Key result
Patients with a high echocardiographic Wilkins score (>8) had a significantly smaller increment in mitral valve area following percutaneous transvenous mitral commissurotomy compared to those with a score ≤8 (0.63 cm² vs 0.93 cm², p<0.025).
Why the study?
Despite extensive experience with PTMC for suitable mitral stenosis, predicting which types of valves achieve good results after the procedure is not well defined.
Does a low Wilkins echocardiographic score (≤8) predict successful outcomes (valve area > 1.5cm2) after percutaneous transvenous mitral commissurotomy in patients with mitral stenosis?
Observational (n=60)
No
Does a low Wilkins echocardiographic score (≤8) predict successful outcomes (valve area > 1.5cm2) after percutaneous transvenous mitral commissurotomy in patients with mitral stenosis?
Absolute Event Rate: 0.63% vs 0.93%
p-value: p=<0.025
A Wilkins echocardiographic score of 8 or less predicts successful procedural outcomes (valve area > 1.5cm2) following percutaneous transvenous mitral commissurotomy.
Provides hypothesis-generating data on echocardiographic predictors of procedural success; leaves open the need for prospective validation.
BACKGROUND Percutaneous transvenous mitral commissurotomy (PTMC) is now a standard treatment for suitable mitral stenosis. However all procedures are not always successful or optimal. Despite having so much experience on the procedure the prediction as which types of valves give good results after PTMC is not very much defined. METHODS Initial sixty patients of PTMC of Shahid Gangalal hospital (18 male, 42 female), age ranging from 13 to 65 years, mean age 29.9±11.5 years, were studied retrospectively. Their echocardiography data before and after balloon dilatation of mitral valve were collected. The appearance of mitral valve on echocardiogram before PTMC was scored for leaflet thickening, leaflet mobility, subvalvular thickening and calcification. They were categorized into low scoring group A if they scored 8 or low, and high scoring group B if they scored above 8 according to Wilkins score. RESULTS Results were classified as successful and optimal (if valve area > 1.5cm2) or suboptimal (if valve area ≤1.5 cm2). High scoring leaflet deformity with more than 8 was associated with suboptimal results while low score group had successful outcomes and their difference was significant statistically. CONCLUSION Patients with high severity scoring of mitral valve disease had poor outcome in comparison to those with low score.
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Rajbhandari et al. (2023) conducted an observational in Mitral stenosis (n=60). High echocardiographic Wilkins score (>8) vs. Low echocardiographic Wilkins score (≤8) was evaluated on Increment in mitral valve area (p=<0.025). Patients with a high echocardiographic Wilkins score (>8) had a significantly smaller increment in mitral valve area following percutaneous transvenous mitral commissurotomy compared to those with a score ≤8 (0.63 cm² vs 0.93 cm², p<0.025).
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