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New integrated approach to percutaneous mitral valvuloplasty combining Wilkins score with commissural calcium score and commissural area ratio
Author(s) -
Gajjala Obul Reddy,
Durgaprasad Rajasekhar,
Velam Vanajakshamma,
Kayala Sridhar Babu,
Kasala Latheef
Publication year - 2017
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13635
Subject(s) - scoring system , medicine , framingham risk score , percutaneous , mitral valvuloplasty , observational study , cardiology , disease
Background Present echocardiographic scoring systems for percutaneous mitral valvuloplasty (PMV) have limitations, and no scoring system is significant determinant of procedural outcome. In this study, we assess the relationship between various echocardiographic parameters and scoring systems with immediate outcomes and test an integrated approach by combining Wilkins score with other parameters. Methods One hundred two patients who had undergone PMV were included in this prospective observational study. Preprocedural mitral valve morphology was assessed and categorized using Wilkins score, Sutaria scoring system, and Nunes quantitative scoring system. Results Optimal PMV results were obtained in 84 patients (82.35%), and suboptimal PMV results were obtained in 18 patients (17.65%). Using Nunes scoring system, suboptimal PMV results were obtained in 9 (37.5%) patients of high‐risk group (n=24), 8 (13.8%) of intermediate‐risk group (n=58), and one (5%) patient of low‐risk group (n=20). Using Wilkins scoring system, in patients having score>8 (n=16) suboptimal results were obtained in 5 (31.7%) and in patients having score<8 (n=86) suboptimal results were obtained in 13 (15.1%). Using Sutaria scoring system, in patients having score 3 to 4 (low risk, n=68) suboptimal results were obtained in 6 (8.8%), and in patients having score 0‐2 (high risk, n=34) suboptimal results were obtained in 12 (35.3%) patients. Conclusion All echocardiographic scores have significant limitations, and an integrative approach is mandatory. Combining traditional Wilkins score with Sutaria score and commissural area ratio better predicts procedural outcomes.