Aortic Valve Stenosis
Conditions
Brief summary
A retrospective, multinational, multicentre, observational study in patients presenting with native severe aortic valve stenosis and treated with Myval™ Transcatheter Heart Valve Series in real-world setting.
Detailed description
Myval Global Study: A retrospective, multicentre, observational study in patients presenting with native severe aortic valve stenosis and treated with Myval™ Transcatheter Heart Valve Series in real-world setting. This study shall retrospectively collect the data of minimal 200 consecutive patients treated with Myval™ THV Series approximately 15 participating sites Globally. Primary Endpoint: Primary Combined Safety and Effectiveness Endpoint: \[Time frame: 30 days\] It is the composite of following: * All-cause mortality * All stroke * Bleeding (type 3 and 4) * Acute kidney injury (stage 2 ,3 & 4) * Major vascular complications * Moderate or severe prosthetic valve regurgitation * Conduction system disturbances resulting in a new permanent pacemaker implantation. Secondary endpoints: 1. All-cause mortality (VARC-3 defined criteria) \[Time Frame: Through 30 days\] 2. All stroke (VARC-3 defined criteria) \[Time Frame: Through 30 days\] 3. Acute Kidney Injury (AKI) based on the Acute Kidney Injury Network (AKIN) System Stage 2, Stage 3 or Stage 4 \[Time Frame: Through 30 days\] 4. Bleeding type 3 and 4 (VARC-3 criteria) \[Time Frame: Through 30 days\] 5. Moderate or severe prosthetic valve regurgitation \[Time Frame: Through 30 days\] 6. New permanent pacemaker implantation \[Time Frame: Through 30 days\] New permanent pacemaker implantation rates will be analyzed further based on the patient's history of left and/or right bundle branch block. 7. Conduction disturbances and arrhythmias according to VARC-3 \[Time Frame: Through 30 days\] 8. Device success (VARC-3 criteria) \[Time Frame: Pre-discharge\] 9. Early safety at 30 days (VARC-3 criteria) \[Time Frame: After 30 days of index procedure\] 10. Clinical efficacy after 30 days (VARC-2 criteria) \[Time Frame: After 30 days of index procedure\] 11. Time-related valve safety (VARC-2 criteria) \[Time Frame: Through 30 days\] 12. Vascular and access related complications (VARC-3 criteria) \[Time Frame: Pre-discharge, Through 30 days\] 13. Major vascular complications (VARC-3 criteria) \[Time Frame: Pre-discharge, Through 30 days\] 14. Functional improvement from baseline as measured per a. NYHA functional classification \[Time frame: Baseline, 30 days\] 15. Echocardiographic End Points * Effective orifice area (EOA) * Index effective orifice area (iEOA) * Mean aortic valve gradient * Peak aortic valve gradient * Peak aortic velocity * Transvalvular, paravalvular and total aortic regurgitation * Left ventricular ejection fraction (LVEF) * Valve calcification * Cardiac output and cardiac index \[Time frame: Through 30 days\] 16. Patient-prosthesis Mismatch: \[Time Frame: Post-procedure, predishcarge, Through 30 days\] Severity patient-prosthesis-mismatch will be based on following * For subjects with BMI \< 30 kg/m2, index effective orifice area (EOAi) 0.85 - 0.66 cm2 /m2 for moderate and ≤0.65 cm2 /m2 for severe * For subjects with BMI ≥30 kg/m2, index effective orifice area (EOAi) 0.70 - 0.56 cm2 /m2 for moderate and ≤0.55 cm2 /m2 for severe BMI = weight(kg)/(height (m)) 2 17. Length of index hospital stay. \[Time frame: At discharge\] \- Number of days from hospital admission to discharge. 18. Re-hospitalization (VARC-3 defined criteria) \[Time Frame: Through 30 days\] 19. New onset of atrial fibrillation or atrial flutter \[Time Frame: Post-procedure, Pre-discharge and 30 days\] 20. Endocarditis \[Time Frame: Through 30 days\] 21. Major bleeding event \[Time Frame: Through 30 days\] 22. Other Endpoints: * Myocardial rupture \[Time Frame: During procedure\] * Paravalvular leak \[Time Frame:Through 30 days\] * Degree of over- or under-expansion of Myval \[Time Frame: During procedure\] * Accuracy of deployment in relation to the annular plane \[Time Frame: During procedure\] * Pacemaker deployment (and the symptoms resulting in it) \[Time Frame: Through 30 days\] * Interference with the mitral valve; and \[Time Frame: During procedure\] * Interference with the LVOT \[Time Frame: During procedure\] * If the endpoint data is available through 1 year, it will also be collected and analyzed. Clinical efficacy data will be collected only for patients with availability of data after 30 days follow-up. Long term clinical follow up by telephonic interview will be conducted for all patients who have completed 30 days safety follow-up, at 1 year, 3 year and 5 years.
Interventions
Myval™ THV is a newer-generation balloon-expandable THV characterized by a nickel-cobalt alloy frame composed of a single element - hexagon arranged in a hybrid honeycomb fashion.
Sponsors
Study design
Eligibility
Inclusion criteria
* All patients of this study must have received Myval™ THV series for treatment of native severe aortic stenosis and completed a minimum of 30-day follow-up.
Exclusion criteria
* No
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Safety and Effectiveness as defined by the Valve Academic Research Consortium-3 (VARC-3) | 30 day | It is the composite of following * All-cause mortality * All stroke (disabling and non-disabling) * Life-threatening or disabling bleeding * Acute kidney injury (stage 2 or 3) * Major vascular complications * Moderate or severe prosthetic valve regurgitation * Conduction system disturbances resulting in a new permanent pacemaker implantation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| All stroke | Through 30 days | — |
| Acute Kidney Injury (AKI) based on the Acute Kidney Injury Network (AKIN) System Stage 2, Stage 3 or Stage 4 | Through 30 days | Number of participants of AKI as per AKIN Network |
| Bleeding type 3 and 4 | Through 30 days | Number of participants for bleeding as per VARC-3 criteria |
| Moderate or severe prosthetic valve regurgitation | Through 30 days | — |
| New permanent pacemaker implantation | Through 30 days | New permanent pacemaker implantation rates will be analyzed further based on the patient's history of left and/or right bundle branch block |
| Conduction disturbances and arrhythmias | Through 30 days | Number of participants for Conduction disturbances and arrhythmias as per VARC-3 Criteria |
| Device Success | During hospital stay or maximum of 7 days after index procedure, whichever is earlier. | Number of participants for Device success as per VARC-3 Criteria |
| Early safety at 30 days | After 30 days of index procedure | Number of participants for Early safety as per VARC-3 Criteria |
| Clinical efficacy after 30 days | After 30 days of index procedure | Number of participants for Clinical efficacy as per VARC-2 Criteria |
| Time related valve safety | Through 30 days | Number of participants for Time related valve safety as per VARC-2 Criteria |
| Vascular and access related complications | Pre-discharge, Through 30 days | Number of participants for Vascular and access related complications as per VARC-3 Criteria |
| Major vascular complications | Pre-discharge, Through 30 days | Number of participants for Major vascular complications as per VARC-3 Criteria |
| Functional improvement from baseline as measured | Baseline, 30 days | Number of participants for Functional improvement as per NYHA functional classification |
| All-cause mortality | 30 day | Number of mortality as per VARC - 3 Criteria |
| Patient-prosthesis Mismatch | Through 30 days | Severity patient-prosthesis-mismatch will be based on following For subjects with BMI \< 30 kg/m2, index effective orifice area (EOAi) 0.85 - 0.66 cm2/m2 for moderate and ≤0.65 cm2/m2 for severe For subjects with BMI ≥30 kg/m2, index effective orifice area (EOAi) 0.70 - 0.56 cm2 /m2 for moderate and ≤0.55 cm2/m2 for severe BMI = weight(kg)/(height (m)) 2 |
| Length of index hospital stay | At discharge | Number of days from hospital admission to discharge |
| Re-hospitalization | Through 30 days | Number of participants as per VARC-3 defined criteria |
| New onset of atrial fibrillation or atrial flutter | Post-procedure, Pre-discharge and 30 days | VARC-3 criteria |
| Endocarditis | Through 30 days | Number of participants for Endocarditis as per VARC-3 criteria |
| Major bleeding event | Through 30 days | Number of participants for Major bleeding event as per VARC-3 criteria |
| Myocardial rupture | During procedure | Number of participants for Myocardial rupture |
| Paravalvular Leak | Through 30 days | Number of participants for Paravalvular Leak |
| Degree of over - or Under-expansion of Myval | During Procedure | Number of participants for Degree of over - or Under-expansion of Myval |
| Accuracy of deployment in relation to the annular plane | During procedure | Number of participants for Accuracy of deployment in relation to the annular plane |
| Pacemaker deployment (and the symptoms resulting in it) | Through 30 days | Number of participants for Pacemaker deployment (and the symptoms resulting in it) |
| Interference with the mitral valve | During procedure | Number of participants for Interference with the mitral valve |
| Interference with the LVOT | During procedure | Number of participants for Interference with the LVOT |
| Echocardiographic End Points | Through 30 days] | * Effective orifice area (EOA) * Index effective orifice area (iEOA) * Mean aortic valve gradient * Peak aortic valve gradient * Peak aortic velocity * Transvalvular, paravalvular and total aortic regurgitation * Left ventricular ejection fraction (LVEF) * Valve calcification * Cardiac output and cardiac index |
Countries
Estonia, Italy, Netherlands, Poland, Slovenia, Spain, Turkey (Türkiye)