This work represents the UK experience with the second generation repositionable and retrievable valve Lotus (Boston Scientific, Natick, Massachusetts).
It prospectively included 228 patients of mean age 81.4 ± 7.6 and a logistic EuroScore of 17.5 ± 12.4.
From the total number of patients, 187 (82%) received the valve for aortic stenosis, 7 (3.1%) for pure aortic regurgitation and 34 (14.9%) for a combination of stenosis and regurgitation.
The femoral was the most common access site (94.7%) and more than half of patients had local anesthesia in addition to a light sedation.
Three valve sizes were used: 23 mm (n=66, 28.9%), 25 mm (n=39, 17.1%) and 27 mm (n=123, 53.9%).
The device was successfully implanted in 99.1% of procedure, with a mean gradient of 11.4 ± 5.4 mmHg and a valve area of 1.6 ± 0.5 cm2.
In-hospital death was 1.8% (n=4); other complications included cardiac tamponade (1.8%), conversion to sternotomy (1.3%), stroke (3.9%), vascular complications (7%) and acute kidney failure (7.9%).
The incidence of moderate to severe aortic regurgitation was 0.8% (n=2) and 31.8% of the population required a definite pacemaker.
Conclusion
This analysis represents the largest series published so far with the LOTUS valve, with very good results, particularly the low rate of aortic regurgitation.
Image: Boston Scientific
Original Title: Transcatheter Aortic Valve Replacement Using the Repositionable LOTUS Valve. United Kingdom Experience.
Reference: Rajiv Rampat et al. J Am Coll Cardiol Intv. 2016;9(4):367-372.
Subscribe to our weekly newsletter
Get the latest scientific articles on interventional cardiology
We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.