To compare 7 available risk models in the prediction of 30-day mortality following TAVI. Heart team decision supported by different risk score calculations is advisable to estimate the individual procedural risk before transcatheter aortic valve implantation (TAVI).One-hundred-and-fifty-six consecutive patients (n=156, 48% female, mean age 80.03 ± 8.18 years) who underwent TAVI between March 2010 and October 2014 were included in the study. Thirty-day follow-up was performed and available in each patient. Baseline risk was calculated according to EuroSCORE I, EuroSCORE II, STS, ACEF, Ambler's, OBSERVANT and SURTAVI scores.In receiver operating characteristics (ROC) analysis, neither of the investigated scales was able to distinguish between patients with or without an endpoint with areas under the curve (AUC) not exceeding 0.6, as follows: EuroScore I, AUC 0.55, 95% confidence intervals [CI] 0.47-0.63, P=0.59; EuroScore II, AUC 0.59 [0.51-0.67], P=0.23; STS, AUC 0.55 [0.47-0.63], P=0.52; ACEF, AUC 0.54 [0.46-0.62], P=0.69; Ambler's, AUC 0.54 [0.46-0.62], P=0.70; OBSERVANT, AUC 0.597 [0.52-0.67], P=0.21; SURTAVI, AUC 0.535 [0.45-0.62], P=0.65. SURTAVI model was calibrated best in high risk patients showing coherence between expected and observed mortality (10.8% vs. 9.4%. P=0.982). ACEF demonstrated best classification accuracy (17.5% vs. 6.9%, P=0.053, observed mortality in high vs. non-high risk cohort, respectively).None of investigated risk scales proved to be optimal in predicting 30-day mortality in unselected, real-life population with AS referred to TAVI. This data supports primary role of heart team in decision process of selecting patients for TAVI.

Background The aim of this study was to evaluate the outcomes of transcatheter aortic valve implantation (TAVI) in bicuspid aortic valve (BiAV) stenosis using a mechanically expanded Lotus™ device. The prior experience with first-generation devices showed disappointing results mainly due to increased prevalence of aortic regurgitation (AR) that exceeded those observed in tricuspid stenosis. Methods and results We collected baseline, in-hospital, 30-day and 2-year follow-up data from a prospective, multicentre registry of patients with BiAV undergoing TAVI using Lotus™ valve. Safety and efficacy endpoints were assessed according to VARC-2 criteria. The study group comprised 24 patients. The mean age was 73.5 years and the mean EuroSCORE 2 was 4.35 ± 2.56%. MDCT analysis revealed Type 1 BiAV in 75% of patients. The mean gradient decreased from 60.1 ± 18.3 to 15 ± 6.4 mm Hg, the AVA increased from 0.6 ± 0.19 to 1.7 ± 0.21 cm². One in-hospital death was observed secondary to aortic perforation. There was no severe AR and the rate of moderate AR equalled 9% at 30 days (n = 2). Device success was achieved in 83% and the 30-day safety endpoint was 17%. In the 2-year follow-up, the overall mortality was 12.5% and the 2-year composite clinical efficacy endpoint was met in 25% of the patients (n = 6) Conclusions The TAVI in selected BiAV patients using the Lotus™ is feasible and characterized by encouraging valve performance and mid-term clinical outcomes. Graphic abstract

Introduction: The aim of the study was to determine the utility and safety of three-dimensional contrast low-dose dobutamine echocardiography (3DCLDDE) in the evaluation of myocardial viability early after ST-elevation myocardial infarction (STEMI). Material and methods: We prospectively...