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The Medtronic Harmony™ Transcatheter Pulmonary Valve Clinical Study

The Medtronic Harmony™ Transcatheter Pulmonary Valve Clinical Study

Status
Active, not recruiting
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02979587
Enrollment
86
Registered
2016-12-01
Start date
2017-01-31
Completion date
2031-02-28
Last updated
2025-09-19

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

Conditions

Congenital Heart Disease, Pulmonary Regurgitation, RVOT Anomaly, Tetrology of Fallot

Brief summary

The purpose of this study is to further evaluate the safety and effectiveness of the Harmony™ TPV system. The Pivotal/CAS phases of the study have transitioned into a post-approval study to confirm the long-term functionality of transcatheter implantation of the Medtronic Harmony TPV.

Detailed description

The continued clinical experience addendum is a prospective, multi-center, non-randomized, interventional study to evaluate the safety and effectiveness of the Harmony TPV system. All implanted subjects will receive the Harmony TPV 22 or Harmony mTPV 25 device. This phase allows up to 45 subjects implanted with TPV 22 in the United States and Canada, and up to 84 subjects implanted with mTPV 25 in the United States. The Post Approval Phase (PAS) addendum is a prospective, multi-center, non-randomized, post-market study to evaluate the safety and effectiveness of the Harmony TPV system in the United States. All implanted subjects have been implanted with the Harmony TPV 22 or Harmony mTPV 25 device during the pivotal or CAS phase of the study. The PAS addendum extends follow-up from five years to ten years for consenting subjects.

Interventions

The Harmony™ TPV (Model NTPV0022) is comprised of a 22mm porcine pericardium valve, sewn to a polyester-covered nitinol frame. The Harmony TPV 25 and mTPV 25 (Model HTPV254952 and HTPV254252, respectively) is comprised of a 25mm porcine pericardium valve, sewn to a polyester covered asymmetrical hourglass nitinol frame with larger diameter inflow and outflow as well as shorter length compared to TPV 22 (Harmony TPV 25 Model HTPV254952 is not applicable for Continued Clinical Experience). The Harmony Delivery System (DS) for the TPV 22, TPV 25, and mTPV 25 (NTPVDS0022 and HTPVDS0025) are all 25 Fr delivery systems using a coil loading catheter.

Sponsors

Medtronic Heart Valves
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Healthy volunteers
No

Inclusion criteria

* Subject has severe pulmonary regurgitation as assessed via echocardiography or CMR determined PR fraction \>/= 30% * Subject has clinical indication for surgical placement of an RV-PA conduit or bioprosthetic pulmonary valve * Subject is willing to consent to participate

Exclusion criteria

* Patients with right ventricular outflow tract obstruction (RVOTO) lesions surgically treated with an RV-to-PA conduit implant * RVOT anatomy or morphology that is unfavorable for device anchoring * Positive pregnancy test * Life expectancy of less than 1 year

Design outcomes

Primary

MeasureTime frameDescription
Freedom From Procedure- or Device-related Mortality at 30 Days.30 daysThe primary safety endpoint is point estimate of freedom from procedure or device-related mortality rate at 30 days post procedure.
Number of Participants With Acceptable Hemodynamic Function Composite at 6 Months6 monthsDefined as: * Mean RVOT gradient as measured by continuous-wave Doppler ≤40 mmHg -AND- * Pulmonary regurgitant fraction as measured by magnetic resonance imaging \<20%

Secondary

MeasureTime frameDescription
Number of Participants With Procedural Success at 30 Days30 daysProcedural success is defined as: * Device success at 30 days, and * None of the following device- or procedure-related serious adverse events: * Life-threatening major bleed * Major vascular or cardiac structural complications required unplanned reintervention or surgery * Stage 2 or 3 acute kidney injury (AKI) (includes new dialysis) * Pulmonary embolism * Severe heart failure (HF) or hypotension requiring IV inotrope, ultrafiltration, or mechanical circulatory support * Prolonged intubation \>48 hours
Freedom From TPV Dysfunction Out to 5 Years5 years (5 year data has an anticipated reporting date of April 2026)TPV dysfunction is defined as any one of the following: * RVOT reoperation for device-related reasons * Catheter re-intervention of TPV * Hemodynamic dysfunction of the TPV (moderate or greater pulmonary regurgitation, and/or a mean RVOT gradient \>40 mmHg)
Number of Participants With Technical Success at Exit From Catheterization Lab/Operating Room (OR)At exit from catheterization lab/operating room (OR)Technical success at exit from catheterization lab/operating room (OR), as defined as: * No device- or procedural-related mortality, with * Successful access, delivery and retrieval of the delivery system, and * Deployment and correct positioning (including minor repositioning if needed) of the single intended device, and * No need for additional unplanned or emergency surgery or re-intervention related to the device or access procedure
Characterization of Quality of Life Scores Out to 5 YearsBaseline, 30 Day, 6 Month, 1 Year, 2 Year, 3 YearQuality of life score over time will be assessed by the SF-36 at pre-implant, 1 month post-implant, 6 months post-implant, 1 year post-implant, 2 years post-implant, and 3 years. The analysis cohort will be the implanted \> 24 hours cohort. Minimum score of 0 and maximum score of 100 is possible. Higher values are considered to be a better outcome.
Characterization of Right Ventricle Remodeling Following TPV ImplantBaseline, 6 MonthRight ventricle remodeling will be assessed via CMR at pre-implant and 6 months post-implant. The analysis cohort will be implanted longer than 24 hours cohort. The characterization will be made using right ventricular end diastolic volume (ml).
Assessment of SafetyOngoingAll procedure-related serious adverse events. All device-related serious adverse events. Death (all-cause, procedural, and device-related).
Device Success Out to 5 Years5 yearsDevice success is defined as: * No device- or procedural-related mortality, with * Original intended device in place, and * No additional surgical or interventional procedures related to access or the device since completion of the original procedure (i.e., exit from the catheterization lab), and * Intended performance of the device, as defined as: * Structural performance: No migration, embolization, detachment, major stent fracture, hemolysis, thrombosis, endocarditis, and * Hemodynamic performance: Relief of insufficiency (PR \< moderate) without producing the opposite (mean RVOT gradient \> 40 mmHg) as measured by continuous wave Doppler, and * Absence of para-device complications, as defined by: * PVL = moderate, or * Erosion, or * RVOT or PA rupture

Countries

Canada, Japan, United States

Participant flow

Participants by arm

ArmCount
Implanted Pivotal Harmony TPV Subjects
This study is comprised of a single arm of subjects implanted with the Harmony TPV device during the pivotal study.
50
Total50

Baseline characteristics

CharacteristicImplanted Pivotal Harmony TPV Subjects
Age, Continuous28.7 years
STANDARD_DEVIATION 11.3
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
6 Participants
Race (NIH/OMB)
Black or African American
0 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
4 Participants
Race (NIH/OMB)
White
40 Participants
Region of Enrollment
Japan
2 participants
Region of Enrollment
United States
48 participants
Sex: Female, Male
Female
19 Participants
Sex: Female, Male
Male
31 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 50
other
Total, other adverse events
33 / 50
serious
Total, serious adverse events
3 / 50

Outcome results

Primary

Freedom From Procedure- or Device-related Mortality at 30 Days.

The primary safety endpoint is point estimate of freedom from procedure or device-related mortality rate at 30 days post procedure.

Time frame: 30 days

Population: The catheterized cohort consists of all subjects who undergo catheterization for possible implantation of the Harmony TPV. The primary safety endpoint population includes all subjects that were catheterized and also had evaluable data at 30 days. Two subjects were exited prior to the 30 day timepoint.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Catheterized CohortFreedom From Procedure- or Device-related Mortality at 30 Days.48 Participants
Primary

Number of Participants With Acceptable Hemodynamic Function Composite at 6 Months

Defined as: * Mean RVOT gradient as measured by continuous-wave Doppler ≤40 mmHg -AND- * Pulmonary regurgitant fraction as measured by magnetic resonance imaging \<20%

Time frame: 6 months

Population: The implanted \>24 hours cohort consists of all subjects who have a Harmony TPV implanted which remains implanted for greater than 24 hours.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Catheterized CohortNumber of Participants With Acceptable Hemodynamic Function Composite at 6 Months43 Participants
Secondary

Assessment of Safety

All procedure-related serious adverse events. All device-related serious adverse events. Death (all-cause, procedural, and device-related).

Time frame: Ongoing

Secondary

Characterization of Quality of Life Scores Out to 5 Years

Quality of life score over time will be assessed by the SF-36 at pre-implant, 1 month post-implant, 6 months post-implant, 1 year post-implant, 2 years post-implant, and 3 years. The analysis cohort will be the implanted \> 24 hours cohort. Minimum score of 0 and maximum score of 100 is possible. Higher values are considered to be a better outcome.

Time frame: Baseline, 30 Day, 6 Month, 1 Year, 2 Year, 3 Year

Population: Number analyzed differs from overall number analyzed because subjects have either exited or have not yet completed that timepoint.

ArmMeasureGroupValue (MEAN)Dispersion
Catheterized CohortCharacterization of Quality of Life Scores Out to 5 YearsBaseline80.5 score on a scaleStandard Deviation 25.6
Catheterized CohortCharacterization of Quality of Life Scores Out to 5 Years30 Day Follow-up90.2 score on a scaleStandard Deviation 15.6
Catheterized CohortCharacterization of Quality of Life Scores Out to 5 Years6 Month Follow-up94.6 score on a scaleStandard Deviation 8.8
Catheterized CohortCharacterization of Quality of Life Scores Out to 5 Years1 Year Follow-up91.6 score on a scaleStandard Deviation 14.9
Catheterized CohortCharacterization of Quality of Life Scores Out to 5 Years2 Year Follow-up94.4 score on a scaleStandard Deviation 11
Catheterized CohortCharacterization of Quality of Life Scores Out to 5 Years3 Year Follow-up98.3 score on a scaleStandard Deviation 4.1
Secondary

Characterization of Quality of Life Scores Out to 5 Years

Quality of life score over time will be assessed by the SF-36 at 4 & 5 years. The analysis cohort will be the implanted \> 24 hours cohort. Minimum score of 0 and maximum score of 100 is possible. Higher values are considered to be a better outcome.

Time frame: 4 Year, 5 Year (4 & 5 year data has an anticipated reporting date of April 2026)

Secondary

Characterization of Right Ventricle Remodeling Following TPV Implant

Right ventricle remodeling will be assessed via CMR at 2 years post- implant and 5 years post-implant. The analysis cohort will be implanted longer than 24 hours cohort. The characterization will be made using right ventricular end diastolic volume (ml).

Time frame: 2 Year, 5 Year (2 & 5 year data has an anticipated reporting date of April 2026)

Secondary

Characterization of Right Ventricle Remodeling Following TPV Implant

Right ventricle remodeling will be assessed via CMR at pre-implant and 6 months post-implant. The analysis cohort will be implanted longer than 24 hours cohort. The characterization will be made using right ventricular end diastolic volume (ml).

Time frame: Baseline, 6 Month

Population: Subjects included in this analysis were those who were successfully implanted with a Harmony TPV for greater than 24 hours and had evaluable CMR data at the given timepoint.

ArmMeasureGroupValue (MEAN)Dispersion
Catheterized CohortCharacterization of Right Ventricle Remodeling Following TPV ImplantPre-implant291.5 mlStandard Deviation 57.4
Catheterized CohortCharacterization of Right Ventricle Remodeling Following TPV Implant6 Months223.0 mlStandard Deviation 54.9
Secondary

Device Success Out to 5 Years

Device success is defined as: * No device- or procedural-related mortality, with * Original intended device in place, and * No additional surgical or interventional procedures related to access or the device since completion of the original procedure (i.e., exit from the catheterization lab), and * Intended performance of the device, as defined as: * Structural performance: No migration, embolization, detachment, major stent fracture, hemolysis, thrombosis, endocarditis, and * Hemodynamic performance: Relief of insufficiency (PR \< moderate) without producing the opposite (mean RVOT gradient \> 40 mmHg) as measured by continuous wave Doppler, and * Absence of para-device complications, as defined by: * PVL = moderate, or * Erosion, or * RVOT or PA rupture

Time frame: 5 years

Secondary

Freedom From TPV Dysfunction Out to 5 Years

TPV dysfunction is defined as any one of the following: * RVOT reoperation for device-related reasons * Catheter re-intervention of TPV * Hemodynamic dysfunction of the TPV (moderate or greater pulmonary regurgitation, and/or a mean RVOT gradient \>40 mmHg)

Time frame: 5 years (5 year data has an anticipated reporting date of April 2026)

Secondary

Number of Participants With Procedural Success at 30 Days

Procedural success is defined as: * Device success at 30 days, and * None of the following device- or procedure-related serious adverse events: * Life-threatening major bleed * Major vascular or cardiac structural complications required unplanned reintervention or surgery * Stage 2 or 3 acute kidney injury (AKI) (includes new dialysis) * Pulmonary embolism * Severe heart failure (HF) or hypotension requiring IV inotrope, ultrafiltration, or mechanical circulatory support * Prolonged intubation \>48 hours

Time frame: 30 days

Population: The attempted implant cohort consists of all subjects who undergo catheterization and a Harmony TPV implantation was attempted (Harmony TPV is introduced into the subject's body).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Catheterized CohortNumber of Participants With Procedural Success at 30 Days42 Participants
Secondary

Number of Participants With Technical Success at Exit From Catheterization Lab/Operating Room (OR)

Technical success at exit from catheterization lab/operating room (OR), as defined as: * No device- or procedural-related mortality, with * Successful access, delivery and retrieval of the delivery system, and * Deployment and correct positioning (including minor repositioning if needed) of the single intended device, and * No need for additional unplanned or emergency surgery or re-intervention related to the device or access procedure

Time frame: At exit from catheterization lab/operating room (OR)

Population: The attempted implant cohort consists of all subjects who undergo catheterization and a Harmony TPV implantation was attempted (Harmony TPV is introduced into the subject's body).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Catheterized CohortNumber of Participants With Technical Success at Exit From Catheterization Lab/Operating Room (OR)45 Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026