This study is for participants who have tricuspid regurgitation, a condition in which your heart's tricuspid valve does not close tightly which causes blood to flow backwards in the incorrect direction. This condition increases the workload on the heart and if left untreated, it can increase the risk of worsening heart failure. In this study, a device called the PASCAL Transcatheter Valve Repair System will be used to treat the tricuspid regurgitation. The PASCAL Transcatheter Valve Repair System is an investigational device meaning it has not been approved for commercial use by the US Food and Drug Administration (FDA). In this study participants will be randomized, meaning randomly assigned like drawing straws, in a 2:1 fashion to either receive the PASCAL Transcatheter Valve Repair System (treatment group) or optimal medical therapy (OMT) (control group). OMT means your medications will be adjusted as needed to provide the most benefit possible. Participants randomized to the OMT group may be eligible to receive the device after completing 2 years of follow up. Participants not eligible for randomization may be eligible for the registry portion of the study if approved by the sponsor. The registry arm participants will not be randomized but will undergo the procedure to place the device.
Participation in this study will last about 5 years and involve up to 15 visits for those in the treatment or registry group and 11 visit for those in the control group. Study related procedures include a right heart catheterization (test to measure the pressures in the heart), echocardiograms (ultrasound test of heart), electrocardiogram or ECG (test of the heart's electrical system) blood work, questionnaires, hall walk test, and physical exam.
The purpose of this study is to evaluate the safety and effectiveness of the JenaValve Trilogy™ Heart Valve System in a patient population with symptomatic severe Aortic regurgitation ( a condition where the heart's aortic valve does not close tightly and allows some blood to leak back into the heart chamber) requiring replacement/repair of their native aortic valve that are at high risk for open surgical aortic valve replacement/repair (SAVR).
Your involvement in this study will last approximately 5 years from the time of your procedure. The visits include: Screening/Baseline, Procedure, Pre-Discharge, 1 month, 6 months and annualy for 5 years
The purpose of this study is to evaluate if the Edwards SAPIEN 3 System with Edwards Caval Prestent (study device) can help treat patients with your symptoms (symptomatic heart failure patients with signs of excessive fluid retention) resulting from reverse caval flow (blood flowing backwards instead of forward to your lungs).
The type of research study you are being asked to join is called an Early Feasibility Study. Prior clinical studies have not been conducted for the study device and its safety and effectiveness are unknown. This means the study Device you are receiving has not been previously studied in humans, and that you will be among the first subjects in the world to undergo this treatment. The study device is considered investigational and not approved for commercial sale by the US Food and Drug Administration (FDA). The study device will be placed in the section of your inferior vena cava (IVC) (the major vein that brings oxygen-poor blood from the lower body back to the heart) below your heart and above the veins in your liver via a vein in your thigh.
The clinical benefits of using the study device for treatment of your condition is not well known at this time. Some possible benefits that may occur from use of the study device may include:
relief of symptoms related to heart failure including but limited to, improved fluid retention,
quality of life, and/or improvement in morbidity (illness or disease) and mortality (death).