Table 1

Anatomic classification of the mitral valve (Wilkins' score, Massachusetts General Hospital)

Leaflet mobility
  •  Highly mobile valve with restriction of only the leaflet tips
•  Mid portion and base of leaflets have reduced mobility
 •  Valve leaflets move forward in diastole mainly at the base
•  No or minimal forward movement of the leaflets in diastole
Valvar thickening
 •  Leaflets near normal (4–5 mm)
•  Mid leaflet thickening, pronounced thickening of the margins
•  Thickening extends through the entire leaflets (5–8 mm)
•  Pronounced thickening of all leaflet tissue (> 8–10 mm)
Subvalvar thickening
 •  Minimal thickening of chordal structures just below the valve
•  Thickening of chordae extending up to one third of chordal length
•  Thickening extending to the distal third of the chordae
•  Extensive thickening and shortening of all chordae extending down to the papillary muscle
Valvar calcification
 •  A single area of increased echo brightness
•  Scattered areas of brightness confined to leaflet margins
•  Brightness extending into the mid portion of leaflets
•  Extensive brightness through most of the leaflet tissue