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BACKGROUND This study was conducted to compare long-term clinical outcomes of mechanical and bioprosthetic tricuspid valve replacement (TVR). METHODS Two-hundred twenty-six TVR patients were enrolled; 120 patients underwent bioprosthetic TVR (BTV group) and 106 underwent mechanical TVR (MTV group). Early results and long-term clinical outcomes were compared. The median follow-up duration was 99 (1-295) months. Propensity score (PS) analyses including PS-adjusted Cox regression models and 11 PS matching were performed. RESULTS The mean