Lotus Valve System meets primary performance endpoint in REPRISE II trial

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The Lotus Valve System (Boston Scientific) met a key performance measure in the treatment of symptomatic patients with severe aortic valve stenosis considered at high risk for surgical valve replacement, according to new data released today at the Transcatheter Cardiovascular Therapeutics (TCT) Conference in San Francisco, USA (27 October–1 November).  

Data presented as a first report investigation by Ian Meredith, director of MonashHeart at Monash Medical Centre in Melbourne, Australia, and principal investigator of the REPRISE II trial, demonstrated that the Lotus Valve System, which was implanted successfully in all 120 patients, met the primary device performance endpoint at 30 days with no severe paravalvular aortic regurgitation.

Lotus is a differentiated second generation transcatheter aortic valve implantation (TAVI) device designed for total control. It is both fully repositionable and retrievable prior to release, with Adaptive Seal technology designed to minimise paravalvular aortic regurgitation, according to a company release.

“The results from the REPRISE II trial continue to demonstrate the benefits of the Lotus Valve System, particularly the ability to position the valve accurately the first time, while having the advantage of full retrieval if needed,” says Meredith. “In all 120 patients, the system was successfully implanted and positioned appropriately with negligible aortic regurgitation while reporting low 30-day all-cause mortality and major stroke rates in this sick patient population. This is a testament to the advancement in technology that the Lotus Valve System offers.”

REPRISE II is an ongoing prospective, single-arm study that has enrolled 120 patients at 14 sites in Australia, France, Germany and the UK. REPRISE II is being extended to enrol an additional 130 patients at twenty sites in Australia and Europe.

Key findings included:

  • The primary device performance endpoint assessed by an independent core lab was met as the 30-day mean aortic valve pressure gradient of 11.5±5.2mmHg was significantly (p<0.001) less than the performance goal of 18mmHg
  • The primary safety endpoint, defined as all-cause mortality at 30 days, was 4.2%
  • Independent core lab assessment of paravalvular aortic regurgitation at 30 days indicated no severe regurgitation and one case of moderate regurgitation (1%).  In 5.2% of patients regurgitation was considered trace and in 78.4% of patients there was no paravalvular regurgitation at 30 days
  • No instances of non-study valve implantation, unplanned use of cardiopulmonary bypass, valve embolisation, valve-in-valve or ectopic valve placement occurred
  • The disabling stroke rate for the 120 patients at 30 days was 1.7%.

One-year results from REPRISE I, a prospective, single-arm feasibility study on patients with severe symptomatic aortic stenosis conducted in Australia, were presented in May at EuroPCR by Meredith and published online ahead of print by EuroIntervention. The data demonstrated sustained safety and performance of the Lotus Valve out to one year with no new major adjudicated events, as defined by the Valve Academic Research Consortium (VARC), and no moderate or severe paravalvular aortic regurgitation in any patient.

“These new results from the REPRISE clinical trial program, and particularly those from the REPRISE II trial, underscore the unique technology behind the Lotus Valve System,” said Keith Dawkins, global chief medical officer, Boston Scientific. “These features lead to a predictable implantation procedure and may result in improved clinical outcomes. The Lotus Valve offers a novel TAVI option for patients with severe aortic valve disease considered at high risk for surgical valve replacement.”