Outcomes following repair of bileaflet prolapse due to myxomatous disease of the mitral valve
Bibliographic record
Abstract
Myxomatous disease represents the most common cause of MR due to bileaflet prolapse. Mitral valve repair of mitral regurgitation (MR) due to bileaflet prolapse poses many technical challenges. In addition, late outcomes following repair are not well characterized in this population. Published series have included mixed patient cohorts and/or lacked long-term echocardiographic follow-up. And thus constitutes the focus of the current study. One-hundred thirty six patients (mean age 57.3 ± 17.5 years) underwent mitral valve repair of bileaflet prolapse due to myxomatous disease from 2002–2010. Concomitant CABG was performed in 16 (12%) patients. All patients were followed by a dedicated mitral valve clinic with a follow-up interval that extended up to 6.6 years. There were no hospital deaths. Ring annuloplasty was used for all patients. Additional mitral valve repair techniques included chordal transfer (N=67), polytetrafluoroethylene neochords (N=22), edge-to-edge repair, including lateral edge-to-edge repair towards either commissure (N=30), or use of the hybrid-flip over technique (N=23). Prolapse involving more than one scallop of the posterior leaflet was observed in 32 (24%) patients whereas prolapse of more than one scallop of the anterior leaflet was observed in 56 (41%) patients. At follow-up, 3 patients had MR⩾2+, and no patients required subsequent mitral valve re-intervention. Five-year survival and freedom from recurrent (⩾2+) MR were 81.9 ± 2.7% and 95.8 ± 2.7%, respectively. Mitral valve repair of bileaflet prolapse due to myxomatous disease is safe and durable. Successful repair often requires a combination of surgical repair techniques.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 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".