AzTrials
AzTrials

Aortic Valve StenosisREPRISE IVNCT03618095

REPRISE IV: LOTUS Edge Valve System in Intermediate Surgical Risk Subjects

A study testing LOTUS Edge Valve System in people with Aortic Valve Stenosis, run by Boston Scientific Corporation at 50 sites in 2 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
Search all trials

Trial summary

REPRISE IV: REpositionable Percutaneous Replacement of Stenotic Aortic Valve through Implantation of LOTUS Edge Valve System in IntermediatE Surgical Risk Subjects Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Aortic Valve Stenosis
What is being tested?
LOTUS Edge Valve System
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
382 participants
Where
50 sitesin 2 countries
Study dates
14 Jan 2019to 31 Mar 2021
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

  • Subject has documented severe aortic stenosis defined as initial aortic valve area (AVA) ≤1.0 cm2 (or AVA index ≤0.6 cm2/m2) AND a mean pressure gradient ≥40 mm Hg OR maximal aortic valve velocity ≥4.0 m/s OR Doppler velocity index ≤0.25 as measured by echocardiography and/or invasive hemodynamics. Note: In cases of low flow, low gradient aortic stenosis with left ventricular dysfunction (ejection fraction <50%), dobutamine can be used to assess the grade of aortic stenosis (maximum dobutamine dose of 20 mcg/kg/min recommended)c; the subject may be enrolled if echocardiographic criteria are met with this augmentation. (IC1)
  • A subject in the Bicuspid Aortic Valve Nested Registry cohort must have a documented Sievers Type 0 or Sievers Type 1 bicuspid aortic valve based on computed tomography (CT) assessment and confirmed by the CT core lab with hemodynamic parameters that meet the criteria in IC1.
  • Subject has a documented aortic annulus size of ≥20 mm and ≤27 mm based on the center's assessment of pre-procedure diagnostic imaging (and confirmed by the Case Review Committee [CRC]).
  • Subject has symptomatic aortic valve stenosis per IC1 definition above with New York Heart Association (NYHA) Functional Class ≥ II.
  • Heart team (which must include an experienced cardiac interventionalist and an experienced cardiac surgeon) agrees that the subject is at intermediate risk of operative mortality (≥3% and <8% at 30 days based on the Society of Thoracic Surgeons [STS] risk score and other clinical comorbidities unmeasured by the risk calculator) and TAVR is appropriate. Note: Risk of operative mortality must be assessed via an in-person evaluation by a center cardiac surgeon and must be confirmed by the CRC (which must include an experienced cardiac surgeon).
  • Heart team agrees that the subject is likely to benefit from valve replacement. IC7. Subject (or legal representative) has been informed of the study requirements and the treatment procedures, and provides written informed consent.
  • Subject, family member, and/or legal representative agree(s) and subject is capable of returning to the study hospital for all required scheduled follow-up visits.
  • Subject is expected to be able to take the protocol-required adjunctive pharmacologic therapy.

Who cannot join

  • Subject has a unicuspid or bicuspid aortic valve (not applicable to subjects in the Bicuspid Nested Registry cohort).
  • Subjects in the Bicuspid Nested Registry cohort will have a documented Sievers Type 0 or Sievers Type 1 bicuspid aortic valve based on CT assessment and confirmed by the CT core lab. Subjects are not eligible for inclusion in the Bicuspid Nested Registry cohort if the maximum diameter of the ascending aorta is >45 mm or if the subject has another indication for aortic root replacement. Subjects with a Sievers Type 2 bicuspid valve are not eligible for enrollment in any study cohort.
  • Subject has had an acute myocardial infarction (MI) within 30 days prior to the index procedure (defined as Q-wave MI or non-Q-wave MI with total creatine kinase (CK) elevation ≥ twice normal in the presence of creatine kinase-myoglobin band (CK-MB) elevation and/or troponin elevation).
  • Subject has had a cerebrovascular accident or transient ischemic attack clinically confirmed by a neurologist or neuroimaging within the past 6 months prior to study enrollment.
  • Subject is on renal replacement therapy or has Glomerular Filtration Rate (GFR) <20 (based on hospital preferred method). See AEC1 below if subject is in the CT Imaging Substudy.
  • Subject has a pre-existing prosthetic aortic or mitral valve.
Show all 26Show fewer
  • Subject has severe (4+) aortic, tricuspid, or mitral regurgitation.
  • Subject has moderate to severe mitral stenosis (mitral valve area ≤1.5 cm2 and diastolic pressure half-time ≥150 ms, Stage C or Dc).
  • Subject has a need for emergency surgery for any reason.
  • Subject has a history of endocarditis within 6 months of index procedure or evidence of an active systemic infection or sepsis.
  • Subject has echocardiographic evidence of new intra-cardiac vegetation or intraventricular or paravalvular thrombus requiring intervention.
  • Subject has platelet count <50,000 cells/mm3 or >700,000 cells/mm3, or white blood cell count <1,000 cells/mm3.
  • Subject will refuse transfusions or has had a gastrointestinal bleed requiring hospitalization or transfusion within the past 3 months, or has other clinically significant bleeding diathesis or coagulopathy that would preclude treatment with required antiplatelet regimen.
  • Subject has known hypersensitivity to contrast agents that cannot be adequately pre-medicated, or has known hypersensitivity to aspirin, all P2Y12 inhibitors, heparin, nickel, tantalum, titanium, or polyurethanes.
  • Subject has a life expectancy of less than 24 months due to non-cardiac, comorbid conditions based on the assessment of the investigator at the time of enrollment.
  • Subject has hypertrophic cardiomyopathy.
  • Subject has any therapeutic invasive cardiac or vascular procedure within 30 days prior to the index procedure (except for balloon aortic valvuloplasty or pacemaker or implantable cardioverter defibrillator implantation, which are allowed).
  • Subject has multivessel coronary artery disease with a Syntax score >22, and/or an unprotected left main coronary artery.
  • Subject has severe left ventricular dysfunction with ejection fraction <20%.
  • Subject is in cardiogenic shock or has hemodynamic instability requiring inotropic support or mechanical support devices.
  • Subject has arterial access that is not acceptable for the study device delivery system as defined in the device Instructions For Use.
  • Subject has severe vascular disease that would preclude safe access (e.g., aneurysm with thrombus that cannot be crossed safely; marked tortuosity; significant narrowing of the abdominal aorta; severe unfolding of the thoracic aorta; or thick, protruding, ulcerated atheroma in the aortic arch).
  • Subject has current problems with substance abuse (e.g., alcohol, etc.) that may interfere with the subject's participation in this study.
  • Subject is participating in another investigational drug or device study that has not reached its primary endpoint.
  • Subject has untreated conduction system disorder (e.g., Type II second degree atrioventricular block) that in the opinion of the treating physician is clinically significant and requires a pacemaker implantation. Enrollment is permissible after permanent pacemaker implantation.
  • Subject has severe incapacitating dementia.

Trial locations and contacts

50 sites in 2 countries.

50 sites in 2 countries

United States49 sites
  • Inova Fairfax Hospital

    Annandale, Virginia, 22042

  • Piedmont Heart Institute

    Atlanta, Georgia, 30309

  • JFK Medical Center

    Atlantis, Florida, 33462

  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts, 02215

  • Mills-Peninsula Medical Center - Sutter Health

    Burlingame, California, 94010

  • Novant Health Heart & Vascular Institute - Charlotte

    Charlotte, North Carolina, 28204

  • The Lindner Center for Research and Education

    Cincinnati, Ohio, 45219

  • Saint Joseph Hospital

    Denver, Colorado, 80218

  • Englewood Hospital

    Englewood, New Jersey, 07631

  • NorthShore University HealthSystem

    Evanston, Illinois, 60201

  • Charlton Memorial Hospital - Southcoast Health

    Fall River, Massachusetts, 02720

  • North Florida Regional Medical Center

    Gainesville, Florida, 32605

  • Spectrum Health - Grand Rapids

    Grand Rapids, Michigan, 49503

  • Greenville Memorial Hospital - Prisma Health

    Greenville, South Carolina, 29605

  • Memorial Hermann - Texas Medical Center

    Houston, Texas, 77030

  • University of Texas - Memorial Hermann Southwest

    Houston, Texas, 77030

  • Huntsville Hospital

    Huntsville, Alabama, 35801

  • Indiana University Health - Methodist Hospital

    Indianapolis, Indiana, 46202

  • Arkansas Heart Hospital

    Little Rock, Arkansas, 72211

  • Kaiser Permanente Los Angeles Medical Center

    Los Angeles, California, 90027

  • USC Medical Center

    Los Angeles, California, 90033

  • North Shore University Hospital

    Manhasset, New York, 11030

  • Wellstar Research Institute

    Marietta, Georgia, 30060

  • Aurora St. Luke's Medical Center

    Milwaukee, Wisconsin, 53215

  • Froedtert Hospital - Medical College of Wisconsin

    Milwaukee, Wisconsin, 53226

  • NYU Winthrop Hospital

    Mineola, New York, 11501

  • WVU Heart & Vascular Institute

    Morgantown, West Virginia, 26506

  • Morristown Medical Center

    Morristown, New Jersey, 07960

  • Centennial Medical Center

    Nashville, Tennessee, 37203

  • Vanderbilt University Medical Center

    Nashville, Tennessee, 37212

  • Yale New Haven Hospital

    New Haven, Connecticut, 06510

  • Ochsner Medical Center

    New Orleans, Louisiana, 70121

  • NYU Langone Medical Center

    New York, New York, 10010

  • Columbia University Medical Center/NewYork Presbyterian Hospital

    New York, New York, 10032

  • AdventHealth Orlando

    Orlando, Florida, 32803

  • Cardiac & Vascular Research Center of Northern Michigan

    Petoskey, Michigan, 49770

  • University of Pennsylvania

    Philadelphia, Pennsylvania, 19104

  • Allegheny General Hospital

    Pittsburgh, Pennsylvania, 15212

  • University of Pittsburgh Medical Center

    Pittsburgh, Pennsylvania, 15213

  • Baylor Scott & White The Heart Hospital

    Plano, Texas, 75093

  • Providence St. Vincent Medical Center

    Portland, Oregon, 97225

  • UNC Rex Hospital

    Raleigh, North Carolina, 27607

  • Beaumont Hospital

    Royal Oak, Michigan, 48073

  • St. Cloud Hospital

    Saint Cloud, Minnesota, 56303

  • Swedish Medical Center

    Seattle, Washington, 98122

  • University of Washington

    Seattle, Washington, 98195

  • Tucson Medical Center

    Tucson, Arizona, 85712

  • Medstar Heart and Vascular Institute

    Washington D.C., District of Columbia, 20010

  • Via Christi Hospital

    Wichita, Kansas, 67214

Other trials in United States

Australia1 site
  • Monash Cardiovascular Research Centre

    Clayton, Victoria, 3168

Other trials in Australia

About this study

Official title: REPRISE IV: REpositionable Percutaneous Replacement of Stenotic Aortic Valve Through Implantation of LOTUS Edge Valve System in IntermediatE Surgical Risk Subjects

REPRISE IV: REpositionable Percutaneous Replacement of Stenotic Aortic Valve through Implantation of LOTUS Edge Valve System in IntermediatE Surgical Risk Subjects

Read the detailed description

To evaluate safety and effectiveness of the LOTUS Edge™ Valve System when used with the Lotus™ or iSleeve™ Introducer Sets for transcatheter aortic valve replacement (TAVR) in symptomatic subjects with severe aortic stenosis who are considered at intermediate risk for surgical valve replacement including those who have a bicuspid native valve.

Being tested
LOTUS Edge Valve System
Medical subject headings
Aortic Valve Stenosis

What participants receive

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

  • LOTUS Edge Valve SystemDevice

    TAVR with the LOTUS Edge Valve System

Study groups in NCT03618095
Study groupRoleWhat they receive
Main CohortExperimentalTranscatheter Aortic Valve Replacement (TAVR) with the LOTUS Edge Valve System
Receives: Device: LOTUS Edge Valve System
Roll-In CohortExperimentalTranscatheter Aortic Valve Replacement (TAVR) with the LOTUS Edge Valve System
Receives: Device: LOTUS Edge Valve System
Bicuspid CohortExperimentalTranscatheter Aortic Valve Replacement (TAVR) with the LOTUS Edge Valve System
Receives: Device: LOTUS Edge Valve System

What is being measured

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

  1. Composite of All-cause Mortality and All Stroke.

    Pre-specified primary outcome measure in the protocol for the Main Cohort only. Critical safety events that are observed in the elderly population undergoing TAVR; assessments recommended by Valve Academic Research Consortium (VARC)

    Measured: 1 year post index procedure and device implantation

Timeline

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

  1. First posted7 Aug 2018
  2. Study start14 Jan 2019
  3. Primary completion30 Mar 2021
  4. Study completion31 Mar 2021

Why it stopped: Investigational Medical Device is no longer available

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
Non-randomised
Intervention model
Single group
Model description
Evaluation of Lotus Edge to treat patients with aortic stenosis. A single intervention is being evaluated in 3 study arms, the roll-in, main and bicuspid cohorts.
Masking
None (open label)
Enrolment
382 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03618095
Sponsor's protocol ID
S2354
Acronym
REPRISE IV
Status last verified
Oct 2022
First submitted
1 Aug 2018
Last updated
27 Dec 2022
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Undecided: The data and study protocol for this clinical trial may be made available to other researchers in accordance with the Boston Scientific Data Sharing Policy (http://www.bostonscientific.com/en-US/data-sharing-requests.html).

Questions about this trial

What is this clinical trial studying?

A study testing LOTUS Edge Valve System in people with Aortic Valve Stenosis, run by Boston Scientific Corporation at 50 sites in 2 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 26 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: stopped early, as of the sponsor's last update on 27 Dec 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 50 sites in United States, Australia. 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 27 Dec 2022). 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?

Composite of All-cause Mortality and All Stroke. (time frame: 1 year post index procedure and device implantation). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 27 Dec 2022.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in