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ALLIANCE AVIV: Safety and Effectiveness of the SAPIEN X4 Transcatheter Heart Valve in Failing Aortic Bioprosthetic Valves

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Edwards Lifesciences

Status

Enrolling

Conditions

Aortic Valve Stenosis
Aortic Valve Insufficiency

Treatments

Device: SAPIEN X4 THV

Study type

Interventional

Funder types

Industry

Identifiers

NCT05172973
2021-05-AVIV

Details and patient eligibility

About

The objective of this study is to establish the safety and effectiveness of the Edwards SAPIEN X4 Transcatheter Heart Valve (THV) in subjects who are at high or greater risk with a failing aortic bioprosthetic valve.

Full description

Prospective, single arm, multicenter study

Enrollment

200 estimated patients

Sex

All

Volunteers

No Healthy Volunteers

Inclusion criteria

  1. Failing aortic bioprosthetic valve demonstrating ≥ moderate stenosis and/or ≥ moderate insufficiency
  2. Bioprosthetic valve size suitable for SAPIEN X4 THV
  3. NYHA functional class ≥ II
  4. Heart Team agrees the subject is at high or greater surgical risk
  5. The subject has been informed of the nature of the study, agrees to its provisions and has provided written informed consent.

Exclusion criteria

  1. Anatomical characteristics that would preclude safe femoral placement of the introducer sheath or safe passage of the delivery system
  2. Failing valve has moderate or severe paravalvular regurgitation
  3. Failing valve is unstable, rocking, or not structurally intact
  4. Known severe patient-prosthesis mismatch or bioprosthetic valve with residual mean gradient > 20 mmHg at the end of the index procedure for implantation of the original valve
  5. Increased risk of THV embolization
  6. Surgical or transcatheter valve in the mitral position
  7. Severe mitral regurgitation (> 3+) or ≥ moderate mitral stenosis
  8. Need for mitral, tricuspid or pulmonic valve intervention within the next 12 months
  9. Left ventricular ejection fraction < 20%
  10. Cardiac imaging evidence of intracardiac mass, thrombus or vegetation
  11. Increased risk of coronary artery obstruction after THV implantation
  12. Myocardial infarction within 30 days prior to the study procedure
  13. Hypertrophic cardiomyopathy with subvalvular obstruction
  14. Subjects with planned concomitant ablation for atrial fibrillation
  15. Clinically significant coronary artery disease requiring revascularization
  16. Any surgical or transcatheter procedure within 30 days prior to the study procedure. Implantation of a permanent pacemaker or implantable cardioverter defibrillator is not considered an exclusion.
  17. Any planned surgical or transcatheter intervention to be performed within 30 days following the study procedure
  18. Endocarditis within 180 days prior to the study procedure
  19. Stroke, transient ischemic attack or neurological signs and symptoms attributed to carotid or vertebrobasilar disease within 90 days prior to the study procedure
  20. Hemodynamic or respiratory instability requiring inotropic or mechanical support within 30 days prior to the study procedure
  21. Renal insufficiency and/or renal replacement therapy
  22. Leukopenia, anemia, thrombocytopenia
  23. Inability to tolerate or condition precluding treatment with antithrombotic therapy
  24. Hypercoagulable state or other condition that increases risk of thrombosis
  25. Absolute contraindications or allergy to iodinated contrast that cannot be adequately treated with premedication
  26. Subject refuses blood products
  27. Body mass index > 50 kg/m2
  28. Estimated life expectancy < 24 months
  29. Female who is pregnant or lactating
  30. Active SARS-CoV-2 infection or previously diagnosed with COVID-19 with sequelae that could confound endpoint assessments
  31. Participating in another investigational drug or device study that has not reached its primary endpoint
  32. Subject considered to be part of a vulnerable population

Trial design

Primary purpose

Treatment

Allocation

Non-Randomized

Interventional model

Single Group Assignment

Masking

None (Open label)

200 participants in 2 patient groups

Transcatheter Aortic Valve Replacement (TAVR) - Surgical Valve
Experimental group
Description:
TAVR implant in subjects with a failing aortic surgical valve.
Treatment:
Device: SAPIEN X4 THV
Transcatheter Aortic Valve Replacement (TAVR) - THV
Experimental group
Description:
TAVR implant in subjects with a failing aortic transcatheter heart valve (THV).
Treatment:
Device: SAPIEN X4 THV

Trial contacts and locations

34

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Central trial contact

Edwards THV Clinical Affairs

Data sourced from clinicaltrials.gov

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