TAVISCORE: a computer program for risk stratification of complications after aortic valve interventions in patients with reduced ejection fraction

Abstract

Aim. To demonstrate the TAVISCORE program designed to stratify the risk of complications after aortic valve (AV) interventions in patients with reduced ejection fraction.Material and methods. For the period from 2015-2022 at the Almazov Federal North-West Medical Research Center, 128 interventions on AV were performed for aortic stenosis in patients with reduced ejection fraction as follows: 61 — surgical AV replacement (SAVR), 67 — transcatheter aortic valve implantation (TAVI). To create an interactive calculator TAVISCORE (link for free download: https://drive.google.com/file/d/1a3s2MK6Tpk0cIQ_aMB7xe63upEwJsJOh/view?usp=sharing) all patients were combined into one group. For each factor present in the patient, the prognostic coefficient, its contribution to the likelihood of an event in the long-term follow-up period (death, myocardial infarction, stroke), was calculated. The next step, based on the calculations obtained and using the Python 3.10.6 language, was the creation of the TAVISCORE program.Results. The TAVISCORE was created for the personalized choice of tactics for the treatment of patients with aortic stenosis. It contains 54 risk factors and makes it possible to determine probability of cardiac or non-cardiac events in the long-term follow-up period after SAVR and TAVI. Thus, a tactic with lower probability of a complication can be chosen as optimal in this particular case. Retrospective use of the TAVISCORE after surgery can identify patients at high risk of complications, which will allow them to be selected for more thorough management and more frequent screening.Conclusion. The TAVISCORE can be used by a multidisciplinary consensus to select the treatment tactics and stratify the risk of complications after different AV replacement variants in patients with a reduced ejection fraction. Further prospective testing of this program is required.