Grinberg et al reported the VMCP score for identifying a patient undergoing heart valve surgery who is at greater risk. The authors are from Universidade de Sao Paulo in Brazil.
VMCP indicates V (valve or prosthesis), M (myocardium), C (coronary artery), P (pulmonary artery systolic pressure).
Parameters:
(1) valve or prosthesis
(2) myocardium (ejection fraction)
(3) coronary artery
(4) pulmonary artery systolic pressure by echocardiography
Parameter
Finding
Points
valve or prosthesis
mild or moderate lesion
1
severe and asymptomatic
2
severe, symptomatic and single valve
3
severe, symptomatic and multiple valves
4
myocardium
LVEF > 60%
1
LVEF 50 to 60%
2
LVEF 30 to 49%
3
LVEF < 30%
4
coronary artery
normal or unknown
1
obstruction <= 60%
2
critical obstruction in 1 vessel
3
critical obstruction in multiple vessels
4
pulmonary artery systolic pressure
< 30 mm Hg
1
30 to 60 mm Hg
2
61 to 100 mm Hg
3
> 100 mm Hg
4
where:
• Critical obstruction of the coronary artery is > 60%.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 4
• maximum score: 16
• A score >= 8 is associated with mortality and a hospital length of stay > 10 days.
Performance:
• The area under the ROC curve for death is 0.64.
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