German Aortic Valve Registry

Trial details

Who runs it

German Aortic Valve Registry

Trial code

NCT01165827

Record updated

7 April 2026

Original description

1. Research aimsRead full original descriptionShow less

National Prospective German Registry for Aortic Valve Therapy

1. Research aims

The increasing prevalence of severe aortic valve defects is a corollary to increases in life expectancy. For many years, surgical valve replacement with extracorporeal circulation has been the gold standard in the treatment of severe aortic valve diseases. Every year, about 12,000 patients in Germany receive isolated aortic valve surgery. Several alternatives to established procedures have recently emerged: * V-TAVI, vascular transcatheter aortic valve implantation and * A-TAVI, apical transcatheter aortic valve implantation. For some time, percutaneous balloon valvuloplasty has been used as a palliative measure for specific patients.

New developments have triggered assumptions that there will over the coming years be a certain reorientation to the treatment of patients with aortic valve defects. In a positioning paper published jointly by the German Cardiac Society (DGK) and the German Society for Thoracic and Cardiovascular Surgery (DGTHG), there is a consensus that these new techniques can be used on patients who have either contraindications against conventional surgery or who are at high risk of preoperative mortality, e.g. due to severe comorbidities.

As there is as yet only limited experience in this field and neither randomised trials nor long-term-results are available, the use of new implantation techniques is therefore not recommended for younger patients or patients without comorbidities. There is accordingly an urgent need for any introduction of this innovative medical procedure to be stringently monitored according to scientific principles. The goal of the planned Germany Aortic Valve Register is to evaluate the new treatments from the point of view of benefits und risks with respect to the gold standard of conventional surgery, with a view to compiling evidence-based indication criteria. The register will furthermore allow for the first time a comparison of various operative procedures, such as Ross procedure, David procedure and various mechanical or biological aortic valve implants. 2. Rationale of the study design Randomised trials in controlled environments are considered best scientific practice for verifying the efficacy of a new method. The disadvantage is that only a small part of potential patients can be included in the trial, and results therefore reflect only a small section of the real world. Furthermore, a randomised study design is for ethical reasons not an acceptable approach to all questions, especially when contraindications exist for a certain branch of treatments and the spectrum of treatments is to be expanded. Nevertheless, new procedures have to be critically and scientifically analysed if the risk-benefit ratio is to be accurately determined. National heath authorities therefore request register data in addition to controlled trials in order to verify the safety and efficacy of new procedures across larger patient populations. 3. Objectives

1. Description of structure, process and outcome quality for the various techniques of aortic valve therapies 2. Definition of indication criteria (e.g. through scoring systems) 3. Collection of information on quality and safety for special medical devices 4. Evaluation of quality of care on the level of participating centres with a view to increasing quality 5. Health economic evaluation of the applied treatments 4. Study design Prospective, controlled, multicenter register study

Inclusion: All consecutive patients from participating hospitals with aortic valve defects who have received one of the following therapies:; surgical aortic valve replacement,; aortic valve surgery (Ross procedure, David procedure); percutaneous transvascular (retrograde) aortic valve implantation; percutaneous transapical aortic valve implantation; aortic valve valvuloplasty as principal indication. If the aortic valve insufficiency is concurrent with combination procedures (e.g. coronary artery bypass graft, mitral valve surgery) the aortic valve stenosis must fulfil only the criteria for indication according to the German guidelines (Hamm et al. 2008).

Exclusion: No consent from the patient to collection and analysis of data.

ClinicalTrials.gov NCT01165827