High-risk mitral valve surgery: what is the role of risk calculators?

The purpose of this review is to discuss the role of established risk scores in assessing patient outcomes following high-risk mitral valve surgery.

The use of risk calculators has become increasingly popular in cardiac surgery, particularly in assessing risk for sick patients for whom percutaneous therapies may be advantageous. A review of the available literature suggests that validated algorithms, namely, the European System for Cardiac Operative Risk Evaluation II and Society of Thoracic Surgeons models, may have poor discriminatory power in assessing risk for patients undergoing high-risk mitral surgery. Therefore, the limitations of these risk scores in this population must be taken into consideration.

Current risk models provide important insight into the perioperative risk to the patient. Further refinement of established risk scores, however, may provide better risk prognostication for patients undergoing high-risk mitral valve surgery.