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Prosthesis SurvivalTAVISARNCT05261204

Transcatheter Aortic Valve Implantation Versus Standard Surgical Aortic Valve Replacement

An observational study of Prosthesis Survival and Prosthesis; Cardiac, Heart, Functional Disturbance as Result, run by Centre Cardiologique du Nord at 1 site in France.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The mechanical intervention is treating aortic valve stenosis (AVS) which may be performed using the standard open surgical approach for aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI). Read more about this study

Who is it for?
Ages 18 to 90 years
What is being tested?
Transcatheter Aortic Valve Implantation, Bioprothesis and Sutureless
How many people
4,000 participants
Where
1 siteFrance
Study dates
1 Jan 2013to 31 May 2029
Phase
Observational
Are there results?
Not yet: the study is under way

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 to 90 years
  • All sexes
  • Adult, Older adult

Study population: Adults with aortic valve stenosis with or without CAD who were symptomatic of congestive heart failure and unresponsive to medical therapy and who were eligible for mechanical intervention performed with the use of TAVI procedure or surgical aortic valve replacement. The severity of AVS was assessed by transthoracic echocardiography, performed using the European Society of Echocardiography criteria.

Who may be able to join

  • Individuals enrolled in TAVI arm were required to have the predicted risk of operative mortality was ≥ 15% and/or a STS score of ≥ 10. A candidate who did not meet the STS score criteria of ≥ 10 was included in the study if a peer review by at least two surgeon investigators concluded and documented that the patient's predicted risk of operative mortality was ≥ 15%. For all group Senile degenerative aortic valve stenosis with echocardiography derived criteria: mean gradient > 40 mm Hg or jet velocity > 4.0 m/s or an aortic valve area (AVA) of < 0.8 cm2 (or AVA index < 0.5 cm2/m2).

Who cannot join

  • • Patients with evidence of an acute myocardial infarction ≤ 1 month before the intended treatment (defined as Q wave MI, or non-Q wave MI with total CK elevation ≥ twice normal in the presence of CK-MB elevation and/or troponin level elevation.
  • Blood dyscrasias as defined : leukopenia (WBC < 3000 mm3), acute anemia (Hb < 9 mg%), thrombocytopenia (platelet count < 50,000 cells/mm³), history of bleeding diathesis or coagulopathy.
  • Hemodynamic instability requiring inotropic therapy or mechanical hemodynamic support devices
  • Need for emergency surgery for any reason.
  • Hypertrophic cardiomyopathy with or without obstruction.
  • Severe ventricular dysfunction with LVEF < 20%.
Show all 21Show fewer
  • Echocardiographic evidence of intracardiac mass, thrombus or vegetation.
  • Active peptic ulcer or upper gastro-intestinal bleeding within the prior 3 months.
  • A known hypersensitivity or contraindication to aspirin, heparin, ticlopidine (Ticlid), or clopidogrel
  • (Plavix), or sensitivity to contrast media, which cannot be adequately pre-medicated.
  • For TAVI arm Native aortic annulus size < 18mm or 25mm as measured by echocardiogram.
  • Subject was offered surgery but refused surgery.
  • Recent (within 6 months) cerebrovascular accident or transient ischemic attack.
  • Renal insufficiency (creatinine > 3.0mg/dL) and/or end stage renal disease requiring chronic
  • dialysis.
  • Life expectancy < 12 months due to non-cardiac co-morbid conditions.
  • For TAVI group significant abdominal or thoracic aorta disease, including aneurysm (defined as maximal luminal diameter 5 cm or greater), marked tortuosity, aortic arch atheroma, narrowing of the abdominal aorta with particular regard for calcification and surface irregularities, or severe "unfolding" and tortuosity of the thoracic aorta. This criteria were applicable for transfemoral patients only.
  • For TAVI group Iliofemoral vessel characteristics that would preclude safe placement of 14F or 18F introducer
  • For TAVI arm sheath such as severe calcification, severe tortuosity or vessels size diameter < 7 mm for 22F
  • Active bacterial endocarditis or other active infections.
  • For TAVI arm bulky calcified aortic valve leaflets in close proximity to coronary ostia.

Trial locations and contacts

1 site in 1 country.

France1 site
  • Francesco Nappi

    Saint-Denis, France, 93200

Other trials in France

About this study

Official title: Transcatheter Aortic Valve Implantation Versus Standard Surgical Aortic Valve Operation for Aortic-Valve Stenosis in Patients at Risk to Severe Valve Obstruction.

The mechanical intervention is treating aortic valve stenosis (AVS) which may be performed using the standard open surgical approach for aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI). The key question of this study is to establish the difference in all-cause and cause-specific (cardiac vs noncardiac) mortality, all hospitalizations for heart failure within 24 months of follow-up, left ventricular reverse remodeling after adjustment for death, as assessed by means of the left ventricular end-diastolic volume (LVEDV), in patients who received the TAVI vs the standard surgical procedure for AVS. Any potential failure of the devices in question will be thoroughly investigated by means of CT scanning and biomechanical computational modelling, utilising finite element analysis (FEA).

Read the detailed description

The target population enrolled in the study includes patients with aortic-valve stenosis at risk to severe valve obstruction who have had TAVI or standard surgical procedure of their aortic valve with or without coronary artery by pass grafting (CABG) or percutaneous coronary intervention (PCI). Individuals were adequately treated per applicable standards, including for coronary artery disease (CAD), left ventricular (LV) dysfunction, AVS, and heart failure (HF). Patients enrolled in the studies were New York Heart Association (NYHA) functional class II, III, or outpatient NYHA IV.

Three groups of patients are included in the study. Patients who were managed with TAVI, patients who received AVR with conventional stented xenograft and recipients of AVR undergoing surgery with the use of sutureless aortic valve.

we calculated that a total of 649 patients per group would be needed for 90% power to show an absolute between-groups difference of 10% in the primary outcome at a two-sided alpha level of 0.02 (corrected alpha level to take into account multiple comparison between 3 groups). In this exhaustive study between 2011 and 2021, we hope to include a total of 6700 patients (2800 in the TAVI group, 3200 patients who received AVR with conventional stented xenograft and 700 patients with the use of sutureless aortic valve).

Two supplementary studies will be conducted. The study will concentrate on the CT scan evaluation of potential morphological and functional alterations in the aortic root following implantation of the respective devices, incorporating a comparative analysis. The second study will concentrate on the biomechanics of the implanted device and potential failure, using a finite element analysis investigation.

Being tested
Transcatheter Aortic Valve Implantation, Bioprothesis, Sutureless
Medical subject headings
Prosthesis Failure

What participants receive

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

  • Transcatheter Aortic Valve ImplantationDevice

    Also called Transcatheter Aortic Valve Repacement

    Patients who are deemed receive TAVI first underwent evaluation of their peripheral arteries before the procedure, in order to separate those eligible for transfemoral placement (TFP) from those who would require transapical placement. Technological advances achieved in the new platforms for the treatment of SHD have allowed the use of reduced size catheters and sheaths in the new armamentarium, favoring the TFP technique. The transcatheter valve (TV) is positioned at the level of the native aortic valve during the final step of valve replacement, when the balloon is inflated within the native valve during a brief period of rapid ventricular pacing. The delivery system i traverses the aorta retrograde over a guidewire from its point of insertion in the femoral artery during the use of TFP. Before balloon inflation, the valve and balloon are collapsed on the catheter and fit within the sheath. After balloon inflation, the calcified native valve is replaced by the expanded TV

  • BioprothesisProcedure or surgery

    Also called SAVR

    The bioprosthesis is implanted using the SAVR procedure during median sternotomy in extracorporeal circulation. Minimally invasive procedures using a thoracotomy approach and peripheral cannulation have found widespread use.

  • SuturelessProcedure or surgery

    Also called SAVR

    The sutureless is implanted using the SAVR procedure during median sternotomy in extracorporeal circulation. Minimally invasive procedures using a thoracotomy approach and peripheral cannulation have found widespread use.

Study groups in NCT05261204
Study groupRoleWhat they receive
Transcatheter Aortic Valve ImplantationPatients with aortic-valve stenosis at risk to severe valve obstruction who received TAVI with or without CABG or PCI. Individuals were adequately treated per applicable standards, including for coronary artery disease, LV dysfunction, aortic valve stenosis, and heart failure. Patients enrolled in the studies were NYHA functional class II, III, or outpatient NYHA IV.
Receives: Device: Transcatheter Aortic Valve Implantation; Procedure: Bioprothesis; Procedure: Sutureless
BioprosthesisPatients with aortic-valve stenosis at risk to severe valve obstruction who undervent SAVR with the use of bioprosthesis with or without CABG or PCI. Individuals were adequately treated per applicable standards, including for coronary artery disease, LV dysfunction, aortic valve stenosis, and heart failure. Patients enrolled in the studies were NYHA functional class II, III, or outpatient NYHA IV.
Receives: Device: Transcatheter Aortic Valve Implantation; Procedure: Bioprothesis; Procedure: Sutureless
SuturelessPatients with aortic-valve stenosis at risk to severe valve obstruction who were managed by mean of SAVR with the use of sutureless with or without CABG or PCI. Individuals were adequately treated per applicable standards, including for coronary artery disease, LV dysfunction, aortic valve stenosis, and heart failure. Patients enrolled in the studies were NYHA functional class II, III, or outpatient NYHA IV.
Receives: Device: Transcatheter Aortic Valve Implantation; Procedure: Bioprothesis; Procedure: Sutureless

What is being measured

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

  1. Treatment failure

    The primary end point of the study is the degree of treatment failure as assessed by death, recurrent aortic valve regurgitation and reoperation

    Measured: 5 years

  2. Hospitalizations for Heart Failure (HF)

    The secondary endpoint of the study is the evaluation of hospedalization rates for heart failure valve due to structural/ non structural valve deterioration, thromboembolism and recurrent endocarditis

    Measured: 5 yeras

  3. Determining Device Malfunction Through CT Evaluation of the Aortic Root

    The primary endpoint of the study is the degree of device failure, assessed by measuring the aortic root via CT scan

    Measured: 5 years

  4. Predictive Determination of Device Malfunction Through FEA of the Aortic Root

    The primary objective of the study is to assess the degree of device malfunction. This is achieved by measuring the mechanical characteristics of the aortic root using computational modelling. The modelling compares different implanted devices.

    Measured: 5 years

Secondary outcomes (7)
  1. Overall Mortality

    The secondary endpoint of the study is the evaluation of overall mortality

    Measured: 5 years

  2. Cardiac Death

    The secondary endpoint of the study is the evaluation of cardiac death

    Measured: 5 years

  3. Non Cardiac Death

    The secondary endpoint of the study is the evaluation of non cardiac death

    Measured: 5 years

  4. Major Adverse Cardiac or Cerebrovascular Events (MACCE)

    Composite of major adverse cardiac or cerebrovascular events (rate of death, stroke, subsequent mitral valve surgery, hospitalization for heart failure, or an increase in New York Heart Association class higher than one), serious adverse events, recurrent aortic regurgitation, quality of life, and rehospitalization

    Measured: 5 years

  5. Echocardiographic Parameter Changes (LVEF)

    Changes from baseline parameters including left ventricular ejection fraction

    Measured: 5 years

  6. Echocardiographic Parameter Changes ( AVR recurrence)

    Recurrent moderate-to-severe aortic regurgitation after intervention

    Measured: 5 years

  7. Echocardiographic Parameter Changes (LVEDD/LVEDV)

    Changes from baseline Left Ventricular End Diastolic Diameter or Volume

    Measured: 5 years

Timeline

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

  1. First posted2 Mar 2022
  2. Study start1 Jan 2013
  3. Primary completion1 Dec 2026 (estimated)
  4. Study completion31 May 2029 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
4,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05261204
Sponsor's protocol ID
CN-22-25
Acronym
TAVISAR
Status last verified
Jul 2026
First submitted
19 Feb 2022
Last updated
19 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Nappi F, Salsano A, Avtaar Singh SS, El-Dean Z, Fiore A, Spadaccio C. Study protocol for an international prospective non-randomized trial evaluating the long-term outcomes of sutureless aortic valve replacement versus stented aortic valve replacement for aortic-valve stenosis in patients at risk to severe valve obstruction: the SAVI-AVR trial. J Cardiothorac Surg. 2026 Apr 21;21(1):330. doi: 10.1186/s13019-026-04091-z.

    PubMed 42015281
  • Nappi F, Schoell T, Avtaar Singh SS, Nassif A, Ellouze O, Nejjari M, Digne F, Stratief V, Dreyfus J, Spadaccio C. Measuring Stress on a Third-Generation Balloon-Expandable Aortic Valve During Expansion. J Vis Exp. 2025 Jul 11;(221). doi: 10.3791/67455.

    PubMed 40720424
  • Nappi F, Bourgois C, Nenna A, Salsano A, Schoell T, El-Dean Z, Fiore A, Spadaccio C. Study protocol for an internahaational prospective non-randomised trial evaluating the long-term outcomes of transcatheter aortic valve implantation versus surgical aortic valve replacement for aortic-valve stenosis in patients at risk to severe valve obstruction: the TAVISAR trial. BMJ Open. 2025 May 24;15(5):e101417. doi: 10.1136/bmjopen-2025-101417.

    PubMed 40413055

Questions about this trial

What is this clinical trial studying?

An observational study of Prosthesis Survival and Prosthesis; Cardiac, Heart, Functional Disturbance as Result, run by Centre Cardiologique du Nord at 1 site in France.

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 1 inclusion and 21 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: under way, not looking for participants, as of the sponsor's last update on 19 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. 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?

This study is still under way. Results are not available in the source record yet.

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?

Treatment failure (time frame: 5 years). The study lists 4 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 NCT05261204, which also lists 3 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 19 Aug 2026.

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