Aortic Valve Velocity Ratio	LV EF (Modified Quinones Equation)	Myocardial Performance Index (RV)
AVA (Continuity Equation VTI)	LV EF (Simplified Quinones Equation)	PCWP by E/Ea (Nagueh Formula)
AVA (Continuity Equation V_Max)	LV Fractional Shortening	PISA (Mitral regurgitation)
dP/dt (LV contractility)	LV Mass and LV Mass Index	PISA (Mitral stenosis)
dP/dt (RV contractility)	Mitral valve area (PHT)	Qp/Qs
Left atrial pressure (MR)	Mitral Valvuloplasty Score (MGH)	RVSP (TR)
LA Volume (Biplane Method)	Modified Bernoulli Equation	Stroke Volume, Cardiac Output
LV EF (Dumesnil Method)	Myocardial Performance Index (LV)

Mitral Valvuloplasty Score (MGH)

Item	Rating	Value

Leaflet Mobility	Highly mobile	1
	Reduced mobility	2
	Basal leaflet motion only	3
	Minimal motion	4


Valve Thickening	Near normal (4-5 mm)	1
	Thickened tips	2
	Entire leaflet thickened (5-8 mm)	3
	Marked leaflet thickening (>8-10 mm)	4


Calcification	Single area of brightness	1
	Scattered areas at leaflet margins	2
	Brightness extends to mid leaflets	3
	Extensive leaflet brightness	4


Subvalvular Thickening	Minimal chordal thickening	1
	Chordal thickening up to 1/3	2
	Distal third of chordae thickening	3
	Extensive thickening to pap muscle	4

Mitral Valve Score
Outcome

In patients undergoing mitral valvuloplasty for mitral stenosis, an echocardiographic scoring system based on 1) leaftlet mobility, 2) valve thickening, 3) calcification, 4) subvalvular thickening can be used to predict the procedural outcome. Each item is graded from 1 (normal) to 4 which yield a score from 4 to 16. A score of 8 or less predicts a more favorable outcome than those with a higher score. However, a score higher than 8 does not exclude a patient from having a mitral valvuloplasty. Commissural calcification or fusion is another important predictor for poor outcome after mitral valvuloplasty.

Mitral Valve Score =

Leaflet Mobility + Valve Thickening + Calcification + Subvalvular Thickening

Variable
Leaflet Mobility
1	Highly mobile
2	Reduced mobility
3	Basal leaflet motion only
4	Minimal motion
Valve thickening
1	Near normal (4-5 mm)
2	Thickened tips
3	Entire leaflet thickened (5-8 mm)
4	Marked leaflet thickening (>8-10 mm)
Calcification
1	Single area of brightness
2	Scattered areas at leaflet margins
3	Brightness extends to mid leaflets
4	Extensive leaflet brightness
Subvalvular thickening
1	Minimal chordal thickening
2	Chordal thickening up to 1/3
3	Distal third of chordae thickening
4	Extensive thickening to pap muscle

References

	Baumgartner H, et al. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. J Am Soc Echocardiogr. 2009 Jan;22(1): 14.

	Wilkins GT, Weyman AE, Abascal VM, Block PC, Palacios IF. Percutaneous balloon dilatation of the mitral valve: analysis of echocardiographic variables related to outcome and the mechanism of dilatation. Br Heart J. 1988 Oct; 60(4):299-308.

	Abascal VM, Wilkins GT, Choong CY, Thomas JD, Palacios IF, Block PC, Weyman AE. Echocardiographic evaluation of mitral valve structure and function in patients followed for at least 6 months after percutaneous balloon mitral valvuloplasty. J Am Coll Cardiol 1988; 12:606-615

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Author: Dr. Chi-Ming Chow

Developer: Edward Brawer

Disclaimer: The calculators provided are not meant to be a substitute for professional advise and are not to be used for medical diagnosis. All calculations must be confirmed before clinical use or diagnostic purposes by qualified medical professionals. The authors make no claims of the accuracy of the information contained herein. The authors make no claims whatsoever, expressed or implied, about the authenticity, accuracy, reliability, completeness or timeliness of the material, software, text, graphics and links given. In no event shall the authors, its suppliers, affiliates or any third parties be liable in any manner whatsoever for any damage arising upon use of any information provided.