SAVR: SAVR with a commercially available bioprosthetic valve.
SAPIEN 3 THV: TAVR with the Edwards SAPIEN 3 Transcatheter Heart Valve and Edwards Commander Delivery System
Study summary
To establish the safety and effectiveness of the Edwards SAPIEN 3 Transcatheter Heart Valve (THV) in patients with severe, calcific aortic stenosis who are at low operative risk for standard aortic valve replacement.
Eligibility
Sex
ALL
Min age
—
Max age
—
Healthy volunteers
No
Inclusion Criteria:
1. Severe, calcific aortic stenosis
2. New York Heart Association Functional Class ≥ 2 OR exercise tolerance test that demonstrates a limited exercise capacity, abnormal BP response, or arrhythmia OR asymptomatic with Left Ventricular Ejection Fraction (LVEF) \<50%
3. Heart team agrees the patient has a risk of operative mortality and has an Society of Thoracic Surgeons (STS) score \< 4
4. The study patient has been informed of the nature of the study, agrees to its provisions and has provided written informed consent.
Exclusion Criteria:
1. Native aortic annulus size unsuitable for sizes 20, 23, 26, or 29 mm transcatheter heart valve
2. Iliofemoral vessel characteristics that would preclude safe passage of the introducer sheath
3. Evidence of an acute myocardial infarction ≤ 30 days before randomization
4. Aortic valve is unicuspid, bicuspid, or non-calcified
5. Severe aortic regurgitation (\>3+)
6. Severe mitral regurgitation (\>3+) ≥ moderate stenosis
7. Pre-existing mechanical or bioprosthetic valve in any position
8. Complex coronary artery disease:
1. Unprotected left main coronary artery
2. Syntax score \> 32
3. Heart Team assessment that optimal revascularization cannot be performed
9. Symptomatic carotid or vertebral artery disease or successful treatment of carotid stenosis within 30 days of randomization
10. Leukopenia, anemia, thrombocytopenia, history of bleeding diathesis or coagulopathy, or hypercoagulable states
11. Hemodynamic or respiratory instability requiring inotropic support, mechanical ventilation or mechanical heart assistance within 30 days of randomization
12. Hypertrophic cardiomyopathy with obstruction
13. Ventricular dysfunction with LVEF \< 30%
14. Cardiac imaging evidence of intracardiac mass, thrombus or vegetation
15. Inability to tolerate or condition precluding treatment with antithrombotic/anticoagulation therapy during or after the valve implant procedure
16. Stroke or transient ischemic attack within 90 days of randomization
17. Renal insufficiency and/or renal replacement therapy at the time of screening.
18. Active bacterial endocarditis within 180 days of randomization
19. Severe lung disease or currently on home oxygen
20. Severe pulmonary hypertension
21. History of cirrhosis or any active liver disease
22. Significant frailty as determined by the Heart Team
23. Significant abdominal or thoracic aortic disease that would preclude safe passage of the delivery system or cannulation and aortotomy for surgical aortic valve replacement
24. Hostile chest or conditions or complications from prior surgery that would preclude safe reoperation
25. Patient refuses blood products
26. Body mass index \> 50 kg/m2
27. Estimated life expectancy \< 24 months
28. Absolute contraindications or allergy to iodinated contrast that cannot be adequately treated with pre-medication
29. Immobility that would prevent completion of study procedures
30. Patient is not a candidate for both arms of the study
31. Currently participating in an investigational drug or another device study.
Primary outcome measure(s)
All-cause Mortality, All Stroke, and Rehospitalization (Valve-related or Procedure-related and Including Heart Failure) — 1 year Number of patients that had any of these events
Trial sites (77)
Facility
City
Region
Status
University of Alabama
Birmingham
Alabama
Banner University Medical Center
Phoenix
Arizona
Mills/Peninsula Health Services
Burlingame
California
Cedars-Sinai Medical Center
Los Angeles
California
University of California, Los Angeles/Ronald Reagan Medical Center
Los Angeles
California
Hoag Hospital
Newport Beach
California
Stanford Hospital and Clinics
Palo Alto
California
Sutter Health Sacramento
Sacramento
California
Kaiser Permanente San Francisco
San Francisco
California
UC Health Northern Colorado/Medical Center of the Rockies
Loveland
Colorado
Hartford
Hartford
Connecticut
JFK Medical Center / Atlantic Clinical Research Collaborative
Atlantis
Florida
University of Florida, Gainesville
Gainesville
Florida
Mount Sinai Medical Center
Miami Beach
Florida
Florida Hospital
Orlando
Florida
Emory University
Atlanta
Georgia
The Queen's Medical Center
Honolulu
Hawaii
Northwestern University
Chicago
Illinois
Rush University Medical Center
Chicago
Illinois
NorthShore University HealthSystem Research Institute
Evanston
Illinois
Prairie Education and Research Cooperative
Springfield
Illinois
University of Iowa Hospitals and Clinics
Iowa City
Iowa
Cardiovascular Research Institute of Kansas
Wichita
Kansas
UPR - Louisiana State University Health Science Center
New Orleans
Louisiana
Ochsner Clinic Foundation
New Orleans
Louisiana
Central Maine Medical Center
Auburn
Maine
Brigham and Women's Hospital
Boston
Massachusetts
Henry Ford Hospital
Detroit
Michigan
William Beaumont Hospital
Royal Oak
Michigan
University of Minnesota Medical Center
Minneapolis
Minnesota
Mayo Clinic
Rochester
Minnesota
Saint Luke's Hospital of Kansas City Mid America
Kansas City
Missouri
Barnes-Jewish Hospital / Washington University
St Louis
Missouri
Nebraska Heart Institute
Lincoln
Nebraska
Dartmouth-Hitchcock Medical Center
Lebanon
New Hampshire
Morristown Medical Center / Atlantic Health System Hospital
Morristown
New Jersey
Newark Beth Israel
Newark
New Jersey
Albany
Albany
New York
University of Buffalo
Buffalo
New York
Winthrop-University Hospital
Mineola
New York
+ 37 more sites — see the full list on the official registry below.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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