Abstract
Consideration for transcatheter aortic valve replacement (TAVR) necessitates an integrated
risk assessment by members of the Heart Valve Team. The utility of the integrated
risk assessment for predicting TAVR outcomes is not established. This article aims
to compare the utility of the integrated risk assessment to that of the Society of
Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) score for predicting patient
outcomes after TAVR. A total of 274 patients who underwent TAVR from January 2016
to August 2017 were included in this study. Patients were deemed intermediate or high
risk by two surgeons on the Heart Valve Team based on an integrated risk assessment
that incorporates the STS-PROM score, fragility measures, end-organ dysfunction, and
surgeon evaluation. Patients were also deemed low, intermediate, or high risk based
solely on their STS-PROM scores of <3%, ≥3% to <8%, and ≥8%, respectively. Differences
in postoperative outcomes between intermediate- and high-risk groups as categorized
by the integrated risk assessment versus STS-PROM were compared. There were no statistically
significant differences in postoperative outcomes between patients who were deemed
high and intermediate risk by the Heart Valve Team risk assessment. In contrast, postoperative
complication rates were significantly higher in patients deemed high risk as compared
with intermediate risk by STS-PROM. Integrated risk assessment by the Heart Valve
Team is not superior to STS-PROM in predicting postoperative outcomes in patients
undergoing TAVR.
Keywords
aortic valve disease - risk factors - heart team - transcatheter - valve replacement
- risk score - outcomes
