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Not yet recruitingNCT07912905Updated Nov 3, 2026

Effect of Double-Tap Optimization on Valve Expansion and Hemodynamics in Balloon-expandable Transcatheter Aortic Valve Implantation: A Randomized Clinical Trial (DO-OPT TAVI Trial)

An interventional study of Double-Tap Balloon Post-dilatation and Conventional Single-Inflation TAVI in Severe Aortic Stenosis, sponsored by Yonsei University. Not yet recruiting. Open to participants aged 19 Years and older. Per ClinicalTrials.gov, last updated 2026-11-03.

Sponsored by Yonsei University · Not applicable, Interventional, and Treatment

Updated Nov 3, 2026Newly registeredGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
250
Allocation
Randomized
Ages
19 Years and older
Sex
All
01

Study summary

This study will compare two balloon inflation strategies during transcatheter aortic valve implantation (TAVI), a procedure used to replace a severely narrowed aortic valve through a catheter. A balloon-expandable replacement valve may not fully expand during its initial placement. An additional inflation using the same balloon and the same inflation volume, called "Double-Tap," may improve valve expansion and function. Its benefits and risks need to be evaluated in a randomized trial.

This prospective, multicenter study aims to include 250 adults with symptomatic severe aortic stenosis undergoing TAVI with an Edwards SAPIEN-family balloon-expandable valve. After successful valve implantation, participants for whom an additional inflation is considered technically feasible and clinically appropriate will be randomly assigned in equal numbers to Double-Tap or conventional single inflation. Patients requiring therapeutic post-dilatation for moderate or greater leakage around the implanted valve will not undergo randomization.

The main question is whether Double-Tap improves valve expansion immediately after TAVI, as measured using fluoroscopic X-ray images. The study will also compare blood flow through the valve, valve expansion and signs of valve thrombosis on cardiac computed tomography, procedure-related complications, and clinical outcomes. Participants will undergo echocardiography before discharge and at 3-6 and 12 months, and cardiac computed tomography at 3-6 months. Clinical follow-up will continue for at least 12 months, with annual follow-up thereafter until the last enrolled participant completes the 12-month visit.

02

Conditions studied

  • Severe Aortic Stenosis
03

In context

Aortic Valve Stenosis

1,010 studies on the registry are indexed under Aortic Valve Stenosis; 285 are open to participants now.

This study's planned enrollment of 250 is above the median of 120 across 540 interventional studies indexed under Aortic Valve Stenosis.

Browse Aortic Valve Stenosis studies →

Lead sponsor

Yonsei University is the lead sponsor of 1,417 studies on the registry; 240 are open to participants now.

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

04

Who can participate

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients ≥ 19 years old
  • Patients undergoing TAVI using a Sapien family valve for severe AS
  • Provision of informed consent

Exclusion criteria

Exclusion criteria:

  • Subannular calcification
  • Bicuspid aortic valve with raphe calcification
  • Valve-in-valve TAVI procedure
  • Planned major surgery
  • Cardiogenic shock or hemodynamic instability
  • Chronic kidney disease stage 3b, 4, or 5 (eGFR \<45mL/min)
  • Thrombocytopenia (platelet count \<100,000) or contraindication to antiplatelet therapy or anticoagulation despite clinical indications
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
250 participants (estimated)

Study arms

  • Experimental
    Double-Tap

    Participants undergo TAVI with an Edwards SAPIEN-family balloon-expandable valve. After successful initial valve implantation and randomization, one additional balloon inflation is performed using the same delivery balloon and the same inflation volume used for initial deployment. The additional inflation is performed immediately after confirming appropriate valve position and procedural stability.

    Procedure: Double-Tap Balloon Post-dilatation

  • Active comparator
    No Double-Tap

    Participants undergo standard TAVI with an Edwards SAPIEN-family balloon-expandable valve deployed using a single balloon inflation. After successful initial valve implantation and randomization, no planned additional balloon inflation for Double-Tap optimization is performed.

    Procedure: Conventional Single-Inflation TAVI

Interventions

  • ProcedureDouble-Tap Balloon Post-dilatation

    Following successful implantation of an Edwards SAPIEN-family balloon-expandable transcatheter heart valve, one additional balloon inflation is performed using the same delivery balloon and the same inflation volume used for initial valve deployment. Balloon inflation volume is not increased for the Double-Tap inflation. The procedure is performed after randomization and confirmation of appropriate valve position and procedural stability.

  • ProcedureConventional Single-Inflation TAVI

    An Edwards SAPIEN-family balloon-expandable transcatheter heart valve is implanted using a single balloon inflation according to standard practice and the manufacturer's instructions for use. No planned additional balloon inflation for Double-Tap optimization is performed after randomization.

06

What researchers measure

Primary outcomes

  1. Percentage valve expansion measured by fluoroscopy

    Expansion of the implanted transcatheter heart valve, expressed as a percentage of the manufacturer's nominal cross-sectional area for the implanted valve size. Valve diameters are measured at the inflow, midframe, and outflow levels in three-cusp and cusp-overlap fluoroscopic views. At each level, the diameters from the two views are averaged, and the cross-sectional area is calculated using the circular area formula. Fluoroscopic images are evaluated by independent imaging core laboratory assessors blinded to treatment assignment and clinical outcomes.

    Time frame: immediately after TAVI procedure

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Registered
First appeared on the registry. No changes since
Nov 3, 2026
Show all 1 update
  1. Nov 3, 2026
    First appeared on the registry

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07912905
Lead sponsor
Yonsei University
Responsible party
Sponsor
First posted
Nov 3, 2026
Start date
Dec 1, 2026 (estimated)
Primary completion
Feb 21, 2029 (estimated)
Completion
Feb 21, 2030 (estimated)
Last update
Nov 3, 2026

Study contacts

Young-Guk Ko, Professor
Contact
ygko@yuhs.ac
+82-22228-8460

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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