Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension with distal lesions
Bibliographic record
Abstract
Background As there are no well-defined criteria to discriminate proximal from distal obstructive lesions in chronic thromboembolic pulmonary hypertension (CTEPH), the operability assessment for pulmonary endarterectomy (PEA) remains the major concern. Aim The intraoperative classification of CTEPH describes different types of arterial obstruction, based on anatomy and location. We describe our experience with the more distal disease (type 3). Methods From 1994, 458 PEAs were performed at our center. From 2005 onward, the operability assessments and the operations were carried out by one surgeon. Into the cohort of 313 consecutive patients (pts) operated from 2005 to 2012, 88 (28%) presented with type 3 CTEPH, and 225 (72%) with type 1 or 2. Results The comparison between the 2 groups is shown in table. Thirty-three (37.5%) pts with type 3 disease were younger than 60 years and were severely symptomatic, and would otherwise have been included in lung transplantation (LTx) waiting list. Type 1 or 2 (225) Type 3 (88) Age (years) 60±15 60±14 Female 51% 67% Intracardiac catheters 1% 7% History of deep venous thrombosis 62% 47% Preoperative PVR (dyn•s•cm-5) 854±422 930±360 Extracorporeal circulation (min) 325±81 353±69 Total circulatory arrest time (min) 76±34 97±30 Postoperative PVR (dyn•s•cm-5) 248±146 302±168 Hospital stay (days) 13[10-17] 13[10-17] Hospital mortality 6% 10% (PVR = pulmonary vascular resistance) Conclusion In experienced centers, PEA is a successful and safe operation even when performed in pts presenting with distal CTEPH. Pts should not be considered inoperable unless they have been referred to an experienced surgeon, as they could benefit from conservative surgery instead of LTx.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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) | 0.001 | 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 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".