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NCT Number: NCT06009588

Comparison of Self- and Balloon-expandable Valves in Patients With Ascending Aortic Dilation Undergoing Transcatheter Aortic Valve Replacement: The AAD-CHOICE

This study aimed at comparing the performance of self-expandable valves versus balloon-expandable valves in patients with ascending aortic dilation undergoing transcatheter aortic valve replacement.

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Key information

Age range

65 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College

Beijing, Beijing Municipality, 100037, China

Location status: Recruiting

Location contact

Kang An, Dr

SUB_INVESTIGATOR

Xiangbin Pan, Dr

CONTACT

[email protected]

0086-010-88396666

Xiangbin Pan, Dr

PRINCIPAL_INVESTIGATOR

About this study

Ascending aortic (AA) dilation is a common feature in patients with aortic stenosis (AS), especially in those with bicuspid aortic valve (BAV). For patients undergoing surgical aortic valve replacement (SAVR), current guidelines recommend concomitant aortic repair or replacement if the diameter of AA exceeds 45mm to avoid aortic dissection or rupture.

Transcatheter aortic valve replacement (TAVR) has profoundly changed the clinical management of AS patients who cannot tolerate SAVR. For patients who are candidates for TAVR, simultaneous repair of a dilated AA can be technically difficult. The safety and feasibility of the procedure and the fate of AA after the procedure in these patients remain unclear. Moreover, there are limited data comparing the performance of self-expandable valves versus balloon-expandable valves in these patients. The aim of the present study is to evaluate the impact of type of transcatheter heart valves on intra-procedural device success and post-procedural AA progression in patients with dilated AA (≥45mm) undergoing TAVR.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Severe aortic stenosis;
  • Transfemoral access;
  • Preoperative aortic CT suggesting maximum ascending aortic diameter ≥45mm and <55mm;
  • Anticipated life expectancy >1 year;
  • Age ≥ 65 years.

Exclusion criteria

  • Dominant aortic regurgitation,;
  • A history of SAVR or TAVR;
  • A history of aortic surgery;
  • Emergent TAVR.

Treatment and study plan

self-expandable valves

Device

patients undergoing TAVR use self-expandable valves

balloon-expandable valves

Device

patients undergoing TAVR use balloon-expandable valves

Primary outcomes

  1. 30-day all-cause mortality

    Time frame: 30 days after TAVR procedure

    all-cause mortality within 30 days after TAVR procedure

  2. 30-day adverse aortic events

    Time frame: 30 days after TAVR procedure

    aortic death, aortic dissection, or aortic rupture

  3. The rate of device success

    Time frame: 30 days

    Device success is defined as following:

    • Technical success (Freedom from mortality; Successful access, delivery of the device, and retrieval of the delivery system; Correct positioning of a single prosthetic heart valve into the proper anatomical location; Freedom from surgery or intervention related to the device or to a major vascular or access-related, or cardiac structural complication)
    • Freedom from mortality
    • Freedom from surgery or intervention related to the device or to a major vascular or access-related or cardiac structural complication
    • Intended performance of the valve (mean gradient <20 mmHg, peak velocity <3 m/s, Doppler velocity index $0.25, and less than moderate aortic regurgitation)

Secondary outcomes

  1. 1-year all-cause mortality

    Time frame: 1 year after TAVR procedure

    all-cause mortality

  2. 1-year cardiovascular mortality

    Time frame: 1 year after TAVR procedure

    Related to heart failure, cardiogenic shock, bioprosthetic valve dysfunction, myocardial infarction, stroke, thromboembolism, bleeding, tamponade, vascular complication, arrhythmia or conduction system disturbances, cardiovascular infection (e.g. mediastinitis, endocarditis), or other clear cardiovascular cause

  3. 1-year adverse aortic events

    Time frame: 1 year after TAVR procedure

    aortic death, aortic dissection, or aortic rupture

  4. Ascending aortic diameter expansion rate ≥3mm/year

    Time frame: 1 year after TAVR procedure

    Expansion rate was calculated as the change of ascending aortic diameters (before the procedure and at the latest follow-up) divided by the follow-up period.

  5. Hospitalization (or re-hospitalization)

    Time frame: 1 year after TAVR procedure

    Any admission after the index hospitalization or study enrolment to an inpatient unit or hospital ward for ≥24 h, including an emergency department stay.

    Hospitalizations planned for pre-existing conditions are excluded unless there is worsening of the baseline condition. Visits to urgent care centres or emergency departments <24 h may also be included if substantive intensification of therapy changes (e.g. heart failure episodes) are enacted (e.g. intravenous diuretics, significant increases in drug therapy dosages or addition of new pharmacotherapy agents)

Study contacts

Contact information is provided by the study sponsor or research team.

Kang An, MD

CONTACT

[email protected]

0085-15801301740

Sponsors and collaborators

Lead sponsor

China National Center for Cardiovascular Diseases

Other Gov

Registry information

Important dates

Study start
2023
Primary completion
2026
Study completion
2026
First posted
Aug 24, 2023
Registry last updated
Aug 5, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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