Long-Term Outcomes After Transcatheter Tricuspid Valve-in-Valve Replacement
Bibliographic record
Abstract
OBJECTIVES: Transcatheter tricuspid valve-in-valve (ViV) replacement has emerged as a less invasive alternative to redo surgery in patients with failing bioprosthetic tricuspid valves. While short- and mid-term outcomes have been reported, data on long-term follow-up remain limited. METHODS: The authors conducted a single-center observational study including 12 consecutive patients who underwent transcatheter tricuspid ViV replacement. Clinical, echocardiographic, and procedural data were prospectively collected. Patients were followed at 1 and 12 months, and yearly thereafter; follow-up included annual clinical visits and echocardiography. RESULTS: The mean age of the patients was 45 years (range, 23-69 years); 92% were women, and the indication for ViV was prosthetic valve regurgitation in most (58%) cases. A balloon-expandable SAPIEN valve (Edwards Lifesciences) was implanted in all cases, with 100% procedural success. After a mean follow-up of 6 years (range, 1-11 years), 3 (25%) patients died, and 1 was readmitted because of heart failure. Functional status improved significantly, with all surviving patients in New York Heart Association class I or II at last follow-up. Transvalvular gradients remained stable over time in 83% of the patients. Two (17%) patients developed bioprosthetic valve dysfunction during follow-up: one due to significant tricuspid stenosis and the other due to severe tricuspid regurgitation. CONCLUSIONS: Tricuspid ViV replacement offers durable symptomatic improvement and stable prosthesis function during long-term follow-up in most cases. This study is the first to report outcomes greater than or equal to 5 years in this population and supports the continued use of ViV as a viable option for these patients. Larger studies are warranted to validate these findings.
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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 | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.014 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| 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".