The future direction of post-transcatheter aortic valve replacement reinterventions: insights from the Transcatheter Valve Therapy Registry
Bibliographic record
Abstract
o r w r o n g , o n l y d e c i s i o n s a n d consequences.Such is the current state of lifetime management in aortic valve disease.After years of articles and panels discussing the long-term implications of transcatheter aortic valve replacement (TAVR), the consequences of our initial strategic choices are becoming clear in the real world.TAVR explant has become the fastest-growing cardiac surgical procedure in the United States, with a growth rate of almost 6,000% over the period from 2012 to 2023 (1).Redo-TAVR has also gained increasing relevance as a primary option in patients with failed TAVR valves (2).Nonetheless, several issues remain with regard to patient-prosthesis mismatch, coronary management and leaflet modification.This has all occurred in the context of a meteoric rise in TAVR among young patients, which is now performed in almost half of patients under the age of 60 years, in some experiences (3).Throughout the years, our understanding of native TAVR and options for post-TAVR reintervention has been significantly supported through national registry data such as the Society of Thoracic Surgeons (STS)/American College of Cardiology Transcatheter Valve Therapy (TVT) Registry.These data will remain vitally important in the future.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.030 |
| 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 | 0.001 | 0.001 |
| 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".