Ignite Creation Date:
2025-12-25 @ 12:13 AM
Ignite Modification Date:
2026-01-01 @ 11:45 PM
Study NCT ID:
NCT01074658
Status:
COMPLETED
Last Update Posted:
2017-12-02
First Post:
2010-02-23
Is NOT Gene Therapy:
True
Has Adverse Events:
True
Brief Title:
CoreValve Advance International Post Market Study
Sponsor:
Organization:
Raw JSON
{'hasResults': True, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24', 'removedCountries': ['Austria', 'Spain', 'Sweden']}, 'conditionBrowseModule': {'meshes': [{'id': 'D001024', 'term': 'Aortic Valve Stenosis'}], 'ancestors': [{'id': 'D000082862', 'term': 'Aortic Valve Disease'}, {'id': 'D006349', 'term': 'Heart Valve Diseases'}, {'id': 'D006331', 'term': 'Heart Diseases'}, {'id': 'D002318', 'term': 'Cardiovascular Diseases'}, {'id': 'D014694', 'term': 'Ventricular Outflow Obstruction'}]}}, 'resultsSection': {'moreInfoModule': {'pointOfContact': {'email': 'hanne.gonnissen@medtronic.com', 'phone': '+3143356', 'title': 'Hanne Gonnissen', 'phoneExt': '6734', 'organization': 'Medronic Bakken Research Center'}, 'certainAgreement': {'otherDetails': 'PI will provide results to sponsor for review and approval at least 60 days prior to submittal for publication or presentation. Review will be limited to determination whether Confidential Information is disclosed and not to censor or interfere with presentation or conclusions beyond the extent necessary to protect Confidential Information, to allow the sponsor to protect its rights in patentable or copyrightable material, and to check for technical correctness of sponsor information.', 'restrictionType': 'OTHER', 'piSponsorEmployee': False, 'restrictiveAgreement': True}}, 'adverseEventsModule': {'timeFrame': '30 days post procedure', 'eventGroups': [{'id': 'EG000', 'title': 'Medtronic CoreValve System', 'description': 'Transcatheter Aortic Valve Implantation (TAVI) with the Medtronic CoreValve System', 'otherNumAtRisk': 996, 'otherNumAffected': 541, 'seriousNumAtRisk': 996, 'seriousNumAffected': 541}], 'otherEvents': [{'term': 'AE related to Device', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 101, 'numAffected': 84}], 'organSystem': 'General disorders'}, {'term': 'AE related to Index procedure', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 883, 'numAffected': 535}], 'organSystem': 'General disorders'}], 'seriousEvents': [{'term': 'Cardiac tamponade', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 3, 'numAffected': 3}], 'organSystem': 'Cardiac disorders'}, {'term': 'Vessel dissection', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 4, 'numAffected': 4}], 'organSystem': 'Injury, poisoning and procedural complications'}, {'term': 'Access site complication', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 6, 'numAffected': 6}], 'organSystem': 'Injury, poisoning and procedural complications'}, {'term': 'Access vessel dissection', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 21, 'numAffected': 21}], 'organSystem': 'Injury, poisoning and procedural complications'}, {'term': 'Access vessel perforation', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 15, 'numAffected': 15}], 'organSystem': 'Injury, poisoning and procedural complications'}, {'term': 'Acute vessel occlusion', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 7, 'numAffected': 7}], 'organSystem': 'Injury, poisoning and procedural complications'}, {'term': 'Hemorrhage requiring transfusion', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 9, 'numAffected': 9}], 'organSystem': 'Injury, poisoning and procedural complications'}, {'term': 'Bradycardia', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 4, 'numAffected': 4}], 'organSystem': 'Cardiac disorders'}, {'term': 'Reposition with snare', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 2, 'numAffected': 2}], 'organSystem': 'Injury, poisoning and procedural complications'}, {'term': 'Valve in valve', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 15, 'numAffected': 15}], 'organSystem': 'Injury, poisoning and procedural complications'}, {'term': 'Valve retrieval', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 4, 'numAffected': 4}], 'organSystem': 'Injury, poisoning and procedural complications'}, {'term': 'Valve dislocation into LVOT', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 1, 'numAffected': 1}], 'organSystem': 'Injury, poisoning and procedural complications'}, {'term': 'Valve dislocation into annular aorta', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 6, 'numAffected': 6}], 'organSystem': 'Injury, poisoning and procedural complications'}, {'term': 'Ventricular rupture', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 3, 'numAffected': 3}], 'organSystem': 'Injury, poisoning and procedural complications'}, {'term': 'Hemodynamic instability requiring Heart/Lung machine', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 2, 'numAffected': 2}], 'organSystem': 'Vascular disorders'}, {'term': 'Resuscitation', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 9, 'numAffected': 9}], 'organSystem': 'Surgical and medical procedures'}, {'term': 'Ventricular fibrillation', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 6, 'numAffected': 6}], 'organSystem': 'Cardiac disorders'}, {'term': 'Failure of closure device requiring surgery', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 11, 'numAffected': 11}], 'organSystem': 'Surgical and medical procedures'}, {'term': 'Arrhythmia', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 18, 'numAffected': 18}], 'organSystem': 'Cardiac disorders'}, {'term': 'Other Procedural Complication', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 25, 'numAffected': 23}], 'organSystem': 'Injury, poisoning and procedural complications'}, {'term': 'Death', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 45, 'numAffected': 45}], 'organSystem': 'General disorders'}, {'term': 'Stroke/TIA', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 30, 'numAffected': 30}], 'organSystem': 'Nervous system disorders'}, {'term': 'Myocardial Infarction', 'notes': 'Myocardial infarction was defined according to the definition proposed by the The Joint ESC/ACC/AHA/WHF Task Force and Academic Research Consortium.(Thygesen K, Alpert JS, White HD. Circulation. 2007;116:2634-2653)', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 110, 'numAffected': 110}], 'organSystem': 'Cardiac disorders'}, {'term': 'Renal Failure', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 36, 'numAffected': 35}], 'organSystem': 'Renal and urinary disorders'}, {'term': 'Structural Valve Deterioration', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 1, 'numAffected': 1}], 'organSystem': 'Cardiac disorders'}, {'term': 'Nonstructural Valve Dysfunction', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 7, 'numAffected': 7}], 'organSystem': 'Cardiac disorders'}, {'term': 'Bleeding Event', 'notes': 'Any episode of major internal or external bleeding that causes death, hospitalization, or permanent injury (i.e. vision loss) or necessitates transfusion.', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 91, 'numAffected': 87}], 'organSystem': 'Vascular disorders'}, {'term': 'Permanent Pacemaker Implantation', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 209, 'numAffected': 209}], 'organSystem': 'Surgical and medical procedures'}, {'term': 'Other Serious Adverse Event', 'stats': [{'groupId': 'EG000', 'numAtRisk': 996, 'numEvents': 286, 'numAffected': 213}], 'organSystem': 'General disorders'}], 'frequencyThreshold': '0'}, 'outcomeMeasuresModule': {'outcomeMeasures': [{'type': 'PRIMARY', 'title': 'Major Adverse Cardiac & Cerebrovascular Events (MACCE)', 'denoms': [{'units': 'Participants', 'counts': [{'value': '996', 'groupId': 'OG000'}]}], 'groups': [{'id': 'OG000', 'title': 'Medtronic CoreValve System', 'description': 'Transcatheter Aortic Valve Implantation (TAVI) with the Medtronic CoreValve System'}], 'classes': [{'categories': [{'measurements': [{'value': '92', 'groupId': 'OG000'}]}]}], 'paramType': 'NUMBER', 'timeFrame': '30 days', 'description': 'MACCE is defined as a composite of:\n\n* All cause mortality\n* Myocardial Infarction (Q-wave and non-Q-wave)\n* Emergent cardiac surgery or percutaneous re-intervention\n* Stroke\n\nThe Kaplan-Meier survival analysis was used to derive the freedom from MACCE at 30 days.', 'unitOfMeasure': 'Freedom from MACCE (%) @30days', 'reportingStatus': 'POSTED', 'populationDescription': 'All attempted population.'}, {'type': 'SECONDARY', 'title': 'Percentage of Participants With Device Success', 'denoms': [{'units': 'Participants', 'counts': [{'value': '578', 'groupId': 'OG000'}]}], 'groups': [{'id': 'OG000', 'title': 'Medtronic CoreValve System', 'description': 'Transcatheter Aortic Valve Implantation (TAVI) with the Medtronic CoreValve System'}], 'classes': [{'categories': [{'measurements': [{'value': '79.4', 'groupId': 'OG000'}]}]}], 'paramType': 'NUMBER', 'timeFrame': 'up to 24 hours', 'description': 'Device Success is defined as a composite of:\n\n* Successful device delivery;\n* Stable device placement;\n* Intact retrieval of delivery catheter;\n* Successful device function as assessed immediately post-procedure by angiography including non-compromised flow in coronary arteries (without obstruction) device position (no migration) and a mean gradient as determined invasively of \\<15mmHg and ≤ 2 aortic regurgitation', 'unitOfMeasure': 'percentage of participants', 'reportingStatus': 'POSTED', 'populationDescription': 'All attempted population in which the separate variables related to device success (see outcome measure description) were analyzable.'}, {'type': 'SECONDARY', 'title': 'Percentage of Participants With Procedural Success', 'denoms': [{'units': 'Participants', 'counts': [{'value': '613', 'groupId': 'OG000'}]}], 'groups': [{'id': 'OG000', 'title': 'Medtronic CoreValve System', 'description': 'Transcatheter Aortic Valve Implantation (TAVI) with the Medtronic CoreValve System'}], 'classes': [{'categories': [{'measurements': [{'value': '71.1', 'groupId': 'OG000'}]}]}], 'paramType': 'NUMBER', 'timeFrame': 'up to 30 days', 'description': 'Procedural success, defined as device success with absence of in-hospital MACCE', 'unitOfMeasure': 'percentage of participants', 'reportingStatus': 'POSTED', 'populationDescription': 'All attempted population in which the separate variables related to procedural success (see outcome measure description) were analyzable.'}]}, 'participantFlowModule': {'groups': [{'id': 'FG000', 'title': 'Medtronic CoreValve System', 'description': 'Transcatheter Aortic Valve Implantation (TAVI) with the Medtronic CoreValve System.'}], 'periods': [{'title': 'Overall Study', 'milestones': [{'type': 'STARTED', 'achievements': [{'groupId': 'FG000', 'numSubjects': '1015'}]}, {'type': 'Attempted Implant', 'achievements': [{'groupId': 'FG000', 'numSubjects': '996'}]}, {'type': 'COMPLETED', 'achievements': [{'groupId': 'FG000', 'numSubjects': '996'}]}, {'type': 'NOT COMPLETED', 'achievements': [{'groupId': 'FG000', 'numSubjects': '19'}]}], 'dropWithdraws': [{'type': 'No implant attempted', 'reasons': [{'groupId': 'FG000', 'numSubjects': '19'}]}]}], 'recruitmentDetails': 'Start Recruitment March 2010 \\> End Recruitment July 2011'}, 'baselineCharacteristicsModule': {'denoms': [{'units': 'Participants', 'counts': [{'value': '1015', 'groupId': 'BG000'}]}], 'groups': [{'id': 'BG000', 'title': 'Medtronic CoreValve System', 'description': 'Transcatheter Aortic Valve Implantation (TAVI) with the Medtronic CoreValve System.'}], 'measures': [{'title': 'Age, Continuous', 'classes': [{'categories': [{'measurements': [{'value': '81.1', 'spread': '6.4', 'groupId': 'BG000'}]}]}], 'paramType': 'MEAN', 'unitOfMeasure': 'years', 'dispersionType': 'STANDARD_DEVIATION'}, {'title': 'Sex: Female, Male', 'classes': [{'categories': [{'title': 'Female', 'measurements': [{'value': '514', 'groupId': 'BG000'}]}, {'title': 'Male', 'measurements': [{'value': '501', 'groupId': 'BG000'}]}]}], 'paramType': 'COUNT_OF_PARTICIPANTS', 'unitOfMeasure': 'Participants'}]}}, 'protocolSection': {'designModule': {'studyType': 'OBSERVATIONAL', 'designInfo': {'timePerspective': 'PROSPECTIVE', 'observationalModel': 'COHORT'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 1015}}, 'statusModule': {'overallStatus': 'COMPLETED', 'startDateStruct': {'date': '2010-03'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2017-10', 'completionDateStruct': {'date': '2017-05', 'type': 'ACTUAL'}, 'lastUpdateSubmitDate': '2017-10-25', 'studyFirstSubmitDate': '2010-02-23', 'resultsFirstSubmitDate': '2016-07-13', 'studyFirstSubmitQcDate': '2010-02-23', 'lastUpdatePostDateStruct': {'date': '2017-12-02', 'type': 'ACTUAL'}, 'resultsFirstSubmitQcDate': '2016-08-30', 'studyFirstPostDateStruct': {'date': '2010-02-24', 'type': 'ESTIMATED'}, 'resultsFirstPostDateStruct': {'date': '2016-10-21', 'type': 'ESTIMATED'}, 'primaryCompletionDateStruct': {'date': '2011-11', 'type': 'ACTUAL'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Major Adverse Cardiac & Cerebrovascular Events (MACCE)', 'timeFrame': '30 days', 'description': 'MACCE is defined as a composite of:\n\n* All cause mortality\n* Myocardial Infarction (Q-wave and non-Q-wave)\n* Emergent cardiac surgery or percutaneous re-intervention\n* Stroke\n\nThe Kaplan-Meier survival analysis was used to derive the freedom from MACCE at 30 days.'}], 'secondaryOutcomes': [{'measure': 'Percentage of Participants With Device Success', 'timeFrame': 'up to 24 hours', 'description': 'Device Success is defined as a composite of:\n\n* Successful device delivery;\n* Stable device placement;\n* Intact retrieval of delivery catheter;\n* Successful device function as assessed immediately post-procedure by angiography including non-compromised flow in coronary arteries (without obstruction) device position (no migration) and a mean gradient as determined invasively of \\<15mmHg and ≤ 2 aortic regurgitation'}, {'measure': 'Percentage of Participants With Procedural Success', 'timeFrame': 'up to 30 days', 'description': 'Procedural success, defined as device success with absence of in-hospital MACCE'}]}, 'oversightModule': {'oversightHasDmc': False}, 'conditionsModule': {'keywords': ['Advance', 'Medtronic CoreValve System', 'International', 'Interventional', 'Post Market Study'], 'conditions': ['Severe Aortic Stenosis']}, 'referencesModule': {'references': [{'pmid': '28633375', 'type': 'DERIVED', 'citation': 'Gerckens U, Tamburino C, Bleiziffer S, Bosmans J, Wenaweser P, Brecker S, Guo J, Linke A. Final 5-year clinical and echocardiographic results for treatment of severe aortic stenosis with a self-expanding bioprosthesis from the ADVANCE Study. Eur Heart J. 2017 Sep 21;38(36):2729-2738. doi: 10.1093/eurheartj/ehx295.'}, {'pmid': '28484830', 'type': 'DERIVED', 'citation': 'Bleiziffer S, Bosmans J, Brecker S, Gerckens U, Wenaweser P, Tamburino C, Linke A; ADVANCE Study Investigators. Insights on mid-term TAVR performance: 3-year clinical and echocardiographic results from the CoreValve ADVANCE study. Clin Res Cardiol. 2017 Oct;106(10):784-795. doi: 10.1007/s00392-017-1120-3. Epub 2017 May 8.'}, {'pmid': '26892451', 'type': 'DERIVED', 'citation': 'Brecker SJ, Bleiziffer S, Bosmans J, Gerckens U, Tamburino C, Wenaweser P, Linke A; ADVANCE Study Investigators. Impact of Anesthesia Type on Outcomes of Transcatheter Aortic Valve Implantation (from the Multicenter ADVANCE Study). Am J Cardiol. 2016 Apr 15;117(8):1332-8. doi: 10.1016/j.amjcard.2016.01.027. Epub 2016 Jan 28.'}, {'pmid': '26762727', 'type': 'DERIVED', 'citation': 'Barbanti M, Schiltgen M, Verdoliva S, Bosmans J, Bleiziffer S, Gerckens U, Wenaweser P, Brecker S, Gulino S, Tamburino C, Linke A; ADVANCE Study Investigators. Three-Year Outcomes of Transcatheter Aortic Valve Implantation in Patients With Varying Levels of Surgical Risk (from the CoreValve ADVANCE Study). Am J Cardiol. 2016 Mar 1;117(5):820-7. doi: 10.1016/j.amjcard.2015.11.066. Epub 2015 Dec 13.'}, {'pmid': '26184612', 'type': 'DERIVED', 'citation': 'Bosmans J, Bleiziffer S, Gerckens U, Wenaweser P, Brecker S, Tamburino C, Linke A; ADVANCE Study Investigators. The Incidence and Predictors of Early- and Mid-Term Clinically Relevant Neurological Events After Transcatheter Aortic Valve Replacement in Real-World Patients. J Am Coll Cardiol. 2015 Jul 21;66(3):209-217. doi: 10.1016/j.jacc.2015.05.025.'}]}, 'descriptionModule': {'briefSummary': 'The CoreValve Advance study is intended to evaluate the clinical utility of the Medtronic CoreValve System in a "Real-World" patient population.', 'detailedDescription': 'The CoreValve Advance study is intended to evaluate the clinical utility of the Medtronic CoreValve System for percutaneous aortic valve implantation in a "Real-World" patient population with severe aortic valve stenosis. Data collected in this study will provide additional information on the understanding of the safety and device performance and how to best treat elderly patients with severe aortic valve stenosis. In addition, health economic data will be collected to understand the improvement of quality of life and the cost effectiveness of the therapy.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'minimumAge': '18 Years', 'samplingMethod': 'NON_PROBABILITY_SAMPLE', 'studyPopulation': 'patients with severe aortic valve stenosis requiring treatment, who are selected to be treated electively with the Medtronic CoreValve System', 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* Patients with severe aortic valve stenosis requiring treatment\n* Patient is an acceptable candidate for elective treatment with the Medtronic CoreValve System and in conformity with the local regulatory and medico economical context\n* Patient is above the minimum age as required by local regulations to be participating in a clinical study\n* The patient or legal representative has been informed of the nature of the study and has consented to participate, and has authorized the collection and release of his/her medical information by signing a consent form ("Patient Informed Consent Form")\n\nExclusion Criteria:\n\n* Currently participating in another trial\n* High probability of non-adherence to the follow-up requirements (due to social, psychological or medical reasons)\n* Pregnancy'}, 'identificationModule': {'nctId': 'NCT01074658', 'briefTitle': 'CoreValve Advance International Post Market Study', 'organization': {'class': 'INDUSTRY', 'fullName': 'Medtronic Cardiovascular'}, 'officialTitle': 'CoreValve Advance International Post Market Study: Evaluation of the Medtronic CoreValve System in a "Real-World" Patient Population.', 'orgStudyIdInfo': {'id': 'Advance'}}, 'armsInterventionsModule': {'armGroups': [{'label': 'severe aortic valve stenosis', 'description': 'elderly patients with severe aortic valve stenosis requiring treatment', 'interventionNames': ['Device: Medtronic CoreValve System']}], 'interventions': [{'name': 'Medtronic CoreValve System', 'type': 'DEVICE', 'description': 'Transcatheter Aortic Valve Implantation of the Medtronic CoreValve System', 'armGroupLabels': ['severe aortic valve stenosis']}]}, 'contactsLocationsModule': {'locations': [{'zip': '2020', 'city': 'Antwerp', 'country': 'Belgium', 'facility': 'ZNA Antwerpen Middelheim', 'geoPoint': {'lat': 51.22047, 'lon': 4.40026}}, {'zip': '2650', 'city': 'Antwerp', 'country': 'Belgium', 'facility': 'Antwerpen UZA', 'geoPoint': {'lat': 51.22047, 'lon': 4.40026}}, {'zip': '4000', 'city': 'Liège', 'country': 'Belgium', 'facility': 'CHU Sart Tillman', 'geoPoint': {'lat': 50.63373, 'lon': 5.56749}}, {'city': 'Cali', 'country': 'Colombia', 'facility': 'Angiografia de Occidente', 'geoPoint': {'lat': 3.43054, 'lon': -76.5199}}, {'zip': 'DK2100', 'city': 'Copenhagen', 'country': 'Denmark', 'facility': 'Rigshospitalet', 'geoPoint': {'lat': 55.67594, 'lon': 12.56553}}, {'zip': '94010', 'city': 'Créteil', 'country': 'France', 'facility': 'Hopital Henri Mondor', 'geoPoint': {'lat': 48.79266, 'lon': 2.46569}}, {'zip': '59037', 'city': 'Lille', 'country': 'France', 'facility': 'Hopital Cardiologique', 'geoPoint': {'lat': 50.63391, 'lon': 3.05512}}, {'zip': '69677', 'city': 'Lyon', 'country': 'France', 'facility': 'Hopital Louis Pradel', 'geoPoint': {'lat': 45.74906, 'lon': 4.84789}}, {'zip': '91300', 'city': 'Massy', 'country': 'France', 'facility': 'Institut Hospitalier Jacques Cartier', 'geoPoint': {'lat': 48.72692, 'lon': 2.28301}}, {'zip': '75013', 'city': 'Paris', 'country': 'France', 'facility': 'Groupe Hospitalier Pitie-Salpetriere', 'geoPoint': {'lat': 48.85341, 'lon': 2.3488}}, {'zip': '31076', 'city': 'Toulouse', 'country': 'France', 'facility': 'Clinique Pasteur', 'geoPoint': {'lat': 43.60426, 'lon': 1.44367}}, {'zip': '52057', 'city': 'Aachen', 'country': 'Germany', 'facility': 'Universitätsklinikum Aachen', 'geoPoint': {'lat': 50.77664, 'lon': 6.08342}}, {'zip': '16321', 'city': 'Bernau B. Berlin', 'country': 'Germany', 'facility': 'Bernau Herzzentrum Brandenburg'}, {'zip': '60389', 'city': 'Frankfurt', 'country': 'Germany', 'facility': 'CardioVascular Center Frankfurt', 'geoPoint': {'lat': 49.68333, 'lon': 10.53333}}, {'zip': '20099', 'city': 'Hamburg', 'country': 'Germany', 'facility': 'Asklepios Klinik St. Georg Hamburg', 'geoPoint': {'lat': 53.55073, 'lon': 9.99302}}, {'zip': '04289', 'city': 'Leipzig', 'country': 'Germany', 'facility': 'Universitat Leipzig Herzzentrum', 'geoPoint': {'lat': 51.33962, 'lon': 12.37129}}, {'zip': '80636', 'city': 'München', 'country': 'Germany', 'facility': 'Deutsches Herzzentrum Munchen', 'geoPoint': {'lat': 51.60698, 'lon': 13.31243}}, {'zip': '53721', 'city': 'Siegburg', 'country': 'Germany', 'facility': 'Helios Herzzentrum Siegburg Gmbh', 'geoPoint': {'lat': 50.80019, 'lon': 7.20769}}, {'zip': '17674', 'city': 'Athens', 'country': 'Greece', 'facility': 'Onassis cardiac surgery center', 'geoPoint': {'lat': 37.98376, 'lon': 23.72784}}, {'zip': '91120', 'city': 'Jerusalem', 'country': 'Israel', 'facility': 'Hadassah Medical Center', 'geoPoint': {'lat': 31.76904, 'lon': 35.21633}}, {'zip': '52621', 'city': 'Tel Aviv', 'country': 'Israel', 'facility': 'Sheba Medical Center', 'geoPoint': {'lat': 32.08088, 'lon': 34.78057}}, {'zip': '64239', 'city': 'Tel Aviv', 'country': 'Israel', 'facility': 'Ichilov Medical Center', 'geoPoint': {'lat': 32.08088, 'lon': 34.78057}}, {'zip': '25123', 'city': 'Brescia', 'country': 'Italy', 'facility': 'Azienda Ospedaliere Spedali Civili di Brescia', 'geoPoint': {'lat': 45.53558, 'lon': 10.21472}}, {'zip': '95024', 'city': 'Catania', 'country': 'Italy', 'facility': 'Policlinico Vittorio Emanuele, P.O. 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