Validation of transcatheter aortic valve implantation risk scores in relation to early and mid-term survival : a single-centre study
Van De Heyning, Caroline M.
Faculty of Medicine and Health Sciences
Interactive cardiovascular and thoracic surgery. - Amsterdam
, p. 273-279
University of Antwerp
OBJECTIVES The aim of this study was to validate recently proposed risk scores for the prediction of mortality up to 1 year after transcatheter aortic valve implantation (TAVI), using a self-expandable valve (CoreValve). METHODS In this single-centre study, 225 consecutive patients with severe symptomatic aortic valve stenosis, who underwent TAVI between December 2007 and January 2015, were included. Conventional surgical risk scores (logistic EuroSCORE, EuroSCORE II and STS score) were calculated as well as newly proposed TAVI risk scores (TAVI2-SCORe, STT Score and OBSERVANT score). Medium-term survival of the patients was assessed up to 1 year after TAVI. RESULTS The median age was 82 (7786) years and 45.3% were male. Patients were categorized into non-high risk or high risk according to logistic EuroSCORE >20%, EuroSCORE II >8%, STS score >10%, TAVI2-SCORe >2, STT score >12% and OBSERVANT score >6. Thirty-day and 1-year survival rates were significantly different between non-high-risk and high-risk patients according to the STS score (1 year: low: 84.4% vs high: 67.0%, P = 0.010) and according to OBSERVANT score (1 year: low: 85.2% vs high: 68.4%, P = 0.005). In contrast, TAVI2-SCORe and STT score did not discriminate non-high-risk and high-risk patients. This was confirmed by Cox regression analysis [STS score >10%: hazard ratio: 2.484 (1.2065.115), P = 0.014; OBSERVANT score >6: hazard ratio: 2.532 (1.2954.952), P = 0.007]. CONCLUSION In this single-centre study, OBSERVANT and STS score most accurately predicted early and mid-term survival in patients undergoing TAVI, using a self-expandable valve (CoreValve).