Start-up of the program of transcatheter aortic valve implantation using a balloon-expandable Edwards Sapien XT transcatheter heart valve. Description of the first case in Mexico
Bibliographic record
Abstract
Start-up of the program of transcatheter aortic valve implantation using a balloon-expandable Edwards Sapien XT transcatheter heart valve. Description of the first case in MexicoPuesta en marcha del programa de implantación transcatéter de válvula aórtica empleando la válvula expandible por balón Edwards Sapien XT.Informe del primer caso en México Degenerative aortic valve stenosis (AS) is the most common valvular heart disease.About two-thirds of all valve operations are for aortic valve replacement (AVR).After onset of symptoms (angina, syncope or heart failure) severe aortic stenosis has a poor prognosis with an average survival of two or three years and a high risk of sudden death. 1 According to the ACC/AHA and the European Society of Cardiology/European Association for Cardio-Thoracic Surgery Guidelines for management of patients with heart valve disease, surgical aortic valve replacement is an indication class I in symptomatic patients with AS, and for patients with severe AS undergoing CABG or surgery of the aorta or other heart valves, and patients with severe AS and LV systolic dysfunction (ejection fraction < 50%). 1,2It is generally accepted that surgical AVR can improve the functional class and prolong survival.Nevertheless, 30% of elderly patients with symptomatic severe aortic valve stenosis do not undergo AVR, attributed to ''inoperable'' conditions or extremely high surgical risk, such as advanced age, pulmonary, renal, hepatic disease, prior cerebrovascular event, weakness or frailty, that increases the risk of poor outcomes. 3Recently, transcatheter aortic valve implantation (TAVI) has become a treatment option for patients with high or prohibitive surgical risk.The concept of transcatheter valve implantation was evaluated by Andersen in 1992 in a porcine model. 4In 2002 the first TAVI was accomplished by Dr. Alan Cribier, via a transeptal antegrade delivery technique using a balloonexpandable aortic valve. 5After this pioneering procedure, several registries and one multicenter randomized control trial have been published worldwide (Fig. 1). 6We describe the first case of TAVI performed in Mexico using a balloon-
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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) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.017 | 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".