<International Circulation>: Percutaneous aortic valve implantation is in its initial stages and not yet perfected. What are the potential problems and solutions arising from this new technology?

    Dr Ussia: Currently worldwide， have been treated more than 20000 patients with both of these valves. There is a learning curve which exists for the first twenty to fifty patients so each center conducting the procedure saw a higher rate of complications in the early stages of their experience， but with increased experience， these centers have seen a marked decrease in the complication rates from 10% to 4%. Potential complications are essentially related to the vascular access because we have to use a sheath of large diameter but the companies are markedly reducing the diameter of the equipment and in the future with a 16 French sheath we will dramatically reduce vascular complications. Another specific complication is the potential for AV conduction disturbances with the need for a permanent pace maker， and potential coronary occlusion， but these complications can be reduced with good patient selection and the experience of the operator in correctly positioning the valve.

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