Bioprostheses with Atrial Fibrillation and Mechanical Prostheses in Aortic Valve Replacement
Bibliographic record
Abstract
BACKGROUND: Clinical performance of bioprostheses (BP) with presence of atrial fibrillation and/or paced rhythm and mechanical prostheses (MP) in aortic valve replacement was considered a study of importance. METHODS: Aortic valve replacement (AVR) was performed in 163 replacements with porcine bioprostheses (Carpentier-Edwards supra-annular) with atrial fibrillation/paced rhythm identified at latest follow-up. Mechanical population was 886 procedures (St. Jude Medical = 436; CarboMedics = 450). Concomitant coronary artery bypass (CAB) was conducted in 40.5 % (66) of BP; 27.0 % (239) of MP. MP patients were all (100 %) on Coumadin and BP patients 35.6 % on acetylsalicylic acid (ASA), 37.4 % Coumadin, 7.4 % Coumadin + ASA, and 19.6 % on no therapy. RESULTS: Major thromboembolism (TE) and hemorrhage (ATH) occurred in 2.4 %/pt-yr (32) for BP and 5.3 %/pt-yr (157) for MP ( p < 0.0001); (TE major 1.6 %/pt-yr [21] for BP and 2.1 %/pt-yr [62] for MP [ p = 0.24]; ATH = 0.8 %/pt-yr [11] for BP and 3.2 %/pt-yr [95] for MP) ( p < 0.0001). There were no predictors of overall TE, TE major, ATH, overall TE + ATH, and TE major + ATH. Age and CAB were predictors of survival. Overall BP survival at 8 years was 97.5 +/- 1.5 %; and for MP 66.4 +/- 4.8 % ( p < 0.01). Actuarial freedom from overall thromboembolism and hemorrhage was 54.5 +/- 10.8 % for MP; 85.9 +/- 3.1 % for BP ( p = 0.0000). For major thromboembolism and hemorrhage, actuarial freedom was 63.4 +/- 11.8 % for MP; 91.4 +/- 2.5 % for BP ( p = 0.0003). CONCLUSIONS: Patients with atrial fibrillation/paced rhythm having AVR with bioprostheses with 45 % on Coumadin have greater freedom from thromboembolism and hemorrhage than after AVR with mechanical prostheses on Coumadin.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".