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Tricuspid Valve InsufficiencyTRI-REPAIRNCT02981953

TRI-REPAIR: TrIcuspid Regurgitation RePAIr With CaRdioband Transcatheter System

A study testing Cardioband Tricuspid in people with Tricuspid Valve Insufficiency and Tricuspid Regurgitation, run by Edwards Lifesciences at 8 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The current management of tricuspid regurgitation (TR) is either conservative (by medication) or by surgery, usually in concomitant with other valves repair or replacement. TR can worsen or appear late after successful mitral valve surgery which portends a poor prognosis. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Cardioband Tricuspid
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
40 participants
Where
8 sitesin 3 countries
Study dates
Oct 2016to 12 Nov 2019
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Chronic functional tricuspid regurgitation (FTR) with annular diameter ≥ 40 mm with valve Systolic pulmonary pressure (sPAP) ≤ 60mmHg
  • ≥18 years old
  • New York Heart Association (NYHA) Class II-IVa
  • Symptomatic despite Guideline Directed Medical Therapy (GDMT); at minimum patient on diuretic regimen
  • LVEF ≥ 30%
  • Patient is willing and able to comply with all specified study evaluations
  • The Local Site Heart Team concur that surgery will not be offered as a treatment option
  • Transfemoral access of the Cardioband is determined to be feasible

Who cannot join

  • Aortic, mitral and/or pulmonic valve stenosis and/or regurgitation ≥ moderate
  • Severe uncontrolled hypertension (Systolic BP ≥ 180 mmHg and/or Diastolic BP ≥ 110 mm Hg)
  • Previous tricuspid valve repair or replacement
  • Trans-tricuspid pacemaker or defibrillator leads suggesting impingement of the of the tricuspid valve leaflets, as evaluated by echocardiography
  • Active endocarditis
  • MI or known unstable angina within the 30 days prior to the index procedure
Show all 27Show fewer
  • Any percutaneous coronary intervention (PCI) or transcatheter valvular intervention within 30 days prior to the index
  • Hemodynamic instability or on IV inotropes
  • Cerebrovascular Accident (CVA) within the past 6 months
  • Subject is on chronic dialysis
  • Anemia (Hb < 9 g/dL) not corrected by transfusion
  • Bleeding disorders or hypercoaguable state
  • Active peptic ulcer or active gastrointestinal (GI) bleeding
  • Contraindication to anticoagulants
  • Known allergy to stainless steel, nickel, and/or polyester
  • Pregnant or lactating; or female of childbearing potential with a positive pregnancy test 24 hours before any study-related radiation exposure
  • In the judgment of the Investigator, co-morbid condition(s) that could limit the subject's ability to participate in the study, including compliance with follow-up requirements, or that could impact the scientific integrity of the study
  • Life expectancy of less than 12 months
  • Impaired judgment and/or is undergoing emergency treatment
  • Currently participating in another investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the endpoints of this study
  • intra-cardiac masses, thrombi or vegetations
  • Patients with cardiac cachexia
  • Subjects in whom transesophageal echocardiography is contraindicated
  • . Known hypersensitivity or contraindication to procedural medications which cannot be adequately managed medically
  • Untreated clinically significant CAD requiring revascularization
  • Echocardiographic evidence of severe right ventricular dysfunction
  • Any coronary or endovascular surgery, within 3 months prior to procedure

Trial locations and contacts

8 sites in 3 countries.

8 sites in 3 countries

Germany6 sites
  • Bonn University - Universitätsklinikum Bonn

    Bonn

  • Universitätsklinikum Köln

    Cologne

  • Asklepios Klinik, St. Georg

    Hamburg, 5 20099

  • Universitätsklinik Hamburg Eppendorf, Herzzentrum

    Hamburg

  • Universitätsmedizin der Johannes Gutenberg-Universität Mainz

    Mainz

  • LMU Klinikum der Universität München, Medizinische Klinik I

    Munich

Other trials in Germany

France1 site
  • Hôpital Bichat-Claude Bernard

    Paris, 18 75877

Other trials in France

Italy1 site
  • Ospedale San Raffaele

    Milan, 20132

Other trials in Italy

About this study

The current management of tricuspid regurgitation (TR) is either conservative (by medication) or by surgery, usually in concomitant with other valves repair or replacement. TR can worsen or appear late after successful mitral valve surgery which portends a poor prognosis. However, standard surgical approaches requiring cardiopulmonary bypass and especially second surgery have an excessive risks. Thus many patients are denied surgery because of unfavorable risk-benefit balance. Therefore there is a need for novel devices enabling interventional cardiologists and cardiothoracic surgeons to perform tricuspid annuloplasty by transcatheter methods. Cardioband replicates established surgical techniques (e.g., annuloplasty) using transfemoral approach, without sutures and with adjusted on the beating heart. Similar to the approved indication for mitral annuloplasty. The Cardioband System is expected to allow for treatment of patients that would otherwise not undergo Tricuspid valve repair due to the invasiveness of current techniques.

Read the detailed description

The Cardioband Transcatheter System (Cardioband) is a marketed system that was approved for treatment of secondary (functional) mitral regurgitation (FMR) (CE granted on September 2015). The Cardioband is an annuloplasty band that is similar to a surgical annuloplasty, however deployed on the beating heart through a transvenous approach. The CE mark study with 30 subjects has been completed and documented significant reduction of severity of MR and improvement in quality of life by Minnesota living with heart failure questionnaire (MLHFQ), New York Heart Association (NYHA) and 6- minute walk test (6MWT), in subjects with moderate to severe MR. The aim of the current study is to evaluate the Cardioband annuloplasty system for repair the Tricuspid Regurgitation.

Being tested
Cardioband Tricuspid
Keywords
Valtech Cardio, Cardioband, Tricuspid
Medical subject headings
Tricuspid Valve Insufficiency, Cardiovascular Diseases, Heart Valve Diseases, Heart Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cardioband TricuspidDevice

    The Cardioband Adjustable implant is delivered and anchored to the tricuspid valve annulus by a transfemoral delivery system. The Cardioband TR will be deployed and adjusted under trans-esophageal and fluoroscopy guidance.

Study groups in NCT02981953
Study groupRoleWhat they receive
Cardioband Tricuspid procedureOtherTricuspid valve repair with Cardioband implanted via transcatheter procedure under transesophageal echocardiography (TEE) and fluoroscopy guidance
Receives: Device: Cardioband Tricuspid

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Major Serious Adverse Events (MSAEs) and Serious Adverse Device Effects (SADE)

    Overall rate of Major Serious Adverse Events (MSAEs)* and serious adverse device effects (SADE)

    Measured: 30 days

  2. Access, Deployment and Positioning of the Cardioband Device

    Successful access, deployment and positioning of the Cardioband device

    Measured: Intra-procedure

Secondary outcomes (26)
  1. Technical Success

    Successful access, deployment and positioning of the Cardioband device and septolateral reduction.

    Measured: 1, 6, 12, and 24 months

  2. Tricuspid Regurgitation [Paired Baseline and Follow-Up]

    Data available at each time point was reported as number of patients with TR grades between Trace, Mild, Moderate, and Severe. Data analysis per core lab.

    Measured: 1, 6, 12, and 24 months over baseline

  3. Tricuspid Regurgitation [Full Analysis Data Set]

    All data available at each time point was reported as number of patients with TR grades between Trace, Mild, Moderate, Severe. Data analysis per core lab.

    Measured: 1, 6, 12, and 24 months over baseline

  4. Effective Regurgitant Orifice Area (EROA) [Paired Baseline and Follow-Up]

    Effective regurgitant orifice area (EROA) at 1 month, 6 months, 12 months, and 24 months over baseline. Data analysis per core lab

    Measured: 1, 6, 12, and 24 months over baseline

  5. Effective Regurgitant Orifice Area (EROA) [Full Analysis Data Set]

    All data available for Effective regurgitant orifice area (EROA) at 1 month, 6 months, 12 months, and 24 months over baseline. Data analysis per core lab.

    Measured: 1, 6, 12, and 24 months over baseline

  6. Regurgitant Volume [Paired Baseline and Follow-Up]

    Regurgitant Volume (by Echocardiography) data available at 1 month, 6 months, 12 months, and 24 months over baseline. Data analysis per core lab.

    Measured: 1, 6, 12, and 24 months over baseline

  7. Regurgitant Volume [Full Analysis Data Set]

    All data for Regurgitant Volume (by Echocardiography) at 1 month, 6 months, 12 months, and 24 months over baseline. Data analysis per core lab.

    Measured: 1, 6, 12, and 24 months over baseline

  8. TAPSE [Paired Baseline and Follow-Up]

    Tricuspid Annular Plane Systolic Excursion at 1 month, 6 months, 12 months, and 24 months over baseline. Data analysis per core lab.

    Measured: 1, 6, 12, and 24 months over baseline

  9. TAPSE [Full Analysis Data Set]

    All data for Tricuspid Annular Plane Systolic Excursion at 1 month, 6 months, 12 months, and 24 months over baseline. Data analyses based on core lab assessment.

    Measured: 1, 6, 12, and 24 months over baseline

  10. NYHA [Paired Baseline and Follow-Up]

    NYHA classification data available at 1 month, 6 months, 12 months, 24 months over baseline.

    Measure Description: NYHA Classification - The stages of heart failure:

    1. Class I - No symptoms and no limitation in ordinary physical activity
    2. Class II - Mild symptoms and slight limitation during ordinary activity.
    3. Class III - Marked limitation in activity due to symptoms, even during less-than-ordinary activity. Comfortable only at rest.
    4. Class IV - Severe limitations. Experiences symptoms even while at rest.

    Measured: 1, 6, 12, and 24 months over baseline

  11. NYHA [Full Analysis Data Set]

    All data available for NYHA classification at 1 month, 6 months, 12 months, and 24 months over baseline.

    Measure Description: NYHA Classification - The stages of heart failure:

    1. Class I - No symptoms and no limitation in ordinary physical activity
    2. Class II - Mild symptoms and slight limitation during ordinary activity.
    3. Class III - Marked limitation in activity due to symptoms, even during less-than-ordinary activity. Comfortable only at rest.
    4. Class IV - Severe limitations. Experiences symptoms even while at rest.

    Measured: 1, 6, 12, and 24 months over baseline

  12. 6MWT [Paired Baseline and Follow-Up]

    Distance in meters walked during 6 Minute Walk Test (6MWT) at 1 month, 6 months, 12 months, and 24 months over baseline.

    Measured: 1, 6, 12, and 24 months over baseline

  13. 6MWT [Full Analysis Data Set]

    Distance in meters walked during 6 minute walk test (6MWT) at 1 month, 6 months, 12 months, and 24 months over baseline.

    Measured: 1, 6, 12, and 24 months over baseline

  14. Kansas City Cardiomyopathy (KCCQ) [Paired Baseline and Follow-Up]

    The Kansas City Cardiomyopathy Questionnaire (KCCQ-12) is a self-administered, 12-item questionnaire that quantifies physical limitations, symptoms, self-sufficiency, social interaction and quality of life. Scores range from 0-100, in which higher scores reflect better health status. An increase in the KCCQ-12 score reflects an improvement in symptoms for the subject. A mean difference over time of 5 points on the KCCQ-12 summary score reflects a clinically significant change in heart failure status.

    Measured: 1, 6, 12, and 24 months over baseline

  15. Kansas City Cardiomyopathy (KCCQ) [Full Analysis Data Set]

    The Kansas City Cardiomyopathy Questionnaire (KCCQ-12) is a self-administered, 12-item questionnaire that quantifies physical limitations, symptoms, self-sufficiency, social interaction and quality of life. Scores range from 0-100, in which higher scores reflect better health status. An increase in the KCCQ-12 score reflects an improvement in symptoms for the subject. A mean difference over time of 5 points on the KCCQ-12 summary score reflects a clinically significant change in heart failure status.

    Measured: 1, 6, 12, and 24 months over baseline

  16. Left Ventricle Ejection Fraction (LVEF) [Paired Baseline and Follow-Up]

    Left ventricle ejection fraction data available for 1 month, 6 months, 12 months, and 24 months over baseline. Data analysis based on core lab assessment.

    Measured: 1, 6, 12, and 24 months over baseline

  17. Left Ventricle Ejection Fraction (LVEF) [Full Analysis Data Set]

    All available data for left ventricle ejection fraction at 1 month, 6 months, 12 months, and 24 months over baseline. Data analysis per echo core lab.

    Measured: 1, 6, 12, and 24 months over baseline

  18. Left Ventricle End Diastolic Volume Index (LVEDVI) [Full Analysis Data Set]

    Left ventricle end diastolic volume index data available for 1 month, 6 months, 12 months, and 24 months over baseline.

    Measured: 1, 6, 12, and 24 months over baseline

  19. Left Ventricle End Systolic Volume Index (LVESVI) [Full Analysis Data Set]

    Left ventricle end systolic volume index data available at 1 month, 6 months, 12 months, and 24 months over baseline.

    Measured: 1, 6, 12, and 24 months over baseline

  20. NT-pro BNP [Full Analysis Data Set]

    N-terminal prohormone of brain natriuretic peptide data available at 1 month, 6 months, 12 months, and 24 months over baseline.

    Measured: 1, 6, 12, and 24 months over baseline

  21. Diuretic Therapy

    Diuretic Therapy data available at 1 month, 6 months, 12 months, and 24 months over baseline.

    Measured: 1, 6, 12, and 24 months over baseline

  22. Bilirubin [Full Analysis Data Set]

    Bilirubin data available at 1 month, 6 months, 12 months, and 24 months over baseline.

    Measured: 1, 6, 12, and 24 months over baseline

  23. Blood Urea Nitrogen (BUN), Serum Creatinine [Full Analysis Data Set]

    All available data for Blood urea nitrogen (BUN) and Serum Creatinine at 1 month, 6 months, 12 months, and 24 months over baseline.

    Measured: 1, 6, 12, and 24 months over baseline

  24. Activity by Wearable Device

    Activity by wearable device available data at 1 month, 6 months, 12 months, and 24 months over baseline.

    Measured: 1, 6, 12, and 24 months over baseline

  25. Glutamic Oxaloacetic Transaminase (GOT) Aspartate Transaminase (AST) [Full Analysis Data Set]

    All data available for Glutamic oxaloacetic transaminase (GOT) and Aspartate Transaminase (AST) at 1 month, 6 months, 12 months, and 24 months over baseline.

    Measured: 1, 6, 12, and 24 months over baseline

  26. Glutamic Pyruvic Transaminase (GPT) Alanine Transaminase (ALT) [Full Analysis Data Set]

    All data available for glutamic pyruvic transaminase (GPT) Alanine Transaminase (ALT) at 1 month, 6 months, 12 months, and 24 months.

    Measured: 1, 6, 12, and 24 months over baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Dec 2016 (estimated)
  2. Study startOct 2016
  3. Primary completion1 Jan 2018
  4. Study completion12 Nov 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
40 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02981953
Sponsor's protocol ID
TR1-1
Acronym
TRI-REPAIR
Status last verified
Jun 2021
First submitted
20 Nov 2016
Last updated
28 Jun 2021
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Nickenig G, Weber M, Schuler R, Hausleiter J, Nabauer M, von Bardeleben RS, Sotiriou E, Schafer U, Deuschl F, Alessandrini H, Kreidel F, Juliard JM, Brochet E, Latib A, Montorfano M, Agricola E, Baldus S, Friedrichs KP, Deo SH, Gilmore SY, Feldman T, Hahn RT, Maisano F. Tricuspid valve repair with the Cardioband system: two-year outcomes of the multicentre, prospective TRI-REPAIR study. EuroIntervention. 2021 Feb 5;16(15):e1264-e1271. doi: 10.4244/EIJ-D-20-01107.

    PubMed 33046437
  • Nickenig G, Weber M, Schueler R, Hausleiter J, Nabauer M, von Bardeleben RS, Sotiriou E, Schafer U, Deuschl F, Kuck KH, Kreidel F, Juliard JM, Brochet E, Latib A, Agricola E, Baldus S, Friedrichs K, Vandrangi P, Verta P, Hahn RT, Maisano F. 6-Month Outcomes of Tricuspid Valve Reconstruction for Patients With Severe Tricuspid Regurgitation. J Am Coll Cardiol. 2019 Apr 23;73(15):1905-1915. doi: 10.1016/j.jacc.2019.01.062.

    PubMed 30999993

Questions about this trial

What is this clinical trial studying?

A study testing Cardioband Tricuspid in people with Tricuspid Valve Insufficiency and Tricuspid Regurgitation, run by Edwards Lifesciences at 8 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 27 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Jun 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites in Germany, France, Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 28 Jun 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Major Serious Adverse Events (MSAEs) and Serious Adverse Device Effects (SADE) (time frame: 30 days). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02981953, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jun 2021.

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