Background:
Replacing a valve in the heart can save many people's lives. The procedure is called transcatheter aortic valve replacement (TAVR). In rare cases, a flap of tissue called a leaflet can shift during TAVR; the leaflet may block blood flow to the coronary arteries, which supply blood to the heart muscle. About 50% of people who experience this problem will die. To reduce this risk, doctors will cut this leaflet during TAVR. But the tools used to cut the leaflet were originally designed for other purposes. Using these tools during TAVR can be complicated and risky. Researchers want to make TAVR safer.
Objective:
To test a new device (TELLTALE) designed specifically for use during TAVR.
Eligibility:
People aged 21 years and older who are undergoing TAVR and who are at high risk of coronary artery obstruction.
Design:
Participants will be screened. They will have routine tests that are done before undergoing TAVR.
Before the procedure, participants will complete a questionnaire. They will talk about how their heart disease affects their quality of life. Their physical abilities and their risk of stroke will be assessed.
Participants will be admitted to the hospital for TAVR. They will be placed under general anesthesia or moderate sedation. The procedure will be performed using the TELLTALE guidewire system.
Participants will repeat the tests of their physical abilities after the procedure. They will also repeat the questionnaire about their quality of life. These will be repeated again at a follow-up visit in 30 days.
Participants will have a final study visit after 90 days. This visit may be in person or remote.
Who can participate
Age range
21 Years – 109 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
* INCLUSION CRITERIA:
In order to be eligible to participate in the study, candidates must meet all of the following criteria:
* Adults age \>= 21 years
* High or prohibitive risk of surgical aortic valve replacement according to the local multidisciplinary heart team
* Undergoing TAVR for bioprosthetic aortic valve failure or native aortic stenosis ( on-label TAVR)
* Local multidisciplinary heart team determines subject to be at high risk of TAVR-induced coronary artery obstruction
* Deemed likely to suffer coronary artery obstruction from TAVR based on NHLBI Core lab analysis of CT, any of
* Risk is narrow Sinus of Valsalva: (a) Leaflet height is greater than coronary artery height, and (b) Virtual transcatheter valve-to-coronary (VTC) distance \< 4mm
* Risk is Sinus sequestration: (a) Threatening leaflet height is greater than sinotubular junction, and (b) Virtual transcatheter valve-to-sinotubular-junction distance (VTS) \< 2mm at the affected Sinus
* Concurrence of the Study Eligibility Committee
* Able to understand the protocol, consents in writing to participate, and willing to comply with all study procedures for the duration of the study
EXCLUSION CRITERIA:
* Requires doppio (two-leaflet) BASILICA
* Flail target leaflet at baseline
* Excessive target aortic leaflet calcification (no basal calcium-free window or potentially obstructive calcific masses) on baseline CT
* Planned provisional (pre-position coronary artery) stents despite BASILICA
* Requires non-…
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
What they're measuring
1
Number of Participant That Experienced Technical Success With the TELLTALE Guidewire System
Timeframe: 1 minute following procedure discharge (Exit from the catheterization laboratory)
2
Number of Inpatient Safety Events
Timeframe: Upon discharge from the index hospital admission, up to 30 days
Trial details
NCT IDNCT05666713
SponsorNational Heart, Lung, and Blood Institute (NHLBI)