Syncardia 50cc TAH-t as a Bridge to Transplant

NCT ID: NCT02459054

Last Updated: 2020-08-10

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

TERMINATED

Clinical Phase

NA

Total Enrollment

16 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-10-31

Study Completion Date

2020-07-29

Brief Summary

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The primary objective of the study is to evaluate whether the 50cc TAH-t can safely support, and provide probable benefit to, transplant-eligible pediatric patients (aged 10 - 18 years) and can safely and effectively support transplant-eligible adult patients (aged 19 - 75 years) at imminent risk of death from biventricular failure without experiencing permanent disabling, stroke-related deficits.

The study will be conducted as a three-arm trial of the 50cc temporary Total Artificial Heart (TAH-t) as a bridge to transplant:

* The Primary Pediatric Arm of the trial will evaluate the safety and probable benefit of the 50cc TAH-t for transplant-eligible patients 10 through 18 years of age.
* The Primary Adult Arm of the trial will evaluate the safety and efficacy of the 50cc TAH-t for transplant-eligible patients 19 through 75 years of age.
* The Secondary Arm will capture pediatric and adult subjects who did not meet enrollment criteria for a Primary Arm, but meet the less restrictive Secondary Arm enrollment criteria, in order to further characterize the use of the device.

Detailed Description

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Heart failure is the reduced ability of the native heart to pump blood and maintain normal bodily function. Heart transplantation is the standard of care treatment for end-stage heart failure but the supply of donor hearts is insufficient to meet the need and many patients are not eligible for transplantation because of age or comorbid conditions.

On 15 October 2004, the SynCardia 70cc temporary TAH-t System received Food and Drug Administration (FDA) approval for Premarket Approval Application (PMA) #P030011 for in-hospital use as a bridge to transplant (BTT) in cardiac transplant-eligible candidates at risk of imminent death from biventricular failure. The system consists of the implantable TAH-t and an external pneumatic driver. Subsequent to the original approval, two additional external pneumatic drivers have been approved for use with the 70cc TAH-t.

On 30 January 2013, FDA granted a Humanitarian Use Designation (HUD) to the 50cc TAH-t for use as BTT in pediatric patients with biventricular heart failure who have a body surface area (BSA) that can sufficiently accommodate the device. To evaluate the ability of the device to support patients who are too small to be supported with the 70cc TAH-t, SynCardia will conduct a clinical study.

The study will be conducted as a three-arm trial of the 50cc temporary Total Artificial Heart (TAH-t) as a bridge to transplant:

* The Primary Pediatric Arm of the trial will evaluate the safety and probable benefit of the 50cc TAH-t for transplant-eligible patients 10 through 18 years of age.
* The Primary Adult Arm of the trial will evaluate the safety and efficacy of the 50cc TAH-t for transplant-eligible patients 19 through 75 years of age.
* The Secondary Arm will capture pediatric and adult subjects who did not meet enrollment criteria for the pediatric arm, but meet the less restrictive Secondary Arm enrollment criteria, in order to further characterize the use of the device.

Pediatric subject data through six months post-implant will be reported to FDA to support a Humanitarian Device Exemption (HDE) application for an orphan indication in pediatric patients for which there is no alternative replacement device. Pediatric subjects (enrolled in the Primary Pediatric Arm or Secondary Arm) who are continuing on TAH-t support at the six month study visit will continue to be followed under the study every six months until transplant, withdrawal from the study, all subjects in the respective arm have reached an endpoint, or death, whichever occurs first.

The primary objective of the Primary Pediatric Arm of the study is to evaluate whether the 50cc TAH-t can safely support, and provide probable benefit to, transplant-eligible pediatric patients at imminent risk of death from biventricular failure without experiencing permanent disabling, stroke-related deficits. Probable benefit will be measured as transplanted during the first six months, or survival at six months and continuing on support on the initially placed 50cc TAH-t, without experiencing permanent disabling stroke-related deficits.

Safety will be evaluated by the characterization of the adverse event (AE) profile through the six month study end date. AEs will be identified by the terms and definitions of the Pedimacs/Intermacs Registry. The secondary endpoints to establish safety for both the pediatric and adult arms will be measured by performance goals (based on prior experience with the 70cc TAH-t) for the four adverse event categories that are likely to delay or preclude transplant. The four categories are: Major infection (sepsis), Neurological event (CVA), Chronic renal dysfunction, Major device failures/malfunctions per the Pedimacs/Intermacs AE definitions.

Adult patient data through six months post-implant will be reported to FDA to support a Premarket application (PMA) for treatment of small-statured adult patients who are unable to accommodate the 70cc TAH-t in their chest cavity and for whom there is no alternative replacement device. Adult subjects (enrolled in the Primary Adult Arm or the Secondary Arm) will be followed through six months post-implant and, if continuing on support at that time, will continue to be followed under the study every six months until transplant, withdrawal from the study, all subjects in the respective arm have reached an endpoint, or death, whichever occurs first.

Conditions

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Heart Failure, Right-Sided Cardiac Failure Heart Failure, Left-Sided

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Primary Pediatric Arm

Cardiac transplant-eligible pediatric patients at imminent risk of death from biventricular failure who are 10 - 18 years old at time of TAH-t implant. The intervention is implantation with the 50cc temporary Total Artificial Heart as a bridge to transplantation.

Group Type EXPERIMENTAL

SynCardia 50cc temporary Total Artificial Heart (TAH-t)

Intervention Type DEVICE

Replacement of both ventricles and all four valves with the investigational device as a bridge to transplantation.

Primary Adult Arm

Cardiac transplant-eligible adult patients at imminent risk of death from biventricular failure who are 19 - 75 years old at time of TAH-t implant. The intervention is implantation with the 50cc temporary Total Artificial Heart as a bridge to transplantation.

Group Type EXPERIMENTAL

SynCardia 50cc temporary Total Artificial Heart (TAH-t)

Intervention Type DEVICE

Replacement of both ventricles and all four valves with the investigational device as a bridge to transplantation.

Secondary Arm

Cardiac transplant-eligible pediatric and adult patients at imminent risk of death from biventricular failure who do not meet enrollment criteria for a Primary Arm, but meet less restrictive enrollment criteria for the Secondary Arm. The intervention is implantation with the 50cc temporary Total Artificial Heart as a bridge to transplantation.

Group Type EXPERIMENTAL

SynCardia 50cc temporary Total Artificial Heart (TAH-t)

Intervention Type DEVICE

Replacement of both ventricles and all four valves with the investigational device as a bridge to transplantation.

Interventions

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SynCardia 50cc temporary Total Artificial Heart (TAH-t)

Replacement of both ventricles and all four valves with the investigational device as a bridge to transplantation.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* At imminent risk of death from biventricular heart failure
* Aged 10 - 18 years (pediatric); 19 - 75 years (adults) at time of implant
* With two functional atrioventricular (A-V) valves
* With Body Surface Area (BSA) of 1.2 through 1.85m2
* With adequate sternum to T10 distance OR Adequate room in chest as determined by 3-D imaging assessment or by other standard clinical assessments


* Not eligible for Primary Arm
* At imminent risk of death from biventricular heart failure
* With Body Surface Area (BSA) of 1.2 through 1.85m2
* With adequate sternum to T10 distance OR Adequate room in chest as determined by 3-D imaging assessment or by other standard clinical assessments

Exclusion Criteria

* Patients who are not cardiac transplant-eligible
* Cardiac transplant-eligible patients

* Who cannot be adequately anticoagulated on the TAH-t
* With insufficient space in the chest
* Who are on extracorporeal membrane oxygenation (ECMO) support \> 3 days
* Patients who are being supported by an investigational device at the time of evaluation for a 50cc TAH-t
* Patients who have required cardiopulmonary resuscitation (CPR) for \> 30 minutes within 14 days prior to proposed implant
* Patients who have experienced a stroke within 30 days prior to proposed implant
* Patients who are dialysis-dependent at time of proposed implant


* Patients who are not cardiac transplant-eligible
* Cardiac transplant-eligible patients

* Who cannot be adequately anticoagulated on the TAH-t
* With insufficient space in the chest
* Patients who are being supported by an investigational device at the time of evaluation for a 50cc TAH-t
Minimum Eligible Age

10 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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SynCardia Systems. LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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David Morales, MD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital Medical Center, Cincinnati

Francisco Arabia, MD

Role: PRINCIPAL_INVESTIGATOR

Cardiac-Dynamics

Locations

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Banner University Medical Center

Tucson, Arizona, United States

Site Status

Cedars-Sinai Medical Center

Los Angeles, California, United States

Site Status

University of California Los Angeles

Los Angeles, California, United States

Site Status

Shands Hospital at the University of Florida

Gainesville, Florida, United States

Site Status

Indiana University Health

Indianapolis, Indiana, United States

Site Status

Riley Hospital for Children at Indiana University Health

Indianapolis, Indiana, United States

Site Status

University of Louisville

Louisville, Kentucky, United States

Site Status

Ochsner Medical Center

New Orleans, Louisiana, United States

Site Status

Strong Memorial Hospital - Paul Yu Heart Center

Rochester, New York, United States

Site Status

Cincinnati Children's Hospital

Cincinnati, Ohio, United States

Site Status

The Ohio State University

Columbus, Ohio, United States

Site Status

Integris Baptist Medical Center

Oklahoma City, Oklahoma, United States

Site Status

The Milton S Hershey Medical Center

Hershey, Pennsylvania, United States

Site Status

The Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, United States

Site Status

Children's Health of Dallas

Dallas, Texas, United States

Site Status

Baylor University Medical Center at Dallas

Dallas, Texas, United States

Site Status

Memorial Hermann Hospital

Houston, Texas, United States

Site Status

Methodist DeBakey Heart and Vascular Center

Houston, Texas, United States

Site Status

University of Virginia Medical Center

Charlottesville, Virginia, United States

Site Status

Virginia Commonwealth University

Richmond, Virginia, United States

Site Status

University of Washington Medical Center

Seattle, Washington, United States

Site Status

Providence Sacred Heart Medical Center

Spokane, Washington, United States

Site Status

Aurora St. Luke's Hospital

Milwaukee, Wisconsin, United States

Site Status

Children's Hospital of Wisconsin

Milwaukee, Wisconsin, United States

Site Status

Froedtert & the Medical College of Wisconsin

Milwaukee, Wisconsin, United States

Site Status

Countries

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United States

Other Identifiers

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RA-551

Identifier Type: -

Identifier Source: org_study_id

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