The Mitral Regurgitation International Database (MIDA) has reported a score for predicting outcome for patients with degenerative mitral regurgitation (DMR).
Patient selection: degenerative mitral valve regurgitation (flail leaflet, prolapse)
Outcome: overall survival
Parameters:
(1) age in years
(2) symptoms
(3) atrial fibrillation
(4) left atrial diameter in mm
(5) right ventricular systolic pressure in mm Hg
(6) left ventricular end-systolic diameter in mm
(7) left ventricular ejection fraction in percent
Parameter
Finding
Points
age in years
< 65 years
0
>= 65 years
3
symptoms
no
0
yes
3
left atrial diameter
< 55 mm
0
>= 55 mm
1
atrial fibrillation
no
0
yes
1
right ventricular systolic pressure
<= 50 mm Hg
0
> 50 mm Hg
2
left ventricular end-systolic diameter
< 40 mm
0
>= 40 mm
1
left ventricular ejection fraction in percent
> 60%
0
<= 60%
1
Interpretation:
• minimum score: 0
• maximum score: 12
• The higher the score the greater the mortality rate.
• The outcome varies whether the patient has medical or surgical management.
• Prognosis is also affected by the EuroScore II (mortality increases with greater EuroScore).
Score
10-Year Survival Medical Management
10-Year Survival Surgical Management
0
90%
96%
1 or 2
86%
90%
3 or 4
49%
82%
5 or 6
40%
74%
7 or 8
27%
66%
9 or 10
25%
41%
11 or 12
< 10%
37%
from Figure 4
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