PREDICTIVE VALUE OF WILKIN’S SCORE IN DETERMINING THE PROCEDURAL SUCCESS OF PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY
Objectives: To assess the predictive value of Wilkin’s score in determining the
procedural 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 or
border line pliable valve were included in study. Patients who had LA thrombus, severe mitral
regurgitation, severe valvular calcification were excluded from study. Patients were evaluated
clinically and echocardiographically 24 hours before and after procedure. Valve morphology was
assessed using 2D echocardiography. Wilkins’ score’s sensitivity and specificity and predictive
accuracy at score >8 was also assessed. Mean was used to express quantitative data while
qualitative data was presented using frequency tables. One-sample kolomogorov smirnov test
was applied to see normality of data. Paired sample t-test was applied for normally distributed
while Wilcoxon test for non-normally distributed data. Results: There were 26(23.6%) male and
84(76.4%) female with mean age 32.30±11.40 years. Successful results of PTMC with MVA ≥1.5
were obtained in 97 (88.2%) while it remained unsuccessful in 13 (11.8%) patients. Successful
results 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% and
92.31% 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 procedure
and therefore should be used to select suitable patients prior to PTMC.