Repair of chronic ischemic mitral regurgitation with posterior leaflet extension
Bibliographic record
Abstract
We read with great interest the review article ‘Chronic ischaemic mitral regurgitation – current treatment results and new mechanism-based surgical approaches’ by Bouma and colleagues in a past issue of this journal [1]. Management of severe ischaemic mitral regurgitation remains challenging with disappointing long-term surgical results. Furthermore, despite the increasing popularity of valve repair, its long-term durability in chronic ischaemic mitral regurgitation continues to be uncertain. In this article, the authors worked in an excellent manner to review the different mechanisms of ischaemic mitral regurgitation, and to describe the variety of surgical approaches used to deal with this entity. To address leaflet tethering commonly observed in these patients, our group had recently reported the midterm results of posterior leaflet extension with a bovine pericardium, coupled with remodelling annuloplasty [2]. After extending the posterior leaflet height by about 1 cm from the medial half of P2 to the end of P3 in 44 consecutive patients with type IIIb ischaemic mitral regurgitation, the observed actuarial freedom from recurrent mitral regurgitation was 90% at 2 years. This also correlated with 90% of patients remaining in the New York Heart Association class I at 2 years. We believe that this is a relatively easy technique, safely reproduced, which can lead to good midterm results. Longer follow-up is necessary to assess the competency of the mitral valve and confirm the effectiveness of this approach.
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 | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.017 | 0.009 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
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".