4D- Flow- MRI After Aortic Valve Surgery

NCT ID: NCT04223713

Last Updated: 2021-03-04

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-14

Study Completion Date

2021-08-31

Brief Summary

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This randomized controlled trial was designed to analyze flow patterns in the ascending aorta with MRI after either Trileaflet reconstruction of the aortic valve with autologous pericardium (TriRec) or surgical valve replacement with biological prosthesis. The hypothesis is that after TriRec procedure more physiological flow patterns will be observed, compared to biological valve prosthesis.

Detailed Description

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Trileaflet reconstruction of the aortic valve with autologous pericardium (TriRec) is a new treatment option for diseased aortic valves and offers benefits compared to conventional valve replacement. At the moment no prospective randomized trials evaluating the role of the TriRec procedure are available and factors contributing to long- term durability are unknown.

The investigators want to examine aortic flow patterns with 4D- Flow- Magnetic Resonance Imaging (MRI) in patients after the TriRec procedure or biological prosthetic valve replacement in a prospective randomized trial. Flow patterns in the ascending aorta, examined with 4D- Flow- MRI, show nearly laminar flow patterns and no outflow obstruction in healthy subjects with tricuspid aortic valves. In contrast, helical flow patterns, turbulences and increased flow velocities are observed in diseased valves and also after valve replacement with mechanical or biological prostheses. These helical flow patterns seem to influence aortic wall remodeling and may contribute to structural valve dysfunction of biological prosthesis.

The investigators hypothesize that after TriRec procedure more physiological flow patterns will be observed, compared to biological valve prosthesis. The results can contribute to understand mechanisms for long- term performance of this technique and determine the role of this novel technique for treatment of aortic valve disease.

Conditions

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Aortic Valve Disease

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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TriRec

Trileaflet Reconstruction of the Aortic Valve

Group Type EXPERIMENTAL

TriRec

Intervention Type PROCEDURE

Trileaflet Reconstruction of the Aortic Valve

Aortic valve replacement

Biological prosthesis, Device: Edwards Perimount

Group Type EXPERIMENTAL

Aortic valve replacement

Intervention Type PROCEDURE

Biological Prosthesis, Device: Edwards Perimount

Interventions

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TriRec

Trileaflet Reconstruction of the Aortic Valve

Intervention Type PROCEDURE

Aortic valve replacement

Biological Prosthesis, Device: Edwards Perimount

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age \> 50 years
* Documented symptomatic moderate or greater aortic stenosis or severe aortic insufficiency
* Aortic annulus \> 19 mm
* Written informed consent of the patients.

Exclusion Criteria

* Concomitant intervention of the aortic root, ascending aorta or aortic arch
* Concomitant valve surgery
* Emergency surgery for any reason
* Neurological events (i.e. stroke, TIA) within the previous 6 months
* Coagulation disorders (including thrombocytopenia \< 100.000/ml)
* Porcelain aorta/severe calcification of the ascending aorta
* Active endocarditis or other active systemic infections
* Participating in another trial that may influence the outcome of this trial
* Pregnancy
* Dual antiplatelet therapy
* Previous cardiac surgery (excluding percutaneous procedures)
* Contraindication for MRI- examinations
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Deutsches Herzzentrum Muenchen

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Deutsches Herzzentrum Muenchen, Department of Cardiovascular Surgery

Munich, , Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Anatol Prinzing, MD

Role: CONTACT

+49891218 ext. 2777

Facility Contacts

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Anatol Prinzing, MD

Role: primary

Other Identifiers

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77/19-S

Identifier Type: -

Identifier Source: org_study_id

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