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OBJECTIVES: The patient selection for transcatheter aortic valve implantation (TAVI) is mainly based on risk score assessment, such as the logistic EuroSCORE (LES). It is well known that the LES overestimates the true risk after TAVI. Aim of this study was to evaluate the accuracy of the recently introduced EuroSCORE II (ES II) in patients undergoing TAVI.
METHODS: Perioperative data of 138 patients receiving transfemoral or transapical aortic valve implantation between January and November 2011 were analyzed. Predicted mortality was calculated by LES and ES II. Median risk as well as 75^th and 90^th percentile for each predicted mortality were calculated and related to actual outcomes.
RESULTS: Mean LES and ES II predicted mortality were 23.2±13.2% and 8.1±6.4% respectively (median 20.0% and 6.3%, respectively). Actual 30-day mortality was 11.6%. Subgroup analysis for both scores revealed a trend towards higher actual mortality in patients with predicted mortality above median, 75^th or 90^th percentile and the patients below without reaching significance (Table 1). The actual mortality for patients with a predicted mortality above the 90^th percentile calculated with ES II was slightly lower without significance. Based on the 75^th percentile ES II showed higher sensitivity than LES (93.75% vs. 25%), but worse specificity (11.5% vs. 75.4%).
CONCLUSIONS: The recently introduced EuroSCORE II seems to better predict overall 30-day mortality after TAVI than logistic EuroSCORE and should become the new golden-standard for risk profile assessment of TAVI patients. Other factors, such as patient frailty will have to be taken into account in addition.
Table 1:

Score	≤ median	> median	≤ 75th percentile	> 75th percentile	≤ 90th percentile	> 90th percentile	p-value
LES	10.0%	13.2%	11.5%	11.8%	11.2%	15.4%	n.s.
ES II	0%	11.9%	6.7%	12.2%	12.2%	11.2%	n.s.