Data Collection and Follow-up
A complete transthoracic echocardiographic study, including complete M-mode, 2-dimensional, and Doppler analyses was performed just before the MVR were adopted and after a mean follow-up of one year, following the American Society of Echocardiography and European Society of Cardiovascular Imaging guidelines recommendation. Additional echocardiography examinations were performed when deemed necessary by the physician. At the outpatient clinic, routine echocardiography was performed approximately every six months. Parameters measured for each patient by transthoracic echocardiography(TTE) obtained from the echocardiography reports within the ultrasound database, including left atrial diameter(LAD)、tricuspid regurgitation area(TRA)、mitral regurgitation areas (MRA)、 transverse diameter of right atrium(RATD)、longitudinal diameter of right atrium(RALD)、left ventricular end diastolic diameter(LVEDD)、left ventricular end systolic diameter(LVESD)、right ventricular diameter(RVD)、Atrial fibrillation (AF) and PH. PASP was derived from the peak FTR velocity using the simplified Bernoulli equation, adding the right atrial pressure estimated from inferior vena cava diameter and collapsibility[8]. All measurements were obtained from the last ultrasound report before surgery and were evaluated in accordance with internationally recommended standards TTEs[9]. Echocardiographic exams were performed by expert trained physicians in each center, and data were revised in blind by two independent expert physicians of the core center according to previously published methods.