A differentiated morphological parameter-coding system to describe the suitability of mitral valve stenoses intended for percutaneous valvotomy

Bogunovic, Nikola; Horstkotte, Dieter; Scholtz, Werner; Faber, Lothar; Bogunovic, Lukas; Buuren, Frank
September 2015
Heart & Vessels;Sep2015, Vol. 30 Issue 5, p632
Academic Journal
Percutaneous balloon-mitral-valvotomy (PBMV) is an alternative to surgery in selected patients with mitral valve (MV) stenosis (MS). Applying echocardiography, suitability for PBMV is assessed by detailed morphological description. Echo-scores alone are suboptimal to describe MV morphology, because single parameters, important for a decision concerning PBMV, are not distinguishable out of a score number. The aim was to design a tool (coding-system), which combines a number for a stenotic MV like scores (for statistical options) and decodable, generally applied parameters describing the MS morphology. The reproducibility of the MS morphology using the coding-system has to be tested in 90 patients. A separate group of 297 patients (pts) with MS, scheduled for PBMV, should be investigated prospectively applying the coding-system and a comparable score. We chose the Wilkins score (WS) as representative of scores. The coding-system is designed as a parameter sequencing set consisting of 6 digits. The first digit indicates a decision code concerning suitability for PBMV. The following 5 digits indicate generally accepted morphological parameters, which are partially also used in the WS. Therefore, the MS morphology can be 'read' retrospectively by decoding. 201/297 patients were found suitable for PBMV. Applying the coding-system all 201 suitable patients were correctly distinguished from 96 morphologically unsuitable patients. Astonishingly 48/96 of the rejected patients showed a WS ≤8 whereas 28/201 of the suitable patients demonstrated a WS >8. 25/28 of them showed a successful initial outcome. Applying the generally known threshold of '8' when predicting suitability of a MS, the WS demonstrated an initial success rate of 62 %, sensitivity of 0.87, specificity of 0.45, precision of 0.79, and accuracy of 0.78. Applying the coding-system, the initial success rate was 70.8 %, sensitivity = 0.96, specificity = 1.0, precision = 1.0, and accuracy = 0.97. The coding-system is an advanced diagnostic aid, is statistically applicable, offers a decodable morphological description, includes a decision code regarding suitability for PBMV, and can be used for comparing different groups of patients with MS by calculating 'mean morphologies' of groups.


Related Articles

  • Treatment with pioglitazone induced significant, reversible mitral regurgitation. Dorkhan, Mozhgan; Dencker, Magnus; Frid, Anders // Cardiovascular Diabetology;2008, Vol. 7, p1 

    There has in recent years been great concern about possible cardiac side effects of thiazolidinediones (TZDs). We present a case-report of a 60 year-old male who developed significant mitral regurgitation during six months treatment with pioglitazone in parallel with laboratory indications of...

  • Moderated Posters sessionNew insights into risk stratification in valvular heart disease - Part B.  // European Heart Journal - Cardiovascular Imaging;Dec2013, Vol. 14 Issue suppl_2, pii18 

    The article presents abstracts of research papers on risk stratification in valvular heart disease including "Left Atrial Strain for Prognosis Prediction in Patients With Moderate Mitral Valve Regurgitation," "Moderate to Severe Tricuspid Regurgitation Is an Independent Predictor for Early...

  • Results of balloon valvuloplasty in 40 dogs with pulmonic stenosis.  // Veterinary Record: Journal of the British Veterinary Association;5/22/2004, Vol. 154 Issue 21, p663 

    Discusses the abstract of a study about the use of balloon valvuloplasty to treat dogs with pulmonic stenosis.

  • First patients enrolled in Evalve's post-market study.  // Medical Device Daily;4/10/2009, Vol. 13 Issue 68, p1 

    The article reports on the enrollment of the first subject in the ACCESS-Europe study, a post-market observational study of Evalve's MitraClip for the percutaneous repair of cardiac valves. The MitraClip system is noted to be the first commercially available treatment in Europe and the U.S. for...

  • Evalve reports 1st Austrian implants of Mitracilp.  // Medical Device Daily;9/14/2009, Vol. 13 Issue 176, p7 

    The article reports on the treatment of the first group of patients with the MitraClip system from Evalve at the Elisabethinen Krankenhaus in Linz, Austria. According to Evalve, the MitraClip system is the only medical device commercially available in the European Union (EU) which offers a...

  • Percutaneous Dual-valve Intervention in a High-risk Patient with Severe Aortic and Mitral Stenosis. Mrevlje, Blaz; Aboukura, Mohamad; Nienaber, Christoph A. // Heart Views;Jul-Sep2016, Vol. 17 Issue 3, p109 

    Aortic stenosis is the most frequent and mitral stenosis is the least frequent native single-sided valve disease in Europe. Patients with the combination of severe symptomatic degenerative aortic and mitral stenosis are very rare. Guidelines for the treatment of heart valve diseases are clear...

  • How to grow a heart: fibreoptic guided fetal aortic valvotomy. Suh, Elsa; Quintessenza, James; Huhta, James; Quintero, Ruben // Cardiology in the Young;Jan2006 Supplement, Vol. 16 Issue S1, p43 

    The article describes the case study of a fetus suspected of developing hypoplasia of the left heart. A male fetus was diagnosed at 21 weeks gestation with critical aortic stenosis by fetal echocardiography. The aortic regurgitation caused significant left ventricular diastolic dysfunction. A...

  • Transoesophageal echocardiographic assessment of mitral valve commissural morphology predicts outcome after balloon mitral valvotomy. Sutaria, N.; Shaw, T. R. D.; Prendergast, B.; Northridge, D. // Heart;Jan2006, Vol. 92 Issue 1, p52 

    Objective: To investigate the value of transoesophageal echocardiography in the assessment of commissural morphology and prediction of outcome after balloon mitral valvotomy (BMV). Design: Prospective study. Setting: Tertiary cardiac referral centre. Patients: 72 consecutive patients (mean age...

  • Incremental utility of Live/Real time three-dimensional transesophageal echocardiography in diagnosis of a unique type of subaortic membrane: a case report. Güngör, Barış; Mutluer, Ferit Onur; Karataş, Baran; Ekmekçi, Ahmet; Orhan, Gökçen; Bolca, Osman // Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi;Jun2014, Vol. 14 Issue 4, p399 

    The article presents a case study of a 29 year-old man who had undergone valvulotomy for congenital aortic stenosis (AS) due to bicuspid aortic valve (BAV) and admitted to hospital with rest dyspnoea. It mentions Chest X-ray and laboratory parameters were normal. It informs about three...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics