Abstract
Objective: To assess the ability of the logistic EuroSCORE to predict long- term mortality of patients undergoing isolated Surgical Aortic Valve Replacement (SAVR). Methods: A retrospective review of all patients undergoing SAVR between September 1999, and March 2018 was done. Results: 2018 patients were eligible for inclusion in the study. Patients were grouped according to risk: low (n = 506), intermediate (n = 609), and high-risk (n = 903) depending on their logistic EuroSCORE values. The 30-day mortality of the low- risk group was 0.47%. The one-, five-, 10-, 15-, and 20-year mortality was 1.66%, 4.9%, 14.9%, 24.3%, and 43.8%, respectively. Intermediate-risk group 30-day mortality was 0.66%. The one-, five-, 10-, 15-, and 20-year mortality was 3.28%, 11.9%, 32%, 54.8%, and 82.6%, respectively. The 30-day mortality of the high- risk group was 3.99%. The one-, five-, 10-, 15-, and 20-year mortality was 8.2%, 27%, 55.4%, 78.6%, and 87%, respectively. Conclusion: Our results confirm that the lES is accurate in predicting long-term mortality outcomes of SAVR. This real-world data provides evidence of the potential usefulness of the EuroSCORE to help the heart team and patients decide on appropriate interventions for aortic stenosis.
Highlights
Aortic Stenosis (AS) is the most common valvular heart disease in Europe and a frequent cause of cardiac surgery [1]
Severe AS is defined as the valve area less than 1 cm2, mean gradient is more than 40 mmHg, and peak aortic jet velocity is more than 4 m/s. 3 Current guidelines recommend Aortic Valve Replacement (AVR) for symptomatic patients with severe AS and those who are asymptomatic with severe AS and left ventricular dysfunction [3] [4]
The starting population consisted of 2606 patients. 588 patients were excluded due to incomplete logistic EuroSCORE (lES) values. 2018 patients were eligible for inclusion in the study
Summary
Aortic Stenosis (AS) is the most common valvular heart disease in Europe and a frequent cause of cardiac surgery [1]. Symptom onset is associated with poor prognosis and mortality rates approach 50% at two years if left untreated [2]. Severe AS is defined as the valve area less than 1 cm, mean gradient is more than 40 mmHg, and peak aortic jet velocity is more than 4 m/s. 3 Current guidelines recommend Aortic Valve Replacement (AVR) for symptomatic patients with severe AS and those who are asymptomatic with severe AS and left ventricular dysfunction [3] [4]. AVR is recommended for patients with moderate AS undergoing other cardiac surgery [4]
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