Durability of bioprosthetic aortic valves in patients under the age of 60 years - rationale and design of the international INDURE registry.


Journal

Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113

Informations de publication

Date de publication:
27 May 2020
Historique:
received: 07 04 2020
accepted: 10 05 2020
entrez: 29 5 2020
pubmed: 29 5 2020
medline: 24 10 2020
Statut: epublish

Résumé

There is an ever-growing number of patients requiring aortic valve replacement (AVR). Limited data is available on the long-term outcomes and structural integrity of bioprosthetic valves in younger patients undergoing surgical AVR. The INSPIRIS RESILIA Durability Registry (INDURE) is a prospective, open-label, multicentre, international registry with a follow-up of 5 years to assess clinical outcomes of patients younger than 60 years who undergo surgical AVR using the INSPIRIS RESILIA aortic valve. INDURE will be conducted across 20-22 sites in Europe and Canada and intends to enrol minimum of 400 patients. Patients will be included if they are scheduled to undergo AVR with or without concomitant root replacement and/or coronary bypass surgery. The primary objectives are to 1) determine VARC-2 defined time-related valve safety at one-year (depicted as freedom from events) and 2) determine freedom from stage 3 structural valve degeneration (SVD) presenting as morphological abnormalities and severe haemodynamic valve degeneration at 5 years. Secondary objectives include the assessment of the haemodynamic performance of the valve, all stages of SVD, potential valve-in-valve procedures, clinical outcomes (in terms of New York Heart Association [NYHA] function class and freedom from valve-related rehospitalisation) and change in patient quality-of-life. INDURE is a prospective, multicentre registry in Europe and Canada, which will provide much needed data on the long-term performance of bioprosthetic valves in general and the INSPIRIS RESILIA valve in particular. The data may help to gather a deeper understanding of the longevity of bioprosthetic valves and may expand the use of bioprosthetic valves in patients under the age of 60 years. ClinicalTrials.gov identifier: NCT03666741 (registration received September, 12th, 2018).

Sections du résumé

BACKGROUND BACKGROUND
There is an ever-growing number of patients requiring aortic valve replacement (AVR). Limited data is available on the long-term outcomes and structural integrity of bioprosthetic valves in younger patients undergoing surgical AVR.
METHODS METHODS
The INSPIRIS RESILIA Durability Registry (INDURE) is a prospective, open-label, multicentre, international registry with a follow-up of 5 years to assess clinical outcomes of patients younger than 60 years who undergo surgical AVR using the INSPIRIS RESILIA aortic valve. INDURE will be conducted across 20-22 sites in Europe and Canada and intends to enrol minimum of 400 patients. Patients will be included if they are scheduled to undergo AVR with or without concomitant root replacement and/or coronary bypass surgery. The primary objectives are to 1) determine VARC-2 defined time-related valve safety at one-year (depicted as freedom from events) and 2) determine freedom from stage 3 structural valve degeneration (SVD) presenting as morphological abnormalities and severe haemodynamic valve degeneration at 5 years. Secondary objectives include the assessment of the haemodynamic performance of the valve, all stages of SVD, potential valve-in-valve procedures, clinical outcomes (in terms of New York Heart Association [NYHA] function class and freedom from valve-related rehospitalisation) and change in patient quality-of-life.
DISCUSSION CONCLUSIONS
INDURE is a prospective, multicentre registry in Europe and Canada, which will provide much needed data on the long-term performance of bioprosthetic valves in general and the INSPIRIS RESILIA valve in particular. The data may help to gather a deeper understanding of the longevity of bioprosthetic valves and may expand the use of bioprosthetic valves in patients under the age of 60 years.
TRIAL REGISTRATION BACKGROUND
ClinicalTrials.gov identifier: NCT03666741 (registration received September, 12th, 2018).

Identifiants

pubmed: 32460798
doi: 10.1186/s13019-020-01155-6
pii: 10.1186/s13019-020-01155-6
pmc: PMC7251702
doi:

Banques de données

ClinicalTrials.gov
['NCT03666741']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

119

Subventions

Organisme : Edwards Lifesciences
ID : n.a.

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Auteurs

Bart Meuris (B)

Cardiac Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. bart.meuris@uzleuven.be.

Michael A Borger (MA)

Leipzig Heart Center, Leipzig, Germany.

Thierry Bourguignon (T)

Tours University Hospital, Tours, France.

Matthias Siepe (M)

Heart Center University of Freiburg, Freiburg and Bad Krozingen, Germany.

Martin Grabenwöger (M)

HZH Heart Center Hietzing, Wien, Austria.

Günther Laufer (G)

Medicine University Wien, Heart Center, Wien, Austria.

Konrad Binder (K)

Heart Center University St. Pölten, St. Pölten, Austria.

Gianluca Polvani (G)

Cardiology Center Monzino, Milan, MI, Italy.

Pierluigi Stefano (P)

Careggi University Hospital, Florence, Italy.

Enrico Coscioni (E)

University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.

Wouter van Leeuwen (W)

Erasmus University Medical Center, Rotterdam, Netherlands.

Philippe Demers (P)

Montreal Heart Institute, Montréal, Canada.

Francois Dagenais (F)

Institute University, Cardiology Center, Québec, Canada.

Sergio Canovas (S)

Hospital University Virgen de la Arrixaca, Murcia, Spain.

Alexis Theron (A)

Hospital de la Timone, Marseille, France.

Thierry Langanay (T)

Rennes University Hospital Center, Rennes, France.

Jean-Christian Roussel (JC)

CHU Nantes, Nantes, France.

Olaf Wendler (O)

King's College Hospital NHS Foundation Trust, London, UK.

Giovanni Mariscalco (G)

Glenfield Hospital, Leicester, UK.

Renzo Pessotto (R)

Royal Infirmary of Edinburgh, Edinburgh, UK.

Beate Botta (B)

Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany.

Peter Bramlage (P)

Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany.

Ruggero de Paulis (R)

Cardiac Surgery, European Hospital, Rome, Italy.

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Classifications MeSH