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The Medtronic CoreValve™ Evolut R™ CE Mark Clinical Study

The Medtronic CoreValve™ Evolut R™ CE Mark Clinical Study

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01876420
Enrollment
60
Registered
2013-06-12
Start date
2013-10-31
Completion date
2016-10-31
Last updated
2018-08-22

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Aortic Stenosis

Brief summary

To assess the safety and clinical performance of the CoreValve™ Evolut R™ System.

Detailed description

The study objectives are to assess the safety and clinical performance of the CoreValve™ Evolut R™ System in patients with severe symptomatic aortic stenosis who are considered at high through extreme risk for surgical aortic valve replacement. These objectives will be accomplished by a prospective clinical study involving up to 60 implanted subjects among up to six study centers.

Interventions

DEVICEThe CoreValve™ Evolut R TAV™ system

CoreValve™ Evolut R™ System which consists of the Evolut R™ Transcatheter Aortic Valve (26 & 29 mm sizes), EnVeo R™ Delivery Catheter System with Enveo InLine™ Sheath, and EnVeo R™ Loading System

Sponsors

Medtronic
CollaboratorINDUSTRY
Medtronic Cardiovascular
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Healthy volunteers
No

Inclusion criteria

1. Severe aortic stenosis, defined as aortic valve area of \< 1.0 cm2 (or aortic valve area index of \< 0.6 cm2/m2) by the continuity equation, AND mean gradient \> 40 mmHg or maximal aortic valve velocity \> 4.0 m/sec by resting echocardiogram. 2. Estimated 30 day mortality risk of \> 15% by study center Heart Team assessment,33 OR at least two cardiovascular surgeons from the study center deny surgery because of prohibitive operative risk, estimated to be a combined \>50% risk of irreversible mortality or morbidity. 3. Symptoms of aortic stenosis, and NYHA Functional Class II or greater. 4. The subject meets the legal minimum age to provide informed consent based on local regulatory requirements, and has provided written informed consent as approved by the EC/IRB of the respective clinical site. 5. The subject and the treating physician agree that the subject will return for all required post-procedure follow-up visits.

Exclusion criteria

Clinical

Design outcomes

Primary

MeasureTime frameDescription
All-cause Mortality Rate at 30 Days30 daysThe All-cause mortality rate at 30 days per the VARC II recommendation of clinical endpoints for TAVI. More specifically: Cardiovascular mortality (Any of the following criteria) * Death due to proximate cardiac cause (e.g. myocardial infarction, cardiac tamponade, worsening heart failure) * Death caused by non-coronary vascular conditions such as neurological events, pulmonary embolism, ruptured aortic aneurysm, dissecting aneurysm, or other vascular disease * All procedure-related deaths, including those related to a complication of the procedure or treatment for a complication of the procedure * All valve-related deaths including structural or non-structural valve dysfunction or other valve-related adverse events * Sudden or unwitnessed death * Death of unknown cause Non-cardiovascular mortality * Any death in which the primary cause of death is clearly related to another condition (e.g. trauma, cancer, suicide)
Stroke Rate (Disabling and Non-disabling) at 30 Days30 daysThe Stroke rate (disabling and non-disabling) at 30 days per the VARC II definitions. Stroke is defined as an acute episode of focal or global neurological dysfunction caused by the brain, spinal cord, or retinal vascular injury as a result of haemorrhage or infarction. Stroke may be classified as ischaemic or haemorrhagic with appropriate subdefinitions. Ischaemic stroke is defined as an acute episode of focal cerebral, spinal, or retinal dysfunction caused by infarction of central nervous system tissue. Haemorrhagic stroke is defined as an acute episode of focal or global cerebral or spinal dysfunction caused by intraparenchymal, intraventricular, or subarachnoid haemorrhage. A stroke may be classified as 'undetermined' if there is insufficient information to allow the categorization as ischaemic or haemorrhagic.
Device Success Rate at 24 Hours to Seven Days24 hours to seven days1. Device success rate at 24 hours to seven days, defined as: * Absence of procedural mortality, AND * Correct positioning of a single prosthetic heart valve into the proper anatomical location, AND * Intended performance of the prosthetic heart valve, defined as the absence of patient-prosthesis-mismatch and mean aortic valve gradient less than 20 mmHg (or peak velocity \< 3 m/sec), AND absence of moderate or severe prosthetic valve regurgitation. 2. The percentage of subjects with no more than mild aortic regurgitation at early post procedure echocardiogram (24 hours through seven days).

Secondary

MeasureTime frameDescription
Hemodynamic Performance Metrics at 30 Days by Doppler Echocardiography - • Effective Orifice Area (EOA)30 daysEffective orifice area
VARC II Combined Safety Endpoint at 30 Days30 daysThe VARC II Combined Safety Endpoint at 30 days includes the following components: All-Cause Mortality, All Stroke, Life Threatening or Disabling Bleeding, Acute Kidney Injury: Stage 2 or 3, Coronary Artery Obstruction, Major Vascular Complication, and Valve-Related Dysfunction Requiring Repeat Procedure.
Resheath or Recapture Success Rate (When Attempted), Where Successful Recapture is Defined as Evolut R™ TAV (Including the Frame) is Fully Resheathed Into the Capsule of the Delivery Catheter, as Verified by Fluoroscopy.Day 1Resheath or Recapture success rate (when attempted), where successful recapture is defined as Evolut R™ TAV (including the frame) is fully resheathed into the capsule of the delivery catheter, as verified by fluoroscopy. Resheathing or recapturing of the TAV was attempted on 15 subjects.
Hemodynamic Performance Metrics at 30 Days by Doppler Echocardiography - Total Aortic Regurgitation (Transvalvular & Paravalvular)30 daysDegree of Total prosthetic valve regurgitation (transvalvular & paravalvular)
Event Rates of the Individual Components of the VARC II Composite Safety Endpoint at 30 Days30 daysThe Individual components of the VARC II composite safety endpoint at 30 days per the Kaplan Meier Event Rate (%).
Hemodynamic Performance Metrics at 30 Days by Doppler Echocardiography - Mean Gradient30 daysThe hemodynamic performance will be measured by the Mean Prosthetic Valve Gradient for 59 subjects, measured with the Doppler echocardiography.

Countries

Australia, New Zealand, United Kingdom

Participant flow

Participants by arm

ArmCount
The CoreValve™ Evolut R TAV™ System
CoreValve™ Evolut R™ System which consists of the Evolut R™ Transcatheter Aortic Valve (26 & 29 mm sizes), EnVeo R™ Delivery Catheter System with Enveo InLine™ Sheath, and EnVeo R™ Loading System The CoreValve™ Evolut R TAV™ system: CoreValve™ Evolut R™ System which consists of the Evolut R™ Transcatheter Aortic Valve (26 & 29 mm sizes), EnVeo R™ Delivery Catheter System with Enveo InLine™ Sheath, and EnVeo R™ Loading System
60
Total60

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyMissed 30 day visit1

Baseline characteristics

CharacteristicThe CoreValve™ Evolut R TAV™ System
Age, Continuous82.8 years
STANDARD_DEVIATION 6.1
Body Surface Area (BSA)1.7 m²
STANDARD_DEVIATION 0.2
Logistic EuroScore20.5 percent risk for cardiac surgery
STANDARD_DEVIATION 12.5
NYHA Class
NYHA I
0 participants
NYHA Class
NYHA II
19 participants
NYHA Class
NYHA III
36 participants
NYHA Class
NYHA IV
5 participants
Region of Enrollment
Australia
25 participants
Region of Enrollment
New Zealand
6 participants
Region of Enrollment
United Kingdom
29 participants
Sex: Female, Male
Female
40 Participants
Sex: Female, Male
Male
20 Participants
STS Score7.0 percent of risk for cardiac surgery
STANDARD_DEVIATION 3.7

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
60 / 60
serious
Total, serious adverse events
40 / 60

Outcome results

Primary

All-cause Mortality Rate at 30 Days

The All-cause mortality rate at 30 days per the VARC II recommendation of clinical endpoints for TAVI. More specifically: Cardiovascular mortality (Any of the following criteria) * Death due to proximate cardiac cause (e.g. myocardial infarction, cardiac tamponade, worsening heart failure) * Death caused by non-coronary vascular conditions such as neurological events, pulmonary embolism, ruptured aortic aneurysm, dissecting aneurysm, or other vascular disease * All procedure-related deaths, including those related to a complication of the procedure or treatment for a complication of the procedure * All valve-related deaths including structural or non-structural valve dysfunction or other valve-related adverse events * Sudden or unwitnessed death * Death of unknown cause Non-cardiovascular mortality * Any death in which the primary cause of death is clearly related to another condition (e.g. trauma, cancer, suicide)

Time frame: 30 days

Population: All implanted subjects at 30 days.

ArmMeasureValue (NUMBER)
All Implanted SubjectsAll-cause Mortality Rate at 30 Days0.0 percentage of participants
Primary

Device Success Rate at 24 Hours to Seven Days

1. Device success rate at 24 hours to seven days, defined as: * Absence of procedural mortality, AND * Correct positioning of a single prosthetic heart valve into the proper anatomical location, AND * Intended performance of the prosthetic heart valve, defined as the absence of patient-prosthesis-mismatch and mean aortic valve gradient less than 20 mmHg (or peak velocity \< 3 m/sec), AND absence of moderate or severe prosthetic valve regurgitation. 2. The percentage of subjects with no more than mild aortic regurgitation at early post procedure echocardiogram (24 hours through seven days).

Time frame: 24 hours to seven days

Population: All implanted subjects at 30 days.

ArmMeasureGroupValue (NUMBER)
All Implanted SubjectsDevice Success Rate at 24 Hours to Seven DaysOverall Device Success78.6 percentage of participants
All Implanted SubjectsDevice Success Rate at 24 Hours to Seven DaysAbsence of Procedural Mortality100.0 percentage of participants
All Implanted SubjectsDevice Success Rate at 24 Hours to Seven DaysCorrect Positioning of Single Valve98.3 percentage of participants
All Implanted SubjectsDevice Success Rate at 24 Hours to Seven DaysIntended Performance of Prosthetic Heart Valve80.0 percentage of participants
All Implanted SubjectsDevice Success Rate at 24 Hours to Seven DaysAbsence of Patient Prosthesis Mismatch83.6 percentage of participants
All Implanted SubjectsDevice Success Rate at 24 Hours to Seven DaysMean Gradient < 20mmHg or Peak Velocity < 3m/sec98.3 percentage of participants
All Implanted SubjectsDevice Success Rate at 24 Hours to Seven DaysAbsence of Mod. or Severe Prosthetic Regurgitation93.3 percentage of participants
Primary

Stroke Rate (Disabling and Non-disabling) at 30 Days

The Stroke rate (disabling and non-disabling) at 30 days per the VARC II definitions. Stroke is defined as an acute episode of focal or global neurological dysfunction caused by the brain, spinal cord, or retinal vascular injury as a result of haemorrhage or infarction. Stroke may be classified as ischaemic or haemorrhagic with appropriate subdefinitions. Ischaemic stroke is defined as an acute episode of focal cerebral, spinal, or retinal dysfunction caused by infarction of central nervous system tissue. Haemorrhagic stroke is defined as an acute episode of focal or global cerebral or spinal dysfunction caused by intraparenchymal, intraventricular, or subarachnoid haemorrhage. A stroke may be classified as 'undetermined' if there is insufficient information to allow the categorization as ischaemic or haemorrhagic.

Time frame: 30 days

Population: All implanted subjects at 30 days.

ArmMeasureValue (NUMBER)
All Implanted SubjectsStroke Rate (Disabling and Non-disabling) at 30 Days0.0 percentage of participants
Secondary

Event Rates of the Individual Components of the VARC II Composite Safety Endpoint at 30 Days

The Individual components of the VARC II composite safety endpoint at 30 days per the Kaplan Meier Event Rate (%).

Time frame: 30 days

Population: The number of subjects analyzed at 30 days.

ArmMeasureGroupValue (NUMBER)
All Implanted SubjectsEvent Rates of the Individual Components of the VARC II Composite Safety Endpoint at 30 DaysAll Stroke0.0 percentage of probability
All Implanted SubjectsEvent Rates of the Individual Components of the VARC II Composite Safety Endpoint at 30 DaysCombined Safety Endpoint13.3 percentage of probability
All Implanted SubjectsEvent Rates of the Individual Components of the VARC II Composite Safety Endpoint at 30 DaysAll Cause Mortality0.0 percentage of probability
All Implanted SubjectsEvent Rates of the Individual Components of the VARC II Composite Safety Endpoint at 30 DaysLife Threatening or Disabling Bleeding5.0 percentage of probability
All Implanted SubjectsEvent Rates of the Individual Components of the VARC II Composite Safety Endpoint at 30 DaysAcute Kidney Injury: Stage 2 or 31.7 percentage of probability
All Implanted SubjectsEvent Rates of the Individual Components of the VARC II Composite Safety Endpoint at 30 DaysCoronary Artery Obstruction0.0 percentage of probability
All Implanted SubjectsEvent Rates of the Individual Components of the VARC II Composite Safety Endpoint at 30 DaysMajor Vascular Complication8.3 percentage of probability
All Implanted SubjectsEvent Rates of the Individual Components of the VARC II Composite Safety Endpoint at 30 DaysValve-Related Dysfunct. Requiring Repeat Procedure0.0 percentage of probability
Secondary

Hemodynamic Performance Metrics at 30 Days by Doppler Echocardiography - • Effective Orifice Area (EOA)

Effective orifice area

Time frame: 30 days

Population: All implanted subjects who had echos at the 30 day visit, which were 58 subjects, only 54 of the echos were able to measure the EOA for those subjects.

ArmMeasureValue (MEAN)Dispersion
All Implanted SubjectsHemodynamic Performance Metrics at 30 Days by Doppler Echocardiography - • Effective Orifice Area (EOA)1.9 cm²Standard Deviation 0.5
Secondary

Hemodynamic Performance Metrics at 30 Days by Doppler Echocardiography - Mean Gradient

The hemodynamic performance will be measured by the Mean Prosthetic Valve Gradient for 59 subjects, measured with the Doppler echocardiography.

Time frame: 30 days

Population: All implanted subjects who had echos at the 30 day visit, which were 58 subjects, only 57 of the echos were able to measure the Mean Gradient for those subjects.

ArmMeasureValue (MEAN)Dispersion
All Implanted SubjectsHemodynamic Performance Metrics at 30 Days by Doppler Echocardiography - Mean Gradient8.1 mmHgStandard Deviation 3.3
Secondary

Hemodynamic Performance Metrics at 30 Days by Doppler Echocardiography - Total Aortic Regurgitation (Transvalvular & Paravalvular)

Degree of Total prosthetic valve regurgitation (transvalvular & paravalvular)

Time frame: 30 days

Population: All implanted subjects who had echos at the 30 day visit, which were 58 subjects, and 58 of the echos were able to measure the Total Aortic Regurgitation for those subjects.

ArmMeasureGroupValue (NUMBER)
All Implanted SubjectsHemodynamic Performance Metrics at 30 Days by Doppler Echocardiography - Total Aortic Regurgitation (Transvalvular & Paravalvular)None8.6 percentage of participants
All Implanted SubjectsHemodynamic Performance Metrics at 30 Days by Doppler Echocardiography - Total Aortic Regurgitation (Transvalvular & Paravalvular)Trace22.4 percentage of participants
All Implanted SubjectsHemodynamic Performance Metrics at 30 Days by Doppler Echocardiography - Total Aortic Regurgitation (Transvalvular & Paravalvular)Mild63.8 percentage of participants
All Implanted SubjectsHemodynamic Performance Metrics at 30 Days by Doppler Echocardiography - Total Aortic Regurgitation (Transvalvular & Paravalvular)Moderate5.2 percentage of participants
All Implanted SubjectsHemodynamic Performance Metrics at 30 Days by Doppler Echocardiography - Total Aortic Regurgitation (Transvalvular & Paravalvular)Severe0.0 percentage of participants
Secondary

Resheath or Recapture Success Rate (When Attempted), Where Successful Recapture is Defined as Evolut R™ TAV (Including the Frame) is Fully Resheathed Into the Capsule of the Delivery Catheter, as Verified by Fluoroscopy.

Resheath or Recapture success rate (when attempted), where successful recapture is defined as Evolut R™ TAV (including the frame) is fully resheathed into the capsule of the delivery catheter, as verified by fluoroscopy. Resheathing or recapturing of the TAV was attempted on 15 subjects.

Time frame: Day 1

Population: Subjects who had either a resheath or recapture attempt at implant and the success rate for each resheathing, or recapturing attempts of the valve at the implant.

ArmMeasureGroupValue (NUMBER)
All Implanted SubjectsResheath or Recapture Success Rate (When Attempted), Where Successful Recapture is Defined as Evolut R™ TAV (Including the Frame) is Fully Resheathed Into the Capsule of the Delivery Catheter, as Verified by Fluoroscopy.Success rate for Resheath or Recapture100.0 percentage of successful attempts
All Implanted SubjectsResheath or Recapture Success Rate (When Attempted), Where Successful Recapture is Defined as Evolut R™ TAV (Including the Frame) is Fully Resheathed Into the Capsule of the Delivery Catheter, as Verified by Fluoroscopy.Success rate for Resheath100.0 percentage of successful attempts
All Implanted SubjectsResheath or Recapture Success Rate (When Attempted), Where Successful Recapture is Defined as Evolut R™ TAV (Including the Frame) is Fully Resheathed Into the Capsule of the Delivery Catheter, as Verified by Fluoroscopy.Success rate for Recapture100.0 percentage of successful attempts
Secondary

VARC II Combined Safety Endpoint at 30 Days

The VARC II Combined Safety Endpoint at 30 days includes the following components: All-Cause Mortality, All Stroke, Life Threatening or Disabling Bleeding, Acute Kidney Injury: Stage 2 or 3, Coronary Artery Obstruction, Major Vascular Complication, and Valve-Related Dysfunction Requiring Repeat Procedure.

Time frame: 30 days

ArmMeasureValue (NUMBER)
All Implanted SubjectsVARC II Combined Safety Endpoint at 30 Days13.3 percentage probability

Source: ClinicalTrials.gov · Data processed: Mar 15, 2026