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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02673697
Registration number
NCT02673697
Ethics application status
Date submitted
21/01/2016
Date registered
4/02/2016
Titles & IDs
Public title
Perceval Sutureless Implant Versus Standard-Aortic Valve Replacement
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Scientific title
Perceval Sutureless Implant Versus Standard-Aortic Valve Replacement A Controlled Randomized Trial in the Surgical Treatment of Aortic Valve Disease
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Secondary ID [1]
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0
TPS003
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Universal Trial Number (UTN)
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Trial acronym
PERSIST-AVR
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Aortic Valve Disease
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0
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Aortic Stenosis
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0
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Condition category
Condition code
Cardiovascular
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0
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Cardiovascular
0
0
0
0
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Diseases of the vasculature and circulation including the lymphatic system
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Cancer
0
0
0
0
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Thyroid
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Cancer
0
0
0
0
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Non melanoma skin cancer
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Cancer
0
0
0
0
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Kidney
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Metabolic and Endocrine
0
0
0
0
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Other endocrine disorders
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Cancer
0
0
0
0
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Leukaemia - Acute leukaemia
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Cancer
0
0
0
0
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Leukaemia - Chronic leukaemia
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Cancer
0
0
0
0
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Children's - Leukaemia & Lymphoma
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Cancer
0
0
0
0
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Lymphoma (non Hodgkin's lymphoma) - High grade lymphoma
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Cancer
0
0
0
0
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Lymphoma (non Hodgkin's lymphoma) - Low grade lymphoma
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Cancer
0
0
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0
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Head and neck
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Oral and Gastrointestinal
0
0
0
0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Devices - Perceval valve
Treatment: Devices - other stented biological valve
Experimental: Perceval - The Perceval sutureless aortic heart valve (Perceval valve) is a bioprosthesis manufactured with bovine pericardium and assembled on a Nitinol stent. The Perceval valve is designed to offer an alternative to surgically implanted flexible prostheses (stented and stentless biological valves). A special feature of the device is that it is self-anchoring and does not require sutures to be fixed to the implant site.
Active comparator: other Stented biological valves - The comparator will be other commercially approved standard biological sutured stented valves, both bovine and porcine. The choice of the comparator tissue valve will be at the discretion of the participating investigators.
Treatment: Devices: Perceval valve
Sutureless Aortic Biological Valve
Treatment: Devices: other stented biological valve
Any biological stented valves available on the market (Edwards, Medtronic, St.Jude, LivaNova, Labcor)
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Intervention code [1]
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Treatment: Devices
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Proportion of Participants With Freedom From Major Adverse Cardiac and Cerebrovascular Events (MACCE)
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Assessment method [1]
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The primary endpoint is freedom from MACCE (composite endpoint of all cause death, myocardial infarction, stroke, and valve re-intervention) at one year based on Clinical Event Committee (CEC) adjudication.
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Timepoint [1]
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1 year post-operatively
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Secondary outcome [1]
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Surgical Times
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Assessment method [1]
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1. Cross clamp time during index procedure
2. Cardiopulmonary bypass time during index procedure
Start time and finish time were collected for operative room time procedure and calculated for each subject. Mean was calculated and reported in the results sections
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Timepoint [1]
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Intra-operative
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Secondary outcome [2]
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Number of participants with acute Graft-versus-host disease (aGvHD) according to the Glucksberg scale and Seattle criteria
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Assessment method [2]
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0
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Timepoint [2]
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18 months after inclusion of first patient, afterwards, annually up to 10 years
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Secondary outcome [3]
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Number of participants with chronic Graft-versus-host disease (cGvHD) according to the Glucksberg scale and Seattle criteria
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Assessment method [3]
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0
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Timepoint [3]
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0
18 months after inclusion of first patient, afterwards, annually up to 10 years
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Secondary outcome [4]
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Number of participants with VOD/SOS according to the Seattle criteria
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Assessment method [4]
0
0
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Timepoint [4]
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0
18 months after inclusion of first patient, afterwards, annually up to 10 years
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Secondary outcome [5]
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Number of participants with Neutrophil recovery as a measure of Safety and Tolerability
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Assessment method [5]
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0
defined as the first of 3 consecutive days with an absolute neutrophil count of 0.5x10\^9/L or higher
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Timepoint [5]
0
0
18 months after inclusion of first patient, afterwards, annually up to 10 years
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Secondary outcome [6]
0
0
Number of participants with Platelet recovery as a measure of Safety and Tolerability
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Assessment method [6]
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0
Defined as the first of 3 consecutive days with platelet counts higher that 20x10\^9/L without transfusion
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Timepoint [6]
0
0
18 months after inclusion of first patient, afterwards, annually up to 10 years
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Secondary outcome [7]
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Number of participants with Primary graft failure or rejection as a measure of Safety and Tolerability
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Assessment method [7]
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Defined by persistent pancytopenia with no evidence of hematologic recovery of donor cells beyond 28 days after transplantation, and secondary graft failure by a rapid decrease in neutrophil count after successful engraftment
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Timepoint [7]
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18 months after inclusion of first patient, afterwards, annually up to 10 years
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Secondary outcome [8]
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Transplant related mortality (TRM)
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Assessment method [8]
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0
the time of transplant until all causes of death after transplant not related to relapse
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Timepoint [8]
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18 months after inclusion of first patient, afterwards, annually up to 10 years
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Secondary outcome [9]
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Event free survival (EFS)
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Assessment method [9]
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the time of transplant until death, relapse or graft failure, whichever occurs first.
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Timepoint [9]
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18 months after inclusion of first patient, afterwards, annually up to 10 years
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Secondary outcome [10]
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Overall survival (OS)
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Assessment method [10]
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the time between transplantation and death due to any causes
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Timepoint [10]
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18 months after inclusion of first patient, afterwards, annually up to 10 years
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Secondary outcome [11]
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Cumulative incidence of relapse
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Assessment method [11]
0
0
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Timepoint [11]
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18 months after inclusion of first patient, afterwards, annually up to 10 years
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Secondary outcome [12]
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0
change in dysphagia across different patient treatments
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Assessment method [12]
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To estimate the treatment specific rate of dysphagia (SSQ \>234 rate). Treatment modality by surgery.
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Timepoint [12]
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24 months
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Secondary outcome [13]
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0
change in dysphagia across different patient treatments
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Assessment method [13]
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To estimate the treatment specific rate of surgery with postoperative radiotherapy.
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Timepoint [13]
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24 months
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Secondary outcome [14]
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0
change in dysphagia across different patient treatments
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Assessment method [14]
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To estimate the treatment specific rate of surgery with surgery with postoperative concurrent chemoradiation.
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Timepoint [14]
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24 months
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Secondary outcome [15]
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0
change in dysphagia across different patient treatments
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Assessment method [15]
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To estimate the treatment specific rate of surgery with radiotherapy alone.
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Timepoint [15]
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24 months
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Secondary outcome [16]
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change in dysphagia across different patient treatments
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Assessment method [16]
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To estimate the treatment specific rate of surgery with concurrent chemoradiation and induction chemotherapy followed by concurrent chemoradiation.
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Timepoint [16]
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24 months
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Secondary outcome [17]
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0
change in rate of secondary treatment side effect
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Assessment method [17]
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To explore treatment effects on other secondary endpoint: pain visual analog scale
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Timepoint [17]
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24 months
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Secondary outcome [18]
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change in rate of secondary treatment side effect
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Assessment method [18]
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To explore treatment effects on other secondary endpoint: speech-language pathology (SLP) recommended swallow exercise adherence status.
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Timepoint [18]
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24 months
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Secondary outcome [19]
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change in rate of secondary treatment side effect
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Assessment method [19]
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To explore treatment effects on other secondary endpoint: Functional Oral Intake Scale (FOIS) Diet Level and disease status / pattern of relapse.
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Timepoint [19]
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24 months
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Eligibility
Key inclusion criteria
1. The subject has an indication for treatment by valve replacement with a bioprosthesis according to the IFU, through either full sternotomy or mini-sternotomy.
2. The subject has aortic valve disease that can be treated with a commercially available Perceval valve size, based on preoperative CT-scan.
3. The subject has:
1. critical aortic valve area defined as an initial aortic valve area of =1.0 cm2 or aortic valve area index < 0.6 cm2/m2 AND
2. Mean gradient > 40 mmHg or Vmax > 4 m/sec by resting echocardiogram or simultaneous pressure recordings at cardiac catheterization [or with dobutamine stress, if subject has a left ventricular ejection fraction (LVEF) <55%] or velocity ratio < 0.25;
4. The subject is symptomatic due to aortic stenosis with functional class of New York Heart Association (NYHA) II or higher.
5. The subject has signed the informed consent.
6. The subject is of legal minimum age.
7. The subject will be available for postoperative follow-up beyond one year.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. The subject has a contraindication for treatment by the Perceval valve or by a bioprosthetic aortic valve as stated in the IFU.
2. The subject has aneurismal dilation or dissection of the ascending aortic wall.
3. The subject is scheduled for concomitant procedures other than Coronary Aortic Bypass Graft (CABG), myectomy with or without aortic annulus enlargement
4. The subject has congenital bicuspid (i.e. Sievers type 0) or unicuspid aortic valve.
5. Anatomical structures not suitable for Perceval valve such as: aortic root enlargement, where the ratio between the diameter of the sino-tubular junction and the annulus diameter is > 1.3.
6. The subject has a prosthetic heart valve in any position, including mitral valve repair.
7. The subject has a stroke or myocardial infarction (STEMI and NSTEMI) within 30 days prior to the planned valve implant surgery.
8. The subject has active endocarditis, myocarditis, or sepsis.
9. The subject is in cardiogenic shock manifested by low cardiac output and needing hemodynamic support.
10. The subject is allergic to nickel alloys.
11. The subject is already included in another clinical trial that could confound the results of this clinical investigation.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
22/03/2016
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
31/07/2020
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Sample size
Target
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Accrual to date
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Final
914
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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- Camperdown
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Recruitment hospital [2]
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- St Leonards
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Recruitment hospital [3]
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University of New South Wales - St. George Hospital - Sydney
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Recruitment hospital [4]
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Cardiac Transplantation Laboratory, The Victor Chang Cardiac Research Institute - Darlinghurst
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Recruitment postcode(s) [1]
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2050 - Camperdown
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Recruitment postcode(s) [2]
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- St Leonards
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Recruitment postcode(s) [3]
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- Sydney
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Recruitment postcode(s) [4]
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NSW 2010 - Darlinghurst
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Recruitment outside Australia
Country [1]
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United States of America
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Arizona
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United States of America
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Indiana
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United States of America
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Maine
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Ohio
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United States of America
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Texas
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United States of America
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Virginia
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Austria
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Graz
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Austria
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Innsbruck
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Austria
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Vienna
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Austria
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Wien
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Belgium
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Antwerp
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Belgium
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Bruxelles
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Belgium
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Leuven
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Canada
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Alberta
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Canada
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Ontario
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Canada
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Quebec
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Chile
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Santiago
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Angers
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Besançon
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Lille
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Montpellier
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France
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Nancy
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France
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Poitiers
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Bad Krozingen
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Germany
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Bad Neustadt An Der Saale
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Germany
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Dresden
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Germany
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Hamburg
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Germany
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Germany
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Nürnberg
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Jerusalem
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Israel
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Tel Aviv
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BS
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Italy
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CT
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Italy
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MI
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Italy
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MS
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Brescia
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Cotignola
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Mantova
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Eindhoven
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Maastricht
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A Coruna
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Badalona
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Gironde
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Val De Marne
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Milano
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Pisa
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Roma
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Siena
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South Glamorgan
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Strathclyde
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Surrey
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Switzerland
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Cansearch Laboratory
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Switzerland
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Basel
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Switzerland
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Geneva
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Switzerland
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Zurich
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Colorado
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China
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Hong Kong
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Utah
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Paris
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Italy
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Bologna
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Spain
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La Coruna
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Corcym S.r.l
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Address
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Country
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Other collaborator category [1]
0
0
Other
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Name [1]
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ALL SCTped Forum
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Address [1]
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0
0
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Ethics approval
Ethics application status
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Summary
Brief summary
Prospective, randomized, stratified non blinded multi-center, international, post market trial assessed in a non-inferiority study. The trial has a flexible sample size that will be determined adaptively. The trial will enroll up to 1234 subjects, but accrual may stop earlier at approximately 900 or 1050 subjects These subjects will be enrolled at approximately 60 worldwide investigational sites where the device is commercially available The primary objective of this trial is to test the safety and efficacy of Perceval versus standard sutured stented bioprosthetic aortic valves among the intended trial population.
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Trial website
https://clinicaltrials.gov/study/NCT02673697
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Trial related presentations / publications
Lorusso R, Folliguet T, Shrestha M, Meuris B, Kappetein AP, Roselli E, Klersy C, Nozza M, Verhees L, Larracas C, Goisis G, Fischlein T. Sutureless versus Stented Bioprostheses for Aortic Valve Replacement: The Randomized PERSIST-AVR Study Design. Thorac Cardiovasc Surg. 2020 Mar;68(2):114-123. doi: 10.1055/s-0038-1675847. Epub 2018 Nov 29. Fischlein T, Folliguet T, Meuris B, Shrestha ML, Roselli EE, McGlothlin A, Kappert U, Pfeiffer S, Corbi P, Lorusso R; Perceval Sutureless Implant Versus Standard-Aortic Valve Replacement Investigators. Sutureless versus conventional bioprostheses for aortic valve replacement in severe symptomatic aortic valve stenosis. J Thorac Cardiovasc Surg. 2021 Mar;161(3):920-932. doi: 10.1016/j.jtcvs.2020.11.162. Epub 2020 Dec 14. Lorusso R, Ravaux JM, Pollari F, Folliguet TA, Kappert U, Meuris B, Shrestha ML, Roselli EE, Bonaros N, Fabre O, Corbi P, Troise G, Andreas M, Pinaud F, Pfeiffer S, Kueri S, Tan E, Voisine P, Girdauskas E, Rega F, Garcia-Puente J, Fischlein T; on behalf the PERSIST-AVR Investigators. Pacemaker implantation after sutureless or stented valve: results from a controlled randomized trial. Eur J Cardiothorac Surg. 2022 Sep 2;62(4):ezac164. doi: 10.1093/ejcts/ezac164. Lorusso R, Jiritano F, Roselli E, Shrestha M, Folliguet T, Meuris B, Pollari F, Fischlein T; PERSIST-AVR Investigators. Perioperative platelet reduction after sutureless or stented valve implantation: results from the PERSIST-AVR controlled randomized trial. Eur J Cardiothorac Surg. 2021 Dec 1;60(6):1359-1365. doi: 10.1093/ejcts/ezab175. Wirth LJ, Brose MS, Sherman EJ, Licitra L, Schlumberger M, Sherman SI, Bible KC, Robinson B, Rodien P, Godbert Y, De La Fouchardiere C, Newbold K, Nutting C, Misir S, Xie R, Almonte A, Ye W, Cabanillas ME. Open-Label, Single-Arm, Multicenter, Phase II Trial of Lenvatinib for the Treatment of Patients With Anaplastic Thyroid Cancer. J Clin Oncol. 2021 Jul 20;39(21):2359-2366. doi: 10.1200/JCO.20.03093. Epub 2021 May 7. Cabanillas ME, McFadden DG, Durante C. Thyroid cancer. Lancet. 2016 Dec 3;388(10061):2783-2795. doi: 10.1016/S0140-6736(16)30172-6. Epub 2016 May 27. Madill-Thomsen KS, Halloran PF. Precision diagnostics in transplanted organs using microarray-assessed gene expression: concepts and technical methods of the Molecular Microscope(R) Diagnostic System (MMDx). Clin Sci (Lond). 2024 Jun 5;138(11):663-685. doi: 10.1042/CS20220530. Loupy A, Duong Van Huyen JP, Hidalgo L, Reeve J, Racape M, Aubert O, Venner JM, Falmuski K, Bories MC, Beuscart T, Guillemain R, Francois A, Pattier S, Toquet C, Gay A, Rouvier P, Varnous S, Leprince P, Empana JP, Lefaucheur C, Bruneval P, Jouven X, Halloran PF. Gene Expression Profiling for the Identification and Classification of Antibody-Mediated Heart Rejection. Circulation. 2017 Mar 7;135(10):917-935. doi: 10.1161/CIRCULATIONAHA.116.022907. Epub 2017 Feb 1. Halloran PF, Potena L, Van Huyen JD, Bruneval P, Leone O, Kim DH, Jouven X, Reeve J, Loupy A. Building a tissue-based molecular diagnostic system in heart transplant rejection: The heart Molecular Microscope Diagnostic (MMDx) System. J Heart Lung Transplant. 2017 Nov;36(11):1192-1200. doi: 10.1016/j.healun.2017.05.029. Epub 2017 May 29. Halloran PF, Reeve J, Aliabadi AZ, Cadeiras M, Crespo-Leiro MG, Deng M, Depasquale EC, Goekler J, Jouven X, Kim DH, Kobashigawa J, Loupy A, Macdonald P, Potena L, Zuckermann A, Parkes MD. Exploring the cardiac response to injury in heart transplant biopsies. JCI Insight. 2018 Oct 18;3(20):e123674. doi: 10.1172/jci.insight.123674. Parkes MD, Aliabadi AZ, Cadeiras M, Crespo-Leiro MG, Deng M, Depasquale EC, Goekler J, Kim DH, Kobashigawa J, Loupy A, Macdonald P, Potena L, Zuckermann A, Halloran PF. An integrated molecular diagnostic report for heart transplant biopsies using an ensemble of diagnostic algorithms. J Heart Lung Transplant. 2019 Jun;38(6):636-646. doi: 10.1016/j.healun.2019.01.1318. Epub 2019 Feb 6. Halloran PF, Madill-Thomsen KS. The Molecular Microscope Diagnostic System: Assessment of Rejection and Injury in Heart Transplant Biopsies. Transplantation. 2023 Jan 1;107(1):27-44. doi: 10.1097/TP.0000000000004323. Epub 2022 Dec 8. Halloran PF, Madill-Thomsen K, Mackova M, Aliabadi-Zuckermann AZ, Cadeiras M, Crespo-Leiro MG, Depasquale EC, Deng M, Gokler J, Hall SA, Kim DH, Kobashigawa J, Macdonald P, Potena L, Shah K, Stehlik J, Zuckermann A, Reeve J. Molecular states associated with dysfunction and graft loss in heart transplants. J Heart Lung Transplant. 2024 Mar;43(3):508-518. doi: 10.1016/j.healun.2023.11.013. Epub 2023 Nov 30. Halloran PF, Madill-Thomsen K, Aliabadi-Zuckermann AZ, Cadeiras M, Crespo-Leiro MG, Depasquale EC, Deng M, Gokler J, Kim DH, Kobashigawa J, Macdonald P, Potena L, Shah K, Stehlik J, Zuckermann A. Many heart transplant biopsies currently diagnosed as no rejection have mild molecular antibody-mediated rejection-related changes. J Heart Lung Transplant. 2022 Mar;41(3):334-344. doi: 10.1016/j.healun.2021.08.004. Epub 2021 Aug 26. Halloran PF, Madill-Thomsen K, Aliabadi-Zuckermann AZ, Cadeiras M, Crespo-Leiro MG, Depasquale EC, Deng M, Gokler J, Hall S, Jamil A, Kim DH, Kobashigawa J, Macdonald P, Melenovsky V, Patel J, Potena L, Shah K, Stehlik J, Zuckermann A. Redefining the molecular rejection states in 3230 heart transplant biopsies: Relationships to parenchymal injury and graft survival. Am J Transplant. 2024 Mar 26:S1600-6135(24)00241-7. doi: 10.1016/j.ajt.2024.03.031. Online ahead of print. Madill-Thomsen KS, Reeve J, Aliabadi-Zuckermann A, Cadeiras M, Crespo-Leiro MG, Depasquale EC, Deng M, Goekler J, Kim DH, Kobashigawa J, Macdonald P, Potena L, Shah K, Stehlik J, Zuckermann A, Halloran PF. Assessing the Relationship Between Molecular Rejection and Parenchymal Injury in Heart Transplant Biopsies. Transplantation. 2022 Nov 1;106(11):2205-2216. doi: 10.1097/TP.0000000000004231. Epub 2022 Oct 21. Halloran PF. Integrating molecular and histologic interpretation of transplant biopsies. Clin Transplant. 2021 Apr;35(4):e14244. doi: 10.1111/ctr.14244. Epub 2021 Feb 17. No abstract available.
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Contacts
Principal investigator
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Theodor Fischlein, MD
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Klinikum Nurnberg, Nurnberg, Germany
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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What supporting documents are/will be available?
No Supporting Document Provided
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Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/97/NCT02673697/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/97/NCT02673697/SAP_001.pdf
Results publications and other study-related documents
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Fischlein T, Folliguet T, Meuris B, Shrestha ML, R...
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Loupy A, Duong Van Huyen JP, Hidalgo L, Reeve J, R...
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Halloran PF, Potena L, Van Huyen JD, Bruneval P, L...
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Halloran PF, Reeve J, Aliabadi AZ, Cadeiras M, Cre...
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Parkes MD, Aliabadi AZ, Cadeiras M, Crespo-Leiro M...
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Halloran PF, Madill-Thomsen KS. The Molecular Micr...
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Halloran PF, Madill-Thomsen K, Mackova M, Aliabadi...
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Halloran PF, Madill-Thomsen K, Aliabadi-Zuckermann...
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Halloran PF, Madill-Thomsen K, Aliabadi-Zuckermann...
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Results are available at
https://clinicaltrials.gov/study/NCT02673697