Efficacy and Safety of Thoracoscopic Morrow Surgery in the Treatment of Hypertrophic Obstructive Cardiomyopathy

NCT ID: NCT06391788

Last Updated: 2024-04-30

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

RECRUITING

Clinical Phase

NA

Total Enrollment

132 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-31

Study Completion Date

2025-03-31

Brief Summary

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This single-center, prospective, open-label, randomized, controlled clinical trial is designed to assess the efficacy and safety of the Thoracoscopic Morrow procedure in the treatment of hypertrophic obstructive cardiomyopathy. The primary objectives include investigating:

Question 1: The efficacy and safety of two surgical modalities in patients presenting with left ventricular outflow tract obstruction and mid-left ventricular hypertrophy.

Question 2: The impact of the two surgical procedures on hemodynamics in patients with left ventricular outflow tract obstruction, mid-left ventricular obstruction, and in individuals with or without organic valvular lesions.

Question 3: The effects of the two surgical procedures on exercise capacity, quality of life, and long-term prognosis among patients with left ventricular outflow tract obstruction and central left ventricular obstruction, both with and without valvular lesions.

Participants will be stratified into two groups. The experimental group will undergo thoracoscopic Morrow surgery, while the control group will undergo median open modified enlarged Morrow surgery.

Detailed Description

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This study is a single-center, prospective, open-label, randomized, controlled trial designed to investigate the therapeutic value of thoracoscopic Morrow procedure in patients with hypertrophic obstructive cardiomyopathy (HOCM). The study focuses on HOCM patients, with the modified extended Morrow procedure via median sternotomy considered as the 'gold standard treatment' in the control group. The objective is to explore the efficacy of the thoracoscopic Morrow procedure in improving exercise tolerance in HOCM patients, assess the short-term and long-term effectiveness, safety, as well as changes in cardiac function, cardiac structure, and myocardial fibrosis levels associated with thoracoscopic Morrow procedure in treating obstructive HOCM.

Conditions

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Cardiomyopathy, Hypertrophic Obstructive Minimally Invasive Surgery

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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Thoracoscopic trans-mitral myectomy

patients who undergo thoracoscopic Morrow procedure

Group Type EXPERIMENTAL

thoracoscopic Morrow surgery

Intervention Type PROCEDURE

minimally invasive trans-mitral Morrow septal myectomy

Modified extended Morrow myectomy

patients who undergo modified extended Morrow myectomy

Group Type ACTIVE_COMPARATOR

modified Morrow surgery

Intervention Type PROCEDURE

median open modified enlarged Morrow septal myectomy

Interventions

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thoracoscopic Morrow surgery

minimally invasive trans-mitral Morrow septal myectomy

Intervention Type PROCEDURE

modified Morrow surgery

median open modified enlarged Morrow septal myectomy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* diagnosed with hypertrophic cardiomyopathy (HCM);
* age ≥18 years old;
* presence of left ventricular outflow tract/mid-ventricular obstruction, with a resting left ventricular outflow tract pressure gradient/left ventricular cavity pressure gradient ≥50 mmHg; significant symptoms persist despite optimal medical therapy, and surgical evaluation indicates the need for intervention;
* left ventricular ejection fraction (LVEF) ≥55%;
* signed informed consent, willing and able to return to the hospital for follow-up.

Exclusion Criteria

* previously underwent septal reduction therapy (including surgical or interventional procedures);
* received or planning to receive an implantable cardioverter-defibrillator (ICD) in the past 3 months;
* individuals with concomitant conditions requiring simultaneous surgical intervention;
* New York Heart Association (NYHA) functional class IV;
* unwilling to undergo surgical treatment;
* pregnant or lactating or planning pregnancy;
* previously participated in other clinical trials before enrollment;
* individuals with concurrent diseases with an expected lifespan of less than 1 year.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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China National Center for Cardiovascular Diseases

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Xin Wang

Role: PRINCIPAL_INVESTIGATOR

Fuwai Hospital, National Centre for Cardiovascular Disease

Lei Song

Role: PRINCIPAL_INVESTIGATOR

Fuwai Hospital, National Centre for Cardiovascular Disease

Locations

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Fuwai Hospital, National Centre for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College

Beijing, , China

Site Status RECRUITING

Countries

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China

Central Contacts

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Xin Wang

Role: CONTACT

Phone: 13901036490

Email: [email protected]

Lei Song

Role: CONTACT

Phone: 13810532620

Email: [email protected]

Facility Contacts

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Xin Wang

Role: primary

Lei Song

Role: backup

Other Identifiers

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2023-ZX013

Identifier Type: -

Identifier Source: org_study_id