2. Equipment and methods
Routine transthoracic and transesophageal echocardiography: All patients received transthoracic echocardiograghy (TTE) and TEE with Philips Epiq 7C echocardiography machine (Philips Netherlands) before CPVA during sinus rhythm. The patient was laid in left side decubitus position and connected to the 12-lead ECG; the transthoracic image acquisition used the ultrasound probe (X5-1) to operate at the sternum side and apex. The degree of MR was measured by 2 experienced doctors. They collected the patient’s sinus rhythm for 5 consecutive cardiac cycles. Doctors observed the structure and function of the mitral valve leaflets, annulus, chordae tendineae, and papillary muscles to rule out primary mitral valve diseases. The two-plane Simpson method was used to calculate ejection fraction. The LAAV of patients was measured by TEE pulse Doppler. The TTE and TEE data were collected from all patients. All parameters were analyzed by two attending doctors or above, and the average value was taken. The two doctors were blinded to each other.