Impact of Percutaneous Transvenous Mitral Commissurotomy on The Left Atrial Appendage Function in Patients With Mitral Stenosis.

"* D.Echocardiography(Transthoracic and transesophageal):~* 2D echocardiography (to detect LA function, severity of MS and Wilkins score).~The following conventional parameters were measured :~* left atrial volume index (LAVi), and left ventricular ejection fraction (LVEF) by modified biplane Simpson's rule , left atrial emptying fraction calculated as (LAVi max-LAVi min)/LAVi max × 100 ,\]degree of concomitant mitral regurgitation. The maximum and minimum LAA areas were measured by planimetry. LAA area change (%) was calculated using the following formula: LAA area change = \[(maximal LAA area-minimal LAA area)/maximal LAA area\] × 100.~* Transesophageal echocardiogram (TEE) (to detect LAA function) .~* LAA flow velocity patterns by pulsed-wave Doppler~* Early diastolic emptying velocity~* Late diastolic emptying velocity or LAA contraction flow~* LAA filling velocity~* Systolic reflection waves~* Two-Dimensional- LAA fractional area change (LAAAC%)"