Safety and Efficacy Comparison Of Two TAVI Systems in a Prospective Randomized Evaluation II (SCOPE II)

Ceric Sàrl

Status

Completed

Conditions

Aortic Valve Stenosis

Treatments

Device: Medtronic CoreValve Evolut R TAVI System

Device: Symetis ACURATE neo™ transfemoral TAVI system

Study type

Observational

Funder types

Industry

Identifiers

NCT03192813

SCOPE II

Details and patient eligibility

About

Current care randomized clinical trial comparing the CE marked Symetis ACURATE neo™ Aortic Bioprosthesis and ACURATE TF™ Transfemoral Delivery System with the CE marked Medtronic CoreValve Evolut R TAVI system (or any future CE-marked CoreValve versions).

Full description

Transcatheter aortic valve implantation (TAVI) is an established and valuable treatment option for patients with severe symptomatic aortic stenosis and at high surgical risk for aortic valve replacement. The use of TAVI is rapidly expanding worldwide and its indications are widening into intermediate and lower risk populations. However, device comparisons by use of randomized trials are scarce in particular for newer generation transcatheter valves.

The Symetis ACURATE neo™, a self-expanding transcatheter valve delivered via transfemoral access, is a second-generation device that gained CE mark approval in June 2014.

The SCOPE-II trial will compare the safety and performance of the Symetis ACURATE neo™ with the self-expanding Medtronic Evolut R system, a widely used and well-established transcatheter heart valve, which obtained CE mark in 8NOV2006 and HAS approval on 13JAN2015.

Enrollment

796 patients

Sex

All

Ages

75+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patient with severe symptomatic aortic stenosis defined by a mean aortic gradient > 40 mmHg or peak jet velocity > 4.0 m/s or an aortic valve area (AVA) < 1cm2 or AVA indexed to body surface area (BSA) of <0.6 cm2/m2
Patient is symptomatic (heart failure with New York Heart Association (NYHA) Functional Class > I, angina or syncope)
Patients are considered at high risk for mortality with conventional surgical aortic valve replacement as assessed by a Heart Team consisting of a cardiologist and surgeon or as confirmed by a logistic EuroSCORE I > 20% and / or STS score > 10%.
Aortic annulus diameter ranging from 21 to 26mm and perimeter rage from 66 - 81.7mm , based on ECG-gated multi-slice computed tomographic measurements. Findings of TTE, TEE and conventional aortography should be integrated in the anatomic assessment.
Arterial aorto-iliac-femoral axis suitable for transfemoral access as assessed by conventional angiography and/or multi-detector computed tomographic angiography (access vessel diameter ≥ 6mm)
Patient understands the purpose, the potential risks as well as benefits of the trial and is willing to participate in all parts of the follow-up
Patient age 75 years or older
Patient has given written consent to participate in the trial

Exclusion criteria

Severely reduced left ventricular (LV) function (ejection fraction <20%)
Pre-existing prosthetic heart valve in aortic and/or mitral position
Participation in another trial, which would lead to deviations in the preparation or performance of the intervention or the post-implantation management from this protocol
Severe coagulation conditions
Inability to tolerate anticoagulation therapy
Contraindication to contrast media or allergy to nitinol
Active infection, including endocarditis
Congenital aortic stenosis or unicuspid or bicuspid aortic valve
Non-valvular aortic stenosis
Hypertrophic obstructive cardiomyopathy
New or untreated echocardiographic evidence of intracardiac mass, thrombus, or vegetation
Non-calcific acquired aortic stenosis
Severe eccentricity of calcification
Anatomy not appropriate for transfemoral implant due to size, disease and degree of calcification or tortuosity of the aorta or ilio-femoral arteries
Severe mitral regurgitation