An Expansible Aortic Ring for a Standardized and Physiological Approach of Aortic Valve Repair
Bibliographic record
Abstract
Aortic Valve Surgery 220 preservation of aortic root dynamics with the treatment of dilated native annulus (Aicher et al., 2010;Hopkins, 2003).This results in a lack of standardization and limits their widespread application.Furthermore, most failures with valve sparing techniques are due to residual cusp prolapse, either as a primary unrecognized lesion or secondary to an induced prolapse after root reconstruction.Despite its more frequent detection intra operatively, cusp prolapse remains challenging to evaluate and treat.As restorations of both root geometry and cusp coaptation are the prerequisite for a successful valve sparing procedure, we propose a standardized aortic valve repair approach addressing both the aorta and the valve, associating a physiological reconstruction of the aortic root, with cusp resuspension and subvalvular external aortic ring annuloplasty (Lansac et al., 2005a(Lansac et al., , 2006(Lansac et al., , 2009(Lansac et al., , 2010a(Lansac et al., , 2010b(Lansac et al., , 2010c(Lansac et al., , 2011a(Lansac et al., , 2011b)).Depending on the phenotype of the ascending aorta, physiological reconstruction of the root will be achieved through to the Remodeling technique (root aneurysm, sinuses of Valsalva ≥45 mm), or a supracoronary graft (supracoronary aneurysm, sinuses of Valsalva <40 mm).Subvalvular aortic annuloplasty is achieved through external implantation of a calibrated expansible aortic ring that reduces dilated diameters in diastole in order to increase valvular coaptation height, while maintaining root systolic expansibility (Lansac et al., 2009). Anatomical landmarks for aortic valve repair The ascending aorta: Descriptive anatomyThe ascending aorta may be defined as the ensemble of two distinct entities, separated by the sinotubular junction (STJ): (1) the aortic root, initial portion of the aorta that includes the aortic valve with its crown-shaped annulus, interleaflet triangles, coronary arteries ostia and sinuses of Valsalva and (2) the supracoronary aorta extending above the STJ up to the brachiocephalic trunk (Fig. 1)
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| 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 | 0.000 | 0.000 |
| 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".