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Can a Novel Echocardiographic Score Better Predict Outcome after Percutaneous Balloon Mitral Valvuloplasty?
Author(s) -
Rifaie Osama,
Esmat Iman,
AbdelRahman Mohamed,
Nammas Wail
Publication year - 2009
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/j.1540-8175.2008.00774.x
Subject(s) - medicine , balloon , percutaneous , cardiology , calcification , stenosis , mitral valvuloplasty , surgery
Objective: The assessment of patients with mitral stenosis before percutaneous balloon mitral valvuloplasty (PBMV) is crucial to predict outcome after the procedure. We tried to explore the prognostic power of a novel echocardiographic score to predict immediate postprocedural outcome in comparison to the standard score. Methods: We enrolled 50 consecutive patients with moderate to severe mitral stenosis admitted to undergo PBMV. For all patients, we assessed both the standard Massachusetts General Hospital (MGH) score and a novel score based on calcification (especially commissural) and subvalvular involvement. Patients underwent PBMV with the double balloon technique. Thereafter, patients were classified into two groups: group 1 (poor outcome) defined as no procedural success and/or increase of MR by more than 1 grade and group 2 (optimal outcome) defined as procedural success with increase of MR by 1 grade or less. Results: The total MGH score did not differ significantly between the two groups. However, among the individual parameters of the score, both calcification and subvalvular affection were significantly higher in group 1 versus group 2 (2.8 ± 0.4 versus 1.7 ± 0.8, and 2.4 ± 0.5 versus 1.6 ± 0.4, respectively, P < 0.01 for both). The total novel score and its two individual parameters (calcification and subvalvular involvement) were all significantly higher in group 1 versus group 2 (6 ± 1.5 versus 2.9 ± 1.9, 4.9 ± 1.2 versus 2.4 ± 1.5, 1.5 ± 1.6 versus 0.5 ± 0.9, respectively, P < 0.01 for all). Multivariate analysis demonstrated the novel score to be the only independent predictor of poor outcome. Conclusion: The novel score is more reliable and correlates with outcome better than the standard score.