Start-up of the program of transcatheter aortic valve implantation using a balloon-expandable Edwards Sapien XT transcatheter heart valve. Description of the first case in Mexico.

Degenerative aortic valve stenosis (AS) is the most common valvular heart disease. About two-thirds of all valve operations are for aortic valve replacement (AVR). After onset of symptoms (angina, syncope or heart failure) severe aortic stenosis has a poor prognosis with an average survival of two or three years and a high risk of sudden death. According to the ACC/AHA and the European Society of Cardiology/European Association for Cardio-Thoracic Surgery Guidelines for management of patients with heart valve disease, surgical aortic valve replacement is an indication class I in symptomatic patients with AS, and for patients with severe AS undergoing CABG or surgery of the aorta or other heart valves, and patients with severe AS and LV systolic dysfunction (ejection fraction < 50%). It is generally accepted that surgical AVR can improve the functional class and prolong survival. Nevertheless, 30% of elderly patients with symptomatic severe aortic valve stenosis do not undergo AVR, attributed to ‘‘inoperable’’ conditions or extremely high surgical risk, such as advanced age, pulmonary, renal, hepatic disease, prior cerebrovascular event, weakness or frailty, that increases the risk of poor outcomes. Recently, transcatheter aortic valve implantation (TAVI) has become a treatment option for patients with high or prohibitive surgical risk. The concept of transcatheter valve implantation was evaluated by Andersen in 1992 in a porcine model. In 2002 the first TAVI was accomplished by Dr. Alan Cribier, via a transeptal antegrade delivery technique using a balloonexpandable aortic valve. After this pioneering procedure, several registries and one multicenter randomized control trial have been published worldwide (Fig. 1). We describe the first case of TAVI performed in Mexico using a balloonexpandable Edwards Sapien XT transcatheter heart valve, Figure 1 Transcatheter aortic valve implantation.