Reemplazo percutáneo de la válvula aórtica en pacientes con estenosis aórtica grave y riesgo quirúrgico elevado

Background: Aortic valve replacement is the treatment of choice in patients with aortic stenosis. However, a significant number of patients are not candidates for surgery due to high surgical risk and to the presence of comorbidities. Percutaneous aortic valve replacement represents an alternative option to conventional aortic valve surgery for selected high risk patients. Objective: To inform about the initial experience with percutaneous aortic valve replacement with a self-expanding CoreValve aortic valve prosthesis (Medtronic, Minneapolis, MN, USA). Material and Methods: We conducted a multicenter registry including 21 patients with severe symptomatic aortic stenosis (aortic valve area ≤1 cm2) and high surgical risk undergoing percutaneous aortic valve replacement in four high complexity cardiovascular centers. A multidisciplinary strategy was used involving several specialists: anesthesiologist, surgeon, diagnostic images specialists and interventional cardiologists. Results: Mean age was 80.8±7.1 years (range: 63-90); 57% were men. Mean aortic valve area was 0.59±0.25 cm2 and mean EuroSCORE was 18.1%±4%. The percentages of patients in functional class III and IV were 73% and 27%, respectively. The procedure was successful in 95.2% (20/21) of patients, with a pronounced reduction in peak transvalvular aortic gradient (from 82±14 mm Hg to 12±3 mm Hg; p