Tricuspid Regurgitation
Conditions
Brief summary
This study is prospective, non-randomized, single-arm,first in human study to evaluate the safety and feasibility of the Versa Vascular System for intervention in adults with severe tricuspid regurgitation who are not surgical candidates.
Interventions
DEVICEVersa Implant
The Versa Vascular Implant and Delivery System consists of a percutaneously delivered, permanent right-atrial implant and the delivery catheter that is used to first position the implant over the native valve orifice and to then place the implant.
Sponsors
Versa Vascular, Inc
Cardiovascular Research Foundation, New York
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DEVICE_FEASIBILITY
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Tricuspid regurgitation (TR) associated symptoms despite optimal medical treatment. * TR ≥ 3 as determined by the assessment of a transthoracic echocardiogram or transesophageal echocardiogram. * The local multi-disciplinary heart team agrees that the participant is a poor candidate for surgery. * Age ≥ 18 years at the time of consent. * Ability and willingness to provide written informed consent prior to any study related procedure(s).
Exclusion criteria
* Severe pulmonary hypertension. * Severe uncontrolled hypertension Systolic Blood Pressure (SBP) ≥ 180 mmHg and/or Diastolic Blood Pressure (DBP) ≥ 110 mmHg. * Any condition that would interfere with the Versa procedure, such as prior tricuspid valve repair or tricuspid valve leaflet anatomy which may preclude successful device implantation, pacemaker or Implantable Cardioverter Defibrillator (ICD) leads that would prevent appropriate placement or visualization of Versa implant, Ebstein Anomaly (normal annulus position, but valve leaflets attached to walls and septum of the right ventricle), tricuspid valve anatomy non-evaluable by echocardiography. * Known allergy to antiplatelet therapy, heparin, or to device materials. * Femoral venous mass or thrombus or vegetation. * Tricuspid valve anatomy not compatible with the Versa implant * Undergone any heart valve surgery within prior 60 days. * Tricuspid valve stenosis - Defined as a tricuspid valve orifice of ≤ 4.0 cm2. * Severe mitral regurgitation. * Left Ventricular Ejection Fraction (LVEF) ≤ 20% * Active endocarditis, other ongoing infection requiring antibiotic therapy. * Myocardial infarction or percutaneous coronary intervention within prior 30 days. * Cardiogenic shock or the need for inotropic support or hemodynamic support device (e.g., intra-aortic balloon pump). * Cerebrovascular Accident (CVA) within prior 30 days * Active gastrointestinal (GI) bleeding * Life expectancy of less than 12 months independent of tricuspid valvular disease. * Subject currently participating in another clinical study (not yet completed primary endpoint). * Pregnant or nursing subjects or those who plan pregnancy during the study. * The presence of anatomic or comorbid conditions, or other medical, social, or psychological conditions that, in the eye of the investigator, limits the subject's ability to participate in the clinical investigation or comply with follow-up requirements. * Absence of appropriate venous access. * Unwillingness to complete the required follow-up visits.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Acute Procedural Success | Immediately after the procedure | Successful in Versa Vascular Device implantation, and residual TR grade equivalent to a reduction of at least 1 grade of TR when compared to TR evaluated prior to implantation of the Versa Vascular Device. |
| Incidence of major adverse events (MAE) | (up to 7 days) from date of procedure to date of patient discharge from hospital | Freedom from procedure and/or device related Major Adverse Events (MAE). MAE are defined as all-cause mortality, reoperation, or reintervention for tricuspid regurgitation prior to hospital discharge. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Tricuspid Regurgitation Severity Change | 90 days | Percentage of patients with tricuspid regurgitation reduced by at least one grade. Echocardiographic analysis of Tricuspid regurgitation at 90 days. TR grade at day 90 will be compared against TR grade at the time of implantation. |
Countries
Brazil, Chile, New Zealand
Contacts
PRINCIPAL_INVESTIGATORMark Webster, MD
Auckland City Hospital
Outcome results
None listed