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NCT05459233NARecruiting

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

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

Start Date

1/11/2023

Completion Date

9/1/2029

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,

Detailed Description

This is a prospective, multicenter, randomized, single-blinded design trial including patients with surgical aortic bioprosthetic dysfunction in the presence of a stented surgical bioprosthesis with a labeled size ≤25 mm. Following the Heart Team's decision to proceed with a ViV-TAVR procedure with the SAPIEN 3 ULTRA valve (or its subsequent iterations), patients will be randomized to valve hemodynamic optimization according to Doppler-echocardiography versus cardiac catheterization parameters.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: * Patients with surgical aortic bioprosthetic valve failure defined as severe aortic stenosis and/or regurgitation approved for a valve-in-valve procedure by the Heart Team * Surgical stented bioprosthetic valve (label size ≤25 mm) * TAVR with the SAPIEN 3 Ultra valve Exclusion Criteria: * Stentless or sutureless surgical valves * Trifecta bioprosthesis * Hancock II bioprosthesis * High-risk of coronary obstruction (defined either as a virtual transcatheter valve - coronary distance as evaluated by CT \<4 mm or based on the criterion of the heart team responsible for the procedure). * Impossibility to obtain written informed consent

Interventions

PROCEDURE

Doppler-echocardiography

PROCEDURE

Invasive hemodynamic measurements

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Conditions

Aortic Valve StenosisAortic Valve RegurgitationProsthesis Failure

Locations

University of California

San Francisco, California 94143

United States

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

Hollywood, Florida 33021

United States

William Beaumont Hospital

Royal Oak, Michigan 48073

United States

Mayo Clinic

Rochester, Minnesota 55905

United States

St-Joseph's Health INC

Syracuse, New York 13203

United States

The Christ Hospital Health Network

Cincinnati, Ohio 45219

United States

IUCPQ

Québec, Quebec G1V 4G5

Canada