Briedis Kasparas, Mizariene Vaida, Rumbinaite Egle, Jurenas Martynas, Aldujeli Ali, Briede Kamilija, Jakuska Povilas, Jankauskas Antanas, Ceponiene Indre, Lenkutis Tadas, Zaliunas Remigijus, Benetis Rimantas
Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Cardiac, Thoracic and Vascular Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Front Cardiovasc Med. 2023 Jul 13;10:1199047. doi: 10.3389/fcvm.2023.1199047. eCollection 2023.
The novel Vienna TAVI system is repositionable and retrievable, already pre-mounted on the delivery system, eliminating the need for assembly and crimping of the device prior to valve implantation.
The purpose of this first-in-human feasibility study was to determine the safety, feasibility, clinical and hemodynamic performance of the Vienna TAVI system at 6-month follow-up. (ClinicalTrials.gov identifier NCT04861805).
This is a prospective, non-randomized, single-arm, single-center, first-stage FIH feasibility study, which is followed by a second-stage pivotal, multicenter, multinational study in symptomatic patients with severe aortic stenosis (SAS). The first-stage FIH study evaluated the safety and feasibility, clinical and hemodynamic performance of the device in 10 patients with SAS based on recommendations by the VARC-2.
All patients were alive at 3-month follow-up. 1 non-cardiovascular mortality was reported 5 months after implantation. There were no new cerebrovascular events, life-threatening bleeding or conduction disturbances observed at 6-month follow-up. The mean AV gradient significantly decreased from 48.7 ± 10.8 to 7.32 ± 2.0 mmHg and mean AVA increased from 0.75 ± 0.18 to 2.16 ± 0.42 cm ( < 0.00001). There was no incidence of moderate or severe total AR observed. In the QoL questionnaires, the patients reported a significant improvement from the baseline 12-KCCQ mean score 58 ± 15 to 76 ± 20. NYHA functional class improved in two patients, remained unchanged in one patient. There was an increase in mean 6-min-walk distance from baseline 285 ± 97 to 347 ± 57 m.
This study demonstrates that using Vienna TAVI system has favourable and sustained 6-month safety and performance outcomes in patients with symptomatic severe aortic stenosis.
新型维也纳经导管主动脉瓣植入(TAVI)系统可重新定位和回收,已预先安装在输送系统上,无需在瓣膜植入前进行装置组装和压接。
这项首次人体可行性研究的目的是在6个月随访时确定维也纳TAVI系统的安全性、可行性、临床和血流动力学性能。(ClinicalTrials.gov标识符NCT04861805)。
这是一项前瞻性、非随机、单臂、单中心的第一阶段首次人体可行性研究,随后是针对有症状的严重主动脉瓣狭窄(SAS)患者的第二阶段关键、多中心、跨国研究。第一阶段首次人体研究根据VARC-2的建议评估了该装置在10例SAS患者中的安全性和可行性、临床和血流动力学性能。
所有患者在3个月随访时均存活。植入后5个月报告1例非心血管死亡。在6个月随访时未观察到新的脑血管事件、危及生命的出血或传导障碍。平均主动脉瓣压差从48.7±10.8显著降至7.32±2.0 mmHg,平均主动脉瓣口面积从0.75±0.18增加至2.16±0.42 cm(<0.00001)。未观察到中度或重度主动脉瓣反流的发生。在生活质量问卷中,患者报告12-KCCQ平均得分从基线的58±15显著提高至76±20。纽约心脏协会(NYHA)功能分级在2例患者中改善,1例患者保持不变。平均6分钟步行距离从基线的285±97增加至347±57 m。
本研究表明,对于有症状的严重主动脉瓣狭窄患者,使用维也纳TAVI系统在6个月时具有良好且持续的安全性和性能结果。