Status:

COMPLETED

Personalised Decision Support for Heart Valve Disease

Lead Sponsor:

German Heart Institute

Collaborating Sponsors:

University of Sheffield

Ansys SAS

Conditions:

Heart Valve Diseases

Eligibility:

All Genders

18+ years

Brief Summary

Valvular Heart Disease currently affects 2.5% of the population, but is overwhelmingly a disease of the elderly and consequently on the rise. It is dominated by two conditions, Aortic Stenosis and Mit...

Detailed Description

Study design: In the study a Decision Support System for aortic and mitral valve replacement/repair will be implemented and tested. Not all of the assessments listed will be performed on every patien...

Eligibility Criteria

Inclusion

  • The patient must give Informed Consent before being enrolled in the study.
  • Only elective cases will be eligible for inclusion. For mitral disease, patients were recruited with;
  • Severe degenerative or functional mitral regurgitation with the need for MVR according to the ESC/EACTS guidelines.
  • Degenerative mitral regurgitation
  • symptomatic patients with LVEF \>30% and LVESD \< 55mm (I B)
  • asymptomatic patients with LV dysfunction (LVESD ≥45 mm and/or LVEF ≤60% (I C)
  • asymptomatic patients with LVEF \> 50%, new onset of atrial fibrillation or pulmonary hypertension (systolic pulmonary pressure at rest \>50 mmHg) (IIa C)
  • patients with severe LV dysfunction (LVEF \< 30% and LVESD \> 55 mm) refractory to medical therapy with high likelihood of durable repair and low comorbidity. (IIa C) Functional mitral regurgitation
  • patients with severe MR (EROA \>= 20 mm², Regurgitation volume \> 30 ml) undergoing CABG, and LVEF \>30% (I C)
  • patients with moderate MR undergoing CABG (IIa C)
  • symptomatic patients with severe MR, LVEF \< 30 %, option for revascularisation, and evidence of viability (IIa C) For aortic valve disease, patients will be recruited with;
  • Severe acquired degenerative aortic valve disease with the need for SAVR or TAVI according to the ESC/EACTS guidelines Severe Aortic stenosis
  • symptomatic patients (I B)
  • patients undergoing CABG or surgery of ascending aorta or another valve (I C)
  • asymptomatic patients with abnormal exercise test (I C) / LVEF \< 50% (I C) / blood pressure drop on exercise / peak gradient \> 5.5 m/sec ( (IIa C)
  • symptomatic patients with low flow, low gradient (\< 40mmHg) and normal LVEF (IIa C)

Exclusion

  • Inability or unwillingness to give formal consent.
  • Emergency interventions
  • Active infective valvular disease or evidence of valvular damage by recent endocarditis
  • Valvular malfunction directly associated with aortic root disease
  • Aortic regurgitation as leading aortic valve pathology
  • Inability or unwillingness to complete follow up
  • MRI contraindications (Implanted pacemaker, Metallic foreign body, Severe claustrophobia)
  • CT contraindications (Known iodine or contrast agent allergy, Hyperhidrosis, Pregnancy)

Key Trial Info

Start Date :

January 20 2016

Trial Type :

OBSERVATIONAL

Allocation :

ACTUAL

End Date :

January 31 2019

Estimated Enrollment :

169 Patients enrolled

Trial Details

Trial ID

NCT04068740

Start Date

January 20 2016

End Date

January 31 2019

Last Update

August 28 2019

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