Initial experience in Mexico with the Evolut™ R valve with direct aortic access

Background: Aortic stenosis (AS) is one of the most frequent valvulopathies in elderly patients. The treatment for AS is heart surgery; however, many patients do not benefit from this treatment because they are considered to be at high surgical or inoperable risk. Transcatheter aortic valve implantation (TAVI) was developed for these patients. Objective: To disseminate the feasibility and safety of other access routes for the implantation of transcatheter aortic valves and that it can also be performed in the hemodynamic laboratory. In addition to the rapid growth in technology and knowledge, there is a lot of experience with TAVI already. Methodology: One of the limitations is the diameter of the femoral, subclavian, and axillary vascular accesses. This is why other approaches such as the direct aortic approach are sought after, despite the invasive nature of mini-thoracotomy and aortotomy is technically feasible, familiar, and easy to learn for cardiac surgeons. Resultado: Se ha asociado con resultados favorables y una menor tasa de complicaciones (sangrado, riesgo de lesion miocardica) y menor duracion de la estancia en la Unidad de Cuidados Intensivos en comparacion con la cirugia o el acceso transapical. Conclusion: Nuestro centro implanto con exito la valvula aortica autoexpandible Evolut™ via aortica directa por presentar una diseccion en la aorta transversa con posibilidades de embolizacion.