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Assessment of TRanscathetEr and Surgical Aortic BiOprosthetic Valve Thrombosis and Its TrEatment With Anticoagulation (RESOLVE)

This study is currently recruiting participants. (see Contacts and Locations)
Verified December 2016 by Cedars-Sinai Medical Center
Sponsor:
Information provided by (Responsible Party):
Raj Makkar, Cedars-Sinai Medical Center
ClinicalTrials.gov Identifier:
NCT02318342
First received: December 4, 2014
Last updated: December 6, 2016
Last verified: December 2016
  Purpose
This is a prospective study designed to evaluate the structural and functional integrity of transcatheter or surgical bioprosthetic valves with multimodality imaging. The study further aims to confirm resolution of the early bioprosthetic valve thrombotic changes with Vitamin K antagonists (warfarin) mediated anticoagulation therapy.

Condition Intervention
Prosthetic Valve Thrombosis
Drug: Warfarin

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Assessment of TRanscathetEr and Surgical Aortic BiOprosthetic Valve Dysfunction With Multimodality Imaging and Its TrEatment With Anticoagulation

Resource links provided by NLM:


Further study details as provided by Cedars-Sinai Medical Center:

Primary Outcome Measures:
  • Frequency of patients with structural/functional abnormalities of bioprosthetic valves [ Time Frame: 3 months ]

Other Outcome Measures:
  • Percentage of patients with resolution of bioprosthetic valve thrombotic lesions with anticoagulation [ Time Frame: 3 months ]

Estimated Enrollment: 1000
Study Start Date: December 2014
Estimated Study Completion Date: December 2021
Estimated Primary Completion Date: December 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Pre-existing bioprosthetic aortic valve
Patients with a history of surgical or transcatheter valve replacement with bioprosthetic valves undergo cardiac contrast CT imaging and transthoracic echocardiography to evaluate structural and functional integrity of the aortic valves. Patients with prosthetic valve abnormalities suggestive of thrombus will be administered anticoagulation therapy with Vitamin K antagonists (Warfarin) for 3 months with goal INR 2-3, followed by repeat contrast CT of the chest and transthoracic imaging. Repeat imaging following 3 months of anticoagulation therapy is performed to evaluate the response to anticoagulation therapy.
Drug: Warfarin
Patients with prosthetic valve abnormalities suggestive of thrombus will be administered anticoagulation therapy with Vitamin K antagonists (Warfarin) for 3 months with goal INR 2-3, followed by repeat contrast CT of the chest and transthoracic imaging. Repeat imaging following 3 months of anticoagulation therapy is performed to evaluate the response to anticoagulation therapy.
Other Name: Coumadin

Detailed Description:
Patients with a history of SAVR or TAVR with bioprosthetic aortic valves undergo cardiac contrast CT imaging and transthoracic echocardiography to evaluate structural and functional integrity of the aortic valves. The imaging studies will be performed at least 48-hours after TAVR/SAVR. Patients with prosthetic valve abnormalities suggestive of thrombus will be administered anticoagulation therapy with Vitamin K antagonists (Warfarin) for 3 months with goal International Normalized Ratio (INR) 2-3, followed by repeat contrast CT of the chest and transthoracic imaging. Repeat imaging following 3 months of anticoagulation therapy is performed to evaluate the response to anticoagulation therapy. INR levels will be monitored and warfarin dose adjusted to maintain target INR 2-3.
  Eligibility

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Phase 1

  • Presence of transcatheter or surgical bioprosthetic aortic valve implanted at least 48 hours prior to enrollment
  • Age 18 years or older
  • Ability to provide informed consent and follow-up with protocol procedures.

Phase 2

  • Appearance of thrombotic changes in the bioprosthetic valves

Exclusion Criteria:

  • Renal insufficiency (creatinine > 1.5 mg/dL)
  • Known allergy to iodinated contrast agents
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT02318342

Contacts
Contact: Tarun Chakravarty, MD 3104233977 tarunchakravarty@gmail.com

Locations
United States, California
Cedars-Sinai Medical Center Recruiting
Los Angeles, California, United States, 90048
Contact: Tarun Chakravarty, MD    310-423-3977    Tarun.Chakravarty@cshs.org   
Principal Investigator: Raj R Makkar, MD         
Sponsors and Collaborators
Cedars-Sinai Medical Center
Investigators
Principal Investigator: Raj Makkar, MD Cedars-Sinai Medical Center, Los Angeles, California
  More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Raj Makkar, Associate Director, Cedars-Sinai Heart Institute; Professor of Medicine, University of California, Los Angeles; Director, Cardiac Catheterization Laboratories and Intervention Center, Cedars-Sinai Medical Center
ClinicalTrials.gov Identifier: NCT02318342     History of Changes
Other Study ID Numbers: CSMC-37587
Study First Received: December 4, 2014
Last Updated: December 6, 2016

Additional relevant MeSH terms:
Thrombosis
Embolism and Thrombosis
Vascular Diseases
Cardiovascular Diseases
Warfarin
Anticoagulants

ClinicalTrials.gov processed this record on April 26, 2017