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HINTS AND TIPS
DEFINITIONS
Trial Review
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Trial registered on ANZCTR
Registration number
ACTRN12613000020785
Ethics application status
Approved
Date submitted
3/01/2013
Date registered
8/01/2013
Date last updated
8/01/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
The MitraClip System ANZ Clinical Trial is a prospective single arm clinical trial for men and women with significant, chronic mitral regurgitation to gather real-world clinical and health-economic outcome data to support the long-term safety, efficacy and economic value of the MitraClip System for treating mitral regurgitation
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Scientific title
A Prospective Single Arm Clinical Trial Evaluating the MitraClip (Registered Trademark) System in Australia and New Zealand for Men and Women with Significant, Chronic Mitral Regurgitation
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Secondary ID [1]
281723
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Mitral Regurgitation
288021
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Condition category
Condition code
Cardiovascular
288398
288398
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
The MitraClip System consists of a delivery catheter and an implantable Clip. The Clip is made of metal and is covered with polyester fabric. The Clip is attached to the end of a delivery catheter, which is a thin flexible tube that is used to insert and position the Clip on the mitral valve. The delivery catheter guides the Clip into place so that it can be attached to the leaflets of the mitral valve. Once the Clip is in place on the mitral valve, the delivery catheter is removed. The procedure to place the Clip will take around 3 to 4 hours and will be done under general anesthesia in the hospital. The procedure will be performed in the cardiac catheterization laboratory. This type of catheterization procedure usually requires an overnight stay in the hospital and around 24 hours to recover. The MitraClip procedure is performed using TEE and x-rays (called fluoroscopy). Participants may be required to limit physical activity for 30 days or longer after the procedure as instructed by the Trial doctor.
Participants will undergo the MitraClip procedure after their doctor has carefully evaluated their MR using ultrasound and if necessary, angiography. To introduce the MitraClip System, the doctor will insert the delivery catheter into the femoral vein in the groin. The delivery catheter will then be advanced along the vein until it enters the heart. A transseptal approach is used to gain access to the mitral valve. This is done by crossing from the right to left side (i.e., the name transseptal means to cross the septum) of the heart through a small opening. This small opening is present in about 1 out of 5 people and in others a commercially available catheter is used to create a small opening by puncturing the septum. In general, this opening will seal up on its own after the procedure. The delivery catheter will then be advanced through the small opening. The doctor will position the Clip, which is at the end of the delivery catheter, to a location in the middle of the mitral valve leaflets.
The Clip has two arms that are then opened to grasp the bottom of the two valve leaflets. Inside each Clip arm is a gripper. Once the arms have grasped the bottom of the leaflets, the grippers are then lowered onto the top of the leaflets, toward the arms. This causes each leaflet to be sandwiched between the arms and the grippers of the Clip. The Clip will be closed to pull the two leaflets together and locked in place. This secures the leaflets into the Clip and holds the two leaflets of the valve together at the point of the Clip. Finally, the Clip is separated from the delivery catheter. The valve will now open with two openings instead of one. At the end of the procedure, the delivery catheter will be removed and the Clip will be left in the body to help the mitral valve leaflets close sufficiently. It is possible that two Clips may be required to sufficiently reduce the mitral regurgitation. In order to place another Clip, if needed, the first delivery catheter will be removed and a new delivery catheter with the other Clip will be passed into the left side of the heart by the same approach as described above. The other Clip will then be placed adjacent to the first Clip in the same manner as previously described. It is also possible that if participants only receive one Clip during the initial procedure, a second Clip may be placed at a later date if required.
Participants will be observed for 2 years as part of this clinical trial.
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Intervention code [1]
286261
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Not applicable
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Comparator / control treatment
N/A
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Echocardiographic Endpoint: MR Severity Grade
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Assessment method [1]
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Timepoint [1]
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at 12 months after implant procedure
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Primary outcome [2]
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Echocardiographic Endpoint: Regurgitant Volume
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Assessment method [2]
288569
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Timepoint [2]
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at 12 months after implant procedure
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Primary outcome [3]
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Echocardiographic Endpoint: Left Ventricle End Diastolic Volume (LVEDV)
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Assessment method [3]
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Timepoint [3]
288584
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at 12 months after implant procedure
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Secondary outcome [1]
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Primary Outcome Echocardiographic Endpoint: Left Ventricular End Systolic Volume (LVESV)
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Assessment method [1]
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Timepoint [1]
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at 12 months after implant procedure
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Secondary outcome [2]
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Primary Outcome Echocardiographic Endpoint: Left Ventricular End Diastolic Dimension (LVIDd)
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Assessment method [2]
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Timepoint [2]
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at 12 months after implant procedure
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Secondary outcome [3]
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Primary Outcome Echocardiographic Endpoint: Left Ventricular End Systolic Dimension (LVIDs)
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Assessment method [3]
300522
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Timepoint [3]
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at 12 months after implant procedure
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Secondary outcome [4]
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Primary Outcome Echocardiographic Endpoint: LV Ejection Fraction (LVEF)
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Assessment method [4]
300523
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Timepoint [4]
300523
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at 12 months after implant procedure
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Secondary outcome [5]
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Primary Outcome Echocardiographic Endpoint: Mitral Valve Area
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Assessment method [5]
300524
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Timepoint [5]
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at 12 months after implant procedure
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Secondary outcome [6]
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Primary Outcome Echocardiographic Endpoint: Mitral Valve Gradient
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Assessment method [6]
300525
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Timepoint [6]
300525
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at 12 months after implant procedure
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Secondary outcome [7]
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Primary Outcome Echocardiographic Endpoint: Left Atrial Volumes
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Assessment method [7]
300526
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Timepoint [7]
300526
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at 12 months after implant procedure
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Secondary outcome [8]
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Primary Outcome Echocardiographic Endpoint: Regurgitant Fraction
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Assessment method [8]
300527
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Timepoint [8]
300527
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at 12 months after implant procedure
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Secondary outcome [9]
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Primary Outcome Clinical Endpoint: Mortality
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Assessment method [9]
300528
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Timepoint [9]
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at 12 months after procedure
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Secondary outcome [10]
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Primary Outcome Clinical Endpoint: NYHA Functional Class (assessed by The New York Heart Association (NYHA) Functional Classification)
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Assessment method [10]
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Timepoint [10]
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at 12 months after procedure
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Secondary outcome [11]
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Primary Outcome Clinical Endpoint: Six-Minute Walk Test (6MWT) distance (Measured by how long participants can walk in six minutes, which will provide information on their ability to exercise.)
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Assessment method [11]
300530
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Timepoint [11]
300530
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at 12 months after procedure
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Secondary outcome [12]
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Primary Outcome Clinical Endpoint: QOL Assessment (Minnesota Living with Heart Failure Questionnaire which contains questions about how the participants health affects their daily life.)
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Assessment method [12]
300531
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Timepoint [12]
300531
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at 12 months after procedure
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Secondary outcome [13]
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Primary Outcome Clinical Endpoint: Mitral valve surgery, including reason for and type of surgery
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Assessment method [13]
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Timepoint [13]
300532
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at 12 months after procedure
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Secondary outcome [14]
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Primary Outcome Clinical Endpoint: Second MitraClip device intervention, including reason for intervention
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Assessment method [14]
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Timepoint [14]
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at 12 months after procedure
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Secondary outcome [15]
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Primary Outcome Clinical Endpoint: Re-hospitalizations:
Reason for rehospitalization (i.e., heart failure, other cardiac, non-cardiac)
Number of rehospitalizations Number of days rehospitalized
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Assessment method [15]
300534
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Timepoint [15]
300534
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at 12 months after procedure
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Eligibility
Key inclusion criteria
1. Age 18 years or older.
2. Significant, chronic MR (greater than or equal to 3+) by echocardiography.
3. In the judgment of the Investigator, transseptal catheterization and femoral vein access are feasible.
4. In the judgment of the Investigator, placement of the MitraClip device on the mitral leaflets is feasible.
5. Mitral valve orifice area greater than or equal to 4.0 cm2.
6. The patient or the patient’s legal representative has been informed of the nature of the trial and agrees to its provisions and has provided written informed consent as approved by the institution’s Human Research Ethics Committee (HREC) of the respective clinical site.
7. The patient agrees to return for all required post-procedure follow-up visits.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Have need for emergency surgery for any reason or need for any other cardiac surgery including surgery for coronary artery disease, atrial fibrillation, pulmonic, aortic or tricuspid disease.
2. Have undergone prior mitral valve repair surgery or have any currently implanted mechanical prosthetic valve or currently implanted ventricular assist device (VAD).
3. Have active endocarditis or active rheumatic heart disease or leaflets degenerated from either endocarditis or rheumatic disease (i.e., noncompliant, perforated).
4. Transesophageal echocardiography (TEE) is contraindicated.
5. Has a known hypersensitivity or contraindication to trial or procedure medications which cannot be adequately managed medically.
6. Currently participating in an investigational drug trial or another device trial that has not yet completed the primary endpoint or that otherwise clinically interferes with the MitraClip System ANZ Clinical Trial data collection. (Note: Trials requiring extended follow-up for products that were investigational, but have since become commercially available, are not considered investigational trials.)
7. Pregnant or planning pregnancy within next 12 months.
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Study design
Purpose
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Duration
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Selection
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Timing
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
24/11/2011
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Date of last participant enrolment
Anticipated
1/12/2014
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
150
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,WA
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Recruitment hospital [1]
350
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Sir Charles Gairdner Hospital - Nedlands
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Recruitment hospital [2]
351
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The Prince Charles Hospital - Chermside
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Recruitment hospital [3]
352
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St Vincent's Private Hospital (Darlinghurst) - Darlinghurst
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Evalve, Inc.
A subsidiary of Abbott Vascular Inc.
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Address [1]
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4045 Campbell Ave
Menlo Park, CA 94025
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Country [1]
286510
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United States of America
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Primary sponsor type
Commercial sector/Industry
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Name
Evalve, Inc. A subsidiary of Abbott Vascular Inc.
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Address
4045 Campbell Ave
Menlo Park, CA 94025
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Country
United States of America
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Secondary sponsor category [1]
285299
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None
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Name [1]
285299
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Address [1]
285299
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Country [1]
285299
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288585
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Sir Charles Gairdner Group Human Research Ethics Committee
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Ethics committee address [1]
288585
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Ethics committee country [1]
288585
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Australia
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Date submitted for ethics approval [1]
288585
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Approval date [1]
288585
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Ethics approval number [1]
288585
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Ethics committee name [2]
288595
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The Prince Charles Hospital Metro North Health Service District Human Research Ethics Committee
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Ethics committee address [2]
288595
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Ethics committee country [2]
288595
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Australia
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Date submitted for ethics approval [2]
288595
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Approval date [2]
288595
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23/11/2011
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Ethics approval number [2]
288595
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Ethics committee name [3]
288596
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St Vincent’s Hospital Human Research Ethics Committee
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Ethics committee address [3]
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Ethics committee country [3]
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Australia
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Date submitted for ethics approval [3]
288596
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Approval date [3]
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17/05/2011
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Ethics approval number [3]
288596
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Summary
Brief summary
The primary objective of the MitraClip System ANZ Clinical Trial is to gather real-world clinical and health-economic outcome data to support the long-term safety, efficacy and economic value of the MitraClip System in the continuum of therapies for treating MR. Specifically, the following clinical and economic data will be collected: New York Heart Association (NYHA) Functional Class, Six-Minute Walk Test (6MWT) distance, quality of life (QOL) information, echocardiographic measures of left ventricular size and function, and data associated with the index hospitalization, rehospitalizations, concomitant medications and discharge facility to support the MitraClip System economic analysis.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof David Muller
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Address
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Cardiology Department
St. Vincent's Hospital
390 Victoria Street
Darlinghurst, NSW 2010
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Country
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Australia
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Phone
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61283822775
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Barathi Sethuraman, PhD
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Address
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Abbott Vascular Structural Heart
4045 Campbell Ave
Menlo Park, CA 94025
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Country
36807
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United States of America
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Phone
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1-650-833-1638
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Fax
36807
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Email
36807
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[email protected]
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Contact person for scientific queries
Name
36808
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Barathi Sethuraman, PhD
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Address
36808
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Abbott Vascular Structural Heart
4045 Campbell Ave
Menlo Park, CA 94025
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Country
36808
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United States of America
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Phone
36808
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1-650-833-1638
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Fax
36808
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Email
36808
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF