ARTIST: Aortic Regurgitation Trial Investigating Surgery Versus Trilogy™
NCT ID: NCT06608823
Last Updated: 2025-11-13
Study Results
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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RECRUITING
NA
1016 participants
INTERVENTIONAL
2025-06-18
2036-02-29
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Transcatheter Aortic Valve Replacement (TAVR)
Transcatheter Aortic Valve Replacement (TAVR) using the Trilogy THV System
Transcatheter Aortic Valve Replacement (TAVR) using Trilogy THV System
Transcatheter Aortic Valve Replacement (TAVR) with Trilogy Device
SAVR
SAVR using commercially available surgical prosthetic valve
SAVR
SAVR using commercially available surgical prosthetic valves.
Interventions
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Transcatheter Aortic Valve Replacement (TAVR) using Trilogy THV System
Transcatheter Aortic Valve Replacement (TAVR) with Trilogy Device
SAVR
SAVR using commercially available surgical prosthetic valves.
Eligibility Criteria
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Inclusion Criteria
1. Class I or II indication for AVR according to ACC/AHA or ESC/EACTS guidelines with moderate to severe or severe AR (Grade ≥3+) on transthoracic echocardiography, transesophageal echocardiography or cardiac MRI as assessed by the core laboratory OR
2. AR severity that remains indeterminate despite core laboratory review of all imaging including at least one advanced imaging modality (TEE or cardiac MRI) AND evidence of left ventricular damage\* from AR with unanimous agreement from the local heart team, an independent clinical evaluation committee and the CRB that the symptomatic subject (NYHA II or greater) will benefit from SAVR for AR
2. The subject is a candidate for TAVR using the Trilogy THV system and SAVR using a commercially approved bioprosthetic heart valve
3. Subject and the treating physician agree that the subject will return for all required post-procedure follow-up visits
4. Subject meets the legal minimum age to provide informed consent based on local regulatory requirements
Exclusion Criteria
2. Estimated life expectancy of less than 24 months due to associated non- cardiac comorbid conditions
3. Subject is high-risk for SAVR as determined by the local heart team
4. Subject refuses SAVR as a treatment option
5. Subject refuses a blood transfusion
6. Subject is selected for aortic valve repair or aortic surgery
7. Marfan syndrome or other known connective tissue disease that would necessitate aortic root replacement/intervention
8. Subject unable to undergo pre-procedure CT scan analysis for annular sizing
9. Mitral or tricuspid disease, considered clinically significant, such that if randomized to surgery, repair or replacement would be expected.
10. Subject has a known hypersensitivity or contraindication to all anticoagulation/antiplatelet medications (or inability to be anticoagulated for the index procedure), nitinol, or sensitivity to contrast media which cannot be adequately pre-medicated
11. Hostile chest or conditions or complications from a prior surgery that would preclude safe reoperation (i.e., mediastinitis, radiation damage, chest wall abnormalities, adhesion of aorta or internal mammary artery (IMA) to the sternum)
12. Need for emergency surgery or TAVR for any reason
13. Cardiogenic shock manifested by low cardiac output, vasopressor dependence, or need for mechanical circulatory support
14. Ongoing sepsis or active infective endocarditis with ongoing antibiotic (including suppressive) therapy or positive blood cultures within 6 weeks
15. Cardiac resynchronization therapy (CRT) device implantation within 30 days of randomization
16. LVEF \<25% according to core laboratory measurement of resting echocardiogram at time of screening
17. Moderate to severe or worse right ventricular dysfunction on resting echocardiogram according to core laboratory
18. Severe chronic liver disease (Child-Pugh C) or any active liver disease
19. Chronic Kidney Disease Stage 4 or 5 (\<30 cc/min/1.73 m2 or dialysis)
20. Severe Pulmonary Hypertension (pulmonary arterial systolic pressure
* amp;amp;gt;2/3 systemic systolic pressure)
21. Severe Chronic Obstructive Pulmonary Disease (COPD) with FEV1
* amp;amp;lt;50% predicted or need for chronic supplementary oxygen
22. Blood dyscrasia as defined: leukopenia (WBC \<3,000 Cells/μL), thrombocytopenia (platelet count \<50,000 Cells/μL), or anemia (hemoglobin \<9.0 g/dL) that is uncorrected prior to randomization
23. History of bleeding diathesis or coagulopathy that is not adequately treated
24. Active gastrointestinal bleeding precluding anticoagulation or antiplatelet therapy
25. Any condition considered a contraindication to mechanical circulatory support
26. Uncontrolled atrial fibrillation (i.e., resting heart rate \>120 bpm)
27. Evidence of an acute myocardial infarction ≤30 days before the index AVR
28. Any percutaneous coronary or peripheral interventional procedure performed ≤30 days prior to AVR (Subjects with placement of coronary or peripheral stent(s) should be assessed for the ability to safely proceed with SAVR within the protocol timeframe)
29. Symptomatic carotid or vertebral artery disease or successful treatment of carotid stenosis within six weeks of randomization
30. Prior stroke with residual modified Rankin Score ≥2
31. Stroke or transient ischemic attack (TIA) within 6 months of randomization
32. Body mass index (BMI) \<20 or \>50 kg/m2
33. Currently participating in a cardiovascular investigational drug or device trial and has not yet completed follow-up for the primary endpoint (excluding registries)
34. Severe cognitive decline (resulting in either inability to provide informed consent for the trial/procedure, prevents independent lifestyle outside of a chronic care facility, or will fundamentally complicate rehabilitation from the procedure or compliance with follow-up visits)
35. Other medical, social, or psychological conditions that in the opinion of the investigator preclude the subject from appropriate consent or adherence to the protocol required follow-up exams
36. Pregnancy or intent to become pregnant prior to completion of all protocol follow-up requirements
1. Congenital bicuspid, unicuspid or quadricuspid aortic valve verified by echocardiography or CCT core laboratory
2. Native aortic annulus perimeter \<66 mm or \>90 mm per the core laboratory reading of baseline cardiac CT imaging
3. Iliofemoral arteries with vessel characteristics unsuitable for sheath passage (e.g., calcification, tortuosity) as determined by the case review board (CRB)
4. Significant abdominal or thoracic aortic disease (such as porcelain aorta, aneurysm, severe calcification, aortic coarctation) that would preclude safe passage of the delivery system or cannulation and aortotomy for SAVR
5. According to the CRB, a combination of aortic root angulation (angle between the plane of the aortic valve annulus and horizontal plane/vertebrae), sinus size, and straight length of the aorta that will not allow safe device delivery and THV deployment
6. Sinus of Valsalva anatomy that would prevent adequate coronary perfusion after valve implantation
38. According to core laboratory evaluation, severe aortic stenosis
39. Uncorrected hypertrophic obstructive cardiomyopathy
40. Echocardiographic or Multi-slice CT (MSCT) evidence of untreated intracardiac mass or vegetation
41. Left ventricular thrombus
42. Left atrial thrombus without continuous appropriate anticoagulation within 90 days of the study procedure
43. Complex coronary artery disease:
1. Unprotected left main coronary artery disease ≥50%
2. Syntax score \>32 (in the absence of prior revascularization)
3. Heart Team determines that optimal revascularization cannot be adequately performed with EITHER CABG at the time of SAVR OR PCI at least 30 days prior to THV implant.
ALL
No
Sponsors
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JenaValve Technology, Inc.
INDUSTRY
Responsible Party
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Principal Investigators
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Vinod H Thourani, MD
Role: PRINCIPAL_INVESTIGATOR
Piedmont Heart Institute
Torsten P Vahl, MD
Role: PRINCIPAL_INVESTIGATOR
Columbia University
Raj Makkar, MD
Role: PRINCIPAL_INVESTIGATOR
Cedars-Sinai Medical Center
Hendrik Treede, MD
Role: PRINCIPAL_INVESTIGATOR
Department of Cardiovascular Surgery Johannes-Gutenberg University
Locations
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CPMC Sutter Health
Burlingame, California, United States
Scripps Health
La Jolla, California, United States
Cedar-Sinai Medical Center
Los Angeles, California, United States
BayCare Health
Clearwater, Florida, United States
HCA North Florida
Gainesville, Florida, United States
Emory University Hospital
Atlanta, Georgia, United States
Piedmont Healthcare
Atlanta, Georgia, United States
University of Michigan
Ann Arbor, Michigan, United States
Henry Ford Health
Detroit, Michigan, United States
Minneapolis Heart Institute Founcation
Minneapolis, Minnesota, United States
Cumc/Nyph
New York, New York, United States
The Christ Hospital
Cincinnati, Ohio, United States
Ohio Health
Columbus, Ohio, United States
Houston Methodist Research Institute
Houston, Texas, United States
Intermountain Health
Murray, Utah, United States
Intermountain Healthcare
Murray, Utah, United States
Sentara Norfolk
Norfolk, Virginia, United States
Countries
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Central Contacts
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Facility Contacts
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Milena Ferreira
Role: primary
Sarah Hoffman
Role: backup
Alison Walton
Role: primary
Sophia Graham
Role: backup
Khaled Alsabaawi
Role: primary
m Gheorghiu
Role: backup
Beth Schelle, RN
Role: primary
Danielle E Murrhee
Role: primary
Brandy Baudon
Role: backup
Olga Riveria, MBA
Role: primary
Maria Garland
Role: primary
Kasey Boyd
Role: primary
Allison Schley
Role: backup
Danielle Holmes
Role: primary
Sara Poggio
Role: backup
Nikki Degeneffe
Role: primary
Katelyn Swanson
Role: backup
Stacey Baum
Role: primary
Kerianne Nordland
Role: backup
Rachel Rogell
Role: primary
Amanda Sears
Role: backup
Katy Monin
Role: primary
Yejide Oyewole, RN
Role: primary
Melissa Alanis, RN
Role: backup
McKenna Jensen
Role: primary
McKenna Jensen
Role: primary
Tina Calayo
Role: primary
Related Links
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Chronic Severe Aortic Regurgitation: Should We Lower Operating Thresholds?
Global longitudinal strain in chronic asymptomatic aortic regurgitation: systematic review
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
Other Identifiers
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JVT24001
Identifier Type: -
Identifier Source: org_study_id