FIH Study of the GEMINUS TAVI System in Patients With Severe Symptomatic Aortic Stenosis

Launched by VALVE MEDICAL · Jun 8, 2023

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ClinConnect Summary

This clinical trial is studying a new device called the GEMINUS system, which is designed to help patients with severe symptomatic aortic stenosis, a condition where the heart's aortic valve is narrowed, making it hard for the heart to pump blood. The main goal of the trial is to see if this device is safe and effective for patients who have this condition. To join the trial, participants need to be at least 18 years old, have been diagnosed with severe aortic stenosis, and meet certain health criteria. This includes having specific heart symptoms and being at an intermediate risk for surgery.

If you participate in this trial, you can expect regular check-ups at 30 days, 6 months, and then yearly for up to five years after receiving the device. This will help the researchers monitor your health and how well the device is working. It's important to know that not everyone with aortic stenosis will qualify for the study; there are certain health conditions that could prevent participation. If you have questions or think you might be eligible, it’s a good idea to talk to your doctor about it.

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Eligibility criteria

• Inclusion Criteria:
• • 1. Age ≥ 18 years
• • 2. Patient understands the implications of participating in the study and provides informed consent
• • 3. Patient is willing to comply with specified follow-up evaluation
• • 4. Severe aortic stenosis as per ACC/AHA 2020 guidelines (e.g. AVA ≤ 1.0 cm2 (or AVA index ≤ 0.6cm2/m2)\* AND PV ≥ 4 m/sec or mean gradient ≥ 40 mmHg)\*\* as determined by TTE/CT-TAVI
• • \*May be larger with mixed AS/AR
• • \*\*For low flow low gradient AS or paradoxical low flow severe AS must meet ACC/AHA guidelines (table 13 stages of AS in the guideline)
• • 5. Cardiac Symptoms: ≥ NYHA Class II
• • 6. Patient ≥ intermediate surgical risk as assessed by the heart team or ≥75 years old.
• • 7. Aortic annulus diameter ≥22 mm and \< 29 mm, assessed by CT TAVI
• • 8. Anatomically suitable for implantation of the GEMINUS device
• • 9. Peripheral vessels (common femoral and iliac arteries) of acceptable size (minimal diameter \> 4mm), tortuosity, and calcification to accommodate the 12Fr catheter system.
• • 10. Patients assessed by the heart team to be at high risk for access site related bleeding/vascular complications due to the caliber/ calcification/ atherosclerosis of the iliofemoral vessels.
• Exclusion Criteria:
• • 1. Patient not suitable for surgical bailout
• • 2. Congenital uni/bi/quadricuspid valve, or noncalcified aortic valve.
• • 3. Mixed aortic valve disease (aortic stenosis and aortic regurgitation with predominant aortic regurgitation ≥3+).
• • 4. Active or recent (within 6 months) endocarditis.
• • 5. Active systemic infections.
• • 6. Recent MI (≤ 1 month).
• • 7. Any therapeutic invasive cardiac procedure (except BAV) performed within 30 days of the index procedure.
• • 8. Prosthetic heart valve in any position.
• • 9. Severe (\> 3+) mitral, tricuspid or pulmonic regurgitation.
• • 10. Blood dyscrasias as defined: leukopenia (WBC\<3000/mm3), acute anemia (Hb \<8mg%), thrombocytopenia (platelet count \<50,000 cells/mm3), history of bleeding diathesis or coagulopathy.
• • 11. Untreated clinically significant coronary artery disease requiring revascularization.
• • 12. Hemodynamic instability requiring inotropic support or mechanical support devices.
• • 13. Hypertrophic cardiomyopathy with or without obstruction (HCM).
• • 14. Severe ventricular dysfunction with left ventricular ejection fraction (LVEF) \<20%.
• • 15. Echocardiographic evidence of intracardiac mass, thrombus or vegetation.
• • 16. Active peptic ulcer or upper GI bleeding within the prior 3 months.
• • 17. Known hypersensitivity or contraindication to heparin, inability to tolerate antiplatelet therapy or sensitivity to contrast media (which cannot be adequately premedicated).
• • 18. Recent (\<6 months) cerebrovascular accident (CVA) or transient ischemic attack (TIA).
• • 19. Renal insufficiency (eGFR\<30 mL/min) and/or end stage renal disease requiring chronic dialysis.
• • 20. Severe aortic disease, including abdominal aortic or thoracic aneurysm (lumen diameter \> 5cm), marked tortuosity, or severe aortic arch atheroma.
• • 21. Life expectancy \< 12 months due to non-cardiac co-morbid conditions.
• • 22. Currently participating in an investigational drug or another device study that has not reached its primary endpoint