Clinical InvestigationValvular and Congenital Heart DiseaseRelationship between the logistic EuroSCORE and the Society of Thoracic Surgeons Predicted Risk of Mortality score in patients implanted with the CoreValve ReValving System—A Bern-Rotterdam Study
Section snippets
Patients
We reviewed the records of 168 consecutive patients in whom a CoreValve ReValving System was implanted between November 2005 and June 2009 at 2 centers: Bern University Hospital (n = 76), Bern, Switzerland, and Erasmus Medical Center (n = 92), Rotterdam, The Netherlands. Patients were referred for TAVI implantation after a team of physicians (typically including interventional cardiologists and cardiac surgeons) agreed that surgical replacement would be associated with either high or
Results
Between November 2005 and June 2009, 168 consecutive patients were implanted with the Medtronic CoreValve aortic valve bioprosthesis and were included in the study analysis. Baseline characteristics of the study patients are summarized in Table I.
Follow-up for the primary end point was 100% complete. There were 19 periprocedural deaths among the 168 patients (11.3%). The presumed causes of death are summarized in Table II.
Discussion
This study describes the correlation between LES and STS scores and their performance characteristics in high-risk surgical patients implanted with the Medtronic CoreValve System in 2 European centers. Whereas LES was calculated prospectively and used for clinical decision making, STS was calculated retrospectively and used for study purposes.
Several aspects were of note. First, LES consistently provided higher estimates of operative mortality than STS (mean LES score 20.2% ± 13.9% vs mean STS
Conclusions
The study results confirm those of previous studies that found the LES to provide substantially higher surgical risk estimates than the STS risk algorithm. In contrast to previous studies that examined the comparative performance of risk scores in patients undergoing surgical aortic valve replacement, the current study uniquely examined patients undergoing TAVI.12, 13,17, 18, 19, 20 Importantly, the purpose of this study was not to discredit “per se” the validity of the surgical risk score for
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