Effects of Changes in Fluid Status on Right Ventricular Volumes and Function

NCT ID: NCT02967315

Last Updated: 2021-04-14

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

NA

Total Enrollment

4 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-06-06

Study Completion Date

2021-03-18

Brief Summary

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The purpose of this study is to evaluate the correlation between fluid volume status and right ventricular volume and function, in those with free pulmonary valve insufficiency after Tetralogy of Fallot (TOF) repair.

Detailed Description

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The purpose of this study is to measure the changes in Right Ventricular size and function with changes in preload, using cardiovascular magnetic resonance (CMR). Based on an intensive research and clinical observations the investigators hypothesize that changes in volume status cause a statistically significant difference in the Cardiovascular magnetic resonance (CMR) measured RV End Diastolic Volume (EDV), end-systolic volume (ESV), ejection fraction (EF) and pulmonary regurgitation (PR). The investigator hypothesizes that smaller changes will occur in left ventricular LV EDV, ESV, and EF.

1. To establish a correlation between the changes in preload volume status and RV size and function in patients with free pulmonary insufficiency (PI) after TOF repair using CMRI.
2. To assess the effects of preload status on the measured severity of pulmonary regurgitation (PR).
3. To assess the effects of preload status on the left ventricular (LV) size

This study will be conducted in compliance with this protocol, good clinical practice and the applicable regulatory requirements.

Conditions

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Tetralogy of Fallot

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Study Group

Procedures include:

Two Cardiac Magnetic Resonance Imaging (CMRIs) A central venous line placement, A chest X-ray Electrocardiogram (ECG) Fluid administration Blood draw Pregnancy test

Group Type EXPERIMENTAL

Cardiac Magnetic Resonance Imaging (CMRI)

Intervention Type PROCEDURE

There will be 2 CMRIs. The first one will be patient's routine clinically schedule CMRI after the patient has fasted for 12 hours.This CMRI uses contrast.

The second CMRI will be the research CMRI after the fluid administration. This CMRI does not use contrast.

Central venous line placement

Intervention Type PROCEDURE

An ultrasound guided central line catheter will be placed in the internal jugular vein (IJV) under local anesthesia.

Chest X-ray

Intervention Type PROCEDURE

A chest X-ray will be performed for safety reasons to rule out pneumothorax (\< 1% risk) after central line placement.

Fluid administration

Intervention Type PROCEDURE

Administration of 15cc/kg of normal saline for fluid hydration through peripheral IV that is placed for the MRI contrast administration.

Blood Draw

Intervention Type PROCEDURE

One to two teaspoons of blood will be drawn for basic metabolic panel.

Pregnancy test

Intervention Type PROCEDURE

A urine pregnancy test will be performed in female subjects.

Electrocardiogram

Intervention Type PROCEDURE

12 lead ECG

Interventions

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Cardiac Magnetic Resonance Imaging (CMRI)

There will be 2 CMRIs. The first one will be patient's routine clinically schedule CMRI after the patient has fasted for 12 hours.This CMRI uses contrast.

The second CMRI will be the research CMRI after the fluid administration. This CMRI does not use contrast.

Intervention Type PROCEDURE

Central venous line placement

An ultrasound guided central line catheter will be placed in the internal jugular vein (IJV) under local anesthesia.

Intervention Type PROCEDURE

Chest X-ray

A chest X-ray will be performed for safety reasons to rule out pneumothorax (\< 1% risk) after central line placement.

Intervention Type PROCEDURE

Fluid administration

Administration of 15cc/kg of normal saline for fluid hydration through peripheral IV that is placed for the MRI contrast administration.

Intervention Type PROCEDURE

Blood Draw

One to two teaspoons of blood will be drawn for basic metabolic panel.

Intervention Type PROCEDURE

Pregnancy test

A urine pregnancy test will be performed in female subjects.

Intervention Type PROCEDURE

Electrocardiogram

12 lead ECG

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. TOF patients who have had repair using a transannular patch.
2. Patients that present with free pulmonary insufficiency.
3. Are older than 18 years.

Exclusion Criteria

1. Patients who have lesions predisposing to chronic volume overload (i.e. patients with significant residual postoperative ventricular septal defects (VSD), or large aorto-pulmonary collaterals or more than moderate tricuspid insufficiency) since all these hemodynamic conditions can influence the late function of the right ventricle and potentially affect the response of the right side of the heart in changes in volume status
2. Patients who had a valve sparing TOF repair and have less than free pulmonary insufficiency.
3. Patients who have significant residual right-sided obstruction (i.e. patients who have residual RVOT obstruction or significant residual branch pulmonary artery stenosis), as it is shown that residual pulmonary stenosis may protect from RV dilation and from deterioration of the RV function.
4. Patients who cannot be reconstructed with a transannular patch and/or require a right ventricle to pulmonary artery homograft for reconstruction including:

* pulmonary atresia and VSD
* patients with anomalous coronary crossing the right ventricular outflow tract (RVOT) and
* patients with TOF-absent pulmonary valve syndrome.
5. Patients with renal failure and renal insufficiency
6. Patients with uncompensated heart failure
7. Cancer patients
8. Latex allergic patients
9. Patients with diabetes
10. Pregnant females
11. Prisoners
12. Individuals who lack consent capacity
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Wisconsin, Madison

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Petros V Anagnostopoulos, MD

Role: PRINCIPAL_INVESTIGATOR

University of Wisconsin, Madison

Locations

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University of Wisconsin-Madison

Madison, Wisconsin, United States

Site Status

Countries

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United States

Other Identifiers

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2013-0276

Identifier Type: OTHER

Identifier Source: secondary_id

SMPH/SURGERY/CARDIOTHORACIC

Identifier Type: OTHER

Identifier Source: secondary_id

2018-0399

Identifier Type: -

Identifier Source: org_study_id

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