Brief Title
Balloon Expandable Transcatheter Aortic Valve Implantation Without Predilation of the Aortic Valve
Official Title
Balloon Expandable Transcatheter Aortic Valve Implantation Without Predilation of the Aortic Valve (EASE-IT) A Two-armed Registry
Brief Summary
There is limited experience for the balloon expandable THV (transcatheter heart valve) on the need for predilation (ballon aortic valvuloplasty, BAV). Therefore we aim to verify results of a small case series published by Wendler et. al. to examine hard endpoints such as the incidence of cerebrovascular complications, paravalvular leakage and operative outcomes in a multicenter registry. We aim to compare the implantation of balloon expandable transcatheter heart valves with or without predilation with respect to procedural outcomes (VARC2).
Detailed Description
Prior to the deployment of transcatheter heart valves (THV), balloon aortic valvuloplasty (BAV) is usually performed under rapid right ventricular pacing (burst >180 bpm) with the induction of a functional cardiac arrest for up to 30 seconds. Aortic valve predilation is aiming at facilitating the crossing of the aortic annulus, accurate valve positioning and does also provide information on the anatomy of the valve complex. However, BAV has been shown to have a number of potentially detrimental effects, such as: - Functional cardiac arrest induced by rapid pacing leads to transient coronary, cerebral, and renal ischemia. - In patients with a reduced left ventricular ejection fraction (LVEF), prolonged cardiac depression after rapid pacing is observed and may result in hemodynamic failure and systemic inflammatory response syndrome (SIRS). Both are associated with a high periprocedural mortality. - BAV has been identified as a major source of thrombotic and valvular material and increases the risk for coronary obstruction with subsequent myocardial infarction and stroke. - The local trauma in the left-ventricular outflow tract caused by BAV may potentially contribute to aortic root rupture.
Study Type
Observational [Patient Registry]
Primary Outcome
VARC2 criteria
Condition
Aortic Valve Stenosis
Intervention
BAV
Study Arms / Comparison Groups
with BAV
Description: Patients undergoing TA-TAVI WITH predilation of the AV (Group A)
Publications
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
Recruitment Information
Recruitment Status
Procedure
Estimated Enrollment
200
Start Date
April 2014
Completion Date
May 2016
Primary Completion Date
March 2016
Eligibility Criteria
Inclusion Criteria: - Patients with an indication for TAVI as to the Edwards THV IFU - Eligible for TABI with AND without BAV - Signed informed consent Exclusion Criteria: - Logistic EuroSCORE I >50% - Mitral or tricuspid valvular insufficiency (> grade II) - Previous aortic valve replacement - Uncontrolled atrial fibrillation - Left ventricular or atrial thrombus by echocardiography - Recent cerebrovascular event (within the last 3 months) - High probability of non-adherence to the follow-up requirements (due to social, psychological or medical reasons)
Gender
All
Ages
18 Years - N/A
Accepts Healthy Volunteers
No
Contacts
Holger Schröfel, MD, ,
Location Countries
Germany
Location Countries
Germany
Administrative Informations
NCT ID
NCT02127580
Organization ID
EASE-IT
Responsible Party
Sponsor
Study Sponsor
Institut für Pharmakologie und Präventive Medizin
Study Sponsor
Holger Schröfel, MD, Principal Investigator, Clinic for Cardiac Surgery Karlsruhe
Verification Date
April 2018