Incomplete Double Aortic Arch and Window Patent Ductus Arteriosus in a CHARGE Syndrome Patient: A Case Report and Review of Literature
Bibliographic record
Abstract
We report on a female infant with CHARGE syndrome who has a previously undescribed combination of two very rare cardiac anomalies: incomplete double aortic arch and “window” patent ductus arteriosus (PDA). The term infant went into heart failure at four weeks of age due to the extremely large PDA. Due to its unusual anatomy and the risk of damage to nearby vital vessels with ligation, the PDA was divided and closed using a patch on both ends while the patient was on cardiopulmonary bypass. Only in retrospect was the rare diagnosis of this “window” PDA and abnormal arch made. This case is the first to demonstrate a “window” PDA and an incomplete double aortic arch consisting of a dominant right aortic arch and persistent proximal left dorsal aorta and the first to provide three-dimensional MRI angiography images of the anatomy. The case provides several key learning points. As cardiac MRI is now a standard imaging tool it is important that physicians be made aware of how the above rare diagnoses appear on three-dimensional angiography. Thorough attention to the cardiac anatomy of patient with CHARGE must continue. We report this case to help physicians successfully diagnose and manage this type of rare anatomy and provide long-term follow-up results that have not been published previously. J Med Cases. 2013;4(5):333-339 doi: https://doi.org/10.4021/jmc1047w
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".