Clinical Trial: Study of Autologous Bone Marrow Derived Mononuclear Cells for Treatment of Ebstein Anomaly

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Phase I Safety and Feasibility Study of Intramyocardial Delivery of Autologous Bone Marrow Derived Mononuclear Cells to Right Ventricle of Patients With Ebstein Anomaly Du

Brief Summary: The objective of this study is to determine the safety and feasibility of autologous mononuclear cells (MNS) collected from bone marrow (BM) and using an add-on intramyocardial delivery for individuals with Ebstein anomaly undergoing surgical intervention compared to the control group undergoing the same surgical procedure without cell delivery. This add-on procedure has the potential to foster a new strategy for individuals with congenital heart disease.This is an open-label study of autologous MNC derived from bone marrow with a 2-year follow-up to document 1) incidence and severity of adverse event and 2) monitor changes in cardiac structure and function.

Detailed Summary: This study is an open label Phase I trial to determine the safety and feasibility of bone marrow-derived mononuclear cells to the right ventricle of subjects with Ebstein anomaly at the time of a planned surgical Ebstein repair compared to the control group undergoing the same planned surgical intervention without the cell delivery add-on procedure. Subjects will be screened at outpatient clinic visits at Mayo Clinic and interested qualified subjects will be consented and offered participation in this trial. Subject/Family will decide to participate in cell delivery or control arm. Once informed consent has been obtained, subjects will undergo identical evaluation (other than Hematology consultation and BM harvest occurring only in the cell-treatment group),preoperative values will be established/confirmed and a selection committee will review subjects within three days prior to planned procedure to confirm inclusion and exclusion criteria. This will require a non-study cardiologist to review the clinical case and confirm the baseline cardiac function with evidence of right ventricle dysfunction. However, individuals at high-risk, primarily neonates and those with preoperative advanced right heart failure will NOT be included such that the risk of this add-on procedure may not be acceptable. Following surgical Ebstein repair for the control group and following cell-based product delivery for the treatment group, all subjects will be followed for 24-months according to a pre-determined schedule that includes imaging studies along with a questionnaire, electrophysiology and laboratory studies at 1, 6, and 24 months post procedure. All subjects will be contacted for surveillance by phone at 3, 12, and 18 month post procedure.
Sponsor: Timothy J. Nelson

Current Primary Outcome:

  • Number of adverse events in the cell treatment arm [ Time Frame: 30 days post cell delivery ]
  • Severity of adverse events in the cell treatment arm [ Time Frame: 30 days post cell delivery ]
  • Number of subjects who died [ Time Frame: 24 months post Ebstein repair ]
  • Number of subjects with sustained or symptomatic ventricular arrhythmias [ Time Frame: 24 months post Ebstein repair ]
  • Number of subjects with myocardial infarction [ Time Frame: 24 months post Ebstein repair ]
  • Number of subjects with unexpected cardiovascular procedures [ Time Frame: 24 months post Ebstein repair ]
  • Number of serious adverse events [ Time Frame: 24 months post Ebstein repair ]
  • Percentage of subjects in the treatment group that have cells delivered [ Time Frame: 24 months post Ebstein repair ]
  • Percentage of subjects in the treatment group completing the 24 month follow-up [ Time Frame: 24 months post Ebstein repair ]
  • Incidence of cardiac related hospitalizations from time of pre-operative evaluation [ Time Frame: 1, 6, and 24 months post Ebstein repair ]
  • Incidence of atrial arrhythmias from time of pre-operative evaluation [ Time Frame: 1, 6, and 24 months post Ebstein repair ]
  • Change in CT/MRI derived right ventricle ejection fraction from time of pre-operative evaluation [ Time Frame: 6 and 24 months post Ebstein repair

    Original Primary Outcome: Same as current

    Current Secondary Outcome:

    Original Secondary Outcome:

    Information By: Mayo Clinic

    Dates:
    Date Received: September 22, 2016
    Date Started: September 2016
    Date Completion: April 2021
    Last Updated: October 5, 2016
    Last Verified: October 2016