Spectroscopic Assessment of Myocardial Oxygenation Changes in Pediatric Heart Surgery

NCT07785141 — Recruiting, 30 participants, Spectrocor

ClinicalTrials Daily  ·  Areas  ·  Conditions  ·  Drugs  ·  Sponsors  ·  
RegistryNCT07785141
StatusRecruiting
Study typeObservational
Enrollment30 (Estimated)
SponsorSpectrocor (Industry); collaborators: Hospital District of Helsinki and Uusimaa
ConditionsMyocardial Ischemia, Heart Defects, Congenital, Reperfusion Injury, Myocardial
Datesstart 2026-09-17, primary completion 2027-12-31 (estimated), completion 2029-02-28 (estimated), first posted 2026-08-25, last updated 2026-09-28
Locations1 site in Finland

Related Papers Related Patents Related Grants Related Experts
All trials for Myocardial Ischemia All trials for Heart Defects, Congenital

-Summary

The goal of this observational study is to investigate the ability of the SpectroCor Tissue Oxygenation Monitor and its accessory SpectroCor Sensor to observe and monitor changes in cardiac oxygen availability in pediatric patients during open-heart surgery.

Patients of less than 18 years old who, and whose guardian(s), when applicable according to national legislation, have signed the informed consent, can participate in the study.

The primary hypothesis is that the SpectroCor Tissue Oxygenation Monitor and its accessory SpectroCor Sensor can detect myocardial oxygen availability in pediatric open-heart surgery patients. It is expected that the detected tissue oxygenation timely correlates with procedures affecting myocardial perfusion and other clinical parameters during the operation.

The secondary hypothesis is that the SpectroCor Tissue Oxygenation Monitor and its accessory, the SpectroCor Sensor, are safe to use, and their usability is acceptable.

No comparison group is included in the study.

The devices are used by the study investigators during open-heart surgery to collect myocardial tissue spectrometer data from the pediatric population to validate and potentially further develop the monitor and its accessory, the sterile sensor. The follow-up period for each participant ends with discharge from the hospital. No data (such as questionnaires) are obtained directly from the study participants.

Expand all sections  ·  Collapse all

+Detailed description

This is a single-center study. Thirty participants, less than 18 years old, with planned elective open-heart surgery, will be recruited for this study. The primary purpose is to investigate the ability of the SpectroCor Tissue Oxygenation Monitor and its accessory SpectroCor Sensor to observe and monitor peripheral tissue oxygenation perioperatively. This open, non-controlled observational study aims to assess the monitor's ability, in combination with the sensor, to monitor and observe tissue oxygenation and the safety of the device in routine clinical practice, reflecting the real-world patient population and treatment scenarios. Therefore, no control group is needed.

For this clinical investigation, pediatric age groups will be defined according to the ICH E11/EMA framework (neonates: 0-28 days; infants: 1-23 months; children: 2-11 years; adolescents: 12-17 years). Although these definitions originate from medicinal product regulation, they are widely accepted and provide a consistent basis for pediatric clinical research.

There is currently no separate international classification system specific to medical devices. However, the ICH E11/EMA framework is appropriate for device investigations because it reflects physiological differences in growth and development that are directly relevant to cardiac surgery and to the intended uses of the monitor and sensor. In particular, the greatest physiological differences compared to adults are found in neonates and infants, where cardiac size, myocardial composition, and perioperative risks differ substantially.

The study, therefore, aims to include patients across the pediatric spectrum with emphasis on neonates and infants, while allowing flexibility in recruitment numbers. Data from older children and adolescents can be reasonably bridged to adult data, given similarities in cardiac anatomy and physiology. This approach ensures that safety and usability are adequately assessed across the relevant pediatric subpopulations without imposing rigid subgroup quotas, which would be impractical in this rare and heterogeneous patient population.

Primary endpoint:

The ability of the SpectroCor Tissue Oxygenation Monitor and its accessory SpectroCor Sensor to observe and monitor changes in cardiac oxygen availability.

Secondary endpoints:

Incidence of (serious) adverse events, (serious) adverse device effects, and device deficiencies.

+Outcome measures

Primary outcomes

  • Ability to observe/monitor changes in myocardial oxygen availability [Intraoperatively, from sensor insertion to removal; typically 1 to 6 hours.]: Proportion of monitor-sensor applications demonstrating expected myocardial oxygenation response - percentage of applications in which the device detects a decrease in Hb/Mb saturation and CcOx oxidation after aortic cross-clamping, an increase after de-clamping, and/or an increase after blood cardioplegia administration.

Secondary outcomes

  • Incidence of device or protocol-related adverse events [From informed consent through hospital discharge; assessed up to approximately 30 days]: An Adverse Event (AE) is an untoward medical occurrence, unintended disease or injury, or any untoward clinical signs, including an abnormal laboratory finding, in subjects, users, or other persons, in the context of a clinical investigation, whether related to the investigated device. This definition includes events that are anticipated as well as unanticipated events occurring in a clinical investigation related to the investigated device or the procedures involved.
  • Incidence of device or protocol-related adverse device events and serious adverse device events [From informed consent through hospital discharge; assessed up to approximately 30 days]: An Adverse Device Effect (ADE) is any AE related to the use of an investigational medical device. This definition includes adverse events resulting from insufficient or inadequate instructions for use, deployment, implantation, installation, or operation, or any malfunction of the investigational medical device, and any event resulting from use error or from intentional misuse of the investigational medical device. A Serious Adverse Device Effect (SADE) is an ADE that has resulted in any of the consequences characteristic of a serious adverse event. SAEs related to procedures imposed by the clinical investigation plan but not with the use of the device shall not be considered Serious Adverse Device Effects.
  • Incidence of device or protocol-related serious adverse events [From informed consent through hospital discharge; assessed up to approximately 30 days]: A Serious Adverse Event (SAE) is any AE that led to any of the following: a) death; b) serious deterioration in the health of the subject that resulted in any of the following: (i) life-threatening illness or injury; (ii) permanent impairment of a body structure or a body function; (iii) hospitalization or prolongation of patient hospitalization; (iv) medical or surgical intervention to prevent life-threatening illness or injury or permanent impairment to a body structure or a body function; (v) chronic disease.
  • Incidence of device defeciencies [From informed consent through hospital discharge; assessed up to approximately 30 days]: A Device Deficiency (DD) is any inadequacy in the identity, quality, durability, reliability, safety, or performance of an investigational device, including malfunction, use errors, or inadequacy in information supplied by the manufacturer.

+Eligibility

Sex: All, ages: 1 Year to 17 Years

Inclusion Criteria:

* Scheduled for open-heart surgery.
* Age <18
* Signed informed consent

Exclusion Criteria:

• Inability to provide informed consent

+Locations (1)

FacilityCityCountryStatus
HUS New Childrens HospitalHelsinki, UusimaaFinlandRecruiting

+Publications

  • Bridgewater B; Adult Cardiac Surgeons of North West England. Mortality data in adult cardiac surgery for named surgeons: retrospective examination of prospectively collected data on coronary artery surgery and aortic valve replacement. BMJ. 2005 Mar 5;330(7490):506-10. doi: 10.1136/bmj.330.7490.506. PMID 15746131
  • Patila T, Kukkonen S, Vento A, Pettila V, Suojaranta-Ylinen R. Relation of the Sequential Organ Failure Assessment score to morbidity and mortality after cardiac surgery. Ann Thorac Surg. 2006 Dec;82(6):2072-8. doi: 10.1016/j.athoracsur.2006.06.025. PMID 17126112
  • Chen JC, Kaul P, Levy JH, Haverich A, Menasche P, Smith PK, Carrier M, Verrier ED, Van de Werf F, Burge R, Finnegan P, Mark DB, Shernan SK; PRIMO-CABG Investigators. Myocardial infarction following coronary artery bypass graft surgery increases healthcare resource utilization. Crit Care Med. 2007 May;35(5):1296-301. doi: 10.1097/01.CCM.0000262403.08546.A2. PMID 17414091
  • Lomivorotov VV, Efremov SM, Pokushalov EA, Romanov AB, Ponomarev DN, Cherniavsky AM, Shilova AN, Karaskov AM, Lomivorotov VN. Randomized trial of fish oil infusion to prevent atrial fibrillation after cardiac surgery: data from an implantable continuous cardiac monitor. J Cardiothorac Vasc Anesth. 2014 Oct;28(5):1278-84. doi: 10.1053/j.jvca.2014.02.019. Epub 2014 Jul 11. PMID 25027101
  • Maganti M, Badiwala M, Sheikh A, Scully H, Feindel C, David TE, Rao V. Predictors of low cardiac output syndrome after isolated mitral valve surgery. J Thorac Cardiovasc Surg. 2010 Oct;140(4):790-6. doi: 10.1016/j.jtcvs.2009.11.022. Epub 2010 Feb 11. PMID 20152992
  • Flogel U, Fago A, Rassaf T. Keeping the heart in balance: the functional interactions of myoglobin with nitrogen oxides. J Exp Biol. 2010 Aug 15;213(Pt 16):2726-33. doi: 10.1242/jeb.041681. PMID 20675541
  • Shiva S, Sack MN, Greer JJ, Duranski M, Ringwood LA, Burwell L, Wang X, MacArthur PH, Shoja A, Raghavachari N, Calvert JW, Brookes PS, Lefer DJ, Gladwin MT. Nitrite augments tolerance to ischemia/reperfusion injury via the modulation of mitochondrial electron transfer. J Exp Med. 2007 Sep 3;204(9):2089-102. doi: 10.1084/jem.20070198. Epub 2007 Aug 6. PMID 17682069
  • Brookes PS, Levonen AL, Shiva S, Sarti P, Darley-Usmar VM. Mitochondria: regulators of signal transduction by reactive oxygen and nitrogen species. Free Radic Biol Med. 2002 Sep 15;33(6):755-64. doi: 10.1016/s0891-5849(02)00901-2. PMID 12208364
  • Lindbergh T, Larsson M, Szabo Z, Casimir-Ahn H, Stromberg T. Intramyocardial oxygen transport by quantitative diffuse reflectance spectroscopy in calves. J Biomed Opt. 2010 Mar-Apr;15(2):027009. doi: 10.1117/1.3374050. PMID 20459283
  • Cohen GA, Permut LC, Arakaki LS, Ciesielski WA, McMullan DM, Parrish AR, Schenkman KA. Direct optical measurement of intraoperative myocardial oxygenation during congenital heart surgery. ASAIO J. 2011 Jul-Aug;57(4):314-7. doi: 10.1097/MAT.0b013e3182179881. PMID 21508828
  • Ohira S, Tanaka H, Harada Y, Minamikawa T, Kumamoto Y, Matoba S, Yaku H, Takamatsu T. Label-free detection of myocardial ischaemia in the perfused rat heart by spontaneous Raman spectroscopy. Sci Rep. 2017 Feb 10;7:42401. doi: 10.1038/srep42401. PMID 28186163
  • Lelovas PP, Kostomitsopoulos NG, Xanthos TT. A comparative anatomic and physiologic overview of the porcine heart. J Am Assoc Lab Anim Sci. 2014 Sep;53(5):432-8. PMID 25255064
  • Drury NE. Myocardial protection in paediatric cardiac surgery: building an evidence-based strategy. Ann R Coll Surg Engl. 2024 Mar;106(3):277-282. doi: 10.1308/rcsann.2023.0004. Epub 2023 May 30. PMID 37249560
  • Turkoz R. Myocardial protection in pediatric cardiac surgery. Artif Organs. 2013 Jan;37(1):16-20. doi: 10.1111/aor.12029. PMID 23305570
  • Jobsis FF. Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. Science. 1977 Dec 23;198(4323):1264-7. doi: 10.1126/science.929199. PMID 929199
  • Bale G, Elwell CE, Tachtsidis I. From Jobsis to the present day: a review of clinical near-infrared spectroscopy measurements of cerebral cytochrome-c-oxidase. J Biomed Opt. 2016 Sep;21(9):091307. doi: 10.1117/1.JBO.21.9.091307. PMID 27170072
  • Holper L, Mann JJ. Test-retest reliability of brain mitochondrial cytochrome-c-oxidase assessed by functional near-infrared spectroscopy. J Biomed Opt. 2018 May;23(5):1-9. doi: 10.1117/1.JBO.23.5.056006. PMID 29766685
  • Lindbergh T, Haggblad E, Ahn H, Goran Salerud E, Larsson M, Stromberg T. Improved model for myocardial diffuse reflectance spectra by including mitochondrial cytochrome aa3, methemoglobin, and inhomogenously distributed RBC. J Biophotonics. 2011 Apr;4(4):268-76. doi: 10.1002/jbio.201000048. PMID 20661995

+Investigators