Wilkin’s Score

Objectives: To assess the predictive value of Wilkin’s score in determining theprocedural success of Percutaneous Transvenous Mitral Commissurotomy. Study Design:Cross sectional study. Setting: Catheterization Laboratory of Gulab Devi Chest Hospital, Lahore.Period: April 2016 to March 2017. Methods: All patients with valve area <1.5cm², pliable orborder line pliable valve were included in study. Patients who had LA thrombus, severe mitralregurgitation, severe valvular calcification were excluded from study. Patients were evaluatedclinically and echocardiographically 24 hours before and after procedure. Valve morphology wasassessed using 2D echocardiography. Wilkins’ score’s sensitivity and specificity and predictiveaccuracy at score >8 was also assessed. Mean was used to express quantitative data whilequalitative data was presented using frequency tables. One-sample kolomogorov smirnov testwas applied to see normality of data. Paired sample t-test was applied for normally distributedwhile Wilcoxon test for non-normally distributed data. Results: There were 26(23.6%) male and84(76.4%) female with mean age 32.30±11.40 years. Successful results of PTMC with MVA ≥1.5were obtained in 97 (88.2%) while it remained unsuccessful in 13 (11.8%) patients. Successfulresults with Wilkins score <8 were obtained in 22(95.6%) and unsuccessful in 1(4.3%) patient.While with Wilkin score ≥8, it remained successful in 75(86.2%) and unsuccessful in 12(13.7%)patients. Sensitivity and specificity of Wilkins score for the success of PTMC was 22.68% and92.31% respectively. Conclusion: The success of PTMC depends upon valve morphology.Wilkins score is the best determinant to predict the likelihood of success or failure of procedureand therefore should be used to select suitable patients prior to PTMC.