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| General |
| Study Status |
Progress Adequate |
| Application Number |
P140031 S028/ PAS002 |
| Date Current Protocol Accepted |
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| Study Name |
SAPIEN 3 Mitral Valve-in-Valve Comp Surv
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| General Study Protocol Parameters |
| Study Design |
Comprehensive/Linked/RegistryBased Surveillance
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| Data Source |
External Registry
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| Comparison Group |
No Control
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| Analysis Type |
Descriptive
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| Study Population |
Infant: 29 days-2 yrs,
Child: 2-12 yrs,
Adolescent: 13-18 yrs,
Transit. Adolescent B (as adults) : 18-21 yrs,
Adult: >21
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| Detailed Study Protocol Parameters |
| Study Design Description |
Patients will be enrolled into the TVT registry for the 2 years following device approval (from June 5, 2017 to June 4, 2019). All patients enrolled in the registry will be followed by the registry for the first year and then linked to CMS claims data for follow-up through five years.
The data collected through this surveillance plan will be submitted to the FDA bi-annually for the first 2 years after device approval and annually until the last enrolled patients reaches 5 years.
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| Study Population Description |
Patients with symptomatic heart disease due to a failed bioprosthetic mitral valve (stenosed, insufficient or combined) who are judged by a heart team, including a cardiac surgeon, to be at high or greater risk for open surgical therapy (i.e. predicted risk of surgical mortality greater than or equal to 8% at 30 days, based on the STS risk score and other clinical co-morbidities unmeasured by the STS risk calculator).
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| Sample Size |
Enrollment will consist of all patients with SAPIEN 3 transcatheter heart valve in the STS/ACC TVT Registry for the 2 years following device approval (i.e. from June 5, 2017 to June 4, 2019). All mitral transcatheter SAPIEN 3 Valve in Surgical Valve patients who have the procedure date in the period of June 5, 2017 to June 4, 2019 will be included in the analysis.
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| Data Collection |
TVT-Captured Safety Endpoints (at discharge, 30 days and 12 months):
All-cause mortality
Heart failure rehospitalization*
Mitral valve reintervention
Device or procedure-related adverse events
Life threatening/major bleeding complications*
Stroke
TIA
Myocardial Infarction
New requirement of dialysis
New onset atrial fibrillation
Unplanned mitral valve surgery due to device/procedure failure or malfunction
Requirement for valve replacement
Unplanned cardiac surgery for any cause
Requirement/insertion of an implantable cardiac defibrillator
*endpoints not available at discharge
TVT-Captured Effectiveness Endpoints (30 days and 12 months):
6-minute walking distance
KCCQ
Change in NYHA functional class
Mitral valve hemodynamics
CMS-Captured Safety Endpoints (year 2 to 5):
All-cause mortality
All Stroke
Repeat procedure for valve-related dysfunction (surgical or interventional therapy)
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| Follow-up Visits and Length of Follow-up |
5 year post-implantation
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| Interim or Final Data Summary |
| Interim Safety Information |
At discharge, the rate of all-cause death was 3.8%. The Kaplan-Meier rate of all-cause death was 5.3% through 30 days and 16.1% through 1 year. Adjudicated strokes were reported as eight events at discharge and through 30 days, and eleven events through 1 year. No ajudicated mitral valve reinterventions were reported at discharge, 30 days and 1 year follow-up.
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| Actual Number of Patients Enrolled |
793 mitral valve-in-valve patients were enrolled in the TVT registry between June 5, 2017 through January 8, 2019.
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| Actual Number of Sites Enrolled |
A total of 231 sites were enrolled (*based on database closed on February 22, 2019)
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| Patient Follow-up Rate |
86% at 30 days and 57% at 1 year, among patients with known visit status.
(*Patients with follow-up data (numerator) include those with follow-up completed or deaths prior to visit; patients with known visit status (denominator) include those with follow-up completed, with missed visit, death prior to visit, withdrawal and lost to follow-up.)
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| Study Strengths & Weaknesses |
Strength: This study uses real-world data collected through the national STS/ACC TVT Registry to assess the safety and effectiveness of SAPIEN 3 Transcatheter Heart Valve in patients with a failed surgical bioprosthetic mitral valve.
Limitation: Results summarized are interim safety data only. Data for effectiveness endpoints will be posted at a later date (December 2024).
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