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Reconsiderations of mitral stenosis: rheumatic mitral valve repair and the Wilkins score

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Abstract

Background

Mitral valve repair is a feasible treatment option in patients with rheumatic mitral valve disease, but it is not always successful. Mitral valve replacement is generally the surgical treatment of choice in such patients. We aimed to examine whether the Wilkins score can predict the feasibility of surgical repair in such patients.

Methods

Mitral valve surgery was performed on 14 patients by the same surgeon (A.A.). Five patients underwent mitral valve repair (group I), and nine patients underwent mitral valve replacement (group II). The Wilkins scores were determined by assessing echocardiography findings. The selection of mitral valve repair or replacement was based on the intraoperative findings and the preferences of the same surgeon (A.A.). In group I, we performed chordal reconstruction, augmentation of the posterior leaflet, resection of chordae, decalcification of the commissure, commissurotomy, slicing of the anterior leaflet, division of the papillary muscle, and ring annuloplasty in various combinations.

Results

There were no significant differences between the two groups with regard to any component of the preoperative Wilkins score. There was no significant difference in the pre- and postoperative scores in group I; however, the mitral valve orifice area was significantly improved after the operation (pre- and postoperative mean values: 1.3 ± 0.3 and 2.0 ± 0.4, P < 0.05).

Conclusion

Mitral valve repair is effective in treating rheumatic mitral stenosis. However, the Wilkins score may not be useful in predicting the feasibility of mitral repair.

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Acknowledgment

Masao Daimon is partially supported by a Grant-in-Aid for Scientific Research C (20500427) from the Japan Society for the Promotion of Science and a Grant-in-Aid for Scientific Research (20231501) from the Ministry of Health, Labour and Welfare.

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Correspondence to Atsushi Amano.

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Makinae, H., Daimon, M., Tambara, K. et al. Reconsiderations of mitral stenosis: rheumatic mitral valve repair and the Wilkins score. J Echocardiogr 8, 106–111 (2010). https://doi.org/10.1007/s12574-010-0052-y

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  • DOI: https://doi.org/10.1007/s12574-010-0052-y

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