Status:
COMPLETED
Evaluation of the HeartWare Left Ventricular Assist Device for the Treatment of Advanced Heart Failure
Lead Sponsor:
Medtronic Cardiac Rhythm and Heart Failure
Conditions:
Chronic Heart Failure
Eligibility:
All Genders
18+ years
Phase:
NA
Brief Summary
The purpose of this study is to evaluate the safety and effectiveness of the HeartWare® LVAD System in patients listed for cardiac transplantation with refractory, advanced heart failure at risk of de...
Eligibility Criteria
Inclusion
- Must be at least 18 years of age at enrollment.
- Body Surface Area (BSA) greater than or equal to 1.2 m2.
- Patient is NYHA Class IV
- Patient listed for cardiac transplantation
- Patient meets United Network for Organ Sharing (UNOS) Status 1A or 1B listing criteria.
- HeartWare® LVAD implant is planned as a bridge to transplant
- The patient or legally authorized representative has signed the informed consent form
Exclusion
- Existence of any ongoing mechanical circulatory support (MCS) other than an intra-aortic balloon pump (IABP)
- Prior cardiac transplant.
- History of confirmed, untreated abdominal or thoracic aortic aneurysm \> 5 cm.
- Cardiothoracic surgery within 30 days of enrollment.
- Acute myocardial infarction within 14 days of implant as diagnosed by ST or T wave changes on the ECG, diagnostic biomarkers, ongoing pain and hemodynamic abnormalities as described (Figure 2) in the guidelines published in ACC/AHA 2007 Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction; A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. JACC Vol. 50, No.7, 2007.
- On ventilator support for \> 72 hours within the fours days immediately prior to enrollment.
- Pulmonary embolus within three weeks of enrollment as documented by computed tomography (CT) scan or nuclear scan.
- Symptomatic cerebrovascular disease or a \> 80% carotid stenosis.
- Patients have moderate to severe aortic insufficiency without plans for correction during pump implantation surgery.
- Patients with mechanical, animal or human tissue heart valves are excluded.
- Severe right ventricular failure as defined by the anticipated need for right ventricular assist device (RVAD) support or extracorporeal membrane oxygenation (ECMO)at the time of HeartWare® LVAD screening/enrollment or right atrial pressure \> 20 mmHg on multiple inotropes, right ventricular ejection fraction (RVEF) \<15% or clinical signs including lower extremity edema, ascites or pleural effusions refractory to treatment with diuretics and two inotropic drugs.
- Active, uncontrolled infection diagnosed by a combination of clinical symptoms and laboratory testing, including but not limited to, continued positive cultures, elevated temperature and white blood cell (WBC) count, hypotension, tachycardia, generalized malaise despite appropriate antibiotic, antiviral or antifungal treatment.
- Uncorrected thrombocytopenia or generalized coagulopathy (e.g., platelet count \< 100,000, INR \> 1.6 or PTT \> 2.5 times control in the absence of anticoagulation therapy).
- Intolerance to anticoagulant or antiplatelet therapies or any other peri- or postoperative therapy that the investigator may administer based upon the patient's health status.
- Serum creatinine greater than 3.0 times the upper limit of normal within 48 hours of study enrollment or requiring dialysis (does not include use of ultra-filtration for fluid removal).
- All three listed liver enzymes \[AST (SGOT), ALT (SGPT), or LDH\] \> 3 times upper limit of normal or a total bilirubin \> 3 mg/dl within 24 hours of study enrollment, or biopsy proven liver cirrhosis or portal hypertension.
- Pulmonary vascular resistance is unresponsive (fixed) to pharmacologic manipulation as demonstrated by a pulmonary artery systolic pressure exceeding 60mmHg in conjunction with any one of the three following variables:
- Pulmonary vascular resistance is greater than 5 Woods Units or
- Pulmonary vascular resistance index is greater than 6 Woods Units or
- Transpulmonary gradient exceeds 16 to 20 mmHg
- Patients requiring aortic, mitral, tricuspid or pulmonary valve replacements (including bioprosthetic valves) or left ventricular (LV) aneurysm resections.
- Participation in any other study involving investigational drugs or devices.
- Severe illness, other than heart disease, which would exclude cardiac transplantation.
- Pregnancy.
- Patient unwilling or unable to comply with study requirements.
Key Trial Info
Start Date :
August 1 2008
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
August 1 2013
Estimated Enrollment :
140 Patients enrolled
Trial Details
Trial ID
NCT00751972
Start Date
August 1 2008
End Date
August 1 2013
Last Update
May 30 2018
Active Locations (35)
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1
Mayo Clinic (Arizona)
Phoenix, Arizona, United States, 85054
2
Sharp Memorial Hospital
San Diego, California, United States, 92123
3
Stanford University School of Medicine
Stanford, California, United States, 94305
4
Washington Hospital Center
Washington D.C., District of Columbia, United States, 20010