Successful Laser‐Assisted Removal of an Infected ICD Lead with a Large Vegetation
Bibliographic record
Abstract
Infective endocarditis involving transvenous pacing leads is an uncommon but potentially lethal complication of implantable cardioverter-defibrillator (ICD) implantation. Complete removal of the device and the leads is presently considered to be the optimal treatment in such patients and laser-assisted lead removal is an effective and safe nonthoracotomy approach. However, large vegetations (>10 mm) attached to the lead limit nonthoracotomy explantation because of the potential for hemodynamically embarrassing pulmonary embolization. Laser extraction of leads with vegetation area >300 mm2 has rarely been reported. In this case report, we describe a patient with an infected ICD lead with vegetation greater than 41 x 12.5 mm (512 mm2) in size that was explanted with laser-assistance. The resulting pulmonary embolus produced a 33 x 20 mm pulmonary infarction without hemodynamic or respiratory compromise.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".