Objectives .– Define echocardiographic predictors of the result after percutaneous mitral balloon commissurotomy (PMC).

Methods .– PMC by the Inoue balloon was attempted in 361 patients (73.68% female) with severe mitral valve stenosis. The mean age was 32.87 years. All the patients had undergone echocardiographic examination before PMC to assess mitral anatomy, commissural calcification, and to determine the Wilkins score. Successful PMC was defined as: final mitral valve area (MVA) ≥ 1.5 cm ² without a post-procedure mitral regurgitation (MR) grade > 2.

Results .– The mean value of Wilkins score was 7.48 ± 1.89 (range 5–13) and the mean mitral valve area (MVA) before PMC was 0.89 ± 0.17 cm ² (range 0.55–1.3 cm ² ). 34 patients (9.4%) had one-commissural calcification. After PMC, the mean MVA increased to 1.82 ± 0.1 cm ² ( P < 0.001) resulting in a success rate of 92.7%. Mitral valve mean gradient (MVMG) decreased from 13.3 ± 5.5 to 6.4 ± 3.4 mmHg. Severe mitral regurgitation (≥ grade 3) occurred in eight patients (2.2%). Wilkins score was an independent predictor of the immediate result of PMC but, if > 8, this score had a weak predictive value. Commissural morphology was another independent predictor of the immediate result of PMC.

Conclusion .– Pre-procedure echocardiographic assessment appears to be helpful in predicting PMC results. Successful PMC is influenced by the Wilkins score and commissural morphology.