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Boston Scientific made the decision to discontinue worldwide commercialization of the ACURATE valve platform.
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The objective of the ACURATE Enhance study is to assess valve frame expansion and hemodynamics in a routine clinical setting when optimized procedural steps for valve implantation are followed.
ACURATE Enhance is a prospective, open-label, single-arm, multicenter, post-market study in patients implanted with the ACURATE neo2™ Aortic Valve System (or future commercially available iteration) for the treatment of severe calcific aortic stenosis in a routine clinical setting.
A subject who provides an Informed Consent Form (ICF) approved by the Independent Ethics Committee (IEC) and signed by the subject or the subject's legally authorized representative is considered enrolled once an attempt is made to insert the ACURATE neo2 Delivery System. Up to 150 subjects will be enrolled.
Follow-up will occur at pre-discharge, 30 days, 6 months and 1 year post index procedure per standard of care. Visits are in-person at 30 days and 1 year. The 6 month visits is in-person (preferred) or via telephone interview.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transcatheter Aortic Valve Implantation/Replacement | Device | The device is placed in patients heart at the level of aortic valve through a transfemoral access from femoral groin as indicated in device IFU |
| Measure | Description | Time Frame |
|---|---|---|
| Primary Endpoint: | Proportion of patients who achieve target valve frame expansion* at the end of the index procedure when following optimized procedural steps. * "Target valve frame expansion" is defined as visual evidence of parallel commissure posts, as confirmed by an independent core laboratory evaluation of procedural angiogram. | Index procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Secondary Endpoint | All-cause mortality (cardiovascular and non-cardiovascular), Stroke (disabling and non-disabling) and Rehospitalization* at 30 days. * Rehospitalization refers to procedure-related or valve-related hospitalization, and includes the following as defined by VARC-3: hospitalization for new complications, bioprosthetic valve dysfunction (such as valve thrombosis, endocarditis, structural valve deterioration, or non-structural valve dysfunction), or heart-failure related hospitalizations. |
| Measure | Description | Time Frame |
|---|---|---|
| Safety endpoints adjudicated by an independent Clinical Events Committee |
|
Inclusion Criteria:
Exclusion Criteria:
Subject has a previously implanted bioprosthesis in the aortic position.
Subject has a unicuspid or bicuspid aortic valve.
Subject has either of the following:
Subject has known hypersensitivity to contrast agents that cannot be adequately pre-medicated or to the individual components of the study valve (nickel, titanium, processed porcine pericardium, polyethylene terephthalate [PET]).
Subject has eGFR <30 mL/min (chronic kidney disease stage IV or stage V).
Subject is unwilling or unable to undergo study required follow-up visits.
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Patients with symptomatic heart disease due to severe native calcific aortic stenosis
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| Name | Affiliation | Role |
|---|---|---|
| Andreas Rück | Karolinska Universitetssjukhuset, Enheten för kardiologi | Principal Investigator |
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The data and study protocol for this clinical trial may be made available to other researchers in accordance with the Boston Scientific Data Sharing Policy. (http://www.bostonscientific.com/en-US/data-sharing-requests.html)
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| ID | Term |
|---|---|
| D001024 | Aortic Valve Stenosis |
| C562942 | Aortic Valve, Calcification of |
| D001018 | Aortic Diseases |
| ID | Term |
|---|---|
| D000082862 | Aortic Valve Disease |
| D006349 | Heart Valve Diseases |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D065467 | Transcatheter Aortic Valve Replacement |
| D012092 | Replantation |
| ID | Term |
|---|---|
| D019918 | Heart Valve Prosthesis Implantation |
| D006348 | Cardiac Surgical Procedures |
| D013504 | Cardiovascular Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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| 30 days |
| Peri- and post-procedure, pre-discharge or 7 days (whichever comes first), and 30 days, 6 months, and 1 year |
| Additional safety endpoints adjudicated by an independent Clinical Events Committee |
| Peri- and post-procedure, pre-discharge or 7 days (whichever comes first), and 30 days, 6 months, and 1 year |
| Safety endpoints per VARC-3 |
| Post-procedure, 30 days and 1 year |
| New York Heart Association (NYHA) functional classification | Classification of heart failure symptoms as evaluated by NYHA classification | baseline, pre-discharge/7 days, 30 days, and 1 year |
| Prosthetic Aortic Valve Performance as measured by transthoracic echocardiography (TTE) | Effective orifice area (EOA), Mean and Peak aortic gradients, peak aortic velocity, and grade of aortic regurgitation/paravalvular leak (PVL). | Pre-discharge/7days, 30 days, and 1 year |
| Patient reported outcomes and health status | Patient reported outcomes and health status as evaluated by the Kansas City Cardiomyopathy Quality of Life questionnairec (KCCQ) at baseline and at 30-day and 1-year follow-up | baseline, 30 days and 1-year |
| D014694 |
| Ventricular Outflow Obstruction |
| D014652 | Vascular Diseases |
| D019919 | Prosthesis Implantation |
| D019616 | Thoracic Surgical Procedures |
| D014180 | Transplantation |