Mortality prediction after transcatheter treatment of failed bioprosthetic aortic valves utilizing various international scoring systems: Insights from the Valve-in-Valve International Data (VIVID)

Mina Aziz, Matheus Simonato, John G. Webb, Mohamed Abdel-Wahab, Doff McElhinney, Alison Duncan, Didier Tchetche, Marco Barbanti, Anna Sonia Petronio, Francesco Maisano, Vasco Gama Ribeiro, Diego Felipe Gaia, Ruhina Rana, Viktor Kocka, Moses Mathur, Harindra Wijeysundera, Farrel Hellig, Henrik Nissen, Raffi Bekeredjian, Charanjit RihalStephen J. Duffy, Danny Dvir

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1163-1170
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume92
Issue number6
DOIs
StatePublished - Nov 15 2018

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Aortic Valve
Mortality
Thorax
Therapeutics
ROC Curve
Calibration
Area Under Curve
Registries
Surgeons

Keywords

  • aortic valve disease
  • structural heart disease intervention
  • surgery—aortic
  • surgery—valvular
  • transcatheter valve implantation
  • valve-in-valve

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Mortality prediction after transcatheter treatment of failed bioprosthetic aortic valves utilizing various international scoring systems : Insights from the Valve-in-Valve International Data (VIVID). / Aziz, Mina; Simonato, Matheus; Webb, John G.; Abdel-Wahab, Mohamed; McElhinney, Doff; Duncan, Alison; Tchetche, Didier; Barbanti, Marco; Petronio, Anna Sonia; Maisano, Francesco; Ribeiro, Vasco Gama; Gaia, Diego Felipe; Rana, Ruhina; Kocka, Viktor; Mathur, Moses; Wijeysundera, Harindra; Hellig, Farrel; Nissen, Henrik; Bekeredjian, Raffi; Rihal, Charanjit; Duffy, Stephen J.; Dvir, Danny.

In: Catheterization and Cardiovascular Interventions, Vol. 92, No. 6, 15.11.2018, p. 1163-1170.

Research output: Contribution to journalArticle

Aziz, M, Simonato, M, Webb, JG, Abdel-Wahab, M, McElhinney, D, Duncan, A, Tchetche, D, Barbanti, M, Petronio, AS, Maisano, F, Ribeiro, VG, Gaia, DF, Rana, R, Kocka, V, Mathur, M, Wijeysundera, H, Hellig, F, Nissen, H, Bekeredjian, R, Rihal, C, Duffy, SJ & Dvir, D 2018, 'Mortality prediction after transcatheter treatment of failed bioprosthetic aortic valves utilizing various international scoring systems: Insights from the Valve-in-Valve International Data (VIVID)', Catheterization and Cardiovascular Interventions, vol. 92, no. 6, pp. 1163-1170. https://doi.org/10.1002/ccd.27714
Aziz, Mina ; Simonato, Matheus ; Webb, John G. ; Abdel-Wahab, Mohamed ; McElhinney, Doff ; Duncan, Alison ; Tchetche, Didier ; Barbanti, Marco ; Petronio, Anna Sonia ; Maisano, Francesco ; Ribeiro, Vasco Gama ; Gaia, Diego Felipe ; Rana, Ruhina ; Kocka, Viktor ; Mathur, Moses ; Wijeysundera, Harindra ; Hellig, Farrel ; Nissen, Henrik ; Bekeredjian, Raffi ; Rihal, Charanjit ; Duffy, Stephen J. ; Dvir, Danny. / Mortality prediction after transcatheter treatment of failed bioprosthetic aortic valves utilizing various international scoring systems : Insights from the Valve-in-Valve International Data (VIVID). In: Catheterization and Cardiovascular Interventions. 2018 ; Vol. 92, No. 6. pp. 1163-1170.
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abstract = "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.",
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T1 - Mortality prediction after transcatheter treatment of failed bioprosthetic aortic valves utilizing various international scoring systems

T2 - Insights from the Valve-in-Valve International Data (VIVID)

AU - Aziz, Mina

AU - Simonato, Matheus

AU - Webb, John G.

AU - Abdel-Wahab, Mohamed

AU - McElhinney, Doff

AU - Duncan, Alison

AU - Tchetche, Didier

AU - Barbanti, Marco

AU - Petronio, Anna Sonia

AU - Maisano, Francesco

AU - Ribeiro, Vasco Gama

AU - Gaia, Diego Felipe

AU - Rana, Ruhina

AU - Kocka, Viktor

AU - Mathur, Moses

AU - Wijeysundera, Harindra

AU - Hellig, Farrel

AU - Nissen, Henrik

AU - Bekeredjian, Raffi

AU - Rihal, Charanjit

AU - Duffy, Stephen J.

AU - Dvir, Danny

PY - 2018/11/15

Y1 - 2018/11/15

N2 - 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.

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KW - aortic valve disease

KW - structural heart disease intervention

KW - surgery—aortic

KW - surgery—valvular

KW - transcatheter valve implantation

KW - valve-in-valve

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