Aortic valve insufficiency
MONDO:0005648Dysfunction of the aortic valve characterized by incomplete valve closure.
Also known as: aortic insufficiency, rheumatic aortic insufficiency, rheumatic aortic regurgitation
108 clinical trials for this condition and its sub-types.
Follow this condition — get notified about new trialsSub-types
Broader categories
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New heart valve procedure could offer safer alternative to Open-Heart surgery for seniors
Disease control Recruiting nowThis study tests whether a newer, less invasive procedure called transcatheter aortic valve replacement (TAVR) using the J-VALVE device is as safe and effective as traditional open-heart surgery for people with severe aortic regurgitation (a leaky heart valve). About 1,250 adults…
Phase: NA • Sponsor: Second Affiliated Hospital, Zhejiang University, School of Medicine • Aim: Disease control
Last updated Aug 14, 2026 00:00 UTC
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Heart valve study seeks best blood thinner to prevent clots and bleeding
Disease control Recruiting nowThis study tests two blood-thinning strategies in people with severe aortic regurgitation who have had a new heart valve placed without open surgery. Participants receive either daily aspirin for a year or warfarin for six months followed by aspirin. The goal is to see which appr…
Phase: NA • Sponsor: Shanghai Zhongshan Hospital • Aim: Disease control
Last updated Aug 12, 2026 00:00 UTC
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New heart valve under 10-Year watch: will it last?
Disease control Recruiting nowThis registry will follow 500 adults with severe aortic stenosis who receive a SAPIEN 3 Ultra Resilia heart valve through a minimally invasive procedure. Researchers will track how well the valve works and how safe it is over 10 years. The goal is to see if this newer valve desig…
Sponsor: Institut für Pharmakologie und Präventive Medizin • Aim: Disease control
Last updated Aug 01, 2026 00:00 UTC
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New device aims to make aortic surgery safer
Disease control Recruiting nowThis study tests a new device called Rapidlink, used during open surgery to repair or replace blood vessels in the chest. It involves 150 adults already scheduled for aortic surgery. The goal is to see if the device reduces major complications like stroke or death. Participants w…
Phase: NA • Sponsor: Vascutek Ltd. • Aim: Disease control
Last updated Jul 29, 2026 00:00 UTC
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New heart valve could offer lifeline for patients with failing artificial valves
Disease control Recruiting nowThis study is testing a new heart valve called the SAPIEN X4 in 200 people whose existing artificial aortic valve is failing. The valve is placed using a thin tube through an artery, avoiding open-heart surgery. The goal is to see if it is safe and effective at improving survival…
Phase: NA • Sponsor: Edwards Lifesciences • Aim: Disease control
Last updated Jul 29, 2026 00:00 UTC
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New heart valve procedure could offer a gentler option for leaky valve patients
Disease control Recruiting nowThis study tests a new, less invasive way to replace a leaky aortic heart valve (aortic regurgitation) using a device called the JenaValve Trilogy, compared to standard open-heart surgery. About 1,000 people with moderate to severe aortic regurgitation will be randomly assigned t…
Phase: NA • Sponsor: JenaValve Technology, Inc. • Aim: Disease control
Last updated Jul 09, 2026 00:00 UTC
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New blood thinner may simplify life after valve replacement
Disease control Recruiting nowThis study tests whether a newer blood thinner (rivaroxaban) works as well as the standard drug (warfarin) for preventing clots and bleeding in people who have a mechanical aortic valve. About 1,300 adults who had valve surgery at least 3 months ago will take one of the two pills…
Phase: PHASE4 • Sponsor: Joon Bum Kim • Aim: Disease control
Last updated Jul 08, 2026 00:00 UTC
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Heart valve patients may ditch blood thinners for simple aspirin
Disease control Recruiting nowThis study compares aspirin to the blood thinner warfarin in 1058 people who just had a bioprosthetic heart valve replacement. For 6 months after surgery, participants take either daily aspirin or warfarin. The goal is to see if aspirin is just as safe and effective at preventing…
Phase: PHASE4 • Sponsor: Asan Medical Center • Aim: Disease control
Last updated Jul 08, 2026 00:00 UTC
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New heart valve design aims to simplify replacements and cut risks
Disease control Recruiting nowThis study is testing a new type of biological heart valve that features an 'easy change' system, designed to make future replacements simpler. Researchers will implant these valves in 500 people with aortic valve disease and track complications like blood clots, infections, and …
Phase: NA • Sponsor: Tomsk National Research Medical Center of the Russian Academy of Sciences • Aim: Disease control
Last updated Jun 28, 2026 00:00 UTC
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New stomach drug could shield heart patients from bleeding
Disease control Recruiting nowThis study compares two stomach-acid-lowering drugs—tegoprazan and rabeprazole—in about 3,300 heart disease patients who take blood thinners and are at high risk for stomach bleeding. The goal is to see if tegoprazan works as well as rabeprazole at preventing serious gut problems…
Phase: PHASE4 • Sponsor: Duk-Woo Park, MD • Aim: Disease control
Last updated Jun 28, 2026 00:00 UTC
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Heart valve showdown: which replacement works best for failed surgical valves?
Disease control Recruiting nowThis study compares two different devices (Allegra and Sapien) used to replace a failing surgically implanted aortic heart valve without open-heart surgery. About 104 adults with a deteriorated biological aortic valve will be randomly assigned to get one of the two devices. The m…
Phase: NA • Sponsor: Fundación EPIC • Aim: Disease control
Last updated Jun 27, 2026 14:00 UTC
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Registry tracks graft performance in 1,200 artery patients
Disease control Recruiting nowThis study follows 1,200 people who received special fabric tubes (grafts) to repair or replace damaged arteries in the neck, belly, or legs. Researchers want to see how well the grafts work over time and how often problems like blockages or infections happen. It is an observatio…
Sponsor: Intervascular • Aim: Disease control
Last updated Jun 27, 2026 14:00 UTC
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New study aims to cut unnecessary pacemakers after heart valve procedure
Disease control Recruiting nowThis study tests a pre-set treatment plan for managing heart rhythm issues that can occur after transcatheter aortic valve replacement (TAVR). The goal is to reduce the number of patients who receive a permanent pacemaker while ensuring no one is put at risk of sudden cardiac dea…
Sponsor: Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Quebec • Aim: Disease control
Last updated Jun 27, 2026 13:02 UTC
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New device aims to catch surgical debris, prevent stroke and kidney damage
Disease control Recruiting nowThis trial tests a special cannula that captures debris during high-risk heart valve surgery. The goal is to see if it reduces the chance of stroke, kidney injury, and delirium. About 842 patients aged 60 and older will be randomly assigned to receive either the new device or a s…
Phase: NA • Sponsor: Icahn School of Medicine at Mount Sinai • Aim: Disease control
Last updated Jun 27, 2026 13:00 UTC
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New app could bring heart rehab home for valve patients
Disease control Recruiting nowThis study tests a home-based cardiac rehabilitation program delivered through a custom app for people who have had a heart valve procedure. Participants who choose not to attend center-based rehab are randomly assigned to usual care, the app with self-guided content, or the app …
Phase: NA • Sponsor: Vanderbilt University Medical Center • Aim: Disease control
Last updated Jun 27, 2026 12:32 UTC
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New valve device could fix leaky heart valve without open surgery
Disease control Recruiting nowThis study is testing a new device called the J-Valve, which is a replacement heart valve delivered through a tube in the leg, to treat severe aortic regurgitation (a leaky heart valve). The trial will include 194 people with severe symptoms who are at high risk for open-heart su…
Phase: NA • Sponsor: JC Medical, Inc., an affiliate of Edwards Lifesciences LLC • Aim: Disease control
Last updated Jun 27, 2026 12:28 UTC
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Heart valve surgery study tracks patient survival over a decade
Disease control Recruiting nowThis study follows 225 adults who have the Ross procedure, a surgery that replaces a diseased aortic valve with the patient's own pulmonary valve. Researchers will track survival, hospital readmissions, and need for repeat surgeries over 1, 5, and 10 years. The goal is to confirm…
Sponsor: Baylor Research Institute • Aim: Disease control
Last updated Jun 27, 2026 12:08 UTC
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New heart valve implant could offer hope for leaky aortic valve patients
Disease control Recruiting nowThis study compares a new, less invasive heart valve implant (TAVR) with standard medication for people who have severe aortic regurgitation, a condition where the heart's aortic valve doesn't close properly. The trial will enroll 210 participants across multiple centers. The goa…
Phase: NA • Sponsor: Nanjing First Hospital, Nanjing Medical University • Aim: Disease control
Last updated Jun 27, 2026 12:05 UTC
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Shockwave therapy opens hardened arteries for Life-Saving aortic repair
Disease control Recruiting nowThis study tests a special balloon that uses shockwaves to crack calcium buildup in the iliac arteries, making it possible to deliver large aortic stents. About 40 adults with severe aortic disease and hardened arteries will be enrolled. The goal is to see if this approach is saf…
Sponsor: EndoCore Lab s.r.l. • Aim: Disease control
Last updated Jun 27, 2026 12:00 UTC
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Should you fix a leaky heart valve early? new study seeks answers
Disease control Recruiting nowThis study looks at whether early surgery to repair or replace the aortic valve is better than waiting until symptoms appear in people with severe aortic regurgitation (a leaky heart valve). About 217 adults with no symptoms but severe valve leakage will be randomly assigned to e…
Phase: NA • Sponsor: Na Homolce Hospital • Aim: Disease control
Last updated Jun 27, 2026 09:06 UTC
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New heart valve procedure could help patients with leaky aortic valve
Disease control Recruiting nowThis study tests a new way to replace the aortic valve in people with severe aortic regurgitation (a leaky heart valve). About 180 patients will get either the new VitaFlow valve or another device through a tube in the leg. The goal is to see if the new valve is safe and effectiv…
Phase: PHASE4 • Sponsor: Ruijin Hospital • Aim: Disease control
Last updated Jun 27, 2026 09:00 UTC
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New 'Y Incision' heart surgery could let doctors fit larger valves in small hearts
Disease control Recruiting nowThis study tests a new surgical technique called the 'Y incision' for people with a small aortic annulus (the ring where the heart valve sits) who need aortic valve replacement. The standard methods often limit how large a replacement valve can be placed, which can lead to poor b…
Phase: NA • Sponsor: willner nadav MD • Aim: Disease control
Last updated Jun 27, 2026 08:14 UTC
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New valve offers hope for leaky heart patients too frail for surgery
Disease control Recruiting nowThis study is testing a device called JenaValve Trilogy to replace the aortic valve without open-heart surgery in 75 people with severe aortic regurgitation (a leaky heart valve). Participants are at high risk for surgery. The main goal is to see if the device works safely and st…
Sponsor: IRCCS Policlinico S. Donato • Aim: Disease control
Last updated Jun 27, 2026 08:07 UTC
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New trial aims to standardize heart valve repair for common birth defect
Disease control Recruiting nowThis clinical trial is testing two different surgical methods to repair a bicuspid aortic valve, a common heart defect where the valve has two flaps instead of three. The study will enroll 100 people with this condition who also have a leaky valve (aortic regurgitation). Half wil…
Phase: NA • Sponsor: University Hospital Augsburg • Aim: Disease control
Last updated Jun 27, 2026 07:53 UTC
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Blood test could predict clot risk after heart valve surgery
Diagnosis Recruiting nowThis study investigates whether a blood test measuring clotting and clot-busting markers can predict complications in patients undergoing aortic valve replacement. Researchers will follow 750 adults with aortic stenosis who receive either surgical or catheter-based valve replacem…
Sponsor: East and North Hertfordshire NHS Trust • Aim: Diagnosis
Last updated Jul 17, 2026 00:00 UTC
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Blood test may replace anesthesia for heart valve fix
Diagnosis Recruiting nowThis study tests whether a quick blood test (CT-ADP) can help doctors detect and fix leaks around a new heart valve during a minimally invasive TAVI procedure. Currently, doctors often use general anesthesia and an ultrasound probe in the throat to check for leaks, but this study…
Phase: NA • Sponsor: University Hospital, Lille • Aim: Diagnosis
Last updated Jun 27, 2026 12:37 UTC
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AI spots hidden heart valve disease in routine scans
Diagnosis Recruiting nowThis study tests an artificial intelligence (AI) model that can screen for heart valve disease using standard chest CT scans that people already get for other reasons. The goal is to see how well the AI catches moderate-to-severe cases without needing extra tests or contrast dye.…
Sponsor: Second Affiliated Hospital, School of Medicine, Zhejiang University • Aim: Diagnosis
Last updated Jun 27, 2026 12:31 UTC
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AI stethoscope could spot heart valve trouble in minutes
Diagnosis Recruiting nowThis study tests whether a portable electronic stethoscope, combined with machine learning, can accurately detect valvular heart disease. About 125 people with and without the condition will use the device and also receive standard heart tests. Researchers will compare the device…
Sponsor: The University of Hong Kong • Aim: Diagnosis
Last updated Jun 27, 2026 12:29 UTC
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Heart vibration tech could spot aortic disease without scans
Diagnosis Recruiting nowThis study explores whether kinocardiography (KCG), a portable device that measures chest vibrations from heartbeats, can diagnose aortic valve disease and thoracic aortic aneurysm. Researchers will compare KCG readings with standard imaging in 180 adults, including those with an…
Sponsor: Université Libre de Bruxelles • Aim: Diagnosis
Last updated Jun 27, 2026 12:28 UTC
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New heart monitor could spot hidden danger after valve surgery
Diagnosis Recruiting nowThis study is testing whether a small implantable heart monitor (Reveal LINQ) can detect serious heart block in people who develop a new electrical problem (left bundle branch block) after having their aortic valve replaced (TAVI). About 80 participants will get the monitor and b…
Phase: NA • Sponsor: Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Quebec • Aim: Diagnosis
Last updated Jun 27, 2026 12:00 UTC
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AI takes on heart valve diagnosis: could it beat the experts?
Diagnosis Recruiting nowThis study tests whether an artificial intelligence (AI) tool can diagnose aortic regurgitation—a leaky heart valve—more accurately than standard manual methods. About 540 adults with confirmed aortic regurgitation will be randomly assigned to either AI-assisted or traditional di…
Phase: NA • Sponsor: Chinese University of Hong Kong • Aim: Diagnosis
Last updated Jun 27, 2026 11:03 UTC
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Can MRI beat ultrasound for heart valve diagnosis?
Diagnosis Recruiting nowThis study compares two heart imaging methods—echocardiography (ultrasound) and cardiac MRI—to see which measures heart valve disease more accurately. Researchers will enroll 200 adults with suspected moderate or severe valve problems. The goal is to improve how doctors assess va…
Sponsor: The Cleveland Clinic • Aim: Diagnosis
Last updated Jun 27, 2026 08:10 UTC
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Simple dental exam before heart surgery may prevent deadly infections
Prevention Recruiting nowThis study is testing whether having a dental checkup before heart valve surgery can prevent serious complications like infection of the heart lining, repeat surgery, or death. About 1,300 adults scheduled for valve surgery will be randomly assigned to either get a dental screeni…
Phase: NA • Sponsor: Region Skane • Aim: Prevention
Last updated Jun 27, 2026 12:35 UTC
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Virtual reality and scents could replace opioids for surgery pain
Symptom relief Recruiting nowThis study tests whether combining virtual reality with pleasant smells can lower pain and anxiety in people recovering from heart or lung surgery. About 80 adults scheduled for cardiothoracic surgery will either receive the VR-and-scent therapy or standard care. The goal is to s…
Phase: NA • Sponsor: Massachusetts General Hospital • Aim: Symptom relief
Last updated Jun 27, 2026 09:07 UTC
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Heart device registry launches to monitor safety in routine care
Knowledge-focused Recruiting nowThis registry will follow 2,500 people who receive Abbott heart devices, such as implants for holes in the heart or replacement heart valves. The goal is to check how safe and effective these devices are when used in everyday hospital practice. Data will be collected from standar…
Sponsor: Abbott Medical Devices • Aim: Knowledge-focused
Last updated Jul 11, 2026 00:00 UTC
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New heart valve registry tracks Long-Term performance
Knowledge-focused Recruiting nowThis study is tracking 500 people who receive the INSPIRIS RESILIA aortic valve during surgery. Researchers will measure how well the valve works by checking blood flow and leakage over time. The goal is to see how the valve performs in everyday medical practice.
Sponsor: Edwards Lifesciences • Aim: Knowledge-focused
Last updated Jun 27, 2026 14:01 UTC
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Heart valve study aims to predict who recovers best after surgery
Knowledge-focused Recruiting nowThis study at Mayo Clinic looks at how changes in the blood vessels of the lungs affect people with heart valve disease. Researchers will use echocardiograms during routine heart catheterization to measure these changes in 600 adults scheduled for valve procedures. The goal is to…
Sponsor: Mayo Clinic • Aim: Knowledge-focused
Last updated Jun 27, 2026 14:00 UTC
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Aortic disease study seeks to uncover hidden toll on work and Well-Being
Knowledge-focused Recruiting nowThis study tracks 300 adults with aortic disease to measure how their condition impacts quality of life, fatigue, mental health, and ability to work. Researchers will use questionnaires over 12 months to gather data. The goal is to better understand these challenges and help desi…
Sponsor: Fondazione Policlinico Universitario Agostino Gemelli IRCCS • Aim: Knowledge-focused
Last updated Jun 27, 2026 13:04 UTC
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New registry to monitor Long-Term success of keyhole heart valve treatments
Knowledge-focused Recruiting nowThis study is a registry that collects information from routine care to see how well minimally invasive heart valve procedures work over 5 years. It includes adults over 18 who have had a transcatheter aortic valve replacement or similar treatment. No new treatments are given; th…
Sponsor: Fondazione IRCCS Policlinico San Matteo di Pavia • Aim: Knowledge-focused
Last updated Jun 27, 2026 12:35 UTC
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Massive heart biobank aims to unlock secrets of aortic disease
Knowledge-focused Recruiting nowThis study is creating a large biobank of blood, DNA, plasma, and tissue samples from 15,000 people with and without heart and aortic diseases. Researchers will use this information to better understand conditions like aortic aneurysm, heart failure, and bicuspid aortic valve. Th…
Sponsor: University of Michigan • Aim: Knowledge-focused
Last updated Jun 27, 2026 12:24 UTC
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AI boosts heart valve diagnosis speed and accuracy
Knowledge-focused Recruiting nowThis study tests whether artificial intelligence (AI) can help cardiologists read echocardiograms (heart ultrasounds) more quickly and consistently. Researchers will give AI analysis to doctors in real time as they review heart images from 50 participants with valve disease. The …
Sponsor: Columbia University • Aim: Knowledge-focused
Last updated Jun 27, 2026 12:07 UTC
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Heart valve registry tracks Real-World device performance
Knowledge-focused Recruiting nowThis study is a registry that will follow up to 2,700 people who have received or will receive a Medtronic heart valve product during surgery. The goal is to monitor the long-term safety and performance of these devices by identifying any unexpected problems or trends. Participan…
Sponsor: Medtronic Cardiac Surgery • Aim: Knowledge-focused
Last updated Jun 27, 2026 12:06 UTC
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Heart valve showdown: which measurement method wins for TAVR patients?
Knowledge-focused Recruiting nowThis study compares two methods—ultrasound (echocardiography) versus direct pressure measurements (catheterization)—to guide additional balloon inflation after valve-in-valve TAVR. About 310 people with failing surgical aortic valves will be randomly assigned to one method. The g…
Phase: NA • Sponsor: Institut universitaire de cardiologie et de pneumologie de Québec, University Laval • Aim: Knowledge-focused
Last updated Jun 27, 2026 12:00 UTC
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Massive heart surgery study aims to uncover hidden risks
Knowledge-focused Recruiting nowThis study is reviewing medical records from 5,000 heart and blood vessel surgery patients to find factors that influence recovery and survival. Researchers are looking at data from 2001 to 2013 to identify what leads to complications or death after surgery. The goal is to improv…
Sponsor: University of California, Davis • Aim: Knowledge-focused
Last updated Jun 27, 2026 09:04 UTC
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Heart strain test may predict bypass weaning trouble
Knowledge-focused Recruiting nowThis study looks at whether a special heart ultrasound measurement, called global longitudinal strain (GLS), can predict if a person will have trouble coming off the heart-lung machine during heart surgery. About 213 adults having planned heart surgery will have their hearts meas…
Sponsor: Kartal Kosuyolu Yuksek Ihtisas Education and Research Hospital • Aim: Knowledge-focused
Last updated Jun 27, 2026 09:02 UTC
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Finger scanner aims to spot heart valve disease without needles
Knowledge-focused Recruiting nowThis observational study is testing whether a noninvasive finger imaging device can detect and evaluate two types of heart valve disease: aortic regurgitation and aortic stenosis. Researchers will record arterial waveforms from participants' fingers and see if the patterns can di…
Sponsor: Anhui Provincial Cancer Hospital • Aim: Knowledge-focused
Last updated Jun 27, 2026 08:13 UTC
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Heart valve disease: could Sex-Specific MRI scans predict better outcomes?
Knowledge-focused Recruiting nowThis study aims to find biological differences between men and women with heart valve disease using advanced MRI techniques. Researchers will enroll 200 adults with moderate to severe aortic or mitral valve problems. The goal is to better predict how the heart recovers after valv…
Sponsor: The Cleveland Clinic • Aim: Knowledge-focused
Last updated Jun 27, 2026 08:08 UTC
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10,000-Patient registry tracks TAVR outcomes worldwide
Knowledge-focused Recruiting nowThis study is a large registry that will follow 10,000 people who have had a procedure called TAVR to replace a faulty heart valve. The goal is to see how patients do over the long term in everyday medical practice. No new treatment is being tested; instead, researchers are colle…
Sponsor: Duk-Woo Park, MD • Aim: Knowledge-focused
Last updated Jun 27, 2026 08:08 UTC
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Hidden clots in the heart: new study aims to prevent second strokes
Knowledge-focused Recruiting nowThis observational study is testing whether advanced heart imaging (MRI or CT scans) can find blood clots in the heart that standard ultrasound might miss. It involves 125 people who had a stroke of unknown cause and have mild heart disease. The goal is to better understand strok…
Sponsor: Niguarda Hospital • Aim: Knowledge-focused
Last updated Jun 27, 2026 08:05 UTC
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10,000 patients join quest to unlock heart valve disease secrets
Knowledge-focused Recruiting nowThis study is following 10,000 adults with heart valve disease to see how their condition changes over time. Researchers will use scans, blood tests, and health records to track progression and the effects of treatments like surgery or medication. The goal is to better predict ou…
Sponsor: Second Affiliated Hospital, School of Medicine, Zhejiang University • Aim: Knowledge-focused
Last updated Jun 27, 2026 08:01 UTC
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AI could revolutionize heart valve surgery predictions
Knowledge-focused Recruiting nowThis study uses artificial intelligence to analyze data from 21,000 patients who had heart valve procedures. The goal is to make AI tools that can predict surgery outcomes, like which device to use and risks of complications, with over 90% accuracy. This is a non-interventional s…
Sponsor: Montreal Heart Institute • Aim: Knowledge-focused
Last updated Jun 27, 2026 07:54 UTC
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New registry aims to uncover gender gaps in heart valve care
Knowledge-focused Recruiting nowThis registry will track 800 adults with valvular heart disease to see if women and men receive different diagnosis, treatment, and follow-up care. Researchers will compare how quickly each group gets guideline-recommended therapies and whether gender, age, or ethnicity affect ou…
Sponsor: Valvular Heart Disease in Women Registry • Aim: Knowledge-focused
Last updated Jun 27, 2026 07:52 UTC
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Blood markers vs. MRI: a heart surgery showdown
Knowledge-focused Recruiting nowThis study looks at whether common blood tests for heart damage (troponin and CK-MB) match what an MRI shows after heart valve surgery. Researchers will enroll 100 adults having aortic or mitral valve surgery. The goal is to improve how heart attacks are diagnosed after surgery, …
Sponsor: Jena University Hospital • Aim: Knowledge-focused
Last updated Jun 27, 2026 07:52 UTC
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Large study aims to clarify risks for patients with mixed aortic valve disease
Knowledge-focused Recruiting nowThis observational study will follow 1900 people with moderate mixed aortic valve disease (a combination of aortic stenosis and regurgitation) to see how symptoms and heart function relate to survival and the need for valve replacement. Researchers hope to identify which patients…
Sponsor: Leiden University Medical Center • Aim: Knowledge-focused
Last updated Jun 26, 2026 17:14 UTC
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4,000-Patient study aims to uncover hidden causes of heart valve disease
Knowledge-focused Recruiting nowThis study is following 4,000 people with heart valve disease to look for new substances in the body (called metabolites) that might be linked to the disease. Researchers hope to find better ways to predict who will get worse and understand why. No new treatments are being tested…
Sponsor: Sun Yat-sen University • Aim: Knowledge-focused
Last updated Jun 26, 2026 13:11 UTC