We read with interest an article recently published in the Journal1 that analyzed published studies on the risk scores used to guide the decision between surgical aortic valve replacement and transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis. It is noteworthy that the title does not mention the main subject, aortic stenosis, but simply refers to risk scores in heart valve surgery without further detail.
On the basis of the cited studies, the author highlights the absence of improvement in quality of life or functional recovery after TAVI and calls for the creation of risk scores for this patient group.
With regard to the first point, in the pioneering randomized clinical Placement of Aortic Transcatheter Valves (PARTNER) trial,2 the clinical course of the TAVI group was excellent, with improvement in New York Heart Association3 functional class at one year, representing improved quality of life in these patients. Concerning the second point, it is worth highlighting the pertinent comparison between risk scores, classifying EuroSCORE II4 as having the best discriminatory power for assessing mortality risk in surgical replacement but lacking accuracy when assessing mortality risk in patients undergoing TAVI.5
Conflicts of interestThe authors have no conflicts of interest to declare.
Please cite this article as: de Oliveira FW, dos Santos AM, Barreto ACMM. Escores de risco nas cirurgias cardíacas valvares. Rev Port Cardiol. 2019;38:69.
