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TRIcvalve biCAVal Valve System for Severe Tricuspid Regurgitation (TRICAV-I)

NCT06137807 · P+F Products + Features USA Inc.
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Official title
A Prospective, Multicenter Clinical Trial of the TricValve® Transcatheter Bicaval Valve System in Subjects With Severe Tricuspid Regurgitation - TRICAV-I Trial
About this study
This is a prospective multicenter clinical investigation designed to evaluate the safety and effectiveness of the TricValve® Transcatheter Bicaval Valve System for improving outcomes in symptomatic subjects with severe TR deemed by the local Heart Team to be at high risk for tricuspid valve surgery. Patients who meet all of the study inclusion criteria, will be treated with the TricValve System. After the intervention, patients will be followed up closely for 12 months. Long term safety and efficacy data will be collected annually up to 5 years.
Eligibility criteria
Inclusion Criteria: 1. Subject must be 18 years or older, at the time of signing the informed consent. 2. Subjects has severe tricuspid regurgitation (TR), as determined by the qualifying transthoracic echocardiogram (TTE) confirmed by an echocardiography Core Lab. 3. NYHA Class III-IVa (not on inotropes, IABP or LVAD) or heart failure (HF) admission in the past 6 months. 4. Subject is adequately treated with optimal medical therapy (OMT) for heart failure per the local Heart Team for at least 30 days prior to the index procedure, including a diuretic. 5. The local Heart Team and IEC determine that the patient is eligible for the TricValve procedure. 6. For females of childbearing potential, negative pregnancy test. 7. Capable of giving signed informed consent. Exclusion Criteria: 1. Subject had a recent MI, stroke or cardiovascular accident; underwent coronary artery bypass graft surgery, had a percutaneous coronary intervention or other major cardiovascular surgery within 90 days prior to TricValve implantation. 2. Subject requires another planned major cardiac procedure, including left-sided transcatheter intervention or surgery (e.g. severe aortic stenosis, severe mitral regurgitation), coronary artery bypass or PCI or pulmonary valve correction. Please note that if closure of an ASD, iatrogenic ASD or PFO is performed, TricValve implantation can be performed 30 days after the intervention. Additionally, TricValve implantation can be performed 30 days after any Electrophysiology procedure (pacemaker, ICD, etc.). 3. LVEF ≤ 30% on echocardiography. 4. Evidence of intracardiac, inferior vena cava (IVC), or femoral venous mass, thrombus or vegetation. 5. Tricuspid stenosis. (Per TVARC, echo criteria: TVA at least 1.5 cm2 or TVAi at least 0.9 cm2/m2 \[at least 0.75 if BMI \>30 kg/m2\], DVI \<2.2, mean gradient \<5mm Hg); reduction of total tricuspid regurgitation to optimal (≤ mild \[1+\]) or acceptable (≤ moderate \[2+\]). 6. Severe right ventricular dysfunction. 7. Cardiac amyloidosis 8. Pulmonary artery systolic pressure (PASP) \>65 mmHg assessed with Echo Doppler and /or right heart catheterization. 9. Lower extremity venous thrombosis and/or the presence of an IVC filter at the time of or 6 months prior to TricValve procedure. 10. Hemodynamically significant pericardial effusion. 11. Patient with refractory heart failure requiring advanced intervention (i.e. left ventricular assist device, transplantation) (ACC/ AHA/ ESC/ EACTS Stage D heart failure) 12. Any known allergy or hypersensitivity to nitinol, bovine tissue or contrast media that cannot be adequately treated with pre-medication. 13. Unable to tolerate anticoagulation/antiplatelet therapy 14. Hemodynamic instability, cardiogenic shock, inotropic support, intra-aortic balloon pump or acute heart failure within 30 days prior to the TricValve procedure. 15. Any known life-threatening condition with an estimated life span of at least 12 months. 16. Platelet count \< 75,000/mm3 17. Child-Pugh Severity Class C (10-15 points). 18. Severe renal insufficiency with estimated glomerular filtration rate (eGFR) ≤ 25 mL/min/1.73 m2 or requiring chronic renal replacement therapy at the time of enrollment. 19. Endocarditis or active/ongoing infection requiring antibiotics. 20. Unable to walk at least 60 meters in a 6minute walk test. 21. Known bleeding or clotting disorders or patient refuses blood transfusion. 22. Active gastrointestinal (GI) bleeding within 3 months of randomization. 23. Presence of significant congenital heart disease including but not limited to hemodynamically significant atrial septal defect, RV dysplasia, and arrhythmogenic RV. 24. Use or participation in other investigational device or drug study in which patient has not reached a primary endpoint to treat cardiovascular conditions related to the outcomes of the current study. 25. Any other condition that would preclude ability to meet study requirements in the opinion of the investigator. 26. Psychiatric/behavioral issues or other medical or social conditions that preclude valid consent and follow-up 27. Pregnant or breastfeeding subjects and those who plan pregnancy during the clinical investigation follow-up period.
Study design
Enrollment target: 50 participants
Allocation: na
Masking: none
Age groups: adult, older_adult
Timeline
Starts: 2024-07-23
Estimated completion: 2029-09
Last updated: 2025-06-08
Interventions
Device: TricValve® Transcatheter Bicaval Valve System
Primary outcomes
  • Mortality (1 Month and 12 Months)
  • Stroke (1 Month)
  • Pulmonary Embolism (1 Month)
Sponsor
P+F Products + Features USA Inc. · industry
With: P+F Products + Features GmbH, Meditrial USA Inc.
Contacts & investigators
ContactMonica Tocchi, MD, PhD · contact · m.tocchi@meditrial.net · 9176841700
InvestigatorKatharina Kiss, MD · study_chair, Products & Features GmbH
All locations (36)
St. Joseph's Hospital and Medical CenterRecruiting
Phoenix, Arizona, United States
Tucson Medical CenterNot Yet Recruiting
Tucson, Arizona, United States
Scripps Memorial Hospital La JollaRecruiting
San Diego, California, United States
UCSFNot Yet Recruiting
San Francisco, California, United States
Delray Medical CenterNot Yet Recruiting
Delray Beach, Florida, United States
Largo Medical CenterRecruiting
Largo, Florida, United States
Tampa General HospitalRecruiting
Tampa, Florida, United States
Endeavor Health, Glenbrook HospitalRecruiting
Glenview, Illinois, United States
Chicago Advocate ChristNot Yet Recruiting
Palos Park, Illinois, United States
Ascension Medical Group St. Vincent The Heart Center of IndianaRecruiting
Indianapolis, Indiana, United States
Cardiovascular Institute of the SouthRecruiting
Houma, Louisiana, United States
Massachusetts General HospitalRecruiting
Boston, Massachusetts, United States
Beth Israel Deaconess Medical CenterNot Yet Recruiting
Boston, Massachusetts, United States
Lahey Hospital & Medical CenterRecruiting
Burlington, Massachusetts, United States
Minneapolis Heart Institute FoundationRecruiting
Minneapolis, Minnesota, United States
Saint Luke's Mid America Heart InstituteNot Yet Recruiting
Kansas City, Missouri, United States
Washington University St LouisNot Yet Recruiting
St Louis, Missouri, United States
Hackensack University Medical CenterNot Yet Recruiting
Hackensack, New Jersey, United States
North Shore University HospitalNot Yet Recruiting
Manhasset, New York, United States
Montefiore Medical CenterRecruiting
The Bronx, New York, United States
Duke Cardiology ClinicNot Yet Recruiting
Durham, North Carolina, United States
Cleveland ClinicRecruiting
Cleveland, Ohio, United States
Riverside Methodist HospitalNot Yet Recruiting
Columbus, Ohio, United States
Oregon Health ServicesNot Yet Recruiting
Portland, Oregon, United States
UPMC PinnacleRecruiting
Harrisburg, Pennsylvania, United States
UPMC Presbyterian ShadysideNot Yet Recruiting
Pittsburgh, Pennsylvania, United States
WellSpan York HospitalNot Yet Recruiting
York, Pennsylvania, United States
MUSCNot Yet Recruiting
Charleston, South Carolina, United States
Houston MethodistRecruiting
Houston, Texas, United States
University of Texas (Memorial Hermann)Recruiting
Houston, Texas, United States
Intermountain Heart Institute - Intermountain Medical CenterRecruiting
Murray, Utah, United States
UVA School of MedicineRecruiting
Charlottesville, Virginia, United States
Sentara HealthcareNot Yet Recruiting
Norfolk, Virginia, United States
Carilion ClinicNot Yet Recruiting
Roanoke, Virginia, United States
MedStar Washington Hospital CenterRecruiting
Multiple Locations, Washington, United States
Swedish Medical CenterNot Yet Recruiting
Seattle, Washington, United States