A novel clinical prediction rule for 30-day mortality following balloon aortic valuloplasty: the CRRAC the AV score

Catheter Cardiovasc Interv. 2011 Jul 1;78(1):112-8. doi: 10.1002/ccd.22912. Epub 2011 Mar 16.


Objectives: We seek to identify predictors of 30-day mortality after balloon aortic valvuloplasty (BAV).

Background: To date, there is no validated method of predicting patient outcomes after percutaneous aortic valve interventions.

Methods: Data for consecutive patients with severe aortic stenosis who underwent BAV at the Mount Sinai Medical Center from January 2001 to July 2007 were retrospectively reviewed. Cox-proportional hazards regression was used to identify significant predictors of 30-day mortality, and the resultant model was compared to the EuroSCORE using Akaike's Information Criterion and area under the receiver-operating curve (AUC).

Results: The analysis included 281 patients (age 83 ± 9 years, 61% women, aortic valve area: 0.64 ± 0.2 cm(2)) and 36 (12.8%) of whom died within 30 days of BAV. With identified risk factors for 30-day mortality, critical status, renal dysfunction, right atrial pressure, and cardiac output, we constructed the CRRAC the AV risk score. Thirty-day survival was 72% in the highest tertile versus 94% in the lower two tertiles of the score. Compared to the additive and logistic EuroSCORE, the risk score demonstrated superior discrimination (AUC = 0.75 vs. 0.60 and 0.63, respectively).

Conclusions: We derived a risk score, the CRRAC the AV score that identifies patients at high-risk of 30-day mortality after BAV. Validation of the developed risk prediction score, the CRRAC the AV score, is needed in other cohorts of post-BAV patients and potentially in patients undergoing other catheter-based valve interventions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / mortality
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / therapy*
  • Atrial Function, Right
  • Cardiac Output
  • Catheterization / mortality*
  • Female
  • Health Status Indicators*
  • Humans
  • Kaplan-Meier Estimate
  • Kidney / physiopathology
  • Kidney Diseases / mortality
  • Kidney Diseases / physiopathology
  • Logistic Models
  • Male
  • New York City / epidemiology
  • Predictive Value of Tests
  • Pressure
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome