Effect of aorto-ventricular angulation on procedural success in transcatheter aortic valve replacements with the Lotus Valve system

Hashrul N. Rashid, Liam M. Mccormick, Andrew H. Talman, Abdul R. Ihdayhid, Nitesh Nerlekar, Ameera S. Amiruddin, James Cameron, Arthur Nasis, Ian T. Meredith, Robert P. Gooley

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: To determine the effect of aorto-ventricular angulation (AA) on procedural success with the Lotus Valve system. Background: AA, the angulation of the aortic valve basal plane, may affect the deployment of transcatheter aortic valve replacements (TAVRs). The Lotus Valve system is fully repositionable and delivered on a pre-shaped catheter which may alter the impact of AA on its deployment. The effect of AA on procedural and clinical outcomes with the Lotus valve is unreported. Methods: Consecutive patients who underwent transfemoral TAVR with the Lotus Valve system were analyzed. AA was determined on pre-procedural multi-detector computed tomography imaging. Device success, procedural characteristics, and clinical events were assessed according to Valve Academic Research Consortium-2 (VARC2) definitions. Results: One hundred sixty-five patients were analyzed (48% male, mean age 84 years). The mean AA was 47.8 degrees. Patients were, therefore, divided into low AA (AA<48°) or high AA (AA≥48°). Baseline characteristics were similar in both cohorts. Device success and procedural outcomes were also similar including procedure time, contrast dose, and need to reposition. There was no difference in degree of moderate or greater para-valvular regurgitation (PVR) (0% vs. 3%, P=0.09). Clinical outcomes of death, stroke, myocardial infarction, and other major VARC2 endpoints were similar. Conclusion: AA did not affect device success or clinical outcome with the Lotus Valve system. The Lotus' unique design features may have mitigated the impact of AA by improving the accuracy, ease of valve positioning, and reducing PVR.

Original languageEnglish
Pages (from-to)1365-1370
Number of pages6
JournalCatheterization and Cardiovascular Interventions
Volume91
Issue number7
DOIs
Publication statusPublished - 1 Jun 2018

Keywords

  • Aortic stenosis
  • Aortic valve
  • TAVI
  • TAVR
  • Transcathether aortic valve replacement

Cite this

@article{eef28309b25e458595574eeb12a02393,
title = "Effect of aorto-ventricular angulation on procedural success in transcatheter aortic valve replacements with the Lotus Valve system",
abstract = "Objective: To determine the effect of aorto-ventricular angulation (AA) on procedural success with the Lotus Valve system. Background: AA, the angulation of the aortic valve basal plane, may affect the deployment of transcatheter aortic valve replacements (TAVRs). The Lotus Valve system is fully repositionable and delivered on a pre-shaped catheter which may alter the impact of AA on its deployment. The effect of AA on procedural and clinical outcomes with the Lotus valve is unreported. Methods: Consecutive patients who underwent transfemoral TAVR with the Lotus Valve system were analyzed. AA was determined on pre-procedural multi-detector computed tomography imaging. Device success, procedural characteristics, and clinical events were assessed according to Valve Academic Research Consortium-2 (VARC2) definitions. Results: One hundred sixty-five patients were analyzed (48{\%} male, mean age 84 years). The mean AA was 47.8 degrees. Patients were, therefore, divided into low AA (AA<48°) or high AA (AA≥48°). Baseline characteristics were similar in both cohorts. Device success and procedural outcomes were also similar including procedure time, contrast dose, and need to reposition. There was no difference in degree of moderate or greater para-valvular regurgitation (PVR) (0{\%} vs. 3{\%}, P=0.09). Clinical outcomes of death, stroke, myocardial infarction, and other major VARC2 endpoints were similar. Conclusion: AA did not affect device success or clinical outcome with the Lotus Valve system. The Lotus' unique design features may have mitigated the impact of AA by improving the accuracy, ease of valve positioning, and reducing PVR.",
keywords = "Aortic stenosis, Aortic valve, TAVI, TAVR, Transcathether aortic valve replacement",
author = "Rashid, {Hashrul N.} and Mccormick, {Liam M.} and Talman, {Andrew H.} and Ihdayhid, {Abdul R.} and Nitesh Nerlekar and Amiruddin, {Ameera S.} and James Cameron and Arthur Nasis and Meredith, {Ian T.} and Gooley, {Robert P.}",
year = "2018",
month = "6",
day = "1",
doi = "10.1002/ccd.27378",
language = "English",
volume = "91",
pages = "1365--1370",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
publisher = "Wiley-Blackwell",
number = "7",

}

Effect of aorto-ventricular angulation on procedural success in transcatheter aortic valve replacements with the Lotus Valve system. / Rashid, Hashrul N.; Mccormick, Liam M.; Talman, Andrew H.; Ihdayhid, Abdul R.; Nerlekar, Nitesh; Amiruddin, Ameera S.; Cameron, James; Nasis, Arthur; Meredith, Ian T.; Gooley, Robert P.

In: Catheterization and Cardiovascular Interventions, Vol. 91, No. 7, 01.06.2018, p. 1365-1370.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Effect of aorto-ventricular angulation on procedural success in transcatheter aortic valve replacements with the Lotus Valve system

AU - Rashid, Hashrul N.

AU - Mccormick, Liam M.

AU - Talman, Andrew H.

AU - Ihdayhid, Abdul R.

AU - Nerlekar, Nitesh

AU - Amiruddin, Ameera S.

AU - Cameron, James

AU - Nasis, Arthur

AU - Meredith, Ian T.

AU - Gooley, Robert P.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Objective: To determine the effect of aorto-ventricular angulation (AA) on procedural success with the Lotus Valve system. Background: AA, the angulation of the aortic valve basal plane, may affect the deployment of transcatheter aortic valve replacements (TAVRs). The Lotus Valve system is fully repositionable and delivered on a pre-shaped catheter which may alter the impact of AA on its deployment. The effect of AA on procedural and clinical outcomes with the Lotus valve is unreported. Methods: Consecutive patients who underwent transfemoral TAVR with the Lotus Valve system were analyzed. AA was determined on pre-procedural multi-detector computed tomography imaging. Device success, procedural characteristics, and clinical events were assessed according to Valve Academic Research Consortium-2 (VARC2) definitions. Results: One hundred sixty-five patients were analyzed (48% male, mean age 84 years). The mean AA was 47.8 degrees. Patients were, therefore, divided into low AA (AA<48°) or high AA (AA≥48°). Baseline characteristics were similar in both cohorts. Device success and procedural outcomes were also similar including procedure time, contrast dose, and need to reposition. There was no difference in degree of moderate or greater para-valvular regurgitation (PVR) (0% vs. 3%, P=0.09). Clinical outcomes of death, stroke, myocardial infarction, and other major VARC2 endpoints were similar. Conclusion: AA did not affect device success or clinical outcome with the Lotus Valve system. The Lotus' unique design features may have mitigated the impact of AA by improving the accuracy, ease of valve positioning, and reducing PVR.

AB - Objective: To determine the effect of aorto-ventricular angulation (AA) on procedural success with the Lotus Valve system. Background: AA, the angulation of the aortic valve basal plane, may affect the deployment of transcatheter aortic valve replacements (TAVRs). The Lotus Valve system is fully repositionable and delivered on a pre-shaped catheter which may alter the impact of AA on its deployment. The effect of AA on procedural and clinical outcomes with the Lotus valve is unreported. Methods: Consecutive patients who underwent transfemoral TAVR with the Lotus Valve system were analyzed. AA was determined on pre-procedural multi-detector computed tomography imaging. Device success, procedural characteristics, and clinical events were assessed according to Valve Academic Research Consortium-2 (VARC2) definitions. Results: One hundred sixty-five patients were analyzed (48% male, mean age 84 years). The mean AA was 47.8 degrees. Patients were, therefore, divided into low AA (AA<48°) or high AA (AA≥48°). Baseline characteristics were similar in both cohorts. Device success and procedural outcomes were also similar including procedure time, contrast dose, and need to reposition. There was no difference in degree of moderate or greater para-valvular regurgitation (PVR) (0% vs. 3%, P=0.09). Clinical outcomes of death, stroke, myocardial infarction, and other major VARC2 endpoints were similar. Conclusion: AA did not affect device success or clinical outcome with the Lotus Valve system. The Lotus' unique design features may have mitigated the impact of AA by improving the accuracy, ease of valve positioning, and reducing PVR.

KW - Aortic stenosis

KW - Aortic valve

KW - TAVI

KW - TAVR

KW - Transcathether aortic valve replacement

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U2 - 10.1002/ccd.27378

DO - 10.1002/ccd.27378

M3 - Article

VL - 91

SP - 1365

EP - 1370

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

IS - 7

ER -