Mitral Valve Stenosis Calculator
Perform online calculations to determine the Class of Recommendation for Mitral Valve Stenosis Intervention according to Guidelines
March 15th, 2022
(updated December 14th, 2024)
How to use the Calculator. The Calculator is an Excel file: type in the yellow cells the information requested, checking the Legend provided in or below the Calculator box for explanations concerning the variable values. The Calculator will instantly calculate the results of formulas in the gray cells, and provide the Wilkins Score, suitability for PMC, and Surgical Indication and Recommendation Class.
The Calculator is based on the recently published 2021 European Guidelines for the management of valvular heart disease.
Wilkins Score
Assessment of mitral valve anatomy according to the Wilkins score
| Grade | Mobility | Thickening | Calcification | Subvalvular thickening |
|---|---|---|---|---|
| 1 | Highly mobile valve with only leaflet tips restricted | Near normal leaflet thickness (4-5 mm) | A single area of increased echo brightness | Minimal thickening just below the mitral leaflets |
| 2 | Leaflet mid and base portions have normal mobility | Mid leaflets normal, considerable thickening of margins (5-8 mm) | Scattered areas of brightness confined to leaflet margins | Thickening of chordal structures extending to 1/3 of the chordal length |
| 3 | Valve continues to move forward in diastole, mainly from the base | Thickening extending through the entire leaflet (5-8 mm) | Brightness extending into the mid portions of the leaflets | Thickening extending to distal third of the chords |
| 4 | No or minimal forward movement of the leaflets in diastole | Considerable thickening of all leaflet tissue (>8-10 mm) | Extensive brightness throughout much of the leaflet tissue | Extensive thickening and shortening of all chordal structures extending down to the papillary muscles |
Legend
- Atrial fibrillation
- Commissural fusion
- Concomitant severe AV disease
- Concomitant indication for TV surgery
- Concomitant CAD requiring surgey
- Desire for pregnancy
- Experienced Center for PMC
- Futility
- High surgical risk / Contraindication
- History of embolism
- LA thrombus
- MAC causing severe MS
- MR grade
- Need for major NCS
- NYHA
- Previous commissurotomy
- SEC (moderate / severe)
- Severe or bi-commissural calcium
- Severe tricuspid stenosis
- Symptoms
- Symptoms at exercise echocardiography
- TR grade
- No= 0 / New onset or PAF= 1 / Permanent= 2
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- Trace= 1 / Mild= 2 / Moderate= 3 / Severe= 4
- No= 0 / Yes= 1
- 1 / 2 / 3 / 4
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- No= 0 / Yes= 1
- Tface= 1 / Mild= 2 / Moderate= 3 / Severe= 4
Abbreviations
- AV: Aortic Valve
- CAD: Coronary Artery Disease
- LA: Left Atrial
- MAC: Mitral Annulus Calcification
- MR: Mitral Regurgitation
- MV: Mitral Valve
- MVA: Mitral Valve Annulus
- NCS: Non Cardiac Surgery
- NYHA: New York Heart Association
- PAF: Paroxysmal Atrial Fibrillation
- PMC: Percutaneous Mitral Commissurotomy
- SEC: Spontaneous Echo Contrast
- TR: Tricuspid Regurgitation
- TV: Tricuspid Valve