Clinical trial NCT05797519: Clinical Safety and Efficacy of the VDyne Transcatheter Tricuspid Valve Replacement System for the Treatment of Tricuspid Regurgitation
Official title: Clinical Safety and Efficacy of the VDyne Transcatheter Tricuspid Valve Replacement System for the Treatment of Tricuspid Regurgitation
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Tricuspid Regurgitation
Tricuspid Valve Disease
Tricuspid Valvular Disorders
Lead sponsor: VDyne, Inc.
Sponsor class: INDUSTRY
First posted: 2023-04-04
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The purpose of this clinical study is to evaluate the safety and clinical efficacy of the VDyne System in the treatment of moderate to severe tricuspid regurgitation (TR).


Eligibility criteria: Inclusion Criteria:

1. Moderate or severe tricuspid valve regurgitation of primary or secondary etiology.
2. Subject is adequately treated with medical therapy for heart failure 30 days prior to index procedure, including a diuretic.
3. Heart Team determines patient is a recommended candidate for the VDyne System.
4. Age 18 years or older.
5. Clinical Screening Committee (CSC) and Imaging Core Labs confirm suitability for treatment with the VDyne System.

Exclusion Criteria:

VDYNE SYSTEM SUITABILITY

1. Patient anatomy (cardiac and vascular) is not suitable for the VDyne System as assessed by Imaging Core Labs, Sponsor and Clinical Screening Committee
2. Intolerance to procedural anticoagulation or post-procedural antiplatelet/anticoagulation regimen that cannot be medically managed
3. Hypersensitivity to nickel or titanium

   CLINICAL EXCLUSION CRITERIA (assessed by pre-procedural imaging)
4. Left Ventricular Ejection Fraction (LVEF) \<30%
5. Severe RV dysfunction
6. Significant abnormalities of the tricuspid valve and sub-valvular apparatus.
7. Sepsis including active infective endocarditis (IE) (within last 6 months)
8. Right ventricular or atrial thrombus or vegetation
9. Severe tricuspid annular or leaflets calcification
10. Systolic pulmonary hypertension with systolic pulmonary artery pressure ≥70 mmHg.

    History of rheumatic fever

    CONCOMITANT PROCEDURES
11. Significant coronary artery disease requiring treatment such as symptomatic, unresolved multi-vessel or unprotected left main coronary artery disease.
12. Any planned surgery or interventional procedure within the period of 30 days prior to 30 days following the implant procedure. This includes any planned concomitant cardiovascular procedure such as CABG, PCI, pulmonary vein ablation, left atrial appendage occlusion, septal defect repair, etc
13. Unresolved severe symptomatic carotid stenosis (\> 70% by ultrasound)
14. Cardiac resynchronization therapy device or implantable pulse generator implanted within 60 days of planned implant procedure.
15. Permanent pacing leads that will interfere with delivery or implantation of the VDyne Valve.
16. Cardiogenic shock or hemodynamic instability requiring inotropes or mechanical support devices at the time of planned implant procedure
17. Prior tricuspid valve surgery or catheter-based therapy with permanent residual devices implanted that would preclude delivery or implantation of the VDyne Valve (e.g. valve replacement, edge to edge repair.)
18. Severe valvular heart disease requiring intervention other than the tricuspid valve
19. Known significant intracardiac shunt (e.g. septal defect) (PFO's without significant shunts are allowed)

    COMORBIDITIES
20. Cerebrovascular accident (stroke, TIA) within 6 months of treatment procedure
21. Severe lung disease (severe COPD or continuous use of home oxygen or oral steroids)
22. Acute myocardial infarction (AMI) within 30 days
23. Significant renal dysfunction (eGFR\<30 ml/min/1.73m2) or on dialysis
24. End-stage liver disease (MELD \> 11 / CHILD class C)
25. Bleeding requiring transfusion within 30 days
26. Coagulopathy or other clotting disorder that cannot be medically managed
27. Chronic immunosuppression or other condition that could impair healing response
28. Any of the following: leukopenia, chronic anemia (Hgb \< 9), thrombocytopenia, history of bleeding diathesis, or coagulopathy
29. Unwilling to receive blood products

    GENERAL EXCLUSION CRITERIA
30. Known hypersensitivity or contraindication to procedural or post-procedural medications (e.g., contrast solution) which cannot be adequately managed medically
31. Life expectancy less than 12 months due to non-cardiac comorbidities
32. Treatment is not expected to provide benefit (futile)
33. Current IV Drug user (must be free drug abuse for \> 1 year)
34. Pregnant, lactating or planning pregnancy within next 12 months. (Female of child-bearing potential use two reliable contraceptive methods during the study - hormonal methods such as pill and condom).
35. Vulnerable patient groups (minors, cognitively impaired persons, prisoners, persons whose willingness to volunteer could be unduly influenced by the expectation of benefits associated with participation or of retaliatory response from senior members of a hierarchy in case of refusal to participate, such as students, residents, and employees)
36. Currently participating in an investigational drug or device trial that has not reached its primary endpoint or is likely to interfere with this study
37. Patient (or legal guardian) unable or unwilling to provide written informed consent before study-specific procedures are conducted
38. Patient unable or unwilling to comply with study required testing and follow-up visits.
39. Rhuematic fever

Primary outcomes:
measure: The percentage of subjects with Device- and/or Procedure-related Major Adverse Events (MAE)
timeFrame: 30 days post-procedure
measure: Mortality
timeFrame: 30 days post-procedure
measure: Device success
timeFrame: From implant start time to procedure room exit
measure: Procedural success
timeFrame: From implant start time to procedure room exit
measure: Change in tricuspid valve regurgitation as measured by the Imaging Core Labs
timeFrame: From Baseline to 1 month post-procedure
measure: Changes in quality of life as measured by the KCCQ changes.
timeFrame: From Baseline to 1 month post-procedure
measure: Changes in functional capacity (6-minute walk test)
timeFrame: From Baseline to 1 month post-procedure
measure: Changes in symptom status (NYHA class)
timeFrame: From Baseline to 1 month post-procedure
Secondary outcomes:
measure: The percentage of subjects with Device- and/or Procedure-related Major Adverse Events (MAE)
timeFrame: From Baseline to 1 year post-procedure
measure: Change in tricuspid valve regurgitation as measured by the Imaging Core Lab
timeFrame: From Baseline to 3 months, 6 months and 1 year
measure: Rate of heart failure hospitalization
timeFrame: From Baseline to 3 months, 6 months and 1 year
measure: Changes in symptom status (NYHA class)
timeFrame: From Baseline to 3 months, 6 months and 1 year
measure: Changes in functional capacity (6 minute walk test)
timeFrame: From Baseline to 3 months, 6 months and 1 year
measure: Changes in quality of life as measured by the KCCQ changes.
timeFrame: From Baseline to 3 months, 6 months and 1 year
Other outcomes:
Locations:
city: Sydney
country: Australia
facility: St. Vincent Hospital
state: New South Wales
city: Adelaide
country: Australia
facility: Flinders Medical Centre
city: Brisbane
country: Australia
facility: Princess Alexandra Hospital
city: Brisbane
country: Australia
facility: The Prince Charles Hospital
city: Melbourne
country: Australia
facility: Monash Heart
city: Linz
country: Austria
facility: Johannes Kepler University Linz - JKU
city: Vienna
country: Austria
facility: Universitätsklinik für Herzchirurgie Medizinische Universität Wien
city: Brugge
country: Belgium
facility: AZ Sint Jan Hospital
city: Trinec
country: Czechia
facility: Nemocnice AGEL Podlesi Trinec
city: Bad Oeynhausen
country: Germany
facility: Herz & Diabeteszentrum Nordrhein Westfalen
city: Berlin
country: Germany
facility: Vivantes Klinik Am Urban
city: Kiel
country: Germany
facility: Universitätsklinikum Schleswig-Holstein, Campus Kiel
city: Rostock
country: Germany
facility: Universitätsmedizin Rostock
city: Hamilton
country: New Zealand
facility: Waikato Hospital
city: Košice
country: Slovakia
facility: Kardiocentrum AGEL
city: Madrid
country: Spain
facility: Hospital Universitario Puerta de Hierro
city: Madrid
country: Spain
facility: Hospital Clínico San Carlos
Study officials:
affiliation: VDyne, Inc.
name: Laura Moffett
role: STUDY_DIRECTOR
References: