Tricuspid valve replacement after cardiac transplantation
Bibliographic record
Abstract
BACKGROUND: Tricuspid regurgitation (TR) occurs commonly in transplanted hearts. Although theoretically attractive, tricuspid valve replacement (TVR) has not been widely investigated as a possible therapy in post-transplant patients. The purpose of this study was to determine the safety of TVR in heart transplant patients and its effects on measurable clinical endpoints. METHODS: We acquired data by both retrospective chart review and prospective data collection in all patients who underwent TVR after cardiac transplantation. RESULTS: Nine patients were identified and followed for a period of six months. The age of patients at time of TVR was 62 +/- 6.1 yr and their average time since transplantation was 12 +/- 3.2 yr. Most patients demonstrated a reduction in their furosemide dose (105 +/- 63 mg/d pre-TVR vs. 67.5 +/- 65 mg/d post-TVR, p = 0.001) with a reduction in serum creatinine levels (188 +/- 72 micromol/L pre-TVR vs. 143 +/- 42 micromol/L post-TVR, p = 0.06). Additionally, we found a significant improvement in albumin values (32 +/- 5 g/L pre-TVR vs. 42 +/- 3 g/L post-TVR, p = 0.002) as well as an improvement in total bilirubin (35 +/- 18 micromol/L pre-TVR vs. 18 +/- 5 micromol/L post-TVR, p = 0.05). There was only one death in our series, in the only patient with known severe graft atherosclerosis. CONCLUSIONS: TVR appears to be a safe procedure in patients without severe graft atherosclerosis with improvements in serum creatinine, albumin and total bilirubin values, in addition to a reduction in furosemide dose. This may reflect improved forward flow, improved symptomatology from TR as well as possible beneficial effects on nutritional status.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".