Thorac Cardiovasc Surg 2013; 61 - SC25
DOI: 10.1055/s-0032-1332523

Is the new Euroscore II a better predictor for transapical aortic valve implantation?

M Haensig 1, D Holzhey 1, MA Borger 1, S Lehmann 1, A Linke 2, J Seeburger 1, G Schuler 2, FW Mohr 1
  • 1Heart Center of the University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany
  • 2Heart Center of the University of Leipzig, Department of Cardiology, Leipzig, Germany

Objective: Conventional surgical risk-scores are used to identify suitable candidates for transapical aortic valve implantation (TA-AVI) at present. However, these scores do not consider multiple high-risk conditions, including porcelain aorta, mediastinal irradiation or frailty. The aim of this study was to compare the predictive ability of the new EuroSCORE II to the surgical risk-scores currently in use.

Methods: From Feb/2006 to May/2011, 360 consecutive high-risk patients, age 81.6 ± 6.4yrs, 64.4% female, were included using the Edwards SapienTM prosthesis. The prognostic value of the EuroSCORE II was evaluated and compared to the logistic EuroSCORE and STS mortality score by ROC curve analysis.

Results: The EuroSCORE II and STS-Score (r = 0.504, p < 0.001) showed a good correlation, whereas a strong correlation was found between EuroSCORE II and logistic EuroSCORE (r = 0.717, p < 0.001). 30-day and in-hospital mortality rate were 10.6% (38/360) and 11.4% (41/360). In-hospital mortality rate was estimated by the logistic EuroSCORE: 30.0 ± 15.7%, the STS-Score: 11.7 ± 7.8%, and the EuroSCORE II: 6.7 ± 5.1%. The prognostic value of the STS-Score, logistic EuroSCORE and the recent EuroSCORE II systems was analyzed in ROC curve analysis for the prediction of 30-day (AUC: 0.64 vs. 0.55 vs. 0.50) and in-hospital mortality (AUC: 0.65 vs. 0.54 vs. 0.49).

Conclusion: In patients undergoing TA-AVI, the new EuroSCORE II correlates strongly with the logistic EuroSCORE, but is a poorer predictor of 30-day and in-hospital mortality than the STS-Score. A true TAVI risk-score would be desirable beyond the established scores.