CClinicalTrials.gg
Active, not recruitingNCT04489823PARADIGMUpdated Feb 10, 2026

PARADIGM: Amplatzer Valvular Plug for PVL Closure

An interventional study of AVP III in Paravalvular Aortic Regurgitation, sponsored by Abbott Medical Devices. Active, not recruiting at 24 sites in 7 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-02-10.

Sponsored by Abbott Medical Devices · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
200
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The Paradigm study is a prospective, multicenter, single arm study to demonstrate the safety and effectiveness of the Amplatzer Valvular Plug III (AVP III) as a treatment for clinically significant PVLs following surgical implant of a mechanical or biological heart valve implanted in the aortic or mitral position.

Read the detailed description

PARADIGM is a prospective, international, multi-center, single arm study to demonstrate the safety and effectiveness of the AVP III for percutaneous, transcatheter closure of paravalvular leak (PVL) occurring after aortic or mitral valve replacement with a surgically-implanted mechanical or bioprosthetic valve. The study will be conducted at approximately 25 clinical sites in the US, Europe, and Canada. A total of 200 subjects with a clinically significant PVL will undergo an AVP III implant procedure for PVL closure. Pre-procedural Baseline and follow-up assessments at Discharge, 30 days, 6 months and 1 year will include echocardiography, physical examinations, lab measurements and questionnaires to assess PVL severity, prosthetic valve function, hemolytic anemia, heart failure symptoms, and quality of life. Adverse events will be recorded throughout the study.

02

Conditions studied

  • Paravalvular Aortic Regurgitation
03

In context

Lead sponsor

Abbott Medical Devices is the lead sponsor of 525 studies on the registry; 35 are open to participants now.

Of its 52 completed or terminated interventional studies of FDA-regulated products, 43 (83%) have results posted.

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

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Subject is implanted with a mechanical or biological surgical valve in the aortic or mitral position
  • Note: Subjects in European countries can only be implanted with a mechanical valve in the aortic or mitral position
  • Subject has a clinically significant paravalvular leak with a severity grade of moderate or higher, associated with signs of heart failure and/or hemolysis necessitating recurring blood transfusions.
  • Subject has one clinically significant PVL defect that can be closed with a single AVP III as assessed pre-procedurally
  • Subject has provided written informed consent
  • Subject is ≥18 years old

Exclusion criteria

Exclusion Criteria:

  • Subject has a rocking valve or extreme dehiscence of the prosthetic valve involving more than 40% of the sewing ring
  • Subject's PVL(s) originates from a transcatheter aortic or mitral valve replacement, or from rapid deployment or sutureless surgical replacement valves
  • Subject has a prosthetic aortic valve and prosthetic mitral valve which both have a clinically significant paravalvular leak.
  • Subject who is hemodynamically unstable or who cannot undergo an elective procedure
  • Subject with active endocarditis or other active infection
  • Subject has within the last 6 months a previously documented intracardiac mass, vegetation, tumor, or thrombus which would interfere with placement of the AVP III
  • Subject has inadequate vasculature for delivery of the AVP III
  • Subject has unsuitable anatomy for PVL closure using the AVP III (such as a PVL associated with an abscess cavity or a pseudoaneurysmal sac) or anatomy where the AVP III would interfere with other intracardiac or intravascular structures (such coronary ostia)
  • Subjects who are unable to receive intraprocedural anticoagulant therapy
  • Pregnant or nursing subjects or subjects who plan pregnancy during the clinical investigation follow-up period.
  • Presence of other anatomic or comorbid conditions, or other medical, social, or psychological conditions that, in the investigator's opinion, could limit the subject's ability to participate in the clinical investigation or to comply with follow-up requirements, or impact the scientific soundness of the clinical investigation results.
  • Life expectancy is less than 1 year in the opinion of the Investigator
  • Incapacitated individuals, defined as persons with mental illnesses or handicaps that impair their ability to provide informed consent, or individuals without legal authority to provide informed consent.
  • Individual who are currently participating in an investigational drug or device study that has not reached the primary endpoint or that may confound the results of this study
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
200 participants (estimated)

Study arms

  • Experimental
    Paravalvular Leak Closure

    Includes all eligible subjects who undergo an AVP III implant attempt for treatment of significant paravalvular leakage with an echocardiographic severity grade of moderate or higher. This is a single arm study.

    Device: AVP III

Interventions

  • DeviceAVP III

    Transcatheter closure of a paravalvular leak using AVP III

06

What researchers measure

Primary outcomes

  1. Paravalvular leak closure success rate (percent of subjects)

    * Successful transcatheter placement in the intended location without interference * Reduction in paravalvular regurgitation severity by ≥ two grades * Freedom from intra-procedural death * Freedom from unplanned transcatheter or surgical re-intervention through 30 days post-implant.

    Time frame: 30 Days

07

Study locations

24 sites
  • University Hospital - Univ. of Alabama at Birmingham (UAB)
    Birmingham, Alabama 35249, United States
  • Emory University Hospital
    Atlanta, Georgia 30322, United States
  • Massachusetts General Hospital
    Boston, Massachusetts 02114, United States
  • Minneapolis Heart Institute
    Minneapolis, Minnesota 55407, United States
  • Saint Luke's Hospital of Kansas City
    Kansas City, Missouri 64111, United States
  • University of Nebraska Medical Center
    Omaha, Nebraska 68198, United States
  • Hackensack University Medical Center
    Hackensack, New Jersey 07601, United States
  • Lenox Hill Hospital
    New York, New York 10021, United States
  • New York Presbyterian Hospital/Cornell University
    New York, New York 10021, United States
  • The Cleveland Clinic Foundation
    Cleveland, Ohio 44195, United States
  • Baptist Memorial Hospital
    Memphis, Tennessee 38120, United States
  • Intermountain Medical Center
    Murray, Utah 84157, United States
  • Carilion Roanoke Memorial Hospital
    Roanoke, Virginia 24014, United States
  • Providence Sacred Heart Medical Center
    Spokane, Washington 99202, United States
  • Institut de Cardiologie de Montreal (Montreal Heart Inst.)
    Montreal, Quebec H1T 1C8, Canada
  • Institut de Cardiologie de Quebec (Hôpital Laval)
    Québec, Quebec G1V 4G5, Canada
  • Ospedale San Raffaele
    Milan, Lombard 20132, Italy
  • St. Antonius Ziekenhuis
    Nieuwegein, Utrecht 3435 CM, Netherlands
  • Gornoslaskie Centrum Medyczne im.prof. Leszka Gieca
    Katowice, Silesian Voivodeship 40-635, Poland
  • Hospital Ramón y Cajal
    Madrid, Madrid 28034, Spain
  • Hospital Universitario de Salamanca
    Salamanca, Spain
  • Edinburgh Heart Centre
    Edinburgh, Lothian EH16 4SA, United Kingdom
  • The Royal Sussex County Hospital
    Brighton, Soeast BN25BE, United Kingdom
  • Papworth Hospital NHS Foundation Trust
    Cambridge, United Kingdom
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04489823
Lead sponsor
Abbott Medical Devices
Responsible party
Sponsor
First posted
Jul 28, 2020
Start date
Dec 1, 2020
Primary completion
Nov 20, 2025
Completion
Dec 13, 2026 (estimated)
Last update
Feb 10, 2026

Study contacts

Carlos Ruiz, M.D., Ph.D
principal investigator · Hackensack Meridian Health

Oversight

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

Not currently enrolling

This study is active, not recruiting, as verified in Jan 2026. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion