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

3 Scopus citations

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

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

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    Aziz, M., Simonato, M., Webb, J. G., Abdel-Wahab, M., McElhinney, D., Duncan, A., Tchetche, D., Barbanti, M., Petronio, A. S., Maisano, F., Ribeiro, V. G., Gaia, D. F., Rana, R., Kocka, V., Mathur, M., Wijeysundera, H., Hellig, F., Nissen, H., Bekeredjian, R., ... 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, 92(6), 1163-1170. https://doi.org/10.1002/ccd.27714