Transcatheter Mitral Valve Repair Device for the Treatment of Tricuspid or Tricuspid and Mitral Regurgitation: A Review of Clinical Effectiveness and Cost-Effectiveness [Internet]
Bibliographic record
Abstract
Tricuspid valve regurgitation is a heart condition in which the valve between the right ventricle and right atrium does not close properly. The malfunctioning valve allows blood to flow back into the heart’s right atrium. Tricuspid regurgitation (TR) can be the result of congenital heart disease (e.g., Ebstein’s anomaly) or valve abnormalities caused by other conditions, such as infective endocarditis, radiation therapy, or mitral regurgitation., Noticeable signs and symptoms of tricuspid regurgitation may include: fatigue, declining exercise capacity, peripheral edema, and abnormal heart rhythms. Long term consequences of untreated TR may include heart failure and atrial fibrillation. TR severity is graded as mild, moderate, severe, or massive (grade I to IV, respectively). In the United States in 2005, the prevalence of moderate and severe TR was estimated to be around 1,600,000, and the estimated number of surgically treated patients was 8,000. In a Canadian hospital in 2014, the prevalence of severe TR was 1.2% in patients referred for echocardiography. With limited effective treatment options, surgery to repair or replace the tricuspid valve (TV) is the current standard of care but has operative mortality of 13 to 18% and ten-year survival rate of 49 to 66%., In patients with untreated TR, prognosis remains poor.MitraClip, also known as transcatheter mitral valve repair device, is a technology designed for catheter-based mitral valve (MV, also known as bicuspid valve) repair on the left side of the heart. It is a less invasive treatment that is performed in the cardiac catheterization laboratory. Although designed for mitral valve repair, MitraClip has recently been considered as an alternative treatment option for the treatment of patients with significant TR who are deemed high-risk for open-heart surgery. The use of MitraClip for the TV, with the transcatheter tricuspid edge-to-edge repair (TTVR) technique, is currently off-label.The purpose of this report is to summarize the clinical effectiveness and cost-effectiveness of the transcatheter mitral valve repair device for TR with or without mitral regurgitation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".