Hemodynamic Matched Comparison of the Balloon-Expandable Transcatheter Heart Valves Myval and Sapien-3 for the Treatment of Aortic Stenosis

NCT04548726 — Completed, 416 participants, Ignacio J. Amat Santos

ClinicalTrials Daily · Areas · Conditions · Drugs · Sponsors ·

Registry	NCT04548726, acronym MATCH-BALL
Status	Completed
Study type	Observational
Enrollment	416 (Actual)
Sponsor	Ignacio J. Amat Santos (Other)
Conditions	Aortic Valve Stenosis, Aortic Valve Regurgitation
Interventions	Sapien 3 Transcather Aortic Valve Implant, Myval Transcather Aortic Valve Implant (Device)
Dates	start 2018-06-01, primary completion 2020-09-30, completion 2020-09-30, first posted 2020-09-14, last updated 2021-01-28
Locations	6 sites in Italy, Spain

-Summary

Transcatheter aortic valve implantation (TAVI) is recommended for patients with severe aortic stenosis (AS) at high to intermediate surgical risk. Despite similar mortality rates compared to surgical aortic valve replacement (SAVR) in this setting, the rate para-valvular leak (PVL) remains higher and has been associated to higher mortality even at mild degree. This is one of the major concerns to extend TAVI to low surgical risk, although the favorable results from PARTNER 3.

The presence of moderate to severe PVL after TAVI is associated to a 2- and 3- fold increase in the mortality rate at 30-day and 1-year follow-up, respectively (24-29).

Prosthesis-patient mismatch (PPM) adversely affects functional improvement and exercise tolerance, left ventricular (LV) mass regression, and late structural valve deterioration. Many studies have previously investigated PPM after surgical AVR suggesting the presence of this problem in more than 40% of the surgically treated patients. This rate was significantly lower with the balloon-expandable Sapien (Edwards Lifesciences, Irvine, California), with PPM that varied from 8% to 18%, but in both cases (patients harboring TAVI and those with SAVR) the mortality rate was higher in the presence of PPM.

Under the hypothesis that there are differences in terms of transvalvular gradients and residual para-valvular leak amongst different balloon-expandable TAVI devices available in the market, the aim of the MATCH-BALL study is to compare the hemodynamic performance of two balloon-expandable TAVI devices, Sapien 3 (Edwards Lifesciences, Irvine, CA, USA) and Myval (Meril Life Sciences Pvt. Ltd., India).

Expand all sections · Collapse all

+Arms and interventions

Arm	Type	Interventions	Description
Sapien 3		Device: Sapien 3 Transcather Aortic Valve Implant	Patients with aortic stenosis treated with Sapien 3 (Edwards Lifesciences, Irvine, CA, USA) TAVI
Myval		Device: Myval Transcather Aortic Valve Implant	Patients with aortic stenosis treated with Myval (Meril Life Sciences Pvt. Ltd., India) TAVI

Sapien 3 Transcather Aortic Valve Implant (Device): Implant of a Ballon Expandable Aortic Valve Sapien 3 (Edwards Lifesciences, Irvine, CA, USA) prosthesis via a transcatheter procedure.
Myval Transcather Aortic Valve Implant (Device): Implant of a Ballon Expandable Aortic Valve Myval (Meril Life Sciences Pvt. Ltd., India) prosthesis via a transcatheter procedure.

+Outcome measures

Primary outcomes

Mean transvalvular gradients [30 days]: Mean Gradients measured in doppler echography are calculated based on the mean velocity of the tracing. The velocities are converted to pressure gradients using the Bernoulli equation.
Aortic valve area [30 days]: Echography measured Aortic valve area
Aortic valve perivalvular leak [30 days]: Echography measured perivalvular leak
Aortic valve central leak [30 days]: Echography measured central leak
Aortic valve global leak [30 days]: Echography measured global leak

Secondary outcomes

Cardiovascular mortality rate [30 days]
All-cause mortality rate [30 days]
Myocardial infarction rate [30 days]
Bleeding complications rate [30 days]
Acute kidney injury rate [30 days]
Vascular complications rate [30 days]
Conduction disorder rate [30 days]
Re-hospitalization rate [30 days]
Need for permanent pacemaker rate [30 days]
New York Heart Association (NYHA) functional class [30 days]

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* All patients diagnosed with aortic stenosis (effective aortic<1.0 cm2) accepted for a TAVI procedure by the Heart Team.
* Implantation of Sapien-3 transfemoral valve or Myval transfemoral prosthesis.
* Availability of the variables selected for the matching process: Left ventricular ejection fraction, aortic annulus diameter and area, eccentricity index, and calcium score (all measured using computed tomography), body surface area, and body mass index.
* Availability of imaging studies at baseline and at discharge or 30-day follow up.

Exclusion Criteria:

* Failure to comply with matching criteria.
* Failure to properly analyse images in the echo core-lab.

+Locations (6)

Facility	City	Country
Policlinico Umberto I	Roma	Italy
Policlinico Universitario Agostino Gemelli	Roma	Italy
Policlinico San Donato	San Donato Milanese	Italy
Ospedale San Raffaele	Segrate	Italy
Hospital Universitario de Gran Canaria Dr Negrin	Las Palmas de Gran Canaria	Spain
Hospital Clínico San Carlos	Madrid	Spain