Response to Letter Regarding Article, “Percutaneous Implantation of the CoreValve Self-Expanding Valve Prosthesis in High-Risk Patients With Aortic Valve Disease: The Siegburg First-in-Man Study”

We agree with Dr Grover and colleagues that on-pump surgical aortic valve replacement is currently the gold standard for operable patients with severe aortic valve stenosis. However, the need for general anesthesia, thoracotomy, and extracorporeal circulation results in a significant risk of morbidity and mortality, particularly in patients with numerous comorbid conditions. The 2 most widely used risk algorithms for cardiac surgery are the Society of Thoracic Surgeons model and the more recently developed, externally validated EuroSCORE.1 From the EuroSCORE, a female “high-risk patient with baseline features …