Cerebral Embolic Load in Patients Undergoing Surgical Aortic Valve Replacement: A Comparison of the Conventional With the Minimized Extracorporeal Circulation Technique Using Transcranial Doppler Ultrasound

NCT ID: NCT02308566

Last Updated: 2016-06-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-06-30

Study Completion Date

2016-06-30

Brief Summary

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In this study, the investigators aim to compare cerebral embolic load in patients undergoing surgical aortic valve replacement using either the minimized extracorporeal circulation or the conventional extracorporeal circulation technique. The detection of cerebral emboli is performed not-invasively by transcranial Doppler detection of high-intensity transient signals representing solid or gaseous microembolism in the middle cerebral arteries. The investigators hope to get more insight in the mechanism (incl. quantity) of cerebral embolism during aortic valve surgery using extracorporeal circulation.

Detailed Description

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Background

The gold standard to treat severe aortic valve stenosis is currently the surgical aortic valve replacement (SAVR) using conventional extracorporeal circulation (CECC). SAVR, however, can be performed also on minimized extracorporeal circulation (MECC), which is characterized by reduced priming volume and interfaces between blood and artificial surfaces and blood-air interface, respectively. Further technical developments of the MECC system together with reports on less induction of the coagulation cascade and activation of inflammatory systemic response may account for a reduced incidence of microbubble generation with MECC system.

Objective

The aim of the is to investigate the procedural-related incidence of high-intensity transient signals (HITS) representing solid or gaseous microembolism reaching the cerebral vessels.

Methods

Patients undergoing SAVR are included in the study and randomised to either MECC or CECC technique. HITS are continuously bilaterally detected during the entire intraoperative period by transcranial Doppler ultrasound.

Conditions

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Aortic Valve Stenosis Extracorporeal Circulation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Conventional Extracorporeal Circulation Technique

Conventional Extracorporeal Circulation Technique

Group Type ACTIVE_COMPARATOR

Conventional Extracorporeal Circulation (CECC)

Intervention Type PROCEDURE

This group of patients receives surgical aortic valve replacement using CECC.

Minimized Extracorporeal Circulation Technique

Minimized Extracorporeal Circulation Technique

Group Type EXPERIMENTAL

Minimized Extracorporeal Circulation (MECC)

Intervention Type PROCEDURE

This group of patients receives surgical aortic valve replacement using MECC.

Interventions

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Minimized Extracorporeal Circulation (MECC)

This group of patients receives surgical aortic valve replacement using MECC.

Intervention Type PROCEDURE

Conventional Extracorporeal Circulation (CECC)

This group of patients receives surgical aortic valve replacement using CECC.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Isolated Severe Aortic Valve Stenosis
* No other cardiac disease
* No other coronary heart disease
* Written informed consent

Exclusion Criteria

* Double valve surgery
* Concomitant coronary artery bypass surgery
* Vascular surgery
* Age \< 18 yrs.
* Age \> 80 yrs.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Insel Gruppe AG, University Hospital Bern

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Thierry Carrel, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Cardiovascular Surgery

Locations

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University Hospital Bern

Bern, , Switzerland

Site Status

Countries

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Switzerland

Other Identifiers

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034/11

Identifier Type: -

Identifier Source: org_study_id

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