Trial Outcomes & Findings for Melody® Transcatheter Pulmonary Valve Post-Approval Study (NCT NCT01186692)

NCT ID: NCT01186692

Last Updated: 2019-05-01

Results Overview

Acceptable TPV hemodynamic function at six months after successful TPV implantation is determined as a composite of the following: * Mean RVOT gradient is less than or equal to 30 mmHg as measured by CW Doppler, and * Severity of pulmonary regurgitation is less than moderate by Doppler echocardiography, and * Free from RVOT conduit reoperation or catheter re-intervention at six months after TPV implantation. The endpoint is defined as the percentage of subjects with acceptable TPV hemodynamic function at six months after Melody valve implantation.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

131 participants

Primary outcome timeframe

6 months

Results posted on

2019-05-01

Participant Flow

Participant milestones

Participant milestones
Measure
Enrolled
All subjects enrolled (n=131)
Overall Study
STARTED
131
Overall Study
COMPLETED
99
Overall Study
NOT COMPLETED
32

Reasons for withdrawal

Reasons for withdrawal
Measure
Enrolled
All subjects enrolled (n=131)
Overall Study
Not Catheterized
11
Overall Study
Futher testing contraindicated implant
19
Overall Study
Adverse Event
2

Baseline Characteristics

Melody® Transcatheter Pulmonary Valve Post-Approval Study

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Enrolled Cohort
n=131 Participants
All subjects enrolled.
Age, Continuous
20.1 years
STANDARD_DEVIATION 9.8 • n=99 Participants
Sex: Female, Male
Female
44 Participants
n=99 Participants
Sex: Female, Male
Male
87 Participants
n=99 Participants
Region of Enrollment
United States
131 participants
n=99 Participants

PRIMARY outcome

Timeframe: 6 months

Population: The implanted \>24 hours cohort consists of all subjects who had a Melody TPV implanted which remained implanted for greater than 24 hours. Of this population those with evaluable echo data at 6 months post implant were included in the analysis.

Acceptable TPV hemodynamic function at six months after successful TPV implantation is determined as a composite of the following: * Mean RVOT gradient is less than or equal to 30 mmHg as measured by CW Doppler, and * Severity of pulmonary regurgitation is less than moderate by Doppler echocardiography, and * Free from RVOT conduit reoperation or catheter re-intervention at six months after TPV implantation. The endpoint is defined as the percentage of subjects with acceptable TPV hemodynamic function at six months after Melody valve implantation.

Outcome measures

Outcome measures
Measure
Implanted >24 Hours Cohort
n=90 Participants
The implanted \>24 hours cohort consists of all subjects who had a Melody TPV implanted which remained implanted for greater than 24 hours.
Acceptable TPV Hemodynamic Function at Six Months After Successful TPV Implantation
96.7 percentage of patients
Interval 91.6 to 100.0

SECONDARY outcome

Timeframe: 6 Months

Population: The attempted implant cohort consists of all subjects who underwent catheterization and a Melody TPV implantation was attempted (Melody TPV valve opened).

Procedural success is defined as a composite of the following: * The TPV is fixated within the desired location, and * The RV-PA peak-to-peak gradient measured in the catheterization lab after TPV implantation is less than 35 mmHg, and * There is no more than trivial pulmonary regurgitation by angiography * The subject is free from explantation of the TPV at 24 hours post-implant

Outcome measures

Outcome measures
Measure
Implanted >24 Hours Cohort
n=101 Participants
The implanted \>24 hours cohort consists of all subjects who had a Melody TPV implanted which remained implanted for greater than 24 hours.
Procedural Success
92.1 percentage of patients

SECONDARY outcome

Timeframe: 6 Months

Population: The catheterized cohort consists of all subjects who underwent catheterization for possible implantation of the Melody TPV.

A procedure-related event is defined as an event that is associated with the implant procedure by the chronology or physiology and was caused by the implant procedure (e.g. rupture of the conduit or damage to an intra-cardiac or intravascular structure by the delivery system).

Outcome measures

Outcome measures
Measure
Implanted >24 Hours Cohort
n=120 Participants
The implanted \>24 hours cohort consists of all subjects who had a Melody TPV implanted which remained implanted for greater than 24 hours.
Serious Procedural Adverse Events
19.2 percentage of patients

SECONDARY outcome

Timeframe: 6 months

Population: The implanted cohort consists of all subjects who underwent catheterization and a Melody TPV was implanted.

A device-related event is defined as an event that is associated with the TPV by the chronology or physiology and was caused by the the TPV (e.g. embolization of the TPV and any adverse events which follow).

Outcome measures

Outcome measures
Measure
Implanted >24 Hours Cohort
n=100 Participants
The implanted \>24 hours cohort consists of all subjects who had a Melody TPV implanted which remained implanted for greater than 24 hours.
Serious Device-related Adverse Events
11.0 percentage of patients

SECONDARY outcome

Timeframe: 6 Months

Population: The implanted \>24 hours cohort consists of all subjects who had a Melody TPV implanted which remained implanted for greater than 24 hours. Of this population those with evaluable paired NYHA data were included in the analysis.

Change in NYHA functional class from pre-implant to 6 month post-implant

Outcome measures

Outcome measures
Measure
Implanted >24 Hours Cohort
n=99 Participants
The implanted \>24 hours cohort consists of all subjects who had a Melody TPV implanted which remained implanted for greater than 24 hours.
Changes in NYHA Functional Classification
Changes in NYHA Functional Classification
93 participants
Changes in NYHA Functional Classification
Improved
51 participants
Changes in NYHA Functional Classification
No Change
39 participants
Changes in NYHA Functional Classification
Worsened
3 participants

Adverse Events

Catheterized Cohort

Serious events: 52 serious events
Other events: 31 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Catheterized Cohort
n=120 participants at risk
The catheterized cohort consists of all subjects who underwent catheterization for possible implantation of the Melody TPV.
Blood and lymphatic system disorders
Anaemias NEC
0.83%
1/120 • Number of events 1 • 6 months
Blood and lymphatic system disorders
Haematological disorders
0.83%
1/120 • Number of events 2 • 6 months
Cardiac disorders
Cardiac disorders NEC
0.83%
1/120 • Number of events 1 • 6 months
Cardiac disorders
Coronary artery disorders NEC
0.83%
1/120 • Number of events 2 • 6 months
Cardiac disorders
Pulmonary valvular disorders
2.5%
3/120 • Number of events 3 • 6 months
Cardiac disorders
Rate and rhythm disorders NEC
0.83%
1/120 • Number of events 1 • 6 months
Cardiac disorders
Supraventricular arrhythmias
0.83%
1/120 • Number of events 1 • 6 months
Cardiac disorders
Ventricular arrhythmias and cardiac arrest
1.7%
2/120 • Number of events 9 • 6 months
Gastrointestinal disorders
Gastrointestinal disorders NEC
1.7%
2/120 • Number of events 2 • 6 months
Gastrointestinal disorders
Nausea and vomiting symptoms
0.83%
1/120 • Number of events 1 • 6 months
Gastrointestinal disorders
diarrhoea (excl infective)
0.83%
1/120 • Number of events 1 • 6 months
General disorders
Device issues NEC
0.83%
1/120 • Number of events 1 • 6 months
General disorders
Device physical property and chemical issues
7.5%
9/120 • Number of events 10 • 6 months
General disorders
Febrile disorders
1.7%
2/120 • Number of events 3 • 6 months
General disorders
Therapeutic and nontherapeutic responses
3.3%
4/120 • Number of events 9 • 6 months
Infections and infestations
Cardiac infections
2.5%
3/120 • Number of events 5 • 6 months
Infections and infestations
Lower respiratory tract and lung infections
0.83%
1/120 • Number of events 1 • 6 months
Infections and infestations
Sepsis, bacteraemia, viraemia and fungaemia NEC
0.83%
1/120 • Number of events 2 • 6 months
Injury, poisoning and procedural complications
Cardiac and vascular procedural complications
0.83%
1/120 • Number of events 1 • 6 months
Injury, poisoning and procedural complications
Non-site specific procedural complications
3.3%
4/120 • Number of events 5 • 6 months
Nervous system disorders
Nervous system disorders NEC
0.83%
1/120 • Number of events 3 • 6 months
Nervous system disorders
Neurological signs and symptoms NEC
0.83%
1/120 • Number of events 2 • 6 months
Respiratory, thoracic and mediastinal disorders
Pneumothorax and pleural effusions NEC
0.83%
1/120 • Number of events 4 • 6 months
Respiratory, thoracic and mediastinal disorders
Pulmonary thrombotic and embolic conditions
0.83%
1/120 • Number of events 2 • 6 months
Respiratory, thoracic and mediastinal disorders
Respiratory tract disorders NEC
3.3%
4/120 • Number of events 5 • 6 months
Vascular disorders
Non-site specific embolism and thrombosis
1.7%
2/120 • Number of events 5 • 6 months
Vascular disorders
Vascular injuries NEC
0.83%
1/120 • Number of events 1 • 6 months

Other adverse events

Other adverse events
Measure
Catheterized Cohort
n=120 participants at risk
The catheterized cohort consists of all subjects who underwent catheterization for possible implantation of the Melody TPV.
General disorders
Pain and discomfort NEC
6.7%
8/120 • Number of events 9 • 6 months
General disorders
Therapeutic and nontherapeutic responses
6.7%
8/120 • Number of events 13 • 6 months
Infections and infestations
Infections NEC
5.8%
7/120 • Number of events 8 • 6 months
Injury, poisoning and procedural complications
Non-site specific procedural complications
6.7%
8/120 • Number of events 8 • 6 months

Additional Information

Susan Patterson

Medtronic

Phone: 763.526.1544

Results disclosure agreements

  • Principal investigator is a sponsor employee A publication committee is in place for this study.
  • Publication restrictions are in place

Restriction type: OTHER