Key result
VHD surgery risk scores show variable accuracy and require local validation, especially in rheumatic populations.
This review highlights the importance and applicability of preoperative risk score systems for assessing surgical morbidity and mortality in diverse populations with valvular heart disease.
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Local validation of valvular surgery risk scores is required before use in rheumatic populations; leaves open need for dedicated prospective studies.
Heart valve disease is a very common medical condition; the most frequent aetiology is degenerative valve disease, mainly represented by calcific aortic stenosis in the elderly. In developing countries, valvular heart disease triggered by rheumatic fever is the most important aetiology and can lead to a heterogeneous heart valve disease, mainly represented by mitral stenosis in young female patients. The need for heart valve surgery is common in this context and preoperative risk stratification is essential in making surgical decisions. To evaluate the preoperative risk of these valve heart disease patients, risk scores have been created to assess the surgical morbidity and mortality. In this article, we aim to discuss the current risk score systems, and the applicability and effectiveness of these systems in specific populations of heart valve disease taking into account the epidemiological characteristics of the studied populations.
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Casalino et al. (2016) conducted a review in Valvular heart disease. Preoperative risk score systems (EuroSCORE II, STS, Ambler) was evaluated. Current risk score systems for valvular heart disease surgery have varying accuracy and require local validation before use, particularly in populations with a high prevalence of rheumatic etiology.
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