Heart Diseases, Pulmonary Valve Regurgitation, Pulmonary Valve Stenosis, Tetralogy of Fallot
Conditions
Brief summary
The purpose of the study is to evaluate the safety and effectiveness of the PULSTA Transcatheter Pulmonary Valve (TPV) System for the treatment of congenital or acquired pulmonary valve stenosis and/or regurgitation who require pulmonary valve replacement.
Detailed description
The PULSTA TPV is a self-expandable valve with flared-ends to adapt to the larger native right ventricular outflow tract (RVOT) and is using a relatively low profile delivery catheter from knitted nitinol wire backbone and trileaflets made from treated porcine pericardial tissue, and a delivery system, which provides access to the right ventricular outflow tract through blood vessels. Consecutive subject data should be collected at discharge, 1, 6 months, and 1-5 years post PULSTA TPV implantation.
Interventions
DEVICEPULSTA TPV System
PULSTA transcatheter pulmonary valve replacement.
Sponsors
Taewoong Medical Co., Ltd.
Avania
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
10 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Body weight greater than or equal to 30 kilograms * Pulmonary regurgitation moderate or severe pulmonary regurgitation or pulmonary valve stenosis with mean gradient \>35mmHg by echocardiography * Main pulmonary artery trunk of ≥16 mm and ≤30 mm * Patients willing to provide written informed consent and comply with follow-up evaluations.
Exclusion criteria
* Females of child-bearing potential who are unable to take adequate contraceptive precautions, are known to be pregnant, or are currently breastfeeding an infant up until 6 months after TPV implantation * Pre-existing mechanical valve in pulmonary position or require concomitant repair of other cardiac valves * Obstruction of the central veins to be approached for the TPV implantation * Coronary artery compression confirmed by angiography * A known severe allergy to Nickel * A known hypersensitivity to any anticoagulation therapy, contrast agent or a hemorrhagic disease * Suspected active infectious disease (e.g. endocarditis, meningitis) * Life expectancy of less than 6 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Procedural/Device related serious adverse events at 6 months | 6 months | — |
| Hemodynamic functional improvement at 6 months | 6 months | Hemodynamic functional improvement is a composite of mean RVOT gradient ≤30 mmHg by continuous wave Doppler and a pulmonary regurgitant fraction \<20% by cardiac magnetic resonance (MR) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Procedural Success | 7 days | Procedural success is defined as the TPV implant within desired position, Right ventricle-Pulmonary artery (RV-PA) peak systolic pressure gradient \<35mmHg by catheter, less mild pulmonary regurgitation by angiography, and freedom from explantation of the TPV at 24 hours post-implant. |
| Hemodynamic Function | 5 years | Hemodynamic function will be assessed including peak RVOT pressure gradient, mean RVOT pressure gradient, right ventricle (RV) end-diastolic volume index by echocardiography or cardiac MR. |
| Pulmonary Regurgitant Fraction | 6months | Pulmonary regurgitant fraction (PRF) will be assessed via cardiac MRI at 6 months after the PULSTA TPV implantation. |
| Severity of Pulmonary Regurgitation | 5 years | Severity of pulmonary regurgitation will be assessed via Doppler echocardiography. |
| NYHA functional classification | 5 years | Clinical outcome will be assessed as per the New York Heart Association (NYHA) functional classification t all follow-up visits and will be compared to baseline values. |
| Catheter reintervention on TPV | 5 years | Catheter re-intervention on PULSTA TPV is defined as any interventional catheter procedure (e.g. balloon angioplasty) that alters or adjusts, or replaces a previously implanted PULSTA TPV during a 5-year follow-up period, and the frequency will be evaluated. |
| Reoperation | 5 years | Reoperation is defined as open surgery that alters or adjusts, or replaces a previously implanted PULSTA TPV during a 5-year follow-up period, and the frequency will be evaluated. |
| Procedural / Device related serious adverse events | 5 years | — |
| Death (All cause / procedural/device-related) | 5 years | — |
| Other adverse events | 5 years | — |
Countries
Germany, Italy, Netherlands, South Korea, Spain, Turkey (Türkiye)
Contacts
STUDY_CHAIRMario Carminati, PhD. MD.
Policlinico San Donato
PRINCIPAL_INVESTIGATORStanimir Georgiev, PhD. MD.
Deutsches Herzzentrum Munchen
PRINCIPAL_INVESTIGATORJose Luis Zunzunegui, PhD. MD.
Gregorio Marañon hospital
PRINCIPAL_INVESTIGATORFederico Gutierrez Larraya, PhD. MD.
Hospital Universitario La Paz
PRINCIPAL_INVESTIGATOREnder Odemis, PhD. MD.
Koc University Hospital
PRINCIPAL_INVESTIGATORAhmet Çelebi, PhD. MD.
Siyami Ersek Hospital
PRINCIPAL_INVESTIGATORGregor Krings, PhD. MD.
Utrecht University Wilhelmina
PRINCIPAL_INVESTIGATORThomas Krasemann, PhD. MD.
Erasmus Medical Center
PRINCIPAL_INVESTIGATORGi Beom Kim, PhD. MD.
Seoul National University Hospital
PRINCIPAL_INVESTIGATORJae Young Choi, PhD. MD.
Severance Hospital
PRINCIPAL_INVESTIGATORSeong Ho Kim, PhD. MD.
Sejong General Hospital
Outcome results
None listed