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Wilkins Score

Wilkins Score (Mitral Valvuloplasty): Echocardiographic score used to predict the outcome of PMBV in patients with Rheumatic Mitral Stenosis.

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

When to Use

Assessment of Rheumatic Mitral Stenosis (MS) suitability for Percutaneous Mitral Balloon Valvuloplasty (PMBV).
To predict the immediate result and long-term durability of the valvuloplasty procedure.

Absolute Contraindications to PMBV

Presence of Left Atrial (LA) thrombus or Moderate-to-Severe Mitral Regurgitation (MR). Even if the Wilkins score is low, these findings preclude the percutaneous approach.

How it Works

Scoring Components

The score evaluates four specific morphologic features of the mitral valve on a scale of 1 to 4:

Criteria

01
Mobility: Refers to the motion of the leaflets.
02
Subvalvular Thickening: Refers to the thickening and fusion of the chordae tendineae and papillary muscles.
03
Leaflet Thickening: Refers to the thickening of the leaflet tissue itself.
04
Calcification: Refers to the presence and extent of echocardiographic brightness (calcification).

Interpretation

Score ≤ 8: High likelihood of success (>90%).
Score 9–11: Intermediate likelihood; procedure may be attempted with caution.
Score ≥ 12: Low likelihood of success; higher risk of severe MR or technical failure.

Clinical Pearls

Cormier Score Alternative

While the Wilkins score is the international standard, the Cormier score is sometimes used in Europe. It focuses more heavily on the degree of calcification and subvalvular involvement, which are the primary drivers of PMBV failure.

Commissural Calcification

Modern refinements to the Wilkins score suggest that the presence of calcium IN THE COMMISSURES is more predictive of poor outcome than overall leaflet calcium. A "low" Wilkins score with commissural calcium may still lead to procedural failure.

The Evidence

Original Validation

The echocardiographic prediction of the anatomic outcome of percutaneous mitral valvuloplasty.

Wilkins GT et al. • J Am Coll Cardiol.. 1988;12(1):25-31. The seminal study establishing the scoring system.

Last Comprehensive Review: 2026-07-17

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

When to Use

Assessment of Rheumatic Mitral Stenosis (MS) suitability for Percutaneous Mitral Balloon Valvuloplasty (PMBV).
To predict the immediate result and long-term durability of the valvuloplasty procedure.

Absolute Contraindications to PMBV

Presence of Left Atrial (LA) thrombus or Moderate-to-Severe Mitral Regurgitation (MR). Even if the Wilkins score is low, these findings preclude the percutaneous approach.

How it Works

Scoring Components

The score evaluates four specific morphologic features of the mitral valve on a scale of 1 to 4:

Criteria

01
Mobility: Refers to the motion of the leaflets.
02
Subvalvular Thickening: Refers to the thickening and fusion of the chordae tendineae and papillary muscles.
03
Leaflet Thickening: Refers to the thickening of the leaflet tissue itself.
04
Calcification: Refers to the presence and extent of echocardiographic brightness (calcification).

Interpretation

Score ≤ 8: High likelihood of success (>90%).
Score 9–11: Intermediate likelihood; procedure may be attempted with caution.
Score ≥ 12: Low likelihood of success; higher risk of severe MR or technical failure.

Clinical Pearls

Cormier Score Alternative

While the Wilkins score is the international standard, the Cormier score is sometimes used in Europe. It focuses more heavily on the degree of calcification and subvalvular involvement, which are the primary drivers of PMBV failure.

Commissural Calcification

Modern refinements to the Wilkins score suggest that the presence of calcium IN THE COMMISSURES is more predictive of poor outcome than overall leaflet calcium. A "low" Wilkins score with commissural calcium may still lead to procedural failure.

The Evidence

Original Validation

The echocardiographic prediction of the anatomic outcome of percutaneous mitral valvuloplasty.

Wilkins GT et al. • J Am Coll Cardiol.. 1988;12(1):25-31. The seminal study establishing the scoring system.

Last Comprehensive Review: 2026-07-17

Recent Journal Updates

JAMAJul 21, 2026
Correction to Primary Composite Outcome in a Trial of Transfusion Strategy

Clinical Context

We think this has broad domain relevance to Wilkins Score (Mitral Valvuloplasty).

FDA MedWatchJul 15, 2026
Early Alert: Ventilator Issue from Resmed

Clinical Context

We think this has broad domain relevance to Wilkins Score (Mitral Valvuloplasty).

Clinical Pharmacology TherapeuticsJul 3, 2026
Decoupling CAR‐T Expansion, Conversion, and Decay Timing: Physiologically Aligned Semi‐Mechanistic Modeling With Smooth Gating and a Cauchy Likelihood Residual Model

Clinical Context

We think this has broad domain relevance to Wilkins Score (Mitral Valvuloplasty).