TRanscatheter Aortic-Valve Implantation With or Without On-site Cardiac Surgery: the TRACS Trial

NCT ID: NCT05751577

Last Updated: 2024-04-08

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

566 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-01

Study Completion Date

2028-05-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The primary efficacy objective is to determine whether a TAVI procedure performed by experienced operators in centers without on-site cardiac surgery is noninferior to TAVI procedure performed by the same operators in centers with on-site cardiac surgery in terms of all-cause death, stroke and rehospitalization for cardiovascular cause. The primary safety objective is to demonstrate that mortality associated with periprocedural complications actionable by emergent cardiac surgery did not differ between study arms.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

TRACS is an all-comer, prospective, randomized, multicenter, open-label trial with blinded adjudicated evaluation of outcomes (PROBE). The TRACS trial will involve centers without on-site cardiac surgery, but with experienced operators already performing TAVI at the referring center with on-site cardiac surgery. Thus, participating centers and their study TAVI operators must follow selective criteria for eligibility. Participants will be recruited after Heart Team indication to TAVI procedure. The eligibility of each single patient to the study MUST BE CONFIRMED and VALIDATED by unanimous decision of the Heart Team. Study patients will be randomized in a 2:1 fashion to TAVI procedure performed by the same experienced operators either in the center without on-site cardiac surgery or in the referring center with on-site cardiac surgery.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Aortic Stenosis, Severe

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
TRACS is an all-comer, prospective, randomized, multicenter, open-label trial with blinded adjudicated evaluation of outcomes (PROBE)

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

EXPERIMENTAL ARM: TAVI WITHOUT ON-SITE SURGERY

After randomization, study TAVI operators of the participating center will schedule the patient for TAVI in their hospital without on-site surgery

Group Type EXPERIMENTAL

TAVI WITHOUT ON-SITE SURGERY

Intervention Type PROCEDURE

After randomization, study TAVI operators of the participating center will schedule the patient for TAVI in their hospital without on-site surgery

CONTROL ARM: TAVI WITH ON-SITE SURGERY

After randomization, the patient will immediately be placed on the waiting list of the referring center with on-site cardiac surgery. Study TAVI operators of the participating center will perform the TAVI procedure in the hospital with on-site surgery according to the waiting list schedule of the latter

Group Type ACTIVE_COMPARATOR

TAVI WITH ON-SITE SURGERY

Intervention Type PROCEDURE

After randomization, the patient will immediately be placed on the waiting list of the referring center with on-site cardiac surgery. Study TAVI operators of the participating center will perform the TAVI procedure in the hospital with on-site surgery according to the waiting list schedule of the latter

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

TAVI WITHOUT ON-SITE SURGERY

After randomization, study TAVI operators of the participating center will schedule the patient for TAVI in their hospital without on-site surgery

Intervention Type PROCEDURE

TAVI WITH ON-SITE SURGERY

After randomization, the patient will immediately be placed on the waiting list of the referring center with on-site cardiac surgery. Study TAVI operators of the participating center will perform the TAVI procedure in the hospital with on-site surgery according to the waiting list schedule of the latter

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Severe aortic stenosis
* Indication to TAVI confirmed by the Study Heart Team

AND one of the following:

* Inoperable due to prohibitive operative risk
* High surgical risk as defined as STS score \>8%

The presence of at least one clinical factor that, by unanimous judgment of the Study Heart Team, compromises the benefit/risk ratio in the case of emergent cardiac surgery:

* Porcelain aorta or severely atherosclerotic aorta
* Frailty/Reduced physical performance
* Cognitive impairment, dementia, or Parkinson's disease
* Severe liver disease/cirrhosis
* Hostile chest
* Internal mammalian artery or other critical conduit(s) crossing midline and/or adhering to the posterior table of the sternum
* Severe pulmonary hypertension and/or severe right ventricular dysfunction
* Severe Chronic Obstructive Pulmonary Disease (COPD)
* Age ≥85 years

Exclusion Criteria

* Unsuitable for transfemoral TAVI
* Emergent TAVI
* Noncardiovascular comorbidity reducing life expectancy to \<1 year
* Any factor precluding 1-year follow-up
* Refusal informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Azienda USL Reggio Emilia - IRCCS

OTHER_GOV

Sponsor Role collaborator

Università degli Studi di Ferrara

OTHER

Sponsor Role collaborator

University Hospital of Ferrara

OTHER

Sponsor Role collaborator

Azienda Usl di Bologna

OTHER_GOV

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Ospedale San Donato di Arezzo

Arezzo, , Italy

Site Status RECRUITING

Ospedale Cardinal Massaia di Asti

Asti, , Italy

Site Status RECRUITING

Ospedale degli Infermi di Biella

Biella, , Italy

Site Status RECRUITING

Azienda Unità Sanitaria Locale

Bologna, , Italy

Site Status RECRUITING

Azienda Ospedaliero Universitaria di Ferrara

Ferrara, , Italy

Site Status RECRUITING

Ospedale Misericordia di Grosseto

Grosseto, , Italy

Site Status RECRUITING

Azienda ULSS 3 Serenissima, Ospedale di Mirano

Mirano, , Italy

Site Status RECRUITING

Ospedale Guglielmo da Saliceto di Piacenza

Piacenza, , Italy

Site Status RECRUITING

Azienda Ospedaliera di Reggio Emilia

Reggio Emilia, , Italy

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Italy

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Gianmarco Iannopollo, Md

Role: CONTACT

0513138704

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Leonardo Bolognese

Role: primary

Gianmarco Iannopollo, Md

Role: primary

0513138704

Carlo Tumscitz

Role: primary

Salvatore Saccà

Role: primary

References

Explore related publications, articles, or registry entries linked to this study.

Iannopollo G, Cocco M, Leone A, Sacca S, Mangino D, Picchi A, Reccia MR, Fineschi M, Meliga E, Audo A, Nobile G, Tumscitz C, Penzo C, Saia F, Rubboli A, Moretti C, Vignali L, Niccoli G, Cimaglia P, Rognoni A, Aschieri D, Iaccarino D, Ottani F, Cavazza C, Varbella F, Secco GG, Bolognese L, Limbruno U, Guiducci V, Campo G, Casella G. Transcatheter aortic-valve implantation with or without on-site cardiac surgery: The TRACS trial. Am Heart J. 2025 Feb;280:7-17. doi: 10.1016/j.ahj.2024.10.019. Epub 2024 Nov 4.

Reference Type DERIVED
PMID: 39505122 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

40-2023-SPER-AUSLBO

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Transfemoral Implant of Inovare® Transcatheter Valve
NCT05531578 ACTIVE_NOT_RECRUITING NA
EffecTAVI Registry
NCT05235555 RECRUITING