Huge aortic pseudoaneurysm arising from the coronary anastomosis after aortic root replacement
Bibliographic record
Abstract
An 87-year-old man was admitted with chest pain. His troponin was elevated and his electrocardiogram showed anterior ST depression. The patient had undergone aortic root replacement 13 years earlier using a mechanical valved conduit with re-implantation of the coronary arteries. Although lost to follow-up, he continued on warfarin. He initially received treatment for a suspected acute coronary syndrome. However, a subsequent echocardiogram suggested a circumferential haematoma around the aorta. Contrast computed tomography (CT) demonstrated a large aortic pseudoaneurysm arising from the left coronary anastamosis (Figure 1A–C). There was complete dehiscence of the coronary anastomosis from the aorta with reduced contrast opacification into the left main coronary artery suggesting impaired blood flow in this territory. As the risk of surgical repair was considered prohibitive, the patient was managed conservatively with cessation of anti-coagulation. The patient’s chest pain resolved and a repeat CT 6 days later demonstrated improved contrast opacification and coronary blood flow in the left coronary artery (Figure 1D). Echocardiography at 6 months demonstrated no expansion of the aortic pseudoaneurysm, and the patient remains off anti-coagulation and free of cardiac complications at 12 months.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 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".