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Comparative Outcomes of Percutaneous Transvenous Mitral Commissurotomy Between Low and High Wilkins Score Publisher Pubmed



Alidoosti M1 ; Sattartabar B1 ; Pourhoseini H1 ; Salarifar M1 ; Nematipour E1 ; Hajizeinali A1 ; Aghajani H2 ; Amirzadegan A2 ; Baharvand F3
Authors
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Authors Affiliations
  1. 1. Tehran Heart Center, Interventional Cardiology Departement, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

Source: Asian Cardiovascular and Thoracic Annals Published:2023


Abstract

Background: Percutaneous transvenous mitral commissurotomy (PTMC) is one of the non-surgical methods for patients with significant mitral stenosis. It is less invasive, less complicating with better outcomes compared to surgery. The Wilkins score ≤8 is used to select patients for PTMC, but the results of several studies suggest that PTMC can also be successful in a higher Wilkins score. The aim of this study is to compare the outcomes of PTMC between two groups. Methods: In this retrospective study, patients who underwent PTMC between April 2011 and December 2019 were included. Patients were divided into two groups based on Wilkins score: 196 patients (57.64%) with a Wilkins score ≤8 (group I) and 134 patients (39.4%) with a Wilkins score >8 (group II). Results: There was no difference in demographic characteristics between two groups except for age (p = 0.04). Pre and post-interventional echocardiographic and catheterization measurements including left atrial pressure, pulmonary artery pressure, mitral valve area, mitral valve mean, and peak gradient were measured, and there was no difference between the two groups (p > 0.05). The most common complication was mitral regurgitation (MR). Serious complications such as stroke and arrhythmias were rare in both groups (<1%). There was no difference between MR, ASD (atrial septal defect) and serious complications between the two groups. Conclusion: This study shows that the Wilkins score with a cutoff value of 8 is not suitable for patient selection and novel criteria including both mitral valve features and other variables affecting the PTMC outcomes is needed. © The Author(s) 2023.