CClinicalTrials.gg
CompletedNCT04091048Updated Jan 13, 2026Results posted

Optimize PRO Study

An observational study in Symptomatic Aortic Stenosis, sponsored by Medtronic Cardiovascular. Completed at 60 sites in 12 countries. Per ClinicalTrials.gov, last updated 2026-01-13.

Sponsored by Medtronic Cardiovascular · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
1,127
Sex
All
01

Study summary

The purpose of this study is to collect clinical evidence on valve performance and procedural outcomes associated with an "optimized" TAVR care pathway and post-TAVR conduction disturbance pathway while using the Evolut™ PRO and Evolut™ PRO+ devices.

The purpose of the addendum is to collect post-market clinical evidence on valve performance and procedural outcomes associated with the Evolut FX Device.

Read the detailed description

This is a post market, multi-center (sites in US/CAN/EMEA/ANZ), prospective, non-randomized study.

The addendum is a post market, multi-center (sites in US only), prospective, non-randomized study.

02

Conditions studied

  • Symptomatic Aortic Stenosis
03

In context

Lead sponsor

Medtronic Cardiovascular is the lead sponsor of 66 studies on the registry; 7 are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 5 (100%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The study population includes patients with symptomatic native aortic valve stenosis that necessitates valve replacement who meet the criteria for on-label use of the Evolut™ PRO or Evolut™ PRO+ (and FX system for the addendum where applicable) system in accordance with Instructions for Use and local regulations.

Inclusion criteria

  • Acceptable candidate for treatment with the Evolut™ PRO or Evolut™ PRO+ system (FX system for the addendum where applicable) in accordance with the Instructions for Use and local regulations;
  • Subject is symptomatic from his/her aortic valve stenosis, as demonstrated by New York Heart Association (NYHA) Functional Class II or greater;
  • Subject and the treating physician agree that the subject will return for all required post procedure follow-up visits;
  • Anatomically suitable for transfemoral TAVR with the Medtronic TAVR system;
  • Subject meets the legal minimum age to provide Informed Consent based on local regulatory requirements.

Exclusion criteria

Exclusion Criteria:

  • Contraindicated for treatment with the Evolut™ PRO or Evolut™ PRO+ or FX system (where applicable) in accordance with the Instructions for Use
  • Anatomically not suitable for the Evolut™ PRO or Evolut™ PRO+ or FX system (where applicable);
  • Previous aortic valve replacement
  • Reduced ventricular function with left ventricular ejection fraction (LVEF) \<35% as measured by resting echocardiogram;
  • Frailty assessments identify:

    • Subject is \<80 years of age and three or more of the following apply; OR subject is > 80 years of age and two or more of the following apply

      • Wheelchair bound
      • Resides in an institutional care facility (e.g. nursing home, skilled care center)
      • Body Mass Index \<20kg/m2
      • Grip strength \<16kg
      • Katz Index score ≤4
      • Albumin \<3.5 g/dL
  • Bicuspid valve verified;
  • Aortic root angulation (angle between plane of aortic valve annulus and horizontal plane/vertebrae) > 70°.
  • Implanted with pacemaker or ICD;
  • Prohibitive left ventricular outflow tract calcification;
  • Estimated life expectancy of less than 12 months due to associated non- cardiac co-morbid conditions;
  • Other medical, social, or psychological conditions that in the opinion of the Investigator precludes the subject from appropriate consent, adherence to the protocol required follow-up exams;
  • Currently participating in an investigational drug or another device trial (excluding registries);
  • Need for emergency surgery for any reason.
  • Subject is less than legal age of consent, legally incompetent, or otherwise vulnerable*.

    • Notes: Vulnerable subjects include individuals whose willingness to volunteer in a clinical investigation could be unduly influenced by the expectation, whether justified or not, of benefits associated with participation or of retaliatory response from senior members of a hierarchy in case of refusal to participate. EXAMPLE Individuals with lack of or loss of autonomy due to immaturity or through mental disability, persons in nursing homes, children, impoverished persons, subjects in emergency situations, ethnic minority groups, homeless persons, nomads, refugees, and those incapable of giving informed consent. Other vulnerable subjects include, for example, members of a group with a hierarchical structure such as university students, subordinate hospital and laboratory personnel, employees of the sponsor, members of the armed forces, and persons kept in detention.
05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
1,127 participants (actual)
Patient registry
No

Groups and cohorts

  • Primary Cohort

    Device: Evolut™ PRO and Evolut™ PRO+ System (Evolut™ FX System for the addendum)

Interventions

  • DeviceEvolut™ PRO and Evolut™ PRO+ System (Evolut™ FX System for the addendum)

    Aortic valve replacement

06

What researchers measure

Primary outcomes

  1. All-cause Mortality or All-stroke

    All-cause mortality or all-stroke at 30 days.

    Time frame: 30 days post procedure

Secondary outcomes

  1. Length of Stay

    Median days from index procedure to discharge

    Time frame: Through discharge up to 7 days post index procedure.

  2. Aortic Regurgitation (AR)

    Percentage of subjects with ≥ moderate AR at discharge

    Time frame: Through discharge up to 7 days post index procedure.

  3. Pacemaker Implantation or Worsening Conduction Disturbance

    Rate of pacemaker implant for new onset or worsening conduction disturbance at 30 days

    Time frame: 30 days

  4. Depth of Implant (Evolut FX Only)

    Percentage of subjects with a Non-Coronary Cusp (NCC) depth of implant between 1.0 and 5.0 mm (Evolut FX Addendum Only)

    Time frame: 30 days

  5. Canting (Evolut FX Addendum Only)

    Percentage of subjects with a canting absolute value \[NCC- Left Coronary Cusp(LCC)\] of ≤ 2.0 mm (Evolut FX Addendum Only)

    Time frame: 30 Days

07

Results

Posted Feb 6, 2025

Participant flow

Participant flow — Overall Study
MilestoneMain ProtocolFX Addendum
Started928199
Completed653151
Not completed27548

Outcome measures

PrimaryAll-cause Mortality or All-stroke

All-cause mortality or all-stroke at 30 days.

Time frame:
30 days post procedure
Reported as:
Number · Percent of Participants (K-M Rate)
All-cause Mortality or All-stroke
Percent of Participants (K-M Rate)Main ProtocolFX Addendum
All-cause Mortality or All-stroke5.12.7
SecondaryLength of Stay

Median days from index procedure to discharge

Time frame:
Through discharge up to 7 days post index procedure.
Reported as:
Median · Days
Length of Stay
DaysMain ProtocolFX Addendum
Length of Stay2.0 (1.0 to 31.0)1.0 (1.0 to 27.0)
SecondaryAortic Regurgitation (AR)

Percentage of subjects with ≥ moderate AR at discharge

Time frame:
Through discharge up to 7 days post index procedure.
Reported as:
Count of participants · Participants
Aortic Regurgitation (AR)
ParticipantsMain ProtocolFX Addendum
Aortic Regurgitation (AR)00
SecondaryPacemaker Implantation or Worsening Conduction Disturbance

Rate of pacemaker implant for new onset or worsening conduction disturbance at 30 days

Time frame:
30 days
Reported as:
Number · Percent of Participants (K-M Rate)
Pacemaker Implantation or Worsening Conduction Disturbance
Percent of Participants (K-M Rate)Main ProtocolFX Addendum
Pacemaker Implantation or Worsening Conduction Disturbance6.56.7
SecondaryDepth of Implant (Evolut FX Only)

Percentage of subjects with a Non-Coronary Cusp (NCC) depth of implant between 1.0 and 5.0 mm (Evolut FX Addendum Only)

Time frame:
30 days
Reported as:
Count of participants · Participants
Depth of Implant (Evolut FX Only)
ParticipantsFX Addendum
Depth of Implant (Evolut FX Only)83
SecondaryCanting (Evolut FX Addendum Only)

Percentage of subjects with a canting absolute value \[NCC- Left Coronary Cusp(LCC)\] of ≤ 2.0 mm (Evolut FX Addendum Only)

Time frame:
30 Days
Reported as:
Count of participants · Participants
Canting (Evolut FX Addendum Only)
ParticipantsFX Addendum
Canting (Evolut FX Addendum Only)59

Adverse events

Collected over Adverse Events collected starting at the time the informed consent was signed until the end of the study (i.e. 12 month follow-up post procedure) or study exit, whichever occurs first.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Main Protocol32/653 (4.9%)212/653 (32.5%)0/653 (0%)
FX Addendum7/151 (4.6%)44/151 (29.1%)0/151 (0%)
Most frequent serious events
Showing 10 of 285
Most frequent serious events
EventMain ProtocolFX Addendum
Atrioventricular block completeCardiac disorders55/6539/151
Atrial fibrillationCardiac disorders29/6537/151
Cerebrovascular accidentNervous system disorders22/6533/151
Transient ischaemic attackNervous system disorders4/6535/151
Acute kidney injuryRenal and urinary disorders9/6535/151
Bundle branch block leftCardiac disorders21/6534/151
SyncopeNervous system disorders4/6534/151
Acute myocardial infarctionCardiac disorders17/6531/151
PneumoniaInfections and infestations14/6533/151
Cardiac failure acuteCardiac disorders13/6531/151

Baseline characteristics

Age, Continuous
Age, Continuous(years)Main ProtocolFX AddendumTotal
Main Protocol79.1 ± 6.5—79.1 ± 6.5
FX Addendum Cohort—78.3 ± 7.178.3 ± 7.1
Sex: Female, Male
Sex: Female, Male(Participants)Main ProtocolFX AddendumTotal
Main Protocol — Female307—307
Main Protocol — Male346—346
FX Addendum — Female—6767
FX Addendum — Male—8484
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Main ProtocolFX AddendumTotal
Main Protocol — American Indian or Alaska Native1—1
Main Protocol — Asian1—1
Main Protocol — Black or African American11—11
Main Protocol — Native Hawaiian or Other Pacific Islander1—1
Main Protocol — White432—432
Main Protocol — Other5—5
FX Addendum — American Indian or Alaska Native—11
FX Addendum — Asian—00
FX Addendum — Black or African American—66
FX Addendum — Native Hawaiian or Other Pacific Islander—22
FX Addendum — White—141141
FX Addendum — Other—11
Body Mass Index (BMI)
Body Mass Index (BMI)(kg/m^2)Main ProtocolFX AddendumTotal
Main Protocol29.6 ± 5.9—29.6 ± 5.9
FX Addendum—30.2 ± 6.030.2 ± 6.0
NYHA
NYHA(Participants)Main ProtocolFX AddendumTotal
Main Protocol — NYHA I0—0
Main Protocol — NYHA II374—374
Main Protocol — NYHA III256—256
Main Protocol — NYHA IV23—23
FX Addendum — NYHA I—11
FX Addendum — NYHA II—110110
FX Addendum — NYHA III—3838
FX Addendum — NYHA IV—22
STS Score
STS Score(Mean)Main ProtocolFX AddendumTotal
Main Protocol3.2 ± 2.5—3.3 ± 2.3
FX Addendum—3.1 ± 2.03.1 ± 2.0
08

Study locations

60 sites
  • University of Alabama at Birmingham Hospital
    Birmingham, Alabama 35233, United States
  • California Pacific Medical Center - Sutter Health
    San Francisco, California 94109, United States
  • Hartford Hospital
    Hartford, Connecticut 06102, United States
  • Yale New Haven Hospital
    New Haven, Connecticut 06510, United States
  • St. Vincent's Hospital / Cardiology Associates of Fairfield County, P.C.
    Norwalk, Connecticut 06851, United States
  • Morton Plant Hospital
    Clearwater, Florida 33756, United States
  • Emory University Hospital
    Atlanta, Georgia 30308, United States
  • Rush University Medical Center
    Chicago, Illinois 60612, United States
  • St. John's Hospital/Prarie Education and Research Cooperative
    Springfield, Illinois 62769, United States
  • Medstar Union Memorial Hospital
    Baltimore, Maryland 21218, United States
  • University of Michigan
    Ann Arbor, Michigan 48109, United States
  • Ascension St. John Hospital
    Detroit, Michigan 48236, United States
  • Spectrum Health
    Grand Rapids, Michigan 49503, United States
  • Abbott Northwestern Hospital (Minneapolis Heart)
    Minneapolis, Minnesota 55407, United States
  • Providence St. Patrick Hospital
    Missoula, Montana 59802, United States
  • University of Nebraska Medical Center
    Omaha, Nebraska 68105, United States
  • Jersey Shore University Medical Center
    Neptune City, New Jersey 07753, United States
  • The Valley Hospital
    Ridgewood, New Jersey 07450, United States
  • Buffalo General Medical Center
    Buffalo, New York 14203, United States
  • The Mount Sinai Hospital
    New York, New York 10029, United States
  • New York Presbyterian - Columbia University Medical Center
    New York, New York 10032, United States
  • Vassar Brother's Medical Center
    Poughkeepsie, New York 12601, United States
  • St. Francis Hospital
    Roslyn, New York 11576, United States
  • Stony Brook University Hospital
    Stony Brook, New York 11794, United States
  • Ohio Health Research Institute
    Columbus, Ohio 43214, United States
  • Kettering Medical Center
    Kettering, Ohio 45429, United States
  • Lehigh Valley Hospital - Cedar Crest
    Allentown, Pennsylvania 18103, United States
  • UPMC Pinnacle Harrisburg
    Harrisburg, Pennsylvania 17101, United States
  • Allegheny General Hospital
    Pittsburgh, Pennsylvania 15212, United States
  • UPMC Presbyterian
    Pittsburgh, Pennsylvania 15213, United States
  • York Hospital
    York, Pennsylvania 17403, United States
  • Houston Methodist Hospital
    Houston, Texas 77030, United States
  • The Heart Hospital - Baylor Plano
    Plano, Texas 75093, United States
  • Dixie Regional Medical Center Intermountain
    St. George, Utah 84770, United States
  • Sentara Norfolk General Hospital
    Norfolk, Virginia 23507, United States
  • Charleston Medical Center
    Charleston, West Virginia 25304, United States
  • Aurora Saint Luke's Medical Center
    Milwaukee, Wisconsin 53125, United States
  • Saint Vincents Hospital Sydney
    Darlinghurst, New South Wales 2010, Australia
  • The Prince Charles Hospital
    Chermside West, Australia
  • Monash Hospital
    Clayton, Australia
  • Austin Hospital
    Heidelberg, Australia
  • Fiona Stanley Hospital
    Murdoch, Australia
  • John Hunter Hospital
    Newcastle, Australia
  • Saint Vincents Hospital Sydney
    Sydney, Australia
  • ZNA Middelheim
    Antwerp, Belgium
  • St Jan Hospital
    Bruges, Belgium
  • Sunnybrook Health Sciences Centre
    Toronto, Ontario M4N 3M5, Canada
  • Laval University Institute of Cardiology and Respirology of Quebec
    Québec, Quebec G1V 4G5, Canada
  • Hôpitaux Universitaires - Hôpital Henri Mondor
    Créteil, France
  • Hôpital Haut-Lévêque - CHU de Bordeaux
    Pessac, France
  • Universitätsklinikum Ulm
    Ulm, Germany
  • Mater Private Hospital
    Dublin, Ireland
  • Galway University Hospitals - University Hospital Galway (UHG)
    Galway, Ireland
  • Shaare Zedek Medical Center
    Jerusalem, Israel
  • Fondazione Poliambulanza
    Brescia, Italy
  • Fondazione Policlinico Universitario Agostino Gemelli
    Roma, Italy
  • Hospital Universitario Central de Asturas
    Oviedo, Spain
  • Akademiska Sjukhuset
    Uppsala, Sweden
  • Royal Victoria Hospital - Belfast Health and Social Care Trust
    Belfast, United Kingdom
  • Manchester Royal Infirmary
    Manchester, United Kingdom
09

References and documents

Publications

  • Grubb KJ, Gada H, Mittal S, Nazif T, Rodes-Cabau J, Fraser DGW, Lin L, Rovin JD, Khalil R, Sultan I, Gardner B, Lorenz D, Chetcuti SJ, Patel NC, Harvey JE, Mahoney P, Schwartz B, Jafar Z, Wang J, Potluri S, Vora AN, Sanchez C, Corrigan A, Li S, Yakubov SJ. Clinical Impact of Standardized TAVR Technique and Care Pathway: Insights From the Optimize PRO Study. JACC Cardiovasc Interv. 2023 Mar 13;16(5):558-570. doi: 10.1016/j.jcin.2023.01.016. PubMed 36922042 ↗

Study documents

  • Study protocol · Jul 21, 2019
  • Study protocol · Sep 20, 2019
  • Study protocol · Oct 27, 2020
  • Study protocol · May 4, 2021
  • Study protocol · Jun 16, 2021
  • Study protocol · Jan 14, 2022
  • Study protocol · Dec 15, 2022
  • Statistical analysis plan · Dec 15, 2023

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 13, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT04091048
Lead sponsor
Medtronic Cardiovascular
Responsible party
Sponsor
First posted
Sep 16, 2019
Start date
Sep 16, 2019
Primary completion
Dec 15, 2023
Completion
Nov 13, 2024
Results posted
Feb 6, 2025
Last update
Jan 13, 2026

Study contacts

Steven Yakubov, MD
principal investigator · OhioHealth
Kendra Grubb, MD
principal investigator · Emory University
Josep Rodés-Cabau, MD
study chair · Laval University
Suneet Mittal, MD
study chair · Valley Health System
Tamim Nazif, MD
study chair · Columbia - New York Presbyterian
Hemal Gada, MD
study chair · UPMC Pinnacle
Douglas Fraser, MD
study chair · Manchester Royal Infirmary

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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