Anomalous single coronary artery from the pulmonary artery in a neonate
Bibliographic record
Abstract
This is the first reported case of an anomalous origin of the entire coronary system as a single coronary artery (SCA) from the main pulmonary artery (MPA). A 10-day-old prematurely born infant (33 + 5 weeks of gestation) was transferred from an outside hospital for evaluation of tachypnoea and diminished pulses. Transthoracic echocardiography demonstrated mildly reduced left ventricular (LV) systolic function and moderate mitral regurgitation (MR). Focused imaging of the coronary artery system revealed an SCA arising from the right-anterior aspect of the MPA (Panel A), a finding which has not been reported before. The SCA bifurcated after a short course into a right coronary artery (RCA) and left main coronary artery (LMCA) (Panel A). The LMCA looped anterior to the MPA and bifurcated into the left anterior descending and circumflex arteries. Intra-operatively, the diagnosis was confirmed and successful re-implantation of the SCA to the anterior right-facing aortic sinus was performed. Epicardial echocardiography demonstrated an unobstructed origin of the re-implanted SCA, with laminar flow into the left and right coronary systems (Panels B and C). Post-operative transthoracic echocardiography also demonstrated good patency of the SCA ostium (Panel D). LV systolic function and degree of MR improved immediately after surgery. Follow-up at 6 weeks revealed good biventricular systolic function and trace MR. This case represents an early clinical presentation of an anomalous SCA, likely related to the fact that the entire coronary perfusion originated from the MPA. Early recognition and surgical repair allowed for a quick clinical recovery and good short-term outcome. No grant or financial support was used for this research project. No author had any financial interest in the subject matter discussed in the submitted manuscript. No conflict of interest needs to be disclosed. All authors state that this study complies with the Declaration of Helsinki.
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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 | 0.007 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.003 |
| 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".