OBJECTIVES: This study sought to present the U.K. experience to date with the second-generation LOTUS bioprosthesis (Boston Scientific, Natick, Massachusetts). BACKGROUND: First-generation transcatheter aortic valves have limitations. Second-generation repositionable valves may improve on some of those limitations. METHODS: Prospectively collected data relating to procedural and in-hospital outcome was analyzed from 10 implantation centers in the United Kingdom. RESULTS: Implants in 228 patients age 81.4 ± 7.6 years were studied; 53.5% were male. Mean logistic EuroScore was 17.5 ± 12.4. One hundred eighty-seven (82.0%) were undertaken for aortic stenosis, 7 (3.1%) for aortic regurgitation, and 34 (14.9%) for mixed aortic valve disease. A total of 67.1% of cases were done under local anesthetic and/or sedation with transfemoral access in 94.7% and transaortic in 5.3%. Three device sizes were used: 23 mm (n = 66, 28.9%), 25 mm (n = 39, 17.1%), and 27 mm (n = 123, 53.9%). The valve was successfully deployed in 99.1% of procedures. After implantation, the mean aortic gradient was 11.4 ± 5.4 mm Hg and aortic valve area 1.6 ± 0.5 cm(2). In-hospital mortality was 1.8% (n = 4). Complications included cardiac tamponade (1.8%), conversion to sternotomy (1.3%), stroke (3.9%), vascular access-related (7.0%), and acute kidney injury (7.9%). The incidence of moderate/severe aortic regurgitation was 0.8% (n = 2). A total of 31.8% of patients required new permanent pacemaker implantation. CONCLUSIONS: This analysis represents the largest published series on use of the LOTUS valve. Outcomes using this valve are excellent. In-hospital mortality is very low. Complication rates are low, and the LOTUS valve improves on first-generation valves, particularly with regard to residual aortic regurgitation.
OBJECTIVES: This study sought to present the U.K. experience to date with the second-generation LOTUS bioprosthesis (Boston Scientific, Natick, Massachusetts). BACKGROUND: First-generation transcatheter aortic valves have limitations. Second-generation repositionable valves may improve on some of those limitations. METHODS: Prospectively collected data relating to procedural and in-hospital outcome was analyzed from 10 implantation centers in the United Kingdom. RESULTS: Implants in 228 patients age 81.4 ± 7.6 years were studied; 53.5% were male. Mean logistic EuroScore was 17.5 ± 12.4. One hundred eighty-seven (82.0%) were undertaken for aortic stenosis, 7 (3.1%) for aortic regurgitation, and 34 (14.9%) for mixed aortic valve disease. A total of 67.1% of cases were done under local anesthetic and/or sedation with transfemoral access in 94.7% and transaortic in 5.3%. Three device sizes were used: 23 mm (n = 66, 28.9%), 25 mm (n = 39, 17.1%), and 27 mm (n = 123, 53.9%). The valve was successfully deployed in 99.1% of procedures. After implantation, the mean aortic gradient was 11.4 ± 5.4 mm Hg and aortic valve area 1.6 ± 0.5 cm(2). In-hospital mortality was 1.8% (n = 4). Complications included cardiac tamponade (1.8%), conversion to sternotomy (1.3%), stroke (3.9%), vascular access-related (7.0%), and acute kidney injury (7.9%). The incidence of moderate/severe aortic regurgitation was 0.8% (n = 2). A total of 31.8% of patients required new permanent pacemaker implantation. CONCLUSIONS: This analysis represents the largest published series on use of the LOTUS valve. Outcomes using this valve are excellent. In-hospital mortality is very low. Complication rates are low, and the LOTUS valve improves on first-generation valves, particularly with regard to residual aortic regurgitation.
Authors: Thomas Pilgrim; Stefan Stortecky; Fabian Nietlispach; Dik Heg; David Tueller; Stefan Toggweiler; Enrico Ferrari; Stéphane Noble; Francesco Maisano; Raban Jeger; Marco Roffi; Jürg Grünenfelder; Christoph Huber; Peter Wenaweser; Stephan Windecker Journal: J Am Heart Assoc Date: 2016-11-17 Impact factor: 5.501
Authors: Thomas Pilgrim; Joe K T Lee; Crochan J O'Sullivan; Stefan Stortecky; Sara Ariotti; Anna Franzone; Jonas Lanz; Dik Heg; Masahiko Asami; Fabien Praz; George C M Siontis; René Vollenbroich; Lorenz Räber; Marco Valgimigli; Eva Roost; Stephan Windecker Journal: Open Heart Date: 2018-01-20
Authors: Mirosław Gozdek; Jakub Ratajczak; Adam Arndt; Kamil Zieliński; Michał Pasierski; Matteo Matteucci; Dario Fina; Federica Jiritano; Paolo Meani; Giuseppe Maria Raffa; Pietro Giorgio Malvindi; Michele Pilato; Domenico Paparella; Artur Słomka; Uri Landes; Ran Kornowski; Jacek Kubica; Roberto Lorusso; Piotr Suwalski; Mariusz Kowalewski Journal: J Thorac Dis Date: 2020-03 Impact factor: 3.005
Authors: Roberto Scarsini; Giovanni L De Maria; Jubin Joseph; Lampson Fan; Thomas J Cahill; Rafail A Kotronias; Francesco Burzotta; James D Newton; Rajesh Kharbanda; Bernard Prendergast; Flavio Ribichini; Adrian P Banning Journal: J Am Heart Assoc Date: 2019-09-14 Impact factor: 5.501