Degenerative Mitral Valve Disease
Conditions
Keywords
transcatheter edge-to-edge repair
Brief summary
To validate the safety and efficacy of transcatheter edge-to-edge repair (TEER) using the NovoClasp® transcatheter mitral valve clip and steerable guide catheter in the treatment of moderate to severe and severe degenerative mitral regurgitation (DMR).
Detailed description
This trial is a prospective multi-center single-arm confirmatory study. A total of 102 subjects will be enrolled in multiple centers nationwide. Subjects who meet the trial requirements, fulfill the inclusion criteria, voluntarily participate in the study, and provide informed consent will undergo mitral edge-to-edge repair using the NovoClasp® transcatheter mitral valve clip system and steerable guide catheter for the treatment of moderate to severe or severe degenerative mitral regurgitation (DMR). Follow-up assessments will be conducted at discharge, as well as at 30 days, 90 days, 180 days, and 360 days postoperatively. The primary endpoint will be the treatment effectiveness rate at 360 days post-surgery. Secondary endpoint measures include treatment effectiveness at other time points, surgical success rate, all-cause mortality, device/procedure-related mortality, incidence of adverse events, and serious adverse event rates. The trial aims to comprehensively assess the safety and efficacy of the NovoClasp® transcatheter mitral valve clip and steerable guide catheter produced by Enlight Medical Technologies (Shanghai) Co., Ltd..
Interventions
DEVICENovoClasp® transcatheter mitral valve clip and steerable guide catheter
The experimental device is a class III implanted valve device, which will be used to treat the mitral valve regurgitation via transcatheter edge-to-edge repair.
Sponsors
Enlight Medical Technologies (Shanghai) Co., Ltd
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Subjects must meet all of the following criteria to be eligible for this study. 1. Age 18 years. 2. Willingness to comply with the protocol requirements and data collection procedures, ability to understand the purpose of the trial, voluntary participation, and signing of informed consent by the subject or legal guardian. 3. Confirmation by echocardiography of moderate to severe (3+) or severe (4+) degenerative mitral regurgitation. 4. Echocardiography showing left ventricular ejection fraction 30%, left ventricular end-systolic diameter (LVESD) 60mm, and pulmonary artery systolic pressure (PASP) 70 mmHg. 5. NYHA functional classification II-IV. 6. Presence of a primary regurgitant jet; if a secondary regurgitant jet is present, it should be clinically insignificant based on investigator assessment. 7. Evaluated by a multidisciplinary team as suitable for the investigational procedure using the study device. 8. Society of Thoracic Surgeons (STS) score 4 or evaluated as high surgical risk for mitral valve repair by two cardiac surgeons.
Exclusion criteria
Subjects meeting any of the following criteria are not eligible for this study. 1. History of prior mitral valve surgery or heart transplant. 2. Severe organ dysfunction that may affect study evaluation, including but not limited to: 1. Right heart failure or biventricular heart failure. 2. Severe restrictive or obstructive lung disease (COPD) requiring continuous oxygen therapy or oral steroid treatment. 3. Severe renal insufficiency requiring or likely to require continuous renal replacement therapy (CRRT) or dialysis postoperatively. 4. Severe carotid artery stenosis confirmed by imaging to be \>70%. 3. History of cerebrovascular accident within the past 1 month. 4. Acute deep vein thrombosis or acute pulmonary embolism history. 5. Any known active infection. 6. Active infective endocarditis (eligible 6 weeks after standard antimicrobial treatment), rheumatic heart valve disease, or radiation-induced valve disease. 7. Cardiac or major vascular surgical or interventional procedure within 30 days (coronary angiography is allowed). 8. Coexisting moderate or greater valvular disease (aortic valve, tricuspid valve, pulmonary valve stenosis or regurgitation). 9. Known other cardiac or major vascular diseases requiring surgical or interventional intervention, including but not limited to coronary artery disease, myocardial disease, aortic disease (except for coronary angiography). 10. Echocardiographic evidence of intracardiac mass, thrombus, vegetation, or mitral valve orifice area (MVOA) 4.0 cm2, or any condition unsuitable for the study device, including but not limited to: 1. Unsuitable for leaflet capture due to severe calcification or cleft. 2. Lack of primary and secondary chordal support in the capture area. 3. Leaflet free edge length \< 0.8 cm. 11. Known conditions that preclude study procedure (including but not limited to allergies to device components, coagulation disorders, life expectancy \< 1 year). 12. Pregnant or breastfeeding women or those planning pregnancy during the trial period. 13. Intending or currently participating in another interventional clinical trial. 14. Other conditions deemed inappropriate for participation in this study by the investigator.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Treatment effectiveness rate | 1 year | Treatment effectiveness is defined as the success of the procedure with the mitral valve regurgitation sustained at moderate or lower (\<=2+) after the surgery, without major adverse events or secondary interventions (interventional or surgical). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Procedural success rate | immediately after procedure | Successful implantation of a single device as intended by the operator, successful retrieval of the delivery system, absence of device migration, dislodgment, embolization, related complications, or other unforeseen incidents. |
| Rate of Treatment success | 30 days, 180 days | Treatment effectiveness is defined as the success of the procedure with the mitral valve regurgitation sustained at moderate or lower (\<=2+) after the surgery, without major adverse events or secondary interventions (interventional or surgical). |
| Changes in New York Heart Association (NYHA) Functional Classification | through study completiong, an average of 1 year. | The NYHA Classification provides nomenclature to describe an overall cardiac appraisal of the status of a patient with heart disease. Class I: Patients with cardiac disease but without resulting limitation of physical activity. Class II: patients with cardiac disease resulting in slight limitation of physical activity. Class III: Patients with cardiac disease resulting in marked limitation of physical activity. Class IV: Patient with cardiac disease resulting in inability to carry on any physical activity without discomfor. |
Other
| Measure | Time frame |
|---|---|
| All cause mortality | through study completion, an average of 1 year |
| Number of participants with device-related adverse events | through study completion, an average of 1 year |
| Device/Procedure-related mortality | through study completion, an average of 1 year |
| Major adverse events | through study completion, an average of 1 year |
| Serious adverse events | through study completion, an average of 1 year |
Countries
China
Outcome results
None listed