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Aortic Stenosis DiseaseOptEx-TAVINCT07042529

Optimized Expansion of the Implanted Transcatheter Aortic Valve

A study testing OptEx-TAVI and SoC-TAVI in people with Aortic Stenosis Disease and Valvular Heart Disease, run by Ole De Backer at 17 sites in 6 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Optimized Expansion of the implanted transcatheter aortic valve to reduce hypoattenuating leaflet thickening in non-atrial fibrillation patients undergoing transcatheter aortic valve implantation (TAVI): an international, multicentre, randomized controlled trial. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
OptEx-TAVI and SoC-TAVI
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,010 participants
Where
17 sitesin 6 countries
Study dates
5 Oct 2025to 1 Jul 2033
Phase
Interventional
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Severe native aortic valve stenosis
  • Indication for TAVI
  • Ability to understand and to comply with the study protocol

Who cannot join

  • Existing indication for oral anticoagulation (e.g., atrial fibrillation, venous thromboembolism, antiphospholipid syndrome, mechanical mitral valve)
  • Creatinine clearance <15 mL/min (CKD-EPI formula) or on renal replacement therapy
  • Iodine contrast allergy or other condition that prohibits cardiac CT imaging

Trial locations and contacts

17 sites in 6 countries. Contact the study team or a site near you to ask about taking part.

Ole De Backer, MD, PhD, FESC contact

+4535457086

ole.de.backer@regionh.dk

Troels H Jørgensen, MD, PhD contact

+4535450892

troels.hoejsgaard.joergensen.01@regionh.dk

17 sites in 6 countries

Belgium4 sites, 4 recruiting
  • AZORG ziekenhuis

    Aalst

    Liesbeth Rosseel, MD, PhD, +32 53 72 41 11, Liesbeth.rosseel@azorg.be

    Recruiting
  • CHU Charleroi

    Charleroi, 6000

    Adel Aminian, adel.aminian@chu-charleroi.be

    Recruiting
  • UZ Leuven

    Leuven, 3000

    Christophe Dubois, MD, PhD, christophe.dubois@uzleuven.be

    Recruiting
  • AZ Delta

    Roeselare

    Maarten Vanhaverbeke, MD, PhD, +32 51 23 61 11, Maarten.Vanhaverbeke@azdelta.be

    Recruiting

Other trials in Belgium

Denmark4 sites, 4 recruiting
  • Skejby Hospital

    Aa, 8200

    Christian J Terkelsen, christian.juhl.terkelsen@clin.au.dk

    Not yet recruiting
  • Aalborg University Hospital

    Aalborg, 9000

    Ashkan Eftekhari, asef@rn.dk

    Recruiting
  • Rigshospitalet

    Copenhagen

    Ole De Backer, MD, PhD, FESC, +4535457086, ole.de.backer@regionh.dk

    Troels H Jørgensen, MD, PhD, +4535450892, troels.hoejsgaard.joergensen.01@regionh.dk

    Recruiting
  • Odense University Hospital

    Odense C, 5000

    Henrik Nissen, henrik.nissen@rsyd.dk

    Not yet recruiting

Other trials in Denmark

Netherlands4 sites, 4 recruiting
  • UMC Amsterdam

    Amsterdam

    Ronak Delewi, MD, (020) 444 4444, r.delewi@amsterdamumc.nl

    Recruiting
  • University Medical Center Groningen

    Groningen

    Joanna J Wykrzykowska, MD, PhD, +31 50 361 6161, j.j.wykrzykowska@umcg.nl

    Recruiting
  • Leiden University Medical Center

    Leiden

    Frank van der Kley, +31 71 526 9111, F.van_der_kley@lumc.nl

    Recruiting
  • St. Antonius Hospital

    Nieuwegein, 3435

    Jur ten Berg, MD, PhD, j.ten.berg@antoniusziekenhuis.nl

    Christian Overduin, MD, PhD, c.overduin@antoniusziekenhuis.nl

    Recruiting

Other trials in Netherlands

Norway2 sites, 2 recruiting
  • Haukeland hospital

    Haukeland

    Erik Packer, MD, +47 55 97 50 00, erik.packer@helse-bergen.no

    Recruiting
  • Oslo universitetssygehus

    Oslo, 0450

    Kristoffer Engh Russell, MD, PhD, krruss@ous-hf.no

    Recruiting

Other trials in Norway

Sweden2 sites, 2 recruiting
  • Sahlgrenska University Hospital

    Gothenburg, 413 45

    Oskar Angerås, MD, PhD, oskar.angeras@vgregion.se

    Recruiting
  • Skånes universitetssjukhus

    Skåne

    Helle Søholm, MD, PhD, +46 46 17 10 00, helle.soholm@gmail.com

    Recruiting

Other trials in Sweden

Finland1 site, 1 recruiting
  • Turku University Hospital

    Turku, 20520

    Mikko Savontaus, mikko.savontaus@tyks.fi

    Recruiting

Other trials in Finland

About this study

Official title: Optimized Expansion of the Implanted Transcatheter Aortic Valve to Reduce Hypoattenuating Leaflet Thickening in Non-atrial Fibrillation Patients Undergoing Transcatheter Aortic Valve Implantation: an International, Multicentre, Randomized Controlled Trial

Optimized Expansion of the implanted transcatheter aortic valve to reduce hypoattenuating leaflet thickening in non-atrial fibrillation patients undergoing transcatheter aortic valve implantation (TAVI): an international, multicentre, randomized controlled trial.

The objective is to evaluate whether TAVI with systematic optimized pre- and post-dilatation (optimized expansion (OptEx) TAVI strategy), compared to a standard of care (SoC) TAVI strategy, is superior in reducing hypoattenuating leaflet thickening as evaluated by cardiac computed tomography (CT) imaging at three months after TAVI.

The primary outcome is at least one thickened TAV leaflet involving ≥ 25% of the leaflet curvilinear dimension as assessed at cardiac CT at three months after TAVI.

Read the detailed description

A total of 1010 patients will be included in the OptEx-TAVI trial and randomised 1:1 to either :

  • SoC-TAVI (N = 505) or
  • OptEx-TAVI (N = 505)

All patients with indication for TAVI and eligible in relation to the study in- and exclusion criteria will be offered participation in the OptEx-TAVI trial.

Inclusion criteria:

  • Severe native aortic valve stenosis
  • Indication for TAVI
  • Ability to understand and to comply with the study protocol

Exclusion criteria:

  • Existing indication for oral anticoagulation (e.g., atrial fibrillation, venous thromboembolism, antiphospholipid syndrome, mechanical mitral valve)
  • Creatinine clearance <15 mL/min (CKD-EPI formula) or on renal replacement therapy
  • Iodine contrast allergy or other condition that prohibits cardiac CT imaging

Baseline characteristics, medical history, procedural details, electrocardiogram, echocardiography and cardiac CT-scan parameters will be recorded by assessing medical charts and patient interview.

During the TAVI-procedure, patients will be treated according to randomisation to either SoC or OptEx

Planned post-procedural visits at:

  • Discharge: on-site - including transthoracic echocardiography (TTE)
  • 3 months visit (± 2 months): on-site - including TTE and cardiac CT scan
  • 1 year (± 3 months): on-site - including TTE and cardiac CT scan
  • 5 years (± 6 months): on-site - including TTE and cardiac positron emission tomography (PET)-CT scan
Being tested
OptEx-TAVI, SoC-TAVI
Keywords
Aortic stenosis, Cardiovascular, Transcatheter aortic valve, Transcatheter aortic valve implantation, Valvular heart disease, TAVI
Medical subject headings
Heart Valve Diseases, Aortic Valve Stenosis

What participants receive

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

  • OptEx-TAVIProcedure or surgery

    During TAVI with either self-expanding or balloon-expandable TAVs:

    • Pre-dilatation: systematic pre-dilatation with an optimally-sized balloon.
    • Post-dilatation: systematic TAV post-dilatation with an optimally-sized balloon.

    Optimally-sized balloon:

    1. The recommended balloon size used for pre- and post-dilatation is the perimeter-derived mean diameter of the native aortic annulus minus 1 mm and should never exceed the perimeter-derived mean diameter of the native aortic annulus. A smaller-sized balloon should be considered in case of severe left ventricular outflow tract calcium and/or severely calcified leaflets in combination with a shallow sinus of Valsalva.
    2. In case of post-dilatation of the Evolut TAV (Medtronic, USA), the instructions for use (IFU) for post-dilatation of the Evolut valve should be respected.
    3. Also, a balloon-expandable TAV has to be post-dilated with an optimally-sized balloon in case of randomization to the OptEx-TAVI arm.
  • SoC-TAVIProcedure or surgery

    During TAVI with either self-expanding or balloon-expandable TAVs: Pre-dilatation: optional, as per operator preference and post-dilatation: optional, as per operator preference. Operators are only encouraged to post-dilate the implanted TAV in case of ≥ moderate paravalvular regurgitation or a suboptimal transvalvular gradient. The balloon size used for pre- or post-dilatation is left at the operator's discretion.

Study groups in NCT07042529
Study groupRoleWhat they receive
SoC-TAVIActive comparatorPre-dilatation and post-dialation optional, as per operator preference. The balloon size used for pre- or post-dilatation is left at the operator's discretion. Operators are only encouraged to post-dilate the implanted transcatheter aortic valve (TAV) in case of ≥ moderate paravalvular regurgitation or a suboptimal transvalvular gradient.
Receives: Procedure: SoC-TAVI
OptEx-TAVIExperimentalSystematic pre-dilatation and post-dilatation with an optimally-sized balloon
Receives: Procedure: OptEx-TAVI

What is being measured

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

  1. At least one TAV leaflet with HALT

    At least one TAV leaflet with hypoattenuated leaflet thickening (HALT) involving more than the base (≥ 25% of the leaflet curvilinear dimension) as assessed at cardiac CT-scan .

    Measured: At three months after TAVI

Secondary outcomes (26)
  1. HALT 50%

    At least one TAV leaflet with HALT involving ≥ 50% of the leaflet curvilinear dimension assessed by cardiac CT-scan

    Measured: At 3 months/At 1 year

  2. HALT 25%

    The rate of TAV leaflets with HALT involving ≥ 25% of the leaflet curvilinear dimension assessed by cardiac CT-scan

    Measured: At 3 months/At 1 year

  3. HALT 50%, multiple

    The rate of TAV leaflets with HALT involving ≥ 50% of the leaflet curvilinear dimension assessed by cardiac CT-scan

    Measured: At 3 months/At 1 year

  4. Bioprosthetic leaflet micro-calcification target-to-background ratio

    Ratio of bioprosthetic micro-calcification activity assessed by PET CT- scan by 18F-NaF uptake originating from the valve leaflets observed on 3 orthogonal planes after co-registration of background PET activity with contrast CT angiography.

    Only for those patients alive at 5 years and volunteering to undergo a F-NaF PET-CT-scan

    Measured: At 5 years

  5. Valve performance

    Intended performance of the valve (mean gradient < 20 mmHg, peak velocity < 3 m/s, Doppler velocity index ≥ 0.25, and less than moderate aortic regurgitation) by TTE as per VARC- 3 criteria

    Measured: At 3 months/At 1 year

  6. structural valve deterioration

    Moderate or greater hemodynamic structural valve deterioration by TTE as per VARC-3 criteria. Only for those patients alive at 5 years and volunteering to undergo a F-NaF PET-CT-scan

    Measured: At 5 years

  7. Bioprosthetic valve dysfunction (BVD)

    Severe bioprosthetic valve dysfunction (BVD) by TTE as per VARC-3 criteria. Only for those patients alive at 5 years and volunteering to undergo a F-NaF PET-CT-scan

    Measured: At 5 years

  8. Bioprosthetic valve failure (BVF)

    As per VARC-3 criteria; Only for those patients alive at 5 years and volunteering to undergo a F-NaF PET-CT-scan

    Measured: At 5 years

  9. Technical success

    As per VARC-3 criteria

    Measured: Periprocedural

  10. Device success

    as per VARC-3 criteria

    Measured: At 3 months

  11. Early safety

    As per VARC-3 criteria

    Measured: At 3 months

  12. Clinical efficacy

    As per VARC-3 criteria

    Measured: At 1 year

  13. Valve-related long-term clinical efficacy

    As per VARC-3 criteria; Only for those patients alive at 5 years and volunteering to undergo a F-NaF PET-CT-scan

    Measured: At 5 years

  14. Freedom from mortality

    Freedom from mortality

    Measured: Periprocedural, at 3 months and at 1 year

  15. Risk of cardiovascular mortality

    Risk of cardiovascular mortality. VARC-3 criteria

    Measured: At 1 year

  16. Risk of non-cardiovascular mortality

    Risk of non-cardiovascular mortality. VARC-3 criteria

    Measured: At 1 year

  17. Risk of acute kidney injury

    Risk of acute kidney injury stage 3 or 4. VARC-3 criteria

    Measured: At 3 months

  18. Risk of bleeding

    Risk of VARC-3 type 2-4 bleeding

    Measured: At 3 months, 1 year and 5 years (Only for those patients alive at 5 years and volunteering to undergo a F-NaF PET-CT-scan)

  19. Risk of stroke

    Risk of all stroke

    Measured: At 3 months and 1 year

  20. Risk of thomboembolism

    Freedom from stroke or peripheral embolism (presumably valve-related, after ruling out other non-valve aetiologies). VARC-3 criteria.

    Measured: At 5 years

  21. Rate of successful access

    Successful access, delivery of the device, and retrieval of the delivery system

    Measured: Periprocedural

  22. Freedom from surgery or intervention

    Rate of freedom from surgery or intervention related to the device or to a major vascular or access-related, or cardiac structural complication

    Measured: Periprocedural and at 3 months

  23. Risk of vascular complications

    Risk of major vascular, access-related, or cardiac structural complication, VARC-3 criteria.

    Measured: At 3 months

  24. Risk of aortic prosthetic regurgitation

    Freedom from moderate or severe aortic regurgitation. VARC-3 criteria

    Measured: At 3 months

  25. Risk of permanent pacemaker

    Risk of new permanent pacemaker due to procedure-related conduction abnormalities

    Measured: At 3 months

  26. Risk of procedure or valve-related hospitalization

    Risk of hospitalization for procedure- or valve-related causes. VARC-3

    Measured: At 1 year

Timeline

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

  1. First posted29 Jun 2025
  2. Study start5 Oct 2025
  3. Primary completion1 Jul 2029 (estimated)
  4. Study completion1 Jul 2033 (estimated)

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
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
1,010 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07042529
Sponsor's protocol ID
OptEx-TAVI Trial
Other IDs
H-25039123
Acronym
OptEx-TAVI
Status last verified
Jul 2026
First submitted
8 Jun 2025
Last updated
10 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing OptEx-TAVI and SoC-TAVI in people with Aortic Stenosis Disease and Valvular Heart Disease, run by Ole De Backer at 17 sites in 6 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 3 inclusion and 3 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: looking for participants now, as of the sponsor's last update on 10 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 17 sites in Belgium, Denmark, Netherlands, Norway, Sweden and 1 more country. 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?

Contact Ole De Backer, MD, PhD, FESC (+4535457086, ole.de.backer@regionh.dk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

At least one TAV leaflet with HALT (time frame: At three months after TAVI). 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 10 Jul 2026.

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