Abstract 13085: Isolated Tricuspid Valve Surgery: Failure of Its Principle? Long-Term Outcome Analysis
Bibliographic record
Abstract
Introduction: Isolated tricuspid valve (TV) surgery for acquired TV disease is high-risk surgery and the decision to operate is still controversial. We describe a single-centre experience with isolated TV surgery and our long-term analysis for adverse outcome. Methods: A retrospective analysis of 62 consecutive patients who underwent isolated TV surgery for acquired TV disease between 2002 and 2014 has been performed. Associated cardiac procedures and congenital TV disease were exclusion criteria. The Kaplan-Meier, Univariate and Cox regression analysis were respectively used to evaluate mortality and identify risk factors at long-term follow-up. The Duke Activity Status Index (DASI) questionnaire, to measure the functional status related to daily living, has been used to assess the survivors’ quality of life. Results: Mean patient age was 60.2±18.9 years, 38% were male and the average log EuroSCORE was 16.8%±15.9%. TV repair was performed in 38 cases (61%), replacement in the remainder and 38% were reoperations. 30-day mortality was 15% (n=9) , similar for repair and replacement. Follow-up (median=35.7 months, range=0.1-150) was 100% complete. Survival at 1, 5 and 10 years was 79.5%±5%, 69.8%±6% and 53.5%±9.7% respectively. Sinus rhythm, NYHA class < III, age < 60 years were identified as independent predictors of survival at long-term follow-up. Furthermore, we found that survivors with a lower pre-operative NYHA functional class were also those with the best quality of life at follow-up (DASI score 20.5 ± 8.6 vs 12.7 ± 7, p=0.028). Conclusions: Patients who undergo isolated TV surgery continue to be a high-risk group in with high early and late mortality. There is no difference in mortality between TV repair and replacement at long-term follow-up. Our experience suggests that a shift towards earlier surgery may be proven to confer an advantage, as surgery before the onset of NYHA class 3 symptoms is associated with improved outcome and better quality of life.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".