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.
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.
Authors: Helmut Baumgartner; Judy Hung; Javier Bermejo; John B Chambers; Arturo Evangelista; Brian P Griffin; Bernard Iung; Catherine M Otto; Patricia A Pellikka; Miguel Quiñones Journal: J Am Soc Echocardiogr Date: 2009-01 Impact factor: 5.251
Authors: Gorav Ailawadi; Brian R Swenson; Micah E Girotti; Leo M Gazoni; Benjamin B Peeler; John A Kern; Lynn M Fedoruk; Irving L Kron Journal: Ann Thorac Surg Date: 2008-07 Impact factor: 4.330
Authors: A Marc Gillinov; Eugene H Blackstone; Abdulrahman Alaulaqi; Joseph F Sabik; Tomislav Mihaljevic; Lars G Svensson; Penny L Houghtaling; Arash Salemi; Douglas R Johnston; Bruce W Lytle Journal: Ann Thorac Surg Date: 2008-09 Impact factor: 4.330