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Evaluation of the HeartWare® LVAD System for the Treatment of Advanced Heart Failure

Summary of Trial: 
 

The purpose of this study is to evaluate the safety and efficacy of the HeartWare LVAD System in patients listed for cardiac transplantation with advanced heart failure.  To be eligible for this study, patients must be 18 years or old, be heart transplant candidate and meet other specific study criteria.

Principal Investigators:Drs. John Conte, Stuart Russell and Ashish Shah
Study Coordinators:

Melanie Herr
Email: mherr2@jhmi.edu
410-955-3597

Study Long Title: 

Evaluation of the HeartWare LVAD System for the Treatment of Advanced Heart Failure

Study Short Title: N/A
JHU eIRB Number:NA_00021882
Funding Source:HeartWare®
Inclusions: 
  • Must be at least 18 years of age at enrollment
  • Body Surface Area (BSA) greater than or equal to 1.2 m2
  • Patient is NYHA Class IV
  • Patient listed for cardiac transplantation (or listed within 96 hours of implant)
  • Patient meets United Network for Organ Sharing (UNOS) Status 1A or 1B listing criteria
  • HeartWare® LVAD implant is planned as a bridge to transplant
  • The patient or legally authorized representative has signed the informed consent
  • Destination therapy patients

Exclusions: 
 

  • Existence of any ongoing mechanical circulatory support (MCS) other than an intra-aortic balloon pump (IABP)
  • Prior cardiac transplant
  • History of confirmed, untreated abdominal or thoracic aortic aneurysm > 5 cm
  • Cardiothoracic surgery within 30 days of enrollment
  • Acute myocardial infarction within 14 days of implant as diagnosed by ST or T wave changes on the ECG, diagnostic biomarkers, ongoing pain and hemodynamic abnormalities
  • On ventilator support for > 72 hours within the fours days immediately prior to enrollment
  • Pulmonary embolus within three weeks of enrollment as documented by computed tomography (CT) scan or nuclear scan
  • Symptomatic cerebrovascular disease or a > 80% carotid stenosis
  • Patients have moderate to severe aortic insufficiency without plans for correction during pump implantation surgery
  • Patient with prosthetic heart valve
  • Severe right ventricular failure as defined by the anticipated need for right ventricular assist device (RVAD) support or extracorporeal membrane oxygenation (ECMO) at the time of HeartWare® LVAD screening/enrollment or right atrial pressure > 20 mmHg on multiple inotropes, right ventricular ejection fraction (RVEF) <15% or clinical signs including lower extremity edema, ascites or pleural effusions refractory to treatment with diuretics and two inotropic drugs
  • Active, uncontrolled infection diagnosed by a combination of clinical symptoms and laboratory testing, including but not limited to, continued positive cultures, elevated temperature and white blood cell (WBC) count, hypotension, tachycardia, generalized malaise despite appropriate antibiotic, antiviral or antifungal treatment
  • Uncorrected thrombocytopenia or generalized coagulopathy (e.g., platelet count < 100,000, INR > 1.6 or PTT > 2.5 times control in the absence of anticoagulation therapy)
  • Intolerance to anticoagulant or antiplatelet therapies or any other peri- or postoperative therapy that the investigator may administer based upon the patient's health status
  • Serum creatinine greater than 3.0 times the upper limit of normal within 48 hours of study enrollment or requiring dialysis (does not include use of ultra-filtration for fluid removal)
  • Liver enzymes [AST (SGOT), ALT (SGPT), or LDH] > 3 times upper limit of normal or a total bilirubin > 3 mg/dl within 24 hours of study enrollment, or biopsy proven liver cirrhosis or portal hypertension
  • Pulmonary vascular resistance is unresponsive (fixed) to pharmacologic manipulation as demonstrated by a pulmonary artery systolic pressure exceeding 60mmHg in conjunction with any one of the three following variables
    • Pulmonary vascular resistance is greater than 5 Woods Units or
    • Pulmonary vascular resistance index is greater than 6 Woods Units or
    • Transpulmonary gradient exceeds 16 to 20 mmHg
  • Patients requiring aortic, mitral, tricuspid or pulmonary valve replacements (including bioprosthetic valves) or left ventricular (LV) aneurysm resections
  • Participation in any other investigational study
  • Severe illness, other than heart disease, which would exclude cardiac transplantation.
  • Pregnancy
  • Patient unwilling or unable to comply with study requirements
Clinical Trial Site: Johns Hopkins Hospital
600 North Wolfe Street, Blalock 618
Baltimore, MD 21287-4618

This is a multi-center study – there are 28 sites across the U.S. that are participating in this clinical trial.
Start Date:May 2009
Anticipated End Date:N/A
Compensation for Participating: None











































 

 

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