Transcatheter aortic-valve replacement: a cardiac surgeon and cardiologist team perspective
Bibliographic record
Abstract
PURPOSE OF REVIEW: Transcatheter aortic-valve implantation is a promising new treatment modality for patients with aortic-valve disease, where it may revolutionize the treatment of elderly and high-risk patients. RECENT FINDINGS: The two devices currently available, the Edwards Sapien valve and the Medtronic CoreValve system, are presented. With a focus on the CoreValve, we describe the indications, contraindications, procedural technique, cardiologist and heart surgeon team dynamics, and special considerations in patients with concomitant cardiopulmonary disease, peripheral arterial disease, low gradient aortic stenosis, and previous bioprosthetic aortic-valve replacement. CONCLUSION: We make a case for judicious team-based adoption of these new technologies and emphasize the need for evidence-based and health economics data. We believe that the above will enable determining the therapeutic niche of these modalities amongst the excellent results of conventional aortic-valve replacement surgery.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.003 |
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".