{
  "abstract": "Objective\n\nTo determine whether tricuspid leaflet multiplicity is associated with divergent postoperative hemodynamic trajectories after surgical repair.Methods\n\nOne hundred seventeen patients undergoing tricuspid valve surgery (January 2023 to March 2025) were prospectively enrolled, with leaflet morphology classified by intraoperative visualization and serial echocardiography over 1 year. The prespecified primary end point was a Doppler-derived tricuspid regurgitation pressure gradient (TRPG) increase, defined as a 5-mm Hg-or-greater increase in TRPG from discharge to 1 year.Results\n\nAmong 100 patients with paired data, the primary end point occurred more frequently in the 4/5-leaflet group despite similar residual tricuspid regurgitation (TR) and discharge TRPG (48.5% vs 26.9%; odds ratio, 2.56; 95% CI, 1.07-6.12; P = .034); the age-adjusted association was borderline (aOR, 2.39; P = .054) and the within-group rise significant only in that cohort (P = .024). Severe-or-greater TR recurrence was rare (3.0% vs 0.0%; P = .327). Discharge tricuspid annular plane systolic excursion was lower in the 4/5-leaflet group (0.96 ± 0.36 vs 1.15 ± 0.36 cm; P = .010) but converged by 1 year (P = .585).Conclusions\n\nTricuspid leaflet multiplicity was associated with a subphenotype showing preserved early TR reduction, lower discharge tricuspid annular plane systolic excursion, and a greater 1-year frequency of Doppler-derived TRPG increase. Morphology-based stratification may refine postoperative surveillance pending external validation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan.",
    "Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.",
    "Department of Pediatric Cardiology, Sakakibara Heart Institute, Tokyo, Japan.",
    "Department of Cardiac Surgery, Heart Center Leipzig at the University of Leipzig, Leipzig, Germany.",
    "Department of Anesthesiology, Sakakibara Heart Institute, Tokyo, Japan.",
    "Sakakibara Heart Institute, Tokyo, Japan."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 14,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Tomohiro Iwakura"
    },
    {
      "affs": [
        1
      ],
      "name": "Mitsunobu Kitamura"
    },
    {
      "affs": [
        0
      ],
      "name": "Yoshinori Nakahara"
    },
    {
      "affs": [
        2
      ],
      "name": "Kanako Kishiki"
    },
    {
      "affs": [
        1
      ],
      "name": "Yuki Izumi"
    },
    {
      "affs": [
        0
      ],
      "name": "Makoto Ono"
    },
    {
      "affs": [
        0
      ],
      "name": "Atsushi Yano"
    },
    {
      "affs": [
        0
      ],
      "name": "Kohei Sumi"
    },
    {
      "affs": [
        0
      ],
      "name": "Akira Marui"
    },
    {
      "affs": [
        3
      ],
      "name": "Thilo Noack"
    },
    {
      "affs": [
        1
      ],
      "name": "Itaru Takamisawa"
    },
    {
      "affs": [
        1
      ],
      "name": "Mamoru Nanasato"
    },
    {
      "affs": [
        4
      ],
      "name": "Jun Shimizu"
    },
    {
      "affs": [
        5
      ],
      "name": "Mitsuaki Isobe"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4vqyaqfvky446.bib",
  "cited_by": 0,
  "doi": "10.1016/j.xjon.2026.102089",
  "fulltext_url": "https://europepmc.org/articles/PMC13711285",
  "id": "4vqyaqfvky446",
  "issns": [
    "2666-2736"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948514",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Adult: Tricuspid Valve"
    ],
    [
      "openalex",
      "2705|Cardiac Valve Diseases and Treatments"
    ]
  ],
  "openalex": "W7204938992",
  "pdf_url": "https://europepmc.org/articles/PMC13711285?pdf=render",
  "pmcid": "PMC13711285",
  "pmid": "42948514",
  "published": "2026-09-01",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/4vqyaqfvky446.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:35Z",
      "native_id": "MED:42948514",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948514"
    },
    {
      "first_seen": "2026-10-31T12:22:05Z",
      "native_id": "PMC13711285",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.xjon.2026.102089"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiac Valve Diseases and Treatments",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Tricuspid valve leaflet multiplicity and Doppler-derived right-heart hemodynamic trajectories after surgical repair.",
  "title_text": "Tricuspid valve leaflet multiplicity and Doppler-derived right-heart hemodynamic trajectories after surgical repair.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:05Z",
  "url": "https://research.draconitic.com/paper/4vqyaqfvky446",
  "venue": "JTCVS open",
  "versions": []
}