Functional Assessment in TAVI: FAITAVI

Last updated: March 18, 2025
Sponsor: Universita di Verona
Overall Status: Active - Not Recruiting

Phase

N/A

Condition

Coronary Artery Disease

Chest Pain

Vascular Diseases

Treatment

Physiologically-guided strategy

Clinical Study ID

NCT03360591
FAITAVI
  • Ages 18-90
  • All Genders

Study Summary

The aim of this study is to compare the clinical outcome of patients with severe aortic valve stenosis and associated significant coronary artery disease treated with TAVI and a percutaneous myocardial revascularization dictated according to two different strategies:

  1. the Angiographically-guided strategy;

  2. the Physiologically-guided strategy.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Age > 18 years

  2. Written informed consent

  3. Diagnosis of severe native aortic valve disease with the indication to endovascularvalve replacement given by Heart Team

  4. Diagnosis of at least one coronary stenosis >50% at angiography

  5. No specific pharmacologic treatment is required to enter the study

Exclusion

Exclusion Criteria:

  1. Age < 18 years

  2. Pregnancy

  3. Lack of informed consent

  4. Impaired left ventricular function

  5. Signs or symptoms of acute (unstable) myocardial ischemia

  6. Contraindication to adenosine administration (e.g., asthma, chronic obstructivepulmonary disease, heart rate <50 beats/min, and systolic blood pressure <90 mmHg)

  7. Reduced survival expectancy due to severe co-morbidities (<1 year)

  8. Impossibility to obtain follow-up information

  9. The lack of any of inclusion criteria

Study Design

Total Participants: 320
Treatment Group(s): 1
Primary Treatment: Physiologically-guided strategy
Phase:
Study Start date:
November 24, 2017
Estimated Completion Date:
June 30, 2025

Study Description

Nowadays there are no clear recommendations about treatment of coronary in patients with severe aortic valve stenosis eligible for percutaneous valve replacement, and those available rely on a "common sense", class C, level of evidence. No randomized trials debride the skein about the best strategy of revascularization in this complex group of patients. In particular, it remains unclear whether it is preferable a preventive treatment or an ischemia-driven revascularization and, in addition, if it is safer and better for patient's health a simultaneous or a staged strategy.

The aim of this study is to compare the clinical outcome of patients with severe aortic valve stenosis and associated significant coronary artery disease treated with TAVI and a percutaneous myocardial revascularization dictated according to two different strategies.

The Angiographically-guided strategy is that of aiming the most complete degree of revascularization based on angiographic evaluation (stenting all coronary stenosis of major branches >2.5mm, with a %DS>50% as evaluated by visual estimation).

The Physiologically-guided strategy is that of treating only lesions with FFR ≤0.80, and leaving on optimal medical treatment lesions with FFR >0.80. The iFR values will be recorded in all patients, and verified in the core laboratory to allow a post-hoc analysis correlating the 0.80 FFR cut-off with different iFR cut-off values, according to recent observations and using the same study end-points.

Particular attention will be dedicated to the eventual occurrence of clinical events in patients deferred on the bases of FFR values >0.80 that show a discrepancy with positive (<0.89) iFR values to investigate the reliability of the FFR in the Aortic Stenosis setting.

Both groups will receive the same TAVI strategy and optimal medical therapy. The study is designed as randomized, prospective, multi.center, open label, experimental trial with medical device. After discharge patients will be contacted at 30 days, 6 - 12 and 24 months after the procedure to assess the general clinical status and at 12 months to assess the occurrence of events included in the primary and secondary endpoints. The duration of study participation is 24 months for enrolment, ad 24 months for final follow-up.

Connect with a study center

  • Azienda Ospedaliera Universitaria Integrata Verona

    Verona, 37126
    Italy

    Site Not Available

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