Experiencia inicial en México con la prótesis aórtica transcatéter Evolut™ R por abordaje aórtico directo.

Abstract

Aortic stenosis is one of the most frequent valvulopathies in the elderly patient. The treatment for aortic stenosis 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 (TAVI) was developed for these patients. To make known 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 rapid growth in technology and know-how, TAVI is already very experienced. 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, despite the invasive nature of mini-thoracotomy and aortotomy is technically feasible, familiar and easy to learn for cardiac surgeons. In addition, it has been associated with favorable outcomes and a lower rate of complications (bleeding, risk of myocardial injury) and shorter length of stay in the Intensive Care Unit compared to surgery or transapical access. Our center successfully implanted the self-expandable aortic valve Evolut™ via direct aortic for presenting a dissection in transverse aorta with possibilities of embolization.