Transcatheter aortic valve implantation using direct aortic access: first procedures in Poland

Transcatheter aortic valve implantation (TAVI) is an alternative option for the treatment of severe aortic stenosis in patients carrying an elevated operative risk of conventional surgical aortic valve replacement (AVR). Recently, data from randomised clinical trials confirmed superiority of TAVI when compared with the conservative treatment in inoperable patients, and its non-inferiority when compared with AVR in a high-risk population. Transfemoral vascular access remains the preferred route for delivering the bioprosthesis. However, in a significant proportion of patients, the presence of severe iliac-femoral arteriopathy or small vessel diameter render the transfemoral approach unusable. In this article, we report the first Polish experience of two successful TAVI procedures with bioprostheses (both balloon- and self-expandable) delivered using direct aortic access.