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.

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