**6.5 Portico (Abbott Laboratories)**

The self-expanding intra-annular Portico TAVI system was approved by the FDA in 2021. It is available in four sizes (23, 25, 27, and 29 mm). Its design consists of bovine leaflets mounted on a large-cell nitinol frame. The annular and large-cell design allows for easy coronary access. It is fully re-sheathable. An 18-F sheath is required and used with its FlexNav delivery system which Abbott claims to need 76% less insertion force than the Evolut PRO.

#### **6.6 LOTUS Edge (Boston Scientific)**

The LOTUS Edge is the second of the LOTUS mechanically expandable valve series that allows for hemodynamic evaluation and repositioning as needed prior to deployment. The expansion is mediated by a mechanical controlled system. Mortality rates in patients who have undergone TAVR with LOTUS were very comparable to the rates from SAPIEN 3 [40]. The LOTUS edge was FDA-approved in 2019. Since then, the newest generation (Mantra) has been created as well. At this time however, these valves have been recalled due to issues with its delivery system, but due to a substantial number of patients in whom the valve was implanted, operators need to be familiar with the valve and its design.
