Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis Using Lotus Valve System

Catheter Cardiovasc Interv. 2017 Jul;90(1):157-163. doi: 10.1002/ccd.26506. Epub 2016 Mar 31.

Abstract

Bicuspid aortic stenosis (BAS) has been excluded in clinical trials on transcatheter aortic valve replacement (TAVR) due to the presumed uneven expansion of the aortic prosthesis, leading to significant paravalvular regurgitation (PVR). There is no transcatheter heart valve (THV) commercially approved for treating BAS. The Lotus Valve System mitigates PVR by possessing an adaptive seal and being fully re-positionable. The latter is also important in preventing embolization, as the location of prosthesis fixation in BAS could be variable due to the presence of less expandable raphe. We report our early experience with the Lotus Valve System in three consecutive TAVR for BAS. They all provide good clinical and hemodynamic results without significant PVR. We conclude that the use of Lotus Valve System for treating BAS is feasible and safe, and may have advantages over the previous generation TAVR systems. © 2016 Wiley Periodicals, Inc.

Keywords: aortic valve disease; percutaneous intervention; transcatheter valve implantation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve / abnormalities*
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / physiopathology
  • Aortic Valve / surgery
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / etiology
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / surgery*
  • Aortography / methods
  • Bicuspid Aortic Valve Disease
  • Computed Tomography Angiography
  • Female
  • Heart Valve Diseases / complications
  • Heart Valve Diseases / diagnostic imaging
  • Heart Valve Diseases / physiopathology
  • Heart Valve Diseases / surgery*
  • Heart Valve Prosthesis*
  • Hemodynamics
  • Humans
  • Male
  • Prosthesis Design
  • Radiography, Interventional
  • Recovery of Function
  • Transcatheter Aortic Valve Replacement / instrumentation*
  • Treatment Outcome