TRILUMINATE Pivotal Trial

NCT ID: NCT03904147

Last Updated: 2024-12-19

Study Results

Results available

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Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

572 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-08-21

Study Completion Date

2029-04-30

Brief Summary

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The primary objective of this trial is to demonstrate the safety and effectiveness of the TriClip device in improving clinical outcomes in symptomatic patients with severe tricuspid regurgitation (TR), who are at intermediate or greater estimated risk for mortality or morbidity with tricuspid valve surgery. This randomized controlled trial will compare the investigational device (TriClip device) to Control (Medical Therapy).

Detailed Description

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Conditions

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Tricuspid Regurgitation

Keywords

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ABT-CIP-10249 Tricuspid Cardiovascular Pivotal

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Randomized - Device Group

Subjects will undergo TriClip implantation and will continue to be managed on medical therapy, per physician discretion

Group Type EXPERIMENTAL

TriClipTM Device

Intervention Type DEVICE

Transcatheter TriClip placement in the tricuspid valve to repair the valve and correct regurgitation

Randomized - Control Group

Subjects will continue to be managed on medical therapy, per physician discretion

Group Type ACTIVE_COMPARATOR

TriClipTM Device

Intervention Type DEVICE

Transcatheter TriClip placement in the tricuspid valve to repair the valve and correct regurgitation

Single Arm Group

Subjects will receive the TriClip device and will continue to be managed on medical therapy, per physician discretion.

Group Type EXPERIMENTAL

TriClipTM Device

Intervention Type DEVICE

Transcatheter TriClip placement in the tricuspid valve to repair the valve and correct regurgitation

Continued Access Study (CAS)

Subjects will undergo TriClip implantation and will continue to be managed on medical therapy, per physician discretion

Group Type EXPERIMENTAL

TriClipTM Device

Intervention Type DEVICE

Transcatheter TriClip placement in the tricuspid valve to repair the valve and correct regurgitation

Interventions

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TriClipTM Device

Transcatheter TriClip placement in the tricuspid valve to repair the valve and correct regurgitation

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* In the judgment of the site local heart team, subject has been adequately treated per applicable standards (including medical management) and stable for at least 30 days as follows:

* Optimized medical therapy for treatment of TR (e.g. diuretics).
* Medical and/or device therapy, for mitral regurgitation, atrial fibrillation, coronary artery disease and heart failure.
* The Eligibility Committee will confirm that the subject has been adequately treated medically.
* Subject is symptomatic with Severe TR despite being optimally treated as described above. TR severity is determined by the assessment of a qualifying TTE and confirmed by the ECL. The ECL will also request a TEE to confirm TR etiology. Note: If any cardiac procedure(s) occur after eligibility was determined, TR severity will need to be re-assessed 30 days after the cardiac procedure(s).
* The cardiac surgeon of the site local heart team concur that the patient is at intermediate or greater estimated risk for mortality or morbidity with tricuspid valve surgery.
* New York Heart Association (NYHA) Functional Class II, III or ambulatory class IV
* In the judgment of the TriClip(TM) implanting Investigator, femoral vein access is determined to be feasible and can accommodate a 25 Fr catheter.
* Age ≥18 years at time of consent.
* Subject must provide written informed consent prior to any trial related procedure.

Exclusion Criteria

* Systolic pulmonary artery pressure (sPAP) \> 70 mmHg or fixed pre-capillary pulmonary hypertension as assessed by right heart catheterization (RHC)
* Severe uncontrolled hypertension Systolic Blood Pressure (SBP) ≥ 180 mmHg and/or Diastolic Blood Pressure (DBP) ≥ 110 mm Hg
* Any prior tricuspid valve procedure that would interfere with placement of the TriClip(TM) device
* Indication for left-sided (e.g. severe aortic stenosis, severe mitral regurgitation) or pulmonary valve correction prior 60 days. Note: Patients with concomitant Mitral and tricuspid valve disease will have the option of getting their MR treated, and wait 60 days prior to being reassessed for the trial.
* Pacemaker or ICD leads that would prevent appropriate placement of the TriClip(TM) clip.
* Tricuspid valve stenosis - Defined as a tricuspid valve orifice of ≤ 1.0 cm2 and/or mean gradient ≥5 mmHg as measured by the ECL
* Left Ventricular Ejection Fraction (LVEF) ≤20%
* Tricuspid valve leaflet anatomy which may preclude clip implantation, proper clip positioning on the leaflets or sufficient reduction in TR. This may include:

* Evidence of calcification in the grasping area
* Presence of a severe coaptation defect (\> 2cm) of the tricuspid leaflets
* Severe leaflet defect(s) preventing proper device placement
* Ebstein Anomaly - Identified by having a normal annulus position while the valve leaflets are attached to the walls and septum of the right ventricle.
* Tricuspid valve anatomy not evaluable by TTE and TEE
* Active endocarditis or active rheumatic heart disease or leaflets degenerated from rheumatic disease (i.e. noncompliant, perforated).
* MI or known unstable angina within prior 30 days
* Percutaneous coronary intervention within prior 30 days
* Hemodynamic instability defined as systolic pressure \< 90 mmHg with or without afterload reduction, cardiogenic shock or the need for inotropic support or intra-aortic balloon pump or other hemodynamic support device.
* Cerebrovascular Accident (CVA) within prior 90 days
* Chronic dialysis
* Bleeding disorders or hypercoagulable state
* Active peptic ulcer or active gastrointestinal (GI) bleeding
* Contraindication, allergy or hypersensitivity to dual antiplatelet and anticoagulant therapy.

* Note: Contraindication to either antiplatelet or anticoagulant therapy (individually not both therapies) is not an exclusion criterion.
* Ongoing infection requiring current antibiotic therapy (if temporary illness, patients may enroll 30 days after discontinuation of antibiotics with no active infection).
* Known allergy or hypersensitivity to device materials
* Evidence of intracardiac, inferior vena cava (IVC), or femoral venous mass, thrombus or vegetation.
* Life expectancy of less than 12 months
* Subject is currently participating in another clinical trial that has not yet completed its primary endpoint.
* Subject is currently participating in another clinical investigation for valvular heart disease(s).
* Pregnant or nursing subjects and those who plan pregnancy during the clinical investigation follow-up period. Female subjects of child-bearing potential are required to have a negative pregnancy test done within 7 days of the baseline visit per site standard test. Female patients of childbearing potential should be instructed to use safe contraception (e.g., intrauterine devices, hormonal contraceptives: contraceptive pills, implants, transdermal patches hormonal vaginal devices, injections with prolonged release.) It is accepted, in certain cases, to include subjects having a sterilized regular partner or subjects using a double barrier contraceptive method.
* Presence of other anatomic or comorbid conditions, or other medical, social, or psychological conditions that, in the investigator's opinion, could limit the subject's ability to participate in the clinical investigation or to comply with follow-up requirements, or impact the scientific soundness of the clinical investigation results.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Abbott Medical Devices

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Meghan Griffin, PhD

Role: STUDY_DIRECTOR

Abbott Structural Heart

David Adams, MD

Role: PRINCIPAL_INVESTIGATOR

Icahn School of Medicine at Mount Sinai

Paul Sorajja, MD

Role: PRINCIPAL_INVESTIGATOR

Allina Health System

Locations

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University Hospital - University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

St. Joseph's Hospital & Medical Center

Phoenix, Arizona, United States

Site Status

Arizona Cardiovascular Research Center

Phoenix, Arizona, United States

Site Status

Phoenix Cardiovascular Research Group

Phoenix, Arizona, United States

Site Status

Scottsdale Healthcare Shea

Scottsdale, Arizona, United States

Site Status

Tucson Medical Center

Tucson, Arizona, United States

Site Status

Scripps Green Hospital

La Jolla, California, United States

Site Status

Cedars-Sinai Medical Center

Los Angeles, California, United States

Site Status

El Camino Hospital

Mountain View, California, United States

Site Status

Providence Medical Foundation (St. Joseph Hospital)

Orange, California, United States

Site Status

Sutter Medical Center, Sacramento

Sacramento, California, United States

Site Status

University of California - Davis Medical Center

Sacramento, California, United States

Site Status

California Pacific Medical Center

San Francisco, California, United States

Site Status

Los Robles Regional Medical Center

Thousand Oaks, California, United States

Site Status

University of Colorado Hospital

Aurora, Colorado, United States

Site Status

Yale New Haven

New Haven, Connecticut, United States

Site Status

JFK Medical Center

Atlantis, Florida, United States

Site Status

Manatee Memorial Hospital

Bradenton, Florida, United States

Site Status

Morton Plant Valve Clinic

Clearwater, Florida, United States

Site Status

Delray Medical Center

Delray Beach, Florida, United States

Site Status

Baptist Hospital of Miami

Miami, Florida, United States

Site Status

Palm Beach Garden Medical Center

Palm Beach Gardens, Florida, United States

Site Status

Tallahassee Research Institute

Tallahassee, Florida, United States

Site Status

Piedmont Heart Institute

Atlanta, Georgia, United States

Site Status

Rush University Medical Center

Chicago, Illinois, United States

Site Status

Northshore University HealthSystem

Evanston, Illinois, United States

Site Status

St. Vincent Hospital

Indianapolis, Indiana, United States

Site Status

Kansas University Medical Center

Kansas City, Kansas, United States

Site Status

Cardiovascular Research Institute of Kansas

Wichita, Kansas, United States

Site Status

Cardiovascular Institute of the South

Houma, Louisiana, United States

Site Status

MedStar Health Research Institute

Hyattsville, Maryland, United States

Site Status

Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status

University of Michigan

Ann Arbor, Michigan, United States

Site Status

Abbott Northwestern Hospital

Minneapolis, Minnesota, United States

Site Status

Albany Medical Center

Albany, New York, United States

Site Status

Buffalo General Hospital

Buffalo, New York, United States

Site Status

North Shore University Hospital

Manhasset, New York, United States

Site Status

Mount Sinai Hospital

New York, New York, United States

Site Status

New York-Presbyterian/Columbia University Medical Center

New York, New York, United States

Site Status

Montefiore Medical Center - Moses Division

The Bronx, New York, United States

Site Status

Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status

Novant Health Heart and Vascular Research Institute

Charlotte, North Carolina, United States

Site Status

Christ Hospital

Cincinnati, Ohio, United States

Site Status

The Cleveland Clinic Foundation

Cleveland, Ohio, United States

Site Status

Ohio Health Research Institute

Columbus, Ohio, United States

Site Status

Providence Heart and Vascular Institute

Portland, Oregon, United States

Site Status

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Allegheny General Hospital

Pittsburgh, Pennsylvania, United States

Site Status

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, United States

Site Status

Centennial Heart Cardiovascular Consultants

Nashville, Tennessee, United States

Site Status

St. Thomas Hospital

Nashville, Tennessee, United States

Site Status

Austin Heart

Austin, Texas, United States

Site Status

Baylor Scott and White Heart and Vascular Hospital

Dallas, Texas, United States

Site Status

The Methodist Hospital

Houston, Texas, United States

Site Status

Methodist Hospital of San Antonio

San Antonio, Texas, United States

Site Status

Intermountain Medical Center

Murray, Utah, United States

Site Status

University of Virginia Medical Center

Charlottesville, Virginia, United States

Site Status

Inova Fairfax Hospital

Falls Church, Virginia, United States

Site Status

Sentara Norfolk General Hospital

Norfolk, Virginia, United States

Site Status

Swedish Medical Center

Seattle, Washington, United States

Site Status

University of Washington Medical Center

Seattle, Washington, United States

Site Status

Aurora Medical Group

Milwaukee, Wisconsin, United States

Site Status

St. Paul's Hospital

Vancouver, British Columbia, Canada

Site Status

Hamilton Health Science Centre

Hamilton, Ontario, Canada

Site Status

Ottawa Heart Institute

Ottawa, Ontario, Canada

Site Status

St. Michael's Hospital

Toronto, Ontario, Canada

Site Status

Sunnybrook Health Science Centre

Toronto, Ontario, Canada

Site Status

Institut de Cardiologie de Montreal (Montreal Heart Inst.)

Montreal, Quebec, Canada

Site Status

The Royal Victoria

Montreal, Quebec, Canada

Site Status

München Grosshadern

München, Bavaria, Germany

Site Status

Universitätsklinikum Bonn AdöR

Bonn, North Rhine-Westphalia, Germany

Site Status

UNIVERSITATSMEDIZIN der Johannes Gutenberg-Universität Mainz

Mainz, Rhineland-Palatinate, Germany

Site Status

Herzzentrum Leipzig GmbH

Leipzig, Saxony, Germany

Site Status

Ospedale San Raffaele - Cardiac

Milan, Lombard, Italy

Site Status

Hospital Clinic I Provincial de Barcelona

Barcelona, Catalonia, Spain

Site Status

Countries

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Switzerland United States Canada Germany Italy Spain

References

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Kar S, Makkar RR, Whisenant BK, Hamid N, Naik H, Tadros P, Price MJ, Singh G, Schwartz JG, Kapadia S, Alli O, Horr S, Seshiah P, Batchelor W, Jones BM, Ahmed MI, Benza R, Jorde U, Thourani VH, Ghobrial AA, Tang GHL, Trusty PM, Huang D, Hahn RT, Adams DH, Sorajja P; TRILUMINATE Pivotal Investigators. Two-Year Outcomes of Transcatheter Edge-to-Edge Repair for Severe Tricuspid Regurgitation: The TRILUMINATE Pivotal Randomized Controlled Trial. Circulation. 2025 Jun 10;151(23):1630-1638. doi: 10.1161/CIRCULATIONAHA.125.074536. Epub 2025 Mar 30.

Reference Type DERIVED
PMID: 40159089 (View on PubMed)

Naik H, Price MJ, Kapadia S, Whisenant BK, Tadros P, Makkar R, Asgar AW, Fam N, Tang GHL, Mehta SR, Byrne T, Singh G, Panaich SS, Peterman K, Trusty PM, Hamid N, Hahn RT, Adams DH, Sorajja P. Tricuspid Transcatheter Edge-to-Edge Repair in Patients With Transvalvular CIED Leads: The TRILUMINATE Pivotal Trial. JACC Clin Electrophysiol. 2025 May;11(5):1012-1020. doi: 10.1016/j.jacep.2025.01.001. Epub 2025 Jan 20.

Reference Type DERIVED
PMID: 39903153 (View on PubMed)

Cavalcante JL, Scherer M, Fukui M, Lerakis S, Harb S, Pursnani A, Schwartz JG, Kapadia S, Ricciardi MJ, Khalique O, Kodali S, Shah D, Little SH, Sekaran N, Whisenant B, Flueckiger P, Yadav P, Emaminia A, Batchelor W, Kellman P, Lin Z, Trusty PM, Hahn RT, Adams D, Sorajja P. Advanced Imaging Assessment of the Impact of Tricuspid Regurgitation on Cardiac Remodeling: The TRILUMINATE Pivotal Imaging Substudy. J Am Coll Cardiol. 2025 Jan 28;85(3):250-261. doi: 10.1016/j.jacc.2024.09.009. Epub 2024 Nov 20.

Reference Type DERIVED
PMID: 39570246 (View on PubMed)

Jorde UP, Benza R, McCarthy PM, Ailawadi G, Whisenant B, Makkar R, Tadros P, Naik H, Fam N, Sauer AJ, Murthy S, Kar S, von Bardeleben RS, Hahn RT, Hamid N, Zbinden J, Sorajja P, Adams D. Impact of Renal and Liver Function on Clinical Outcomes Following Tricuspid Valve Transcatheter Edge-to-Edge Repair. J Am Coll Cardiol. 2024 Dec 17;84(25):2446-2456. doi: 10.1016/j.jacc.2024.08.044. Epub 2024 Aug 31.

Reference Type DERIVED
PMID: 39222896 (View on PubMed)

Sorajja P, Whisenant B, Hamid N, Naik H, Makkar R, Tadros P, Price MJ, Singh G, Fam N, Kar S, Schwartz JG, Mehta S, Bae R, Sekaran N, Warner T, Makar M, Zorn G, Spinner EM, Trusty PM, Benza R, Jorde U, McCarthy P, Thourani V, Tang GHL, Hahn RT, Adams DH; TRILUMINATE Pivotal Investigators. Transcatheter Repair for Patients with Tricuspid Regurgitation. N Engl J Med. 2023 May 18;388(20):1833-1842. doi: 10.1056/NEJMoa2300525. Epub 2023 Mar 4.

Reference Type DERIVED
PMID: 36876753 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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ABT-CIP-10249

Identifier Type: -

Identifier Source: org_study_id