Comparison of valve performance of the mechanically expanding Lotus and the balloon-expanded SAPIEN3 transcatheter heart valves: an observational study with independent core laboratory analysis

Abstract

Overall, haemodynamic performance was comparable between the Lotus and SAPIEN3 valves. Lotus valve required less oversizing and was associated with less PAR than SAPIEN3.

A Longitudinal Echocardiographic Analysis of Patients Treated Using the Repositionable and Fully Retrievable Lotus Valve: A Sub-Analysis of the RESPOND Study

“…28 This difference in PVL in favor of the Lotus THV over other THVs such as the SAPIEN3 was seen in an earlier smaller study by our group. 15 This may reflect a better effect of the adaptive seal in combination with a denser configuration of the frame of the Lotus THV. Another important feature favoring the Lotus THV is repositionability that allows the operator to control and adjust the depth of implantation, consequently reducing or eliminating PVL.…”

“…In this study, as well as in a previous study by our group, 15 a rigorous core laboratory algorithm was used to assess the location and severity of PVL and included the VARC-2 Doppler and 2D echocardiographic parameters of PVL assessment as well as three novel Core Laboratory developed PARS scores, which are necessary for optimal PVL assessment. In particular, the PARS radial score proved to be important when PVL was not seen or difficult to quantify in the axial parasternal SAX view.…”

“…For PVL assessments, short-axis views were recorded at multiple levels in the parasternal window to ensure good interrogation of any PVL jet. PVL was adjudicated according to the Soliman's et al Core Laboratory protocol that was described in detail elsewhere 15 along with current guidelines 13,[16][17][18] in brief, the presence, location (central, paravalvular and total) of AR jets were first assessed. Since central post-TAVR AR is uncommon, this paper focuses on PVL.…”

“…Quantification of PVL was performed according to the Paravalvular Aortic Regurgitation Severity (PARS) model as previously described. 15 In brief, the PARS model includes quantification of PVL jets on color Doppler images at 18 locations in parasternal short-axis (PSAX); parasternal long-axis (PLAX); apical 5-and apical 3-chamber views. First, radial width (similar to vena contracta width) is measured perpendicular to the flow and LVOT resulting in the PARS radial score, which is calculated as the sum of the radial width of PVL jet(s) at the 18 locations.…”

The Role of Quantitative Aortographic Assessment of Aortic Regurgitation by Videodensitometry in the Guidance of Transcatheter Aortic Valve Implantation

“…7 , 8 Although newer generations of THVs have been designed to reduce the PVL, BPD is still performed in up to 17% of cases receiving the new generation of THVs. 7 , 9 , 10 Therefore, BPD remains one important technique to optimize implantation of the THV.…”