Transcatheter Aortic Valve Replacement With the LOTUS Edge System: Early European Experience.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Armario Xavier, Rosseel Liesbeth, Kharbanda Rajesh, Khogali Saib, Abdel-Wahab Mohamed, Van Mieghem Nicolas M, Tchétché Didier, Dumonteil Nicolas, De Backer Ole, Cotton James, McGrath Brian, Balakrishnan Deepu, Ali Noman, Farhan Serdar, Joseph Jubin, Charbonnier Gaetan, Okuno Taishi, McHugh Fiachra, Hildick-Smith David, Gilgen Nicole, Hokken Thijmen, Spence Mark S, Frerker Christian, Angelillis Marco, Grygier Marek, Cockburn James, Bjursten Henrik, Jeger Raban V, Teles Rui, Petronio Anna S, Pilgrim Thomas, Sinning Jan-Malte, Nickenig Georg, Søndergaard Lars, Blackman Daniel J, Mylotte Darren
Аннотация
BACKGROUND: The LOTUS Edge system was commercially re-released in April 2019. The authors report the first European experience with this device.
METHODS: A multicenter, single-arm, retrospective registry was initiated to evaluate short-term clinical outcomes. Included cases are the first experience with this device and new implantation technique in Europe. Clinical, echocardiographic, and computed tomographic data were analyzed. Endpoints were defined according to Valve Academic Research Consortium-2 and were site reported.
RESULTS: Between April and November 2019, 286 consecutive patients undergoing TAVR with the LOTUS Edge system at 18 European centers were included. The mean age and Society of Thoracic Surgeons score were 81.2 ± 6.9 years and 5.2 ± 5.4%, respectively. Nearly one-half of all patients (47.9%) were considered to have complex anatomy. Thirty-day major adverse events included death (2.4% [n = 7]) and stroke (3.5% [n = 10]). After TAVR, the mean aortic valve area was 1.9 ± 0.9 cm2, and the mean transvalvular gradient was 11.9 ± 5.7 mm Hg. None or trace paravalvular leak (PVL) occurred in 84.4% and moderate PVL in 2.0%. There were no cases of severe PVL. New permanent pacemaker (PPM) implantation was required in 25.9% among all patients and 30.8% among PPM-naive patients.
CONCLUSIONS: Early experience with the LOTUS Edge system demonstrated satisfactory short-term safety and efficacy, favorable hemodynamic data, and very low rates of PVL in an anatomically complex cohort. New PPM implantation remained high. Further study will evaluate if increasing operator experience with the device and new implantation technique can reduce the incidence of PPM implantation.