Medtronic Congenital Heart Disease Studies Show Strong 10-Year
Performance for Melody Transcatheter Pulmonary Valve and Primary
Results from the Harmony Pivotal Trial
Medtronic plc (NYSE:MDT) today announced results from two
late-breaking clinical trials presented virtually at the 2020
Society for Cardiovascular Angiography and Interventions (SCAI)
Scientific Sessions. Ten-year outcomes from the
Melody™ Transcatheter Pulmonary Valve (TPV) Therapy
demonstrated strong long-term hemodynamic and safety outcomes,
while the first-ever results from the investigational Harmony™ TPV
pivotal trial met safety and efficacy endpoints for hemodynamic
function at six months.
Congenital heart disease (CHD) is the most common
type of birth defect in the United States, affecting an estimated
40,000 infants each year1. Approximately 22% of CHD patients
have structural malformations that disrupt the connection between
the heart and the lungs2, called the right ventricular outflow
tract (RVOT). Typically, a subset of these patients will require
open-heart surgery early in life to correct these malformations and
some will receive a prosthetic conduit that increases blood flow
from the heart to the lungs. Once the conduit is no longer
functional, in regions where commercially approved, Melody TPV
can be implanted to restore pulmonary valve function and delay
additional surgical intervention. As part of the Medtronic
congenital heart disease program, the safety and effectiveness of
the Harmony TPV is currently being evaluated for patients with RVOT
malformations who require a correction to their structural
malformation early in life and need a minimally invasive option to
restore pulmonary valve function, and are without a conduit.
Melody TPV 10-Year Data
Highlights:
- The study demonstrated sustained long-term function of Melody
TPV when compared to the historical control of surgical
conduit
- The Melody TPV demonstrated consistent hemodynamics through 10
years as measured by stable RVOT gradients
- Strong valve efficacy with 97% none/trace/mild pulmonary
regurgitation at 10 years
- Annualized incidence of TPV-related endocarditis was 2% per
patient-year, over the course of long-term follow-up
- Freedom from major stent fracture 84% at 10 years, steady after
five years
- Freedom from any reintervention (surgical or catheter) was 61%
at 10 years
“Having long-term data is an important milestone
especially for this pediatric patient population who are growing
and changing so rapidly during a ten-year period,” said Thomas K.
Jones, M.D., director of cardiac catheterization at Seattle
Children’s in Seattle, Wash. “While the study reinforces the
longevity, durability, and efficacy of the Melody TPV, it will also
serve as a study model for future evaluations of novel pediatric
congenital heart disease technologies.”
The Melody TPV 10-year outcomes trial studied 150
implanted patients ranging from age 7-53, with a median age of 19,
and the primary indication for intervention was pulmonary
regurgitation (PR). The study assessed Melody long-term
functionality, or TPV dysfunction, which is defined as reoperation,
catheter reintervention, or hemodynamic dysfunction (i.e. moderate
or greater PR and/or mean RVOT gradient >40 mm Hg). The study’s
safety outcomes included serious device-related adverse events,
stent fracture, catheter reintervention, surgical conduit
replacement, and mortality rate.
The first transcatheter valve implanted in a human
anywhere in the world and the first to be approved by the Food and
Drug Administration (FDA), Melody is the longest studied TPV with
the largest body of evidence. This landmark 10-year study provides
insight into the long-term durability, safety, and effectiveness of
the Melody TPV.
First-Ever Data from the Harmony TPV
Pivotal Trial
- The study met its primary safety and effectiveness endpoints of
freedom from procedure or device-related mortality and met its
hemodynamic function target at six months
- 100% of patients experienced freedom from procedure-or device
related mortality at 30 days
- Acceptable hemodynamic function at six months was achieved in
89% of the pivotal trial participants. For the pre-specified
primary endpoint analysis, 91% of patients from both the EFS and
pivotal trial achieved acceptable hemodynamic function, surpassing
the performance target of 75%
- 84% of patients were free from device failure at six
months
- At six months, 94% of patients had no, or mild pulmonary
regurgitation and 97% had no or mild paravalvular leak
Building onto the initial Early Feasibility Study
(EFS), the pivotal study was designed to evaluate the safety and
effectiveness of a minimally invasive alternative to open-heart
surgery. Harmony TPV was designed to treat patients with RVOT
anomalies who develop severe PR typically when a pervious repair
fails.
"These pivotal data support the rationale for a
potential new therapy designed specifically for the right
ventricular outflow tract,” said John P. Cheatham, M.D., lead
principal investigator and professor emeritus, Department of
Pediatrics, Cardiology at Nationwide Children's Hospital in
Columbus, Ohio. “If future study data continues to be strong, we’re
hopeful that Harmony may potentially impact this critical,
hard-to-treat segment of patients, who have limited treatment
choices with current transcatheter technologies.”
This trial is a prospective, non-randomized study
evaluating procedural success, safety, and performance of the
Harmony TPV device. The study was active across 12 sites in the
U.S., Canada and Japan among 50 patients with a mean age of 29 +/-
11. The rigorous patient selection process included those with
severe PR after RVOT malformation repair, and an indication for
surgical placement of a RV-pulmonary artery conduit
or bioprosthetic pulmonary valve. Due to the highly
variable anatomy of the patient population, the study required
careful screening to assess device fit.
“As demonstrated by these late-breaking studies,
we’re consistently building our body of new, short-, and long-term
research around innovative, minimally-invasive TPV solutions for
CHD patients,” said Sandra Lesenfants, vice president and general
manager of the Structural Heart division, which is part of the
Cardiac and Vascular Group at Medtronic. “These Harmony data
demonstrate our commitment to generating new therapies and growing
our congenital heart disease program to support a lifetime of care
that this patient population needs.”
Worldwide, the Harmony TPV is limited to
investigational use and not approved for sale or distribution.
In collaboration with leading clinicians,
researchers and scientists worldwide, Medtronic offers the broadest
range of innovative medical technology for the interventional and
surgical treatment of cardiovascular disease and cardiac
arrhythmias. The company strives to offer products and services
that deliver clinical and economic value to healthcare consumers
and providers around the world.
About MedtronicMedtronic plc
(www.medtronic.com), headquartered in Dublin, Ireland, is among the
world's largest medical technology, services and solutions
companies – alleviating pain, restoring health and extending life
for millions of people around the world. Medtronic employs more
than 90,000 people worldwide, serving physicians, hospitals and
patients in more than 150 countries. The company is focused on
collaborating with stakeholders around the world to take healthcare
Further, Together.
Any forward-looking statements are subject
to risks and uncertainties such as those described in Medtronic's
periodic reports on file with the Securities and Exchange
Commission. Actual results may differ materially from anticipated
results.
-end-
1 Hoffman JL, Kaplan S. The incidence of
congenital heart disease. J Am Coll Cardiol.
2002;39(12):1890-1900.
2 McElhinney DB, Hennesen JT. The
Melody® valve and Ensemble® delivery system for transcatheter
pulmonary valve replacement. Ann NY Acad
Sci. 2013; 1291: 77-85.
Allison KyriagisPublic Relations+1-612-750-6061
Ryan WeispfenningInvestor Relations+1-763-505-4626
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