A novel prognostic scoring system to predict late outcome after percutaneous balloon valvotomy in patients with severe mitral stenosis

• Published in: The American heart journal Vol. 134; no. 4; pp. 772 - 778
• Main Authors: Zhang, He Ping, Ruiz, Carlos E., Allen, John W., Lau, Francis Y.K.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.10.1997; Elsevier
• Subjects: Biological and medical sciences; Cardiology. Vascular system; Catheterization; Disease-Free Survival; Echocardiography; Endocardial and cardiac valvular diseases; Follow-Up Studies; Heart; Humans; Medical sciences; Middle Aged; Mitral Valve Stenosis - diagnostic imaging; Mitral Valve Stenosis - pathology; Mitral Valve Stenosis - physiopathology; Mitral Valve Stenosis - therapy; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Risk Factors; Severity of Illness Index; Survival Analysis; Time Factors; Treatment Outcome; Human; Mitral valve; Prognosis; Instrumentation therapy; Cuffed tube; Cardiovascular disease; Narrowing; Instrumental dilatation; Survival; Treatment; Cardiac valvular disease; Follow up study; Severity score
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/S0002-8703(97)70063-2

We developed a prognostic scoring system to predict the outcome of follow-up after balloon mitral valvotomy. The system incorporates seven variables before valvotomy: age, New York Heart Association class, fluoroscopic calcification, echocardiographic score, cardiac rhythm, mitral regurgitation, and mitral valve area. Each variable was coded with either 0 or 1 and a total score was between 0 and 7. The study included 150 patients with a mean follow-up of 33 ± 24 months. In patients with scores of 0-1, 2-3, 4-5, and 6-7, the estimated cardiac event-free survival rate was 97%, 94%, 86%, and 68%, respectively, at 1 year; 95%, 88%, 74%, and 47%, respectively, at 3 years; and 92%, 82%, 61%, and 30%, respectively, 5 years after valvotomy ( p = 0.0001). The hazard risk ratio for cardiac events was 1.7 times greater for every step up of the score ( p = 0.0001). Our scoring system provides a simple but effective method to predict late outcome of balloon mitral valvotomy. (Am Heart J 1997;134:772-8.)