RecruitingNot ApplicableNCT05459233

Valve Hemodynamic Optimization Based on Doppler-Echocardiography vs Catheterization Measurements Following ViV TAVR

Valve Hemodynamic Optimization Based on Doppler-Echocardiography Versus Catheterization Measurements Following Valve-in-Valve TAVR: A Prospective Randomized Trial


Sponsor

Institut universitaire de cardiologie et de pneumologie de Québec, University Laval

Enrollment

310 participants

Start Date

Jan 11, 2023

Study Type

INTERVENTIONAL

Conditions

Summary

Data on valve performance following ViV-TAVR has usually been obtained with the use of Doppler-echocardiography. However, some reports have shown significant discordances in the evaluation of mean transvalvular gradient between echocardiography and catheterization, with an overestimation of the real gradient with echo (vs. cath) in most cases. Thus, the incidence of procedural-device failure may be lower than that reported in the ViV-TAVR literature,


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study is comparing two methods of fine-tuning a replacement heart valve after a "valve-in-valve" procedure — where a new valve is placed inside a worn-out surgical valve — to see which gives better results. One method uses ultrasound (echocardiography) and the other uses a catheter to measure pressures directly in the heart. **You may be eligible if...** - You have a failing surgical aortic valve and have been approved by your heart team for a valve-in-valve procedure - You have a stented surgical valve size 25mm or smaller - You are receiving the SAPIEN 3 Ultra replacement valve **You may NOT be eligible if...** - You have a different type of valve failure (not aortic stenosis or regurgitation) - You are getting a different type of replacement valve - You have contraindications to the catheter measurement procedure Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

PROCEDUREDoppler-echocardiography

The TAVR (valve-in-valve) procedure will be performed with the SAPIEN 3 Ultra valve, with valve sizing according to current manufacturer recommendations. Following valve implantation, further intervention will be based on Doppler-echocardiographic measurements. Balloon post-dilation with a non-compliant balloon will be performed in the presence of a residual mean gradient ≥20 mmHg as assessed by Doppler-echocardiography.

PROCEDUREInvasive hemodynamic measurements

The TAVR (valve-in-valve) procedure will be performed with the SAPIEN 3 Ultra valve, with valve sizing according to current manufacturer recommendations. Following valve implantation, further interventions will be based on invasive hemodynamic measurements (with simultaneous aortic and ventricular pressure recording). Balloon post-dilation will be performed with a non-compliant balloon in the presence of a mean residual gradient ≥20 mmHg as assessed by hemodynamic measurements.


Locations(7)

University of California

San Francisco, California, United States

South Broward Hospital Disctrict D/B/A Memorial Healthcare System

Hollywood, Florida, United States

William Beaumont Hospital

Royal Oak, Michigan, United States

Mayo Clinic

Rochester, Minnesota, United States

St-Joseph's Health INC

Syracuse, New York, United States

The Christ Hospital Health Network

Cincinnati, Ohio, United States

IUCPQ

Québec, Quebec, Canada

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NCT05459233


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