Specific risk scores had better prognostic performance than classical risk scores. The STS-IE score had the highest discrimination and was adequately calibrated. The PALSUSE score also showed optimal discrimination and calibration. The De Feo-Cotrufo score had a lower discrimination in our sample; however, the De Feo-Cotrufo score is recommended in the current guidelines. The Costa score had the lowest discrimination.
Research on non-clinical factors could clarify the differences in the ratio of cesarean sections in private hospitals compared with public hospitals and among distinct levels of public hospitals.
Congratulations to Dr Shalabi and colleagues [1] for this valuable study. This was an interesting comparison with a good number of patients. We have some considerations about some issues regarding this study. Different types of valves with different generic names obviously have different orifice diameters and orifice areas. We believe that this situation requires that these data should have been supplemented by the manufacturers and included in the text instead of just stating that a valve was a 19-or 21-mm sutured bioprosthesis. The Perceval sutureless valve (LivaNova, London, United Kingdom) has a metallic fixation stent to prevent migration and oscillation. This segment possesses a higher-profile metallic load compressing the aortic wall, unlike the other types of bioprosthetic valves. This feature may create some lesions on the aortic wall. Finally, the Perceval system is very similar to that used in transcatheter aortic valve implantation. Could the authors mention why they used surgical sutureless valve implantation instead of transcatheter aortic valve implantation?
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