Transfemoral Replacement of Aortic Valve With HLT MeriDIAN Valve Feasibility Trial CANADA

Study Overview
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Brief Summary
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To evaluate the safety and performance of the HLT System in patients with severe aortic stenosis who present at high risk for aortic valve replacement surgery.

Official Title
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Transfemoral Replacement of Aortic Valve With HLT MeriDIAN Valve Feasibility Trial CANADA

Conditions
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Aortic Valve Stenosis

Intervention / Treatment
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* Device: HLT Transcatheter Aortic Valve System


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 70 years of age or older Echocardiographic or hemodynamic based evidence of calcific (senile) aortic stenosis with one of the following: aortic valve EOA <1.0 cm2 or 0.6 cm2/m2 , mean aortic valve gradient >40 mmHg or peak aortic valve velocity >4 m/sec Symptomatology due to aortic stenosis resulting in one of the following: NYHA Functional Classification of II or greater Presence of angina Presence of syncope Aortic valve annular diameter ≥ 24 and ≤26 mm measured by MSCT based on area or perimeter STS score of ≥8, or documented heart team agreement of high risk for surgical aortic valve replacement (SAVR) due to frailty or comorbidities. Geographically available, willing to comply with follow up and able to provide written informed consent Exclusion Criteria: Congenital unicuspid or bicuspid aortic valve, or noncalcified aortic valve; or valve eccentricity (calcific or otherwise) that in the opinion of the investigator could compromise procedural success. Patients at high risk for coronary obstruction in the opinion of the investigator (e.g. combination of a coronary height < 12 mm and coronary sinus diameter < 30 mm) Patients with low flow/low gradient aortic stenosis Patients with significant annular calcification (e.g. Agatston score > 4000) Pre-existing prosthetic heart valve in any position, or prosthetic ring Severe aortic, mitral or tricuspid valve regurgitation Moderate to severe mitral stenosis Myocardial infarction within the past 30 days* Echocardiographic evidence of intracardiac mass, thrombus or vegetation LVEF < 30% Severe pulmonary hypertension with pulmonary systolic pressure greater than two-thirds of systemic pressure Hemodynamic instability requiring inotropic drug therapy within the past 14 days Untreated clinically significant coronary artery disease requiring revascularization Presence of significant aortic disease such as atheroma, thrombus, or aneurysm which, in the opinion of the investigator, precludes safe implant delivery Blood dyscrasias defined as: acute leukopenia, acute anemia, acute thrombocytopenia, history of bleeding diathesis or coagulopathy Patient ineligible for or refuses blood transfusions Unfavorable peripheral vascular anatomy or disease (e.g. severe obstructive calcification, severe tortuosity or vessels < 6 mm) that would preclude passage of catheters from the femoral arterial access to the aorta as evidenced by peripheral MSCT Active peptic ulcer or gastrointestinal bleeding within the past 90 days* Symptoms of carotid or vertebral artery disease (e.g. stroke or transient ischemic attack) within past 6 month, or treatment of carotid stenosis within past two months* Renal insufficiency as demonstrated by a serum creatinine > 2.5 mg/dL or end stage renal disease requiring chronic dialysis Active infection requiring ongoing treatment Need for emergent surgery or intervention other than the investigational procedure Any therapeutic invasive cardiac procedure performed or planned to perform within 30 days of the index procedure except for PCI which is within 7 days of the index procedure* Hypersensitivity or contraindication to procedural medication and device materials (e.g. titanium, nickel, pork) which cannot be adequately pre-medicated Life expectancy < 1 year due to non-cardiac co-morbid conditions Currently participating in any investigational drug or device studies that may confound the results of this study History of any cognitive or mental health status that would interfere with study participation * At the time of procedure, if a subject's medical status has changed since enrollment, the subject shall be re-evaluated for eligibility.

Ages Eligible for Study
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Minimum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: HLT Transcatheter Aortic Valve System<br>Transcatheter aortic valve replacement with HLT Transcatheter Aortic Valve System | Device: HLT Transcatheter Aortic Valve System<br>* Transcatheter aortic valve replacement with HLT Transcatheter Aortic Valve System<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Primary Endpoint: Mortality at 30 days | The primary safety endpoint is all-cause mortality at 30 days | 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Secondary Performance Endpoint 1: Procedural Device Performance | The secondary performance endpoint is Device Success defined as: Absence of procedural mortality AND Correct positioning of a single Valve into the proper anatomical location AND Intended performance of the Valve (no severe prosthesis-patient mismatch and clinically acceptable gradient) AND no moderate or severe aortic valve regurgitation) | 1 day | 
| Secondary Performance Endpoint 2: Post-procedural Valve Performance (Aortic Valve Effective Orifice Area) | Aortic valve effective orifice area (EOA) will be evaluated with echocardiograms | 1 week, 1, 6, 12, 24, 36, 48 and 60 months | 
| Secondary Performance Endpoint 2: Post-procedural Valve Performance (Severity of Aortic Valve Regurgitation) | Severity of aortic valve regurgitation (AR) will be evaluated with echocardiograms | 1 week, 1, 6, 12, 24, 36, 48 and 60 months | 
| Secondary Performance Endpoint 2: Post-procedural Valve Performance (Aortic Valve Gradient) | Aortic valve gradient will be evaluated with echocardiograms | 1 week, 1, 6, 12, 24, 36, 48 and 60 months | 
| Secondary Safety Endpoint 3: Adverse Events | All adverse events will be assessed throughout the 5 year follow up period. | throughout the 5 year follow up period | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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aortic stenosis, transcatheter aortic valve replacement (TAVR)