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.