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BACKGROUND / PURPOSE: The Lotus valve (Boston Scientific, Natick, MA, USA) is a contemporary transcatheter aortic valve implantation (TAVI) device that is fully repositionable and retrievable to aid implantation and optimise procedural results. The ability to implant the device without routine pre-dilatation is another possible advantage reducing associated risks and procedure times. The aim of this study is to report procedural and 30-day outcomes following TAVI in a consecutive patient group presenting with severe symptomatic aortic stenosis with the Lotus valve system without routine pre-dilatation. METHODS / MATERIALS: 146 consecutive patients that underwent TAVI at the John Radcliffe Hospital, Oxford between January 2015 - December 2016 were retrospectively analysed. RESULTS: The mean age was 81.1±7.4 years and the mean logistic EuroSCORE was 14.6±10. 134 (91.8%) of patients were treated under conscious sedation. 144 (98.6%) of procedures were successful. Two patients (1.4%) died during the follow-up period. None or mild residual aortic regurgitation was achieved in 98.6% of patients. The mean and peak transvalvular gradients were 8.6±3.6mmHg and 16.6±6.6mmHg respectively. Eight patients (5.5%) suffered a stroke. Over time, there was a reduction in major vascular complications (14.3% vs. 2.2%, p=0.03) and a trend toward shorter procedure times (97.6±44.3 vs. 86.8±31.4 minutes, p=0.14) and the administration of less contrast (104.4±45.2 vs. 91.7±37.6 millilitres, p=0.16). The overall new pacemaker implantation rate was 36.3%. CONCLUSIONS: The use of the Lotus valve as a 'workhorse' device without routine pre-dilatation is safe and efficacious and is associated with a very low incidence of residual aortic regurgitation and acceptable transvalvular haemodynamics.

Original publication




Journal article


Cardiovasc Revasc Med

Publication Date





78 - 82


Aortic stenosis, Lotus, transcatheter aortic valve implantation, transfemoral, Aged, Aged, 80 and over, Aortic Valve, Aortic Valve Stenosis, Cardiac Pacing, Artificial, Catheterization, Peripheral, England, Female, Femoral Artery, Heart Valve Prosthesis, Hemodynamics, Humans, Male, Operative Time, Pacemaker, Artificial, Postoperative Complications, Prosthesis Design, Punctures, Retrospective Studies, Risk Factors, Time Factors, Transcatheter Aortic Valve Replacement, Treatment Outcome