Clinical trial NCT05647161: BAX602 in Preventing the Adhesion Around Great Cardiac Vessels in Pediatric Patients With Congenital Heart Disease Undergoing Re-do Open Heart Surgery (Japan Trial)
Official title: A Multicenter, Randomized, Controlled Study to Evaluate the Safety and Efficacy of the Adhesion Prevention Device BAX602 in Preventing the Adhesion Around Great Cardiac Vessels in Pediatric Patients With Congenital Heart Disease Undergoing Re-do Open Heart Surgery
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Congenital Heart Disease in Children
Keywords: open heart surgery
anti-adhesion
Lead sponsor: Baxter Healthcare Corporation
Sponsor class: INDUSTRY
First posted: 2022-12-12
Enrollment: 34
Sex: ALL
Minimum age (years): 0
Maximum age (years): 12
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Congenital heart disease occurs in about 1% of live births and can range from (1) naturally curable conditions that require no treatment to (2) conditions that require multiple immediate operations or refractory severe conditions. In the course of a staged surgical intervention, adhesion formation around the heart and large vessels can occur, and dissection of the adhesion site is required at the time of reoperation. There is a concern that dissection may markedly increase the risk of operation such as prolonged surgical time, cardiovascular injury, and increased blood loss, and medical devices to prevent adhesion formation after operation in the field of pediatric cardiovascular operation are strongly desired in medical settings.

The investigational product (BAX602), which has already been manufactured and marketed by Baxter overseas, has been used for open heart surgery as a local hemostatic agent without biological materials in Europe and the US for more than 20 years.

However, since it has not been approved in Japan, this randomized controlled study will be conducted in Japan to demonstrate the effect of BAX602 to prevent and reduce adhesion formation between the surface of the heart/large vessels and surrounding tissues in pediatric patients undergoing planned multistage operation for congenital heart disease.


Eligibility criteria: Inclusion Criteria:

1. Patients \<12 years of age
2. Patients who have undergone the first scheduled palliative surgery for the following diseases and are scheduled to undergo re-do open heart surgery (anatomical repair surgery):

   * Ventricular septal defect
   * Atrioventricular septal defect
   * Tetralogy of Fallot (spectrum)
   * Single ventricle disease (The participant should not meet the exclusion criteria (1) to (3)).
3. Patients who will undergo BT shunting or pulmonary artery banding (including bilateral pulmonary artery banding) for the first surgery
4. Patients undergoing repair surgery (anatomical repair surgery) or bi-directional Glenn surgery as the second target procedure
5. Patients for whom written consent has been obtained from the patient or a surrogate

Exclusion Criteria:

1. Patients with hypoplastic left heart syndrome (HLHS) and its analogues.
2. Patients with asplenia or hypersplenism.
3. Patients undergoing Norwood surgery as the second surgery.
4. Patients undergoing open heart surgery prior to the first scheduled palliative surgery.
5. Patients with complications of other organs that affect the indication for cardiac surgery.
6. Patients with chromosomal or genetic abnormalities that may affect the indication for cardiac surgery.
7. Patients with severe infections or multiple organ failure.
8. Patients who require emergency surgery that requires emergency life support.
9. Patients' body weight is less than 2,500g at birth.
10. Patients who are participating in other clinical trials or who are scheduled to participate in other clinical trials during this study period.
11. Patients who are judged by the investigator or sub investigator to be inappropriate to participate in this study for other reasons.

Primary outcomes:
measure: Grade of adhesion between the surface of the heart/large vessels and surrounding tissues
timeFrame: Day 90 to Day 360 (2nd open heart surgery)
Secondary outcomes:
measure: Total surgery time
timeFrame: Day 90 to Day 360 (2nd open heart surgery)
measure: Time from start of skin incision to start of extracorporeal circulation
timeFrame: Day 90 to Day 360 (2nd open heart surgery)
measure: Time from start of skin incision to the end of adhesion dissection
timeFrame: Day 90 to Day 360 (2nd open heart surgery)
measure: Total score of grade of adhesion at evaluation sites
timeFrame: Day 90 to Day 360 (2nd open heart surgery)
measure: Grade of adhesion by evaluation site and presence or absence of extracorporeal circulation
timeFrame: Day 90 to Day 360 (2nd open heart surgery)
measure: Number of sites of Grades ≥1, ≥2, ≥3, or 4 of adhesion
timeFrame: Day 90 to Day 360 (2nd open heart surgery)
measure: Number of participants with sites of Grades ≥1, ≥2, ≥3, or 4 of adhesion
timeFrame: Day 90 to Day 360 (2nd open heart surgery)
measure: Worst grade of adhesion by participants
timeFrame: Day 90 to Day 360 (2nd open heart surgery)
measure: Intraoperative breeding amount
timeFrame: Day 90 to Day 360 (2nd open heart surgery)
measure: Number of participants by type of local hemostatic agent used during surgery
timeFrame: Day 90 to Day 360 (2nd open heart surgery)
Other outcomes:
Locations:
city: Obu City
country: Japan
facility: Aichi Children's Hospital and Medical Center
state: Aichi Prefecture
city: Fukuoka City
country: Japan
facility: Fukuoka Children's Hospital
state: Fukuoka Prefecture
city: Kobe city
country: Japan
facility: Hyogo Prefectural Kobe Children's Hospital
state: Hyogo
city: Azumino City
country: Japan
facility: Nagano Children's Hospital
state: Nagano
city: Okayama City
country: Japan
facility: Okayama University Hospital
state: Okayama Prefecture
city: Shizuoka City
country: Japan
facility: Shizuoka Children's Hospital
state: Shizuoka Prefecture
Study officials:
References: