title: The predictive value of conventional surgical risk scores for periprocedural mortality in percutaneous mitral valve repair.
abstract: BACKGROUND
  Surgical risk scores are used to identify high-risk patients for surgical mitral valve repair. There is no scoring system to estimate the mortality risk for patients undergoing percutaneous treatment. The aim of this analysis is to evaluate the predictive value of the EuroSCOREs and the Society of Thoracic Surgeons Predicted Risk of Mortality Score (STS) for periprocedural mortality in percutaneous edge-to-edge mitral valve repair.
  
  
  METHODS
  From 2009 to 2013, 136 high-risk patients were included who underwent 143 procedures. Observed periprocedural mortality was compared with predicted mortality using the logistic EuroSCORE, EuroSCORE II and STS. The predictive value was analysed by receiver operating characteristic curves for each score.
  
  
  RESULTS
  Observed periprocedural mortality was 3.5 %. The predicted surgical mortality risk was: 23.1 ± 15.7 % for the logistic EuroSCORE, 9.6 ± 7.7 % for the EuroSCORE II and 13.2 ± 8.2 % for the STS. The predictive value estimated by the area under the curve was: 0.55, 0.54 and 0.65 for the logistic EuroSCORE, EuroSCORE II and STS respectively. Severe pulmonary hypertension and acute procedural success were significant predictive parameters in univariate analysis.
  
  
  CONCLUSIONS
  Contemporary surgical scores do not adequately predict periprocedural mortality for high-risk patients undergoing edge-to-edge mitral valve repair, but they can be used to help decision-making in the selection process for this procedure.
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. f.kortlandt@antoniusziekenhuis.nl.
authors.forename: F A
authors.initials: FA
authors.lastname: Kortlandt
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: C C
authors.initials: CC
authors.lastname: van 't Klooster
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: A L M
authors.initials: AL
authors.lastname: Bakker
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: Swaans
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: J C
authors.initials: JC
authors.lastname: Kelder
authors.affiliation: Department of Cardio-Thoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: T L
authors.initials: TL
authors.lastname: de Kroon
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: B J W M
authors.initials: BJ
authors.lastname: Rensing
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: F D
authors.initials: FD
authors.lastname: Eefting
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: J A S
authors.initials: JA
authors.lastname: van der Heyden
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: M C
authors.initials: MC
authors.lastname: Post
keywords: EuroSCORE; Mitral valve repair; Percutaneous; STS