke or transient ischemic attack (TIA) within prior 6 months
Evidence of an acute myocardial infarction (MI) within 30 days prior to study procedure
Hemodynamic or respiratory instability requiring inotropic support, mechanical ventilation, or mechanical heart assistance within prior 30 days
Severe left ventricular (LV) dysfunction with LV ejection fraction (LVEF) <20%
Severe pulmonary hypertension and right ventricular (RV) dysfunction
Echocardiographic evidence of intracardiac mass, thrombus or vegetation
Life expectancy <12 months due to non-cardiac co-morbid conditions
Evidence of active systemic or local groin infection
Significant aortic disease, including abdominal aortic or thoracic aneurysm defined as maximal luminal diameter 5cm or greater; marked tortuosity (hyperacute bend), aortic arch atheroma or severe atheroma (especially with calcification and surface irregularities) of the thoracic aorta, severe "unfolding" and tortuosity of the thoracic aorta
Known hypersensitivity or contraindication to aspirin, heparin or bivalirudin, ticlopidine, or clopidogrel, and/or contrast agents, that cannot be managed with premedication
Planned other cardiac surgical procedure within 2 weeks prior to or planned cardiac surgical or interventional procedure within 30 days after the TAVR procedure.
Note: Diagnostic cardiac catheterization is permitted within 10 days prior to the TAVR procedure
Known allergy to any device component
Known or suspected to be pregnant or lactating
Currently enrolled in an investigational drug or device clinical study in which the primary endpoint has not occurred
Patient has other medical, social or psychological problem that in the opinion of the investigator precludes them from participating
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Waikato Hospital | Hamilton | New Zealand |
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| ID | Term |
|---|---|
| D001024 | Aortic Valve Stenosis |
| ID | Term |
|---|---|
| D000082862 | Aortic Valve Disease |
| D006349 | Heart Valve Diseases |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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Incidence of stroke according to VARC-3 definitions (subclassified ischemic, hemorrhagic, or undetermined, and as disabling or non-disabling) and TIA
| Discharge and 30 Day Post-Procedure |
| Adverse Events | Sunmary of all Adverse Events | Up to 30 Days Post-procedure |
| D014694 |
| Ventricular Outflow Obstruction |