SMall Annuli Randomized To Evolut™ Or SAPIEN™ Trial

Overview

About this study

The purpose of this trial is to generate clinical evidence on valve safety and performance of self-expanding (SE) versus balloon-expandable (BE) transcatheter aortic valve replacement (TAVR) in subjects with a small aortic annulus and symptomatic severe native aortic stenosis.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

  • Symptomatic subjects with predicted risk of operative mortality < 15% at 30‐days per multidisciplinary local heart team assessment.
  • Severe aortic stenosis, defined as: 
    • Aortic valve area ≤ 1.0 cm^2  (or aortic valve area index of ≤0.6  cm2 /m2 ); OR 
    • Mean gradient ≥ 40 mmHg; OR 
    • Maximal aortic valve velocity ≥ 4.0 m/sec by transthoracic echocardiography at rest.
  • Aortic valve annulus area ≤ 430 mm^2  based on MDCT.
  • Subject's anatomy is appropriate for both Medtronic Evolut PRO/PRO+ TAV and Edwards SAPIEN 3/3 Ultra TAV.
  • Subject’s anatomy is suitable for TAVR via transfemoral vessel access.
  • Commercial indication for transcatheter aortic valve replacement (TAVR), in conformity with both local regulations and Instructions for Use (IFU).
  • Subject and the treating physician agree that the subject will return for all required post‐procedure follow‐up visits  

Exclusion Criteria:

  • Estimated life expectancy of less than 2 years.
  • Multivessel coronary artery disease with a Syntax score > 32 and/or unprotected left main coronary  artery. 
  • Participating in another trial that may influence the outcome of this trial.
  • Need for an emergent procedure for any reason.
  • Contraindicated for treatment with the Evolut PRO/PRO+ and Edwards SAPIEN 3/3 Ultra TAV in  accordance with the Instructions for Use.
  • Other medical, social, or psychological conditions that in the opinion of the Investigator precludes the subject from appropriate consent or adherence to the protocol required follow‐up exams.
  • Pregnant, nursing or planning to be pregnant.  
  • Subject is less than legal age of consent, legally incompetent, unable to provide his/her own informed consent, or otherwise vulnerable.* 
    • * Notes:   Vulnerable subjects include individuals whose willingness to volunteer in a clinical investigation could be unduly influenced by the expectation, whether justified or not, of  benefits associated with participation or of retaliatory response from senior members of a hierarchy in case of refusal to participate.  
    • EXAMPLE Individuals with lack of or loss of autonomy due to immaturity or through mental disability, persons in nursing homes,  children, impoverished persons, subjects in emergency situations, ethnic minority groups, homeless persons, nomads, refugees, and those incapable of giving informed consent. Other  vulnerable subjects include, for example, members of a group with a hierarchical structure such as university students, subordinate hospital and laboratory personnel, employees of  the sponsor, members of the armed forces, and persons kept in detention. 
    • If treated in France, any subject who is a “personne vulnerable” per French legislation, including protected adults and prisoners.
  • Subject has an active COVID‐19 infection or relevant history of COVID‐19. 
    • Note: An active COVID‐19 infection is defined as a positive Polymerase Chain Reaction (PCR) result. Relevant history of COVID‐19 is defined as availability of a positive COVID‐19 test with sequela or hospitalization for treatment of COVID‐19 that was less than 3 months prior to enrollment. Subjects with a positive COVID‐19 test  who were asymptomatic or had mild symptoms should be excluded only if the positive test was less  than 3 months prior to enrollment.
  • Previous aortic valve replacement.

Eligibility last updated 11/9/21. Questions regarding updates should be directed to the study team contact.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Mayra Guerrero, M.D.

Closed for enrollment

Contact information:

Structural Heart Disease Research Coordinators

(507) 255-6133

More information

Publications

Publications are currently not available
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CLS-20525494

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