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Mitral Valvuloplasty Score (MGH)

Calculation


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
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Information

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 Illustrator: Ellen Ho
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