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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT02000115




Registration number
NCT02000115
Ethics application status
Date submitted
26/11/2013
Date registered
3/12/2013
Date last updated
25/10/2023

Titles & IDs
Public title
Portico Re-sheathable Transcatheter Aortic Valve System US IDE Trial
Scientific title
Portico Re-sheathable Transcatheter Aortic Valve System US IDE Trial
Secondary ID [1] 0 0
1203
Universal Trial Number (UTN)
Trial acronym
PORTICO-IDE
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Aortic Valve Stenosis 0 0
Condition category
Condition code
Cardiovascular 0 0 0 0
Diseases of the vasculature and circulation including the lymphatic system

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Devices - Portico transcatheter aortic valve
Treatment: Devices - Commercially available transcatheter aortic valve

Experimental: Randomized IDE Cohort, Portico Valve - Portico transcatheter aortic valve and Portico delivery system.
Status: ACTIVE, NOT ENROLLING.

Active Comparator: Randomized IDE Cohort, CAV - Any FDA approved, commercially-available transcatheter aortic valve (CAV).
Status: ACTIVE, NOT ENROLLING.

Experimental: Nested Valve-in-Valve Registry - Subjects who have documented failed aortic surgical valve prosthesis and are deemed eligible to receive a transcatheter Portico valve
Status: ACTIVE, ENROLLING.

Experimental: FlexNav Delivery System Study - Portico transcatheter aortic valve and FlexNav delivery system
Status: ACTIVE, NOT ENROLLING


Treatment: Devices: Portico transcatheter aortic valve
St. Jude Medical transcatheter Portico aortic valve

Treatment: Devices: Commercially available transcatheter aortic valve
Commercially available transcatheter aortic valve
Intervention code [1] 0 0
Treatment: Devices
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Primary Effectiveness Endpoint (Randomized IDE Cohort)
Timepoint [1] 0 0
One-year from randomization
Primary outcome [2] 0 0
Primary Safety Endpoint (Randomized IDE Cohort)
Timepoint [2] 0 0
30 days from randomization
Primary outcome [3] 0 0
Percentage of Patients With Major Vascular Complications (Primary Safety Endpoint- FlexNav Delivery System Study)
Timepoint [3] 0 0
30 days from index procedure
Secondary outcome [1] 0 0
Percentage of Patients With Severe Aortic Regurgitation (Randomized IDE Cohort)
Timepoint [1] 0 0
One year
Secondary outcome [2] 0 0
Kansas City Cardiomyopathy Questionnaire (KCCQ) Overall Summary Score (Randomized IDE Cohort)
Timepoint [2] 0 0
One year
Secondary outcome [3] 0 0
Percentage of Patients With Moderate or Severe Aortic Regurgitation (Randomized IDE Cohort)
Timepoint [3] 0 0
One year
Secondary outcome [4] 0 0
Six-Minute Walk Test- Total Distance Walked (Randomized IDE Cohort)
Timepoint [4] 0 0
One year
Secondary outcome [5] 0 0
Percentage of Patients With Composite Safety Endpoint (Nested Valve-in-Valve Registry)
Timepoint [5] 0 0
30 days from index procedure
Secondary outcome [6] 0 0
Percentage of Patients With All-cause Mortality or Disabling Stroke (Nested Valve-in-Valve Registry)
Timepoint [6] 0 0
One year from index procedure

Eligibility
Key inclusion criteria
Inclusion Criteria

1. Subjects must have co-morbidities such that the surgeon and cardiologist
Co-Investigators concur that the predicted risk of operative mortality is =15% or a
minimum Society of Thoracic Surgeons (STS) score of 8%. A candidate who does not meet
the STS score criteria of = 8% can be included in the study if a peer review by at
least two surgeons concludes and documents that the patient's predicted risk of
operative mortality is =15%. The surgeon's assessment of operative comorbidities not
captured by the STS score must be documented in the study case report form as well as
in the patient medical record.

2. Subject is 21 years of age or older at the time of consent.

3. Subject has senile degenerative aortic valve stenosis with echocardiographically
derived criteria: mean gradient >40 mmHg or jet velocity greater than 4.0 m/s or
Doppler Velocity Index <0.25 and an initial aortic valve area (AVA) of = 1.0 cm2
(indexed effective orifice area (EOA) = 0.6 cm2/m2). (Qualifying AVA baseline
measurement must be within 60 days prior to informed consent).

4. Subject has symptomatic aortic stenosis as demonstrated by New York Heart Association
(NYHA) Functional Classification of II, III, or IV.

5. The subject has been informed of the nature of the study, agrees to its provisions and
has provided written informed consent as approved by the Institutional Review Board
(IRB) of the respective clinical site.

6. The subject and the treating physician agree that the subject will return for all
required post-procedure follow-up visits.

7. Subject's aortic annulus is 19-27mm diameter as measured by computerized tomography
(CT) conducted within 12 months prior to informed consent. Note: if CT is
contraindicated and/or not possible to be obtained for certain subjects, a 3D echo and
non-contrast CT of chest and abdomen/pelvis may be accepted if approved by the subject
selection committee.

For a subject to be considered an Extreme Risk candidate they must meet # 2, 3, 4, 5,
6, 7 of the above criteria, and

8. The subject, after formal consults by a cardiologist and two cardiovascular surgeons
agree that medical factors preclude operation, based on a conclusion that the
probability of death or serious, irreversible morbidity exceeds the probability of
meaningful improvement. Specifically, the probability of death or serious,
irreversible morbidity should exceed 50%. The surgeons' consult notes shall specify
the medical or anatomic factors leading to that conclusion and include a printout of
the calculation of the STS score to additionally identify the risks in these patients.
Minimum age
21 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
Exclusion Criteria

1. Evidence of an acute myocardial infarction (defined as: ST Segment Elevation as
evidenced on 12 Lead ECG) within 30 days prior to index procedure.

2. Aortic valve is a congenital unicuspid or congenital bicuspid valve or is
non-calcified as verified by echocardiography.

3. Mixed aortic valve disease (aortic stenosis and aortic regurgitation with predominant
aortic regurgitation 3-4+).

4. Any percutaneous coronary or peripheral interventional procedure performed within 30
days prior to index procedure.

5. Pre-existing prosthetic heart valve or other implant in any valve position, prosthetic
ring, severe circumferential mitral annular calcification (MAC) which is continuous
with calcium in the left ventricular outflow tract (LVOT), severe (greater than 3+)
mitral insufficiency, or severe mitral stenosis with pulmonary compromise. Subjects
with pre-existing surgical bioprosthetic aortic heart valve should be considered for
the Valve-in-Valve registry.

6. Blood dyscrasias as defined: leukopenia (WBC<3000 mm3), acute anemia (Hb < 9 g/dL),
thrombocytopenia (platelet count <50,000 cells/mm³).

7. History of bleeding diathesis or coagulopathy.

8. Cardiogenic shock manifested by low cardiac output, vasopressor dependence, or
mechanical hemodynamic support.

9. Untreated clinically significant coronary artery disease requiring revascularization.

10. Hemodynamic instability requiring inotropic support or mechanical heart assistance.

11. Need for emergency surgery for any reason.

12. Hypertrophic cardiomyopathy with or without obstruction (HOCM).

13. Severe ventricular dysfunction with left ventricular ejection fraction (LVEF) <20% as
measured by resting echocardiogram.

14. Echocardiographic evidence of intracardiac mass, thrombus or vegetation.

15. Active peptic ulcer or upper gastrointestinal (GI) bleeding within 3 months prior to
index procedure.

16. A known hypersensitivity or contraindication to aspirin, heparin, ticlopidine
(Ticlid), or clopidogrel (Plavix), or sensitivity to contrast media which cannot be
adequately premedicated.

17. Recent (within 6 months prior to index procedure date) cerebrovascular accident (CVA)
or a transient ischemic attack (TIA).

18. Renal insufficiency (creatinine > 3.0 mg/dL) and/or end stage renal disease requiring
chronic dialysis.

19. Life expectancy < 12 months from the time of informed consent due to non-cardiac
co-morbid conditions.

20. Significant aortic disease, including abdominal aortic or thoracic aneurysm defined as
maximal luminal diameter 5cm or greater; marked tortuosity (hyperacute bend), aortic
arch atheroma (especially if thick [> 5 mm], protruding or ulcerated) or narrowing
(especially with calcification and surface irregularities) of the abdominal or
thoracic aorta, severe "unfolding" and tortuosity of the thoracic aorta (applicable
for transfemoral patients only).

21. Native aortic annulus size < 19 mm or > 27 mm per the baseline diagnostic imaging.

22. Aortic root angulation > 70° (applicable for transfemoral patients only).

23. Currently participating in an investigational drug or device study.

24. Active bacterial endocarditis within 6 months prior to the index procedure.

25. Bulky calcified aortic valve leaflets in close proximity to coronary ostia.

26. Non-calcified aortic annulus

27. Iliofemoral vessel characteristics that would preclude safe placement of the
introducer sheath such as severe obstructive calcification, or severe tortuosity
(applicable for transfemoral patients only).

Additional Exclusion Criteria (Transcatheter Access Related)

For selection of an appropriate alternative access delivery method, subjects were screened
using the following access specific exclusion criteria:

Transaortic (TAo) Subject Cohort Specific Exclusion Criteria

1. Subject has pre-existing patent RIMA graft that would preclude access.

2. Subject has a hostile chest or other condition that complicates transaortic access.

3. Subject has a porcelain aorta, defined as an extensive circumferential calcification
of the ascending aorta that would complicate TAo access.

Additional exclusion criteria for transaortic access using the FlexNav™ Delivery System:

1. Subject has a distance between the annular plane and the aortic access site <7 cm
(2.8")

2. Subject has a distance between the annular plane and the separate introducer sheath
distal tip <6 cm (2.4")

Subclavian/Axillary Subject Cohort Specific Exclusion Criteria

1. Subject's access vessel (subclavian/axillary) diameter will not allow for introduction
of the applicable 18 Fr or 19 Fr delivery system.

2. Subject's subclavian/axillary arteries have severe calcification and/or tortuosity.

3. Subject's aortic root angulation is:

- Left Subclavian/Left Axillary: >70?

- Right Subclavian/Right Axillary: >30?

4. Subject has a history of patent LIMA/RIMA graft that would preclude access

Additional exclusion criteria for subclavian/axillary access using the FlexNav™ Delivery
System:

1. Subject's access vessel (subclavian/axillary) has a distance between the annular plane
and the integrated sheath distal tip <17 cm (6.7")

2. Subject's access vessel requires the delivery system to be advanced through a separate
introducer sheath

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
Phase
Not Applicable
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
1/05/2014
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
1/07/2025
Actual
Sample size
Target
1150
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC,WA
Recruitment hospital [1] 0 0
Macquarie University Hospital - Sydney
Recruitment hospital [2] 0 0
The Prince Charles Hospital - Chermside
Recruitment hospital [3] 0 0
Royal Adelaide Hospital - Adelaide
Recruitment hospital [4] 0 0
The Alfred Hospital - Melbourne
Recruitment hospital [5] 0 0
Fiona Stanley Hospital - Murdoch
Recruitment postcode(s) [1] 0 0
2109 - Sydney
Recruitment postcode(s) [2] 0 0
4032 - Chermside
Recruitment postcode(s) [3] 0 0
5000 - Adelaide
Recruitment postcode(s) [4] 0 0
3004 - Melbourne
Recruitment postcode(s) [5] 0 0
6150 - Murdoch
Recruitment outside Australia
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United States of America
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Alabama
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Arizona
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California
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District of Columbia
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Florida
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Georgia
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Illinois
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Indiana
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Iowa
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Kansas
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Louisiana
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Massachusetts
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Michigan
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Minnesota
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Mississippi
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Missouri
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New Hampshire
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New Jersey
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New York
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North Carolina
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Ohio
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Oklahoma
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Pennsylvania
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South Dakota
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Tennessee
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Texas
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Utah
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Virginia
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United States of America
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Washington

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Abbott Medical Devices
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
The objective of the PORTICO pivotal IDE trial is to evaluate the safety and effectiveness of
the St Jude Medical (SJM) Portico Transcatheter Heart Valve and Delivery Systems (Portico) in
the treatment of severe symptomatic aortic stenosis via transfemoral and alternative delivery
methods in high risk and extreme risk patients.
Trial website
https://clinicaltrials.gov/ct2/show/NCT02000115
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Raj R Makkar, MD
Address 0 0
Cedars-Sinai Medical Center
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Kimberly S Behning
Address 0 0
Country 0 0
Phone 0 0
651-756-5622
Fax 0 0
Email 0 0
kimberly.behning@abbott.com
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT02000115