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 April 14th, 2022)


Wilkins Score

Assessment of mitral valve anatomy according to the Wilkins score

GradeMobilityThickeningCalcificationSubvalvular thickening
1Highly mobile valve with only leaflet tips restrictedNear normal leaflet thickness (4-5 mm)A single area of increased echo brightnessMinimal thickening just below the mitral leaflets
2Leaflet mid and base portions have normal mobilityMid leaflets normal, considerable thickening of margins (5-8 mm)Scattered areas of brightness confined to leaflet marginsThickening of chordal structures extending to 1/3 of the chordal length
3Valve continues to move forward in diastole, mainly from the baseThickening extending through the entire leaflet (5-8 mm)Brightness extending into the mid portions of the leafletsThickening extending to distal third of the chords
4No or minimal forward movement of the leaflets in diastoleConsiderable thickening of all leaflet tissue (>8-10 mm)Extensive brightness throughout much of the leaflet tissueExtensive thickening and shortening of all chordal structures extending down to the papillary muscles
Bonow RO et al. J Am Coll Cardiol 2020;76:96117.

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