Diagnostic accuracy of total echo score and total commissural morphology score for the prediction of outcome after percutaneous transvenous mitral commissurotomy (PTMC)

Abstract

INTRODUCTION: Percutaneous transvenous mitral commissurotomy (PTMC), a procedure that treats certain individuals with mitral stenosis, is now frequently used as an alternative to closed surgical mitral commissurotomy (CMC). Cardiologists disagree on which is superior when comparing the total echo score (also known as the Wilkin's score) and the commissural morphology score (TC) for predicting excellent and bad outcomes of PTMC procedures. Therefore, we created this study so that a good predictive score can be used in the future with supporting data before PTMC. AIMS & OBJECTIVE: To evaluate the diagnostic efficacy of the total echo score and the total commissural morphology score for the prognosis following percutaneous transvenous mitral commissurotomy (PTMC). MATERIALS & METHODS: This research was a cross-sectional analysis of patients at the Punjab Institute of Cardiology. This research took place over the course of 6 months, from August 20, 2014 to February 20, 2015. A total of 110 participants participated in the study. RESULTS: The mean age of patients in this study was 43.80 ± 14.18 years with 49(44.5%) males and 61(55.5%) female patients in this study. According to operational definition success of procedure was seen in 103(93.6%) of the patients while 7(6.4%) had unsuccessful procedure. On comparing Total Echo score and “successful procedure” the sensitivity and specificity of Total echo score was 83.5% and 85.71% while PPV and NPV were 98.85% and 26.09% respectively with diagnostic accuracy of 83.64%. The sensitivity and specificity of Commissural score was 92.23% and 57.14% while PPV and NPV were 96.94% and 36.33% respectively with diagnostic accuracy of 90%. CONCLUSION: Total ECO score has high sensitivity, specificity and over diagnostic accuracy but total commissural morphology score has high sensitivity but with less specificity with high diagnostic score. So total echo score can be used as predictive tool for outcome of PTMC in our population KEYWORDS: Rheumatic Heart Disease, Mitral Stenosis, PTMC, Mitral Commissurotomy