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Trial registered on ANZCTR
Registration number
ACTRN12621000203853
Ethics application status
Approved
Date submitted
12/11/2020
Date registered
26/02/2021
Date last updated
26/02/2021
Date data sharing statement initially provided
26/02/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
Pilot Study of an Extra Aortic Counterpulsation Device acutely attached to the ascending aorta in the open chest for patients with hypertensive heart failure
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Scientific title
Pilot Study assessing blood flow changes in patients with hypertensive heart failure fitted with an Extra Aortic Counterpulsation Device (BioQ CA) acutely attached to the ascending aorta in the open chest
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Secondary ID [1]
297749
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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:
Cardiovascular
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Hypertensive heart failure
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Hypertension
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aortic stiffness
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Condition category
Condition code
Cardiovascular
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0
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Hypertension
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Cardiovascular
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The BIOQ CA is a passive recoil extra aortic balloon that is strapped to the ascending aorta using a vessel cuff that wraps around the vessel. The device is then inflated up to the blood pressure of the patient and active for 30 minutes of testing. The BioQ CA device dampens the pressure pulse when the heart ejects blood charging the device, and discharges pushing back on the vessel when the heart is filling. This is achieved by the compression and expansion of the balloon and the air contained within it. The device is implanted by the treating cardiac surgeon prior to performing the scheduled procedure while the patient in under general anaesthesia.
Patients will be grouped into 2 groups as follows:
Group 1 will consist of up to 20 patients with hypertensive HF with low ejection fraction (30% - 45% EF).
Group 2 will consist of up to 20 patients with hypertensive HF with preserved ejection fraction (>50% EF).
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Intervention code [1]
313990
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Treatment: Devices
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Comparator / control treatment
Each study participant is measured without the investigational treatment (control group) and compared to the measures with the treatment of the device (treatment group).
Control assessments without the device are taken for 30 minutes prior to the device being applied,
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Control group
Active
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Outcomes
Primary outcome [1]
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Measure the heart's blood flow and pressure changes with the use of the device to determine the device's ability to provide a therapeutic treatment for heart failure and drug resistant hypertension.
Measurements will be made using the operating theatre monitoring equipment including a cardiac output catheter and echocardiography.
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Assessment method [1]
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Timepoint [1]
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Measurements will be made during a 30 minute period before applying the device and during a 30 minute period after implantation of the device.
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Primary outcome [2]
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Any adverse events with the use of the device will be investigated by the surgical investigators during device use and after removal by examination of the aorta by visual examination and echocardiography.
The aorta will be later examined using echocardiography during a scheduled follow up examination.
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Assessment method [2]
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Timepoint [2]
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Device adverse events will be monitored during the 30 minutes of use and for a minimum of 30 minutes after device removal during the scheduled procedure time. Echocardiography will be used to examine the patient's aorta during a scheduled follow up examination 8 weeks after the scheduled surgery.
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Secondary outcome [1]
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Device features for successful surgical attachment and removal.
The time for attaching and adjusting and then removal as well as surgeon feedback will be used to determine the difficulty and ease of use.
Device attachment and adjustment times will be recorded in case report forms and reviewed. Surgeon feedback in the case report form section and via interview will be conducted for review.
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Assessment method [1]
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Timepoint [1]
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After 30 minutes of control measurements (no device), the device will be attached for 30 minutes and removed.
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Eligibility
Key inclusion criteria
Inclusion criteria will include
• Adults of 18 years or over
• Patient has read and signed the informed consent prior to study related procedures
• Willing and able to comply with all required follow-up evaluations and assessments
• Patients scheduled for Coronary Artery Bypass Grafting (CABG) will be assessed for:
1) hypertension and ejection fraction (EF) cut-offs defined below,
2) Presence of heart failure ( Class I to IV),
3) coronary artery disease,
4) aortic stiffness,
5) stroke risk,
6) valve dysfunction,
7) aortic calcification and atherosclerosis
8) ischemia/non-ischemia classification.
o Group 1 will consist of up to 20 patients with hypertensive heart failure PLUS low ejection fraction (30% - 45% EF).
o Group 2 will consist of up to 20 patients with hypertensive heart failure PLUS preserved ejection fraction (>50% EF).
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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
Exclusion criteria will include:
• history of previous stroke,
• significant mitral and or aortic valve disease/dysfunction,
• ascending aortic disease calcification or atherosclerosis or aneurysm.
• intraoperative echo or epi-aortic ultrasound will be used during the surgical procedures to exclude or confirm presence of severe aortic disease before applying the device as a final precautionary measure prior to placement. Patients will be excluded at this point if they are confirmed in the exclusion criteria.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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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
22/02/2021
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Date of last participant enrolment
Anticipated
8/02/2022
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Actual
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Date of last data collection
Anticipated
8/04/2022
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Actual
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Sample size
Target
40
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Accrual to date
1
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Monash Medical Centre - Clayton campus - Clayton
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Recruitment postcode(s) [1]
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3168 - Clayton
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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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BIOQ DEVICES PTY LTD
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Address [1]
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Suite 3, 52 High street, Toowong, QLD 4066
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Country [1]
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Australia
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Funding source category [2]
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Government body
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Name [2]
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Australia India Strategic Research Fund (Department of Science)
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Address [2]
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Department of Science
Commonwealth of Australia
10 Binara St, Canberra ACT 2601
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Country [2]
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Australia
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Primary sponsor type
Commercial sector/Industry
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Name
BIOQ DEVICES PTY LTD
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Address
Suite 3, 52 High street, Toowong, QLD 4066
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Monash Health
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Ethics committee address [1]
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Research Support Services Level 2, i Block, Monash Medical Centre 246 Clayton Road CLAYTON VIC 3168
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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20/03/2019
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Approval date [1]
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03/06/2020
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Ethics approval number [1]
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RES-19-0000-218A
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Summary
Brief summary
We propose treating hypertensive moderate heart failure by directly treating aortic stiffness (increasing aortic distensibility; increasing expansion and contraction). Our passive recoil extra aortic balloon counterpulsation device, the BioQ Cardiac Assist device (BioQ CA), reduces aortic stiffness leading to a reduction in afterload, achieving reduced pulse and mean aortic pressures in pilot animal testing by 27% and 10% respectively, and improved left coronary artery (LCA) blood flow by 39%. The device is minimally invasive, non-blood contacting, failure mode safe, and requires no pump, leads, or ECG timing, and is a cost effective approach. Additionally, the device offers the ability to adjust its performance post implantation (for future chronic studies) by changing balloon pressure via a subcutaneous inflation port. Device proof-of-principle has been established where the BioQ CA device has shown to operate as a counterpulsation device by decreasing heart load, reducing pulse and mean pressures, and improving left coronary artery blood flow. These changes are within the range of improvement achieved with pump powered Intra-Aortic Balloon Pump (IABP) and extra-aortic balloon (EAB) systems, and the blood pressure reduction achieved with renal denervation and barostim modulation, demonstrating our passive recoil counterpulsation device is competitive on performance yet with the advantages of being a simple self-powered, stand alone device, offering superior cost savings compared to other technology approaches. More recently the device was implanted in two patients in India prior to scheduled coronary artery bypass grafting (CABG). Devices were attached around the ascending aorta for approx. 30 minutes with increases in left coronary artery (LCA) blood flow of 30% to 100% measured, cardiac output improvements of up to 18%, and heart rate decreased by 8%. Patients recovered normally and were released from hospital with no adverse events. This data is very competitive and justifies further acute studies before considering a chronic human study. In this pilot study, we propose to test up to 40 patients with the device for 30 minutes on consenting patients who are scheduled for CABG. Testing will be done during vessel harvesting to minimise procedure time. We aim to measure LCA blood flow, arterial blood pressures, and cardiac output.
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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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Prof Julian Smith
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Address
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Monash Medical Centre
246 Clayton rd, Clayton Vic 3168
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Country
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Australia
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Phone
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+61 3 9594 5500
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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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Madhu Neeli
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Address
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QHeart Medical (BioQ Devices Pty Ltd)
Suite 3, 52 High street, Toowong, QLD 4066
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Country
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Australia
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Phone
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+61403546511
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Peter Walsh
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Address
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QHeart Medical (BioQ Devices Pty Ltd)
Suite 3, 52 High street, Toowong, QLD 4066
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Country
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Australia
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Phone
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+61405173832
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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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.
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