Fenestrations of the Aortic Valve Cusps: An Anatomical Explanation?
Bibliographic record
Abstract
Fenestrations of the aortic cusps are a common finding in older adults. In most cases, they are benign although there are reports of spontaneous rupture and acute onset of aortic insufficiency. The process of fenestration development is poorly understood however, it is possible that variation in cuspal anatomy may be an important factor. The aortic valves from 40 adult cadaveric specimens were harvested and examined for fenestrations. The cuspal height, free margin length, and attached margin length were measured and leaflet perimeter and area were calculated. 37.5% of all specimens were found to have aortic valves with at least one fenestrated cusp. Of those with fenestrations, 73.3% were in the left coronary cusp, 53.3% were in the right coronary cusp and 33.3% were in the non‐coronary cusp. Preliminary data suggests that cusps with a smaller perimeter are more prone to fenestrations. Previous studies have suggested that the, often larger, non‐coronary sinus and cusp are subject to greater stresses during the cardiac cycle which in turn leads to increased collagen deposition within the cusp. Although counterintuitive to the increased stresses, the non‐coronary aortic cusps in this series had less fenestrations, perhaps suggesting that increased stresses may actually prevent fenestration development. The initial findings warrant further investigation with a larger sample size and further statistical analysis. Grant Funding Source : Queen Elizabeth II Graduate Scholarship in Science and Technology
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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 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.004 |
| Scholarly communication | 0.001 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
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".