Balloon dilation of pulmonary valve stenosis in infants less than 3 kg: A 20‐year experience
Bibliographic record
Abstract
OBJECTIVES: This study focused on the anatomical features and outcomes of percutaneous pulmonary valve balloon dilation (PVD) in newborns < or = 3 kg in weight. BACKGROUND: Although PVD is the treatment of choice for isolated pulmonary valve stenosis, there are no studies detailing technical, anatomical, and outcome variables in the smallest of infants undergoing the procedure. METHODS: A retrospective, consecutive review of all initial and follow-up echocardiograms, catheterization data, cineangiograms, and surgical records of all neonates less than 3 kg. RESULTS: Fifty infants underwent 55 PVD's, median age 7 days and weight 2.7 kg. Congestive heart failure and/or cyanosis were present in 55%, 46% prostaglandin dependent, with 28% having a hypoplastic right ventricle. The pulmonary valve diameter median z-score was -2.6, (range -5.8 to 1.2, P < 0.0001 vs. normal). The procedure was accomplished in all but one child, using a balloon to annulus ratio of 1.3 (range 1.1 to 1.7). There was a reduction in both the peak right ventricular systolic pressure (P < 0.0001) and outflow gradient (P < 0.0001). There was no procedure related mortality, although six children died in long-term follow-up (14%). Reintervention was necessary in 15 infants within 8 months of the procedure. Pulmonary regurgitation, present in 36% after the procedure, showed a gradual increase over time while outflow gradients decreased and valve annular dimensions increased toward normal. CONCLUSIONS: In infants < or = 3 kg, PVD is safe and effective. A large proportion remains free from surgery (76% at 10 years). Small valve annular dimensions show catch up growth with time.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 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".