The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)


Patient selection for transcatheter or surgical intervention: the Heart Team TRUMPS the STS

EuroIntervention 2016;12:1439-1440. DOI: 10.4244/EIJV12I1A236

1. Galway University Hospital, Saolta Health Care Group, National University of Ireland, Galway, Ireland; 2. McGill University Health Centre, Glen Hospital/Royal Victoria Hospital, Montreal, Quebec, Canada

In 2007, when transcatheter aortic valve implantation (TAVI) was commercialised in Europe for the management of symptomatic severe aortic stenosis, patient selection was relatively straightforward: candidates were old, frail, with multiple comorbid illnesses, and had an elevated logistic EuroSCORE (>20%) or Society of Thoracic Surgeons predicted risk of mortality (STS-PROM) score (>10%). The inclusion of risk prediction models in this selection process was curious, since these scores were never developed to determine treatment allocation and, moreover, the risk prediction algorithm included only patients who underwent surgical intervention, with few patients who could be deemed typical TAVI candidates. Rather, these surgical ...

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