Mortality prediction after transcatheter treatment of failed bioprosthetic aortic valves utilizing various international scoring systems: Insights from the Valve-in-Valve International Data (VIVID)
Language English Country United States Media print-electronic
Document type Comparative Study, Journal Article, Multicenter Study, Observational Study
PubMed
30079597
DOI
10.1002/ccd.27714
Knihovny.cz E-resources
- Keywords
- aortic valve disease, structural heart disease intervention, surgery-aortic, surgery-valvular, transcatheter valve implantation, valve-in-valve,
- MeSH
- Aortic Valve physiopathology surgery MeSH
- Bioprosthesis * MeSH
- Time Factors MeSH
- Heart Valve Prosthesis Implantation adverse effects instrumentation mortality MeSH
- Risk Assessment MeSH
- Humans MeSH
- Decision Support Techniques * MeSH
- Predictive Value of Tests MeSH
- Prosthesis Design MeSH
- Registries MeSH
- Risk Factors MeSH
- Prosthesis Failure * MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Heart Valve Prosthesis * MeSH
- Transcatheter Aortic Valve Replacement adverse effects instrumentation mortality MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Observational Study MeSH
- Comparative Study MeSH
BACKGROUND: Transcatheter Aortic Valve Implantation (TAVI) is commonly used to deploy new bioprosthetic valves inside degenerated surgically implanted aortic valves in high risk patients. The three scoring systems used to assess risk of postprocedural mortality are: Logistic EuroSCORE (LES), EuroSCORE II (ES II), and Society of Thoracic Surgeons (STS). OBJECTIVE: The purpose of this study is to analyze the accuracy of LES, ES II, and STS in estimating all-cause mortality after transcatheter aortic valve-in-valve (ViV) implantations, which was not assessed before. METHODS: Using the Valve-in-Valve International Data (VIVID) registry, a total of 1,550 patients from 110 centers were included. The study compared the observed 30-day overall mortality vs. the respective predicted mortalities calculated by risk scores. The accuracy of prediction models was assessed based on calibration and discrimination. RESULTS: Observed mortality at 30 days was 5.3%, while average expected mortalities by LES, ES II and STS were 29.49 (± 17.2), 14.59 (± 8.6), and 9.61 (± 8.51), respectively. All three risk scores overestimated 30-day mortality with ratios of 0.176 (95% CI 0.138-0.214), 0.342 (95% CI 0.264-0.419), and 0.536 (95% CI 0.421-0.651), respectively. 30-day mortality ROC curves demonstrated that ES II had the largest AUC at 0.722, followed by STS at 0.704, and LES at 0.698. CONCLUSIONS: All three scores overestimated mortality at 30 days with ES II showing the highest predictability compared to LES and STS; and therefore, should be recommended for ViV procedures. There is a need for a dedicated scoring system for patients undergoing ViV interventions.
3rd Faculty of Medicine Charles University Prague Czech Republic
Azienda Ospedaliero Universitaria Pisana Pisa Italy
Centro Hospitalar Vila Nova de Gaia Vila Nova de Gaia Portugal
Clinique Pasteur Toulouse France
Escola Paulista de Medicina UNIFESP São Paulo Brazil
Ferrarotto Hospital Catania Italy
Mayo Clinic Rochester Minnesota
Odense University Hospital Odense Denmark
Royal Brompton Hospital London United Kingdom
Segeberger Kliniken Bad Segeberg Germany
St Paul's Hospital Vancouver Canada
Stanford University School of Medicine Stanford California
Sunninghill Hospital Johannesburg Republic of South Africa
Sunnybrook Hospital Toronto Canada
The Alfred Hospital Melbourne Australia
University Hospital Heidelberg Heidelberg Germany
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