title: [Echocardiographic factors determining immediate result of percutaneous mitral balloon commissurotomy].
abstract: OBJECTIVE
  Define echocardiographic predictors of the result after percutaneous mitral balloon commissurotomy (PMC).
  
  
  METHODS
  PMC by the Inoue balloon was attempted in 247 patients (77% female) with severe mitral valve stenosis. The mean age was 35 years. All the patients had undergone echocardiographic examination before PMC to assess mitral anatomy, commissural calcification, and to determine the Wilkins score.
  
  
  RESULTS
  The mean value of Wilkins score was 7,98 +/- 1,61 (range 5-13) and the mean mitral valve area (MVA) before PMC was 1 +/- 0,19 cm2 (range 0,5- 1,4 cm2). 29 patients (11,7%) had one-commissural calcification and 2 patients (0,8%) had bi-commissural calcifications. After PMC, the mean MVA increased to 1,79 +/- 0,34 cm2 (p <0,001) resulting in a success rate of 83%. Severe mitral regurgitation (> or =grade 3) occurred in five patients (2%). Wilkins score was an independent predictor of the immediate result of PMC but, if > 8, this score had a weak predictive value. Commissural morphology was another independent predictor of the immediate result of PMC.
  
  
  CONCLUSIONS
  Echocardiography is now the cornerstone for the assessment of mitral anatomy before PMC and should integrate Wilkins score and commissural morphology for the selection of patients to PMC.
authors.affiliation: Service de Cardiologie, Hôpital Charles Nicolle, Tunis.
authors.forename: Leila
authors.initials: L
authors.lastname: Bezdah
authors.forename: Mohamed Akram
authors.initials: MA
authors.lastname: Drissa
authors.forename: Riadh
authors.initials: R
authors.lastname: Kasri
authors.forename: Hedi
authors.initials: H
authors.lastname: Baccar
authors.forename: Ali
authors.initials: A
authors.lastname: Belhani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000628:therapy; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D002648:Child; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D008944:Mitral Valve Insufficiency / Q000209:etiology; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D011183:Postoperative Complications; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D016896:Treatment Outcome