Mitral Stenosis

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Introduction

Mitral Stenosis

Welcome to the cardiac surgery urgency assessment tool for Mitral Stenosis (9073).

This implementation is a temporary work around replacing the old CPS tool which ‘died’ sooner and more completely than expected.

It is planned that a more comprehensive, user friendly, environment will be created to improve the utility and look and feel. The goal is to ensure all patients undergoing elective or urgent cardiac surgery, and soon cardiological intervention, will be scored consistently.

Prioritisation

Mitral Stenosis

Valve severity
  • (MVA 1.0-1.5cm²)
  • (MVA 0.6-0.99cm²)
  • (MVA < 0.6cm²)
Symptoms related to the valve disease
  • (NYHA IIa, angina CCS I or presyncope)
  • (NYHA IIb or NYHA III, angina CCS II-III or syncope or recurrent presyncope, or requiring diuretic treatment for heart failure)
  • (On maximal ℞ for heart failure, unstable angina despite maximal ℞, recurrent syncope)
Cardiac dysfunction
  • (Normal or mildly dilated LA size in SR)
  • (e.g. Early LV dysfunction but EF>50%, severe LVH, Nt-BNP>300pg/ml or BNP>100pg/ml or >1.5X increase/year, abnormal TDI [sPAP 40-50mmHg at rest, Dilated LA (area to be determined from guidelines)])
  • (LVEF 40-50% or Definite heart failure level BNP [AF (includes paroxysmal or recent onset AF) OR sPAP > 50mmHg at rest])
  • (LVEF < 40%, doubling of a definite heart failure level BNP [No additional information])
Disease progression
  • (No additional information)
  • ((> 15% deterioration in 2 measures over ≤ 1 year) (Not scored for MS – will score 0 – is this what we want?))
Additional AHA/ACC/ESC class 1 indication for surgery
Euroscore

Calculate Euroscore   (opens in new tab)

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