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?

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 euroSCORE 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 Factors Score
Age (per 5 years or part thereof over 60 years) 1
Sex female 1
Chronic pulmonary disease long-term use of bronchodilators or steroids for lung disease 1
Extracardiac arteriopathy any one or more of the following: claudication, carotid occlusion or >50% stenosis, previous or planned intervention on the abdominal aorta, limb arteries or carotids 2
Neurological dysfunction disease severely affecting ambulation or day-to-day functioning 2
Previous cardiac surgery requiring opening of the pericardium 3
Serum creatinine >200m micromol/L preoperatively 2
Active endocarditis patient still under antibiotic treatment for endocarditis at the time of surgery 3
Critical preoperative state any 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 factors Score
Unstable angina rest angina requiring iv nitrates until arrival in the anesthetic room 2
LV dysfunction moderate or LVEF30-50% 1
poor or LVEF <30 3
Recent myocardial infarct (<90 days) 2
Pulmonary hypertension Systolic PA pressure (greater than) 60 mmHg 2
Operation-related factors Score
Emergency carried out on referral before the beginning of the next working day 2
Other than isolated CABG major cardiac procedure other than or in addition to CABG 2
Surgery on thoracic aorta for disorder of ascending, arch or descending aorta 3
Postinfarct septal rupture   4

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.

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Source: The Premier Heart Associates

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