RecruitingNot ApplicableNCT06455787

J-Valve Transfemoral Pivotal Study

J-Valve to Treat Aortic Regurgitation Via Transcatheter Therapy


Sponsor

JC Medical, Inc., an affiliate of Edwards Lifesciences LLC

Enrollment

194 participants

Start Date

Oct 17, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

The primary objective of this study is to assess the safety and efficacy of the J-Valve Transfemoral (TF) System in patients with symptomatic, severe (grade 3 or 4), native aortic valve regurgitation (AR) and AR-dominant mixed aortic valve disease, who are judged by a multi-disciplinary heart team to be at high risk for open surgical aortic valve replacement (SAVR). A Cardiac Magnetic Resonance (CMR) sub-study will examine if intervention for AR translates to improved ventricular remodeling, the impact of LV remodeling on clinical outcomes and quality of life, as well as volumetric and myocardial differences between genders.


Eligibility

Min Age: 18 Years

Inclusion Criteria8

  • Symptomatic according to New York Heart Association (NYHA) functional class (FC) II or higher
  • Severe AR, defined as follows, as assessed by Imaging Core Laboratory:
  • A. Severe AR by Transthoracic Echocardiography (TTE) (grade 3 or 4)
  • B. OR, if indeterminate AR, by TTE, ANY ONE of the following:
  • i. Cardiac magnetic resonance imaging (CMR)-derived aortic regurgitant fraction (RF) ≥43% ii. CMR-derived RF ≥33% + left ventricular dilation (left ventricular end diastolic volume index \[LVEDVi\]) \>105 mL/m\^2 for men or LVEDVi \>96 mL/m\^2 for women) iii. CMR-derived RF ≥33% + LV ejection fraction (LVEF) ≤55% or left ventricular end systolic volume index (LVESVi) ≥43mL/m\^2; iv. Severe AR by Transesophageal Echocardiography (TEE) (grade 3 or 4)
  • High risk for surgery as judged by a multi-disciplinary heart team
  • Suitable anatomy to accommodate the insertion, delivery, and deployment of the study devices (see anatomic exclusions below)
  • Written informed consent and agreement to comply with all required post-procedure follow-up visits at investigational site.

Exclusion Criteria41

  • Previous prosthetic aortic valve (bioprosthesis or mechanical) implant
  • Aortic valve stenosis \> moderate\*
  • Severe mitral valve or tricuspid valve regurgitation\*
  • Severe mitral valve or tricuspid valve stenosis\*
  • Active infection, including infective endocarditis
  • Cardiac imaging evidence of cardiac mass, thrombus or vegetation
  • Inability to tolerate or a condition precluding treatment with antithrombotic (antiplatelet, anticoagulant) therapy
  • Renal insufficiency (eGFR \<30 mL/min/1.73m\^2) or end stage renal disease requiring chronic dialysis
  • Liver disease (cirrhosis of the liver \[Child-Pugh Class B or C\])
  • Blood dyscrasias as defined: leukopenia (WBC \<3000 cells/mcL), thrombocytopenia (platelet count \<50,000 cells/mcL), anemia (hemoglobin \<9 g/dL), history of bleeding diathesis coagulopathy, or hypercoagulable state (unless therapeutically stable)
  • Known hypersensitivity or contraindication to aspirin, heparin, bivalirudin, clopidogrel, Nitinol (Nickel, Titanium) or sensitivity to contrast media, which cannot be adequately premedicated
  • Left ventricular dysfunction with left ventricular ejection fraction (LVEF) \<25% as measured by resting echocardiogram (or by CMR, when performed)\*
  • Clinically significant untreated coronary artery disease requiring revascularization or anticipated coronary revascularization procedure within 12-months post index procedure
  • Acute myocardial infarction within 30 days prior to index procedure
  • PCI within 30 days prior to index procedure
  • Carotid intervention within 6 weeks prior to index procedure or carotid artery disease requiring intervention
  • Previous, or planned, other surgical or interventional procedures within 30 days before, during, or within 30 days after the index procedure
  • Uncontrolled atrial fibrillation
  • Severe right ventricular (RV) dysfunction\*
  • Pulmonary hypertension (systolic PA pressure \>70mmHg or systolic PA pressure ≥2/3 of systemic systolic BP)
  • Severe chronic obstructive pulmonary disease (COPD) requiring chronic oral steroids or requiring continuous home O2
  • Stroke (CVA), transient ischemic attack (TIA) or neurological signs and symptoms attributed to carotid or vertebrobasilar disease within 90 days prior to index procedure
  • Cardiogenic shock defined as systolic blood pressure \<90 mmHg in addition to signs of tissue hypoperfusion or the need for vasopressors and/or mechanical hemodynamic support to maintain systolic blood pressure ≥90mmHg
  • Patient requires mechanical circulatory support within 30 days prior to index procedure
  • Estimated life expectancy of less than 24 months due to associated non-cardiac co-morbid conditions
  • Pregnancy or intent to become pregnant prior to completion of all protocol follow-up requirements
  • Participation in another investigational study that has not reached its primary endpoint
  • Considered to be part of a vulnerable population
  • As assessed by Imaging Core Laboratory
  • Anatomic Exclusions:
  • Ascending Aortic diameter \>5 cm\*
  • Aortic Annulus Perimeter \<57 mm or \>104 mm\*
  • Inappropriate anatomy for femoral introduction and delivery of the study system
  • Left ventricular end-diastolic diameter (LVEDD) \>75 mm\*
  • Congenital aortic valve disease including Unicuspid, Bicuspid, or Quadricuspid aortic valve anatomy\*
  • Congenital univentricle or other condition that, in the opinion of the investigator and/or consulting physician, may constitute an unwarranted surgical risk
  • Excessive aortic valve prolapse that would preclude proper seating of the implant in the aortic annulus
  • Abdominal/thoracic aortic aneurysm ≥5.0 cm\*
  • Aorto-iliac disease requiring intervention to facilitate delivery of access sheath
  • Excessive tortuosity of delivery system pathway, defined as severe tortuosity of multiple vessels including iliofemoral, thoracoabdominal aorta, aortic arch, or LV-aortic root angle \>80⁰
  • As assessed by Imaging Core Laboratory

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Interventions

DEVICEJ-Valve Transfemoral (TF) System

Treatment includes using the J-Valve Transfemoral (TF) System, a transcatheter aortic valve replacement system that consists of the J-Valve TF Bioprosthesis and the J-Valve TF Delivery Device and Loading Accessories, during transcatheter aortic valve replacement (TAVR). The Edwards 16Fr eSheath+ Introducer Set may be used for the introduction and removal of the J-Valve TF System.


Locations(37)

HonorHealth Research & Innovation Institute

Scottsdale, Arizona, United States

Cedars Sinai

Los Angeles, California, United States

Stanford University Medical Center

Palo Alto, California, United States

Bay Area Structural Heart at Sutter Health

San Francisco, California, United States

University of California San Francisco

San Francisco, California, United States

UC Health Northern Colorado (Medical Center of the Rockies)

Loveland, Colorado, United States

Washington Hospital Center DC

Washington D.C., District of Columbia, United States

NCH Rooney Heart Institute

Naples, Florida, United States

Emory University Atlanta

Atlanta, Georgia, United States

Piedmont

Atlanta, Georgia, United States

Northwestern University Chicago

Chicago, Illinois, United States

Glenbrook - Endeavor Health

Glenview, Illinois, United States

Ascension Via Christi

Wichita, Kansas, United States

Cardiovascular Institute of the South

Houma, Louisiana, United States

Massachusetts General Hospital Boston

Boston, Massachusetts, United States

Brigham and Women's Hospital

Boston, Massachusetts, United States

Henry Ford Hospital Detroit

Detroit, Michigan, United States

Minneapolis Heart Institute Foundation

Minneapolis, Minnesota, United States

CentraCare Heart and Vascular Center

Saint Cloud, Minnesota, United States

Washington University - Barnes-Jewish Hospital St. Louis

St Louis, Missouri, United States

University at Buffalo - Kaleida Health

Buffalo, New York, United States

Columbia University Irving Medical Center/New York-Presbyterian Hospital

New York, New York, United States

St. Francis Hospital

Roslyn, New York, United States

Montefiore Medical Center

The Bronx, New York, United States

Carolinas Health System (Atrium)

Charlotte, North Carolina, United States

The Christ Hospital and The Carl & Edyth Lindner Center for Research and Education

Cincinnati, Ohio, United States

Oregon Health & Science University

Portland, Oregon, United States

Ascension St. Thomas West Hospital

Nashville, Tennessee, United States

Vanderbilt University Medical Center

Nashville, Tennessee, United States

HCA Houston Healthcare Medical Center

Houston, Texas, United States

Houston Methodist Hospital

Houston, Texas, United States

The Heart Hospital - Baylor Plano

Plano, Texas, United States

Swedish Heart & Vascular Research

Seattle, Washington, United States

St. Paul's Hospital Vancouver

Vancouver, British Columbia, Canada

Juntendo University Hospital

Tokyo, Bunkyo-ku, Japan

Keio University Hospital

Tokyo, Shinjuku-Ku, Japan

Oxford - John Radcliff Hospital

Oxford, United Kingdom

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NCT06455787


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