[Future development of heart valve surgery. New prostheses and access routes]

Valvular surgery has evolved in the last year with the development of new valvular prostheses and new minimally invasive implanting techniques. We discuss the advantages of the new mechanical aortic prostheses of superior hemodynamic characteristics, which avoid the need to widen the valvular ring in many cases. At the same-time, we emphasize on the use of new biological aortic prostheses, with minimal transvalvular gradient and less incidence of calcification. The advantages and disadvantages of the different minimally invasive techniques are analyzed without reaching yet a definite conclusion on their application.