Answers to Common Aortic Stenosis Questions

Premier Health providers answer frequently asked questions about aortic stenosis.

What is a euroSCORE Risk Calculator and how is it used in assessing heart patients?

Premier Health’s Dr. George Broderick explains what the euroSCORE Risk Calculator is and how it is used. Click play to watch the video or read the transcript.

 

Treatment for aortic stenosis involves replacing the aortic valve. The classical surgery is an open-heart procedure, but not all patients are good candidates for this type of operation. Doctors use the euroSCOREOff Site Icon Risk Calculator to quantify a patient’s risk for operative mortality, defined as “any death, regardless of cause, occurring within 30 days after surgery in or out of the hospital and after 30 days during the same hospitalization subsequent to the operation.”

euroSCORE stands for European System for Cardiac Operative Risk Evaluation. The system calculates a score based on a number of patient-related, cardiac-related and operation-related factors as follows:

Patient Related FactorsScore
Age(per 5 years or part thereof over 60 years)1
Sexfemale1
Chronic pulmonary diseaselong-term use of bronchodilators or steroids for lung disease1
Extracardiac arteriopathyany one or more of the following: claudication, carotid occlusion or >50% stenosis, previous or planned intervention on the abdominal aorta, limb arteries or carotids2
Neurological dysfunction diseaseseverely affecting ambulation or day-to-day functioning2
Previous cardiac surgeryrequiring opening of the pericardium3
Serum creatinine>200m micromol/L preoperatively2
Active endocarditispatient still under antibiotic treatment for endocarditis at the time of surgery3
Critical preoperative stateany one or more of the following: ventricular tachycardia or fibrillation or aborted sudden death, preoperative cardiac massage, preoperative ventilation before arrival in the anesthetic room, preoperative inotropic support, intraaortic balloon counterpulsation or preoperative acute renal failure (anuria or oliguria<10 ml/hour)
3
Cardiac-related factorsScore
Unstable anginarest angina requiring iv nitrates until arrival in the anesthetic room2
LV dysfunctionmoderate or LVEF30-50%1
poor or LVEF <303
Recent myocardial infarct(<90 days)2
Pulmonary hypertensionSystolic PA pressure (greater than) 60 mmHg2
Operation-related factorsScore
Emergencycarried out on referral before the beginning of the next working day2
Other than isolated CABGmajor cardiac procedure other than or in addition to CABG2
Surgery on thoracic aortafor disorder of ascending, arch or descending aorta3
Postinfarct septal rupture 4

According to Dr. Broderick, when a patient’s score is 7 or higher, they are likely to be recommended to undergo the transcatheter aortic valve replacement (TAVR) procedure.

For more information about euroSCORE, talk with your doctor.

Learn more:

Source: George Broderick, Jr., MD, FACC, The Premier Heart Associates

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