Selection of patients for percutaneous balloon mitral valvotomy: Is there a definitive limit for the Wilkins score?

Paiva, Mariana; Correia, Ana Sofia; Lopes, Ricardo; Gonçalves, Alexandra; Almeida, Rui; Almeida, Pedro; Frutuoso, Cecília; Silva, João Carlos; Maciel, Maria Júlia

doi:10.1016/j.repc.2013.02.017

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Paiva et al [19] noticed none significant differences between patients with score 9 -11 and patients with score < 8 regarding major complication or success rate. Pre-operative transthoracic echocardiography also showed that patients who developed severe MR had higher incidence of other valvular lesions, MV commissural calcification, pre-operative MR, and higher prevalence of AF.…”

Section: Discussionmentioning

confidence: 92%

Predictors of Complications during Percutaneous Multitrack Balloon Mitral Valvuloplasty

Sabry¹,

Montaser²

2020

WJCD

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Background: Percutaneous mitral balloon valvuloplasty is the main procedure in mitral stenosis (MS). It can replace surgical commissurotomy in many cases; however, mitral regurgitation (MR) remains the major procedure complication. Objectives: This study was conducted to investigate predictors of MR as a complication following percutaneous mitral valvuloplasty (PMV) using multitrack balloon technique. Methods: This cohort study was conducted at both Menoufia University Hospital and Mabaret Misr Elkadima Hospital. We enrolled 121 patients with moderate to severe MS who were subjected to PMV using multitrack balloon technique during the period from October 2017 to October 2019. Transthoracic echocardiographic evaluation was performed for all patients before and after the procedure. Patients who developed severe MR post procedure were compared with other patients to identify important distinction points. Results: Most patients (N = 109, 90.1%) developed no/mild MR (group A), whereas 12 (9.9%) patients developed severe MR (group B) after PMV. Those who developed severe MR had significantly higher weight, height, body mass index, and body surface area (P value < 0.001 for each). Also, there was a significant difference between both groups regarding pre-operative Wilkins score (8.7 ± 1.3 for severe MR versus 7.9 ± 1.2 for No/Mild MR, P = 0.046). Patients who developed severe MR had higher incidence of other valvular lesions such as mild aortic regurgitation (91.7% versus 36.7%, P < 0.001), higher mitral valve (MV) commissural calcification (50.0% versus 14.7%, P = 0.008), pre-operative MR (100.0% versus 35.8%, P < 0.001), higher prevalence of atrial fibrillation (100.0% versus 38.5%, P < 0.001). Regarding balloon sizing, it was significantly higher among patients who developed severe MR compared with those having mild or no MR (P = 0.001). Multivariate regression analysis identified MV balloon sizing How to cite this paper:

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Section: Discussionmentioning

confidence: 92%

Predictors of Complications during Percutaneous Multitrack Balloon Mitral Valvuloplasty

Sabry¹,

Montaser²

2020

WJCD

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Contemporary Diagnosis and Management of Rheumatic Heart Disease: Implications for Closing the Gap: A Scientific Statement From the American Heart Association

Kumar¹,

Antunes²,

Beaton³

et al. 2020

Circulation

112

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The global burden of rheumatic heart disease continues to be significant although it is largely limited to poor and marginalized populations. In most endemic regions, affected patients present with heart failure. This statement will seek to examine the current state-of-the-art recommendations and to identify gaps in diagnosis and treatment globally that can inform strategies for reducing disease burden. Echocardiography screening based on World Heart Federation echocardiographic criteria holds promise to identify patients earlier, when prophylaxis is more likely to be effective; however, several important questions need to be answered before this can translate into public policy. Population-based registries effectively enable optimal care and secondary penicillin prophylaxis within available resources. Benzathine penicillin injections remain the cornerstone of secondary prevention. Challenges with penicillin procurement and concern with adverse reactions in patients with advanced disease remain important issues. Heart failure management, prevention, early diagnosis and treatment of endocarditis, oral anticoagulation for atrial fibrillation, and prosthetic valves are vital therapeutic adjuncts. Management of health of women with unoperated and operated rheumatic heart disease before, during, and after pregnancy is a significant challenge that requires a multidisciplinary team effort. Patients with isolated mitral stenosis often benefit from percutaneous balloon mitral valvuloplasty. Timely heart valve surgery can mitigate the progression to heart failure, disability, and death. Valve repair is preferable over replacement for rheumatic mitral regurgitation but is not available to the vast majority of patients in endemic regions. This body of work forms a foundation on which a companion document on advocacy for rheumatic heart disease has been developed. Ultimately, the combination of expanded treatment options, research, and advocacy built on existing knowledge and science provides the best opportunity to address the burden of rheumatic heart disease.

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A predictor for mitral valve repair in patient with rheumatic heart disease: the bending angle of anterior mitral leaflet

Popal

Jiao

et al. 2018

J. Thorac. Dis.

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Selection of patients for percutaneous balloon mitral valvotomy: Is there a definitive limit for the Wilkins score?

Abstract: PBMV was a safe and effective procedure in patients in the WS gray zone. Optimal results can be achieved in these patients if they are carefully selected and operated at experienced centers.

Cited by 3 publications

References 17 publications

Predictors of Complications during Percutaneous Multitrack Balloon Mitral Valvuloplasty

Predictors of Complications during Percutaneous Multitrack Balloon Mitral Valvuloplasty

Contemporary Diagnosis and Management of Rheumatic Heart Disease: Implications for Closing the Gap: A Scientific Statement From the American Heart Association

A predictor for mitral valve repair in patient with rheumatic heart disease: the bending angle of anterior mitral leaflet

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