Freedom from structural valve deterioration among patients aged < or = 60 years undergoing Freestyle stentless aortic valve replacement.
Bibliographic record
Abstract
BACKGROUND AND AIM OF THE STUDY: Certain theoretical arguments suggest that a stentless bioprosthetic valve may be less subject to calcification and degeneration compared to an equivalent stented bioprosthesis. The study aim was to define the long-term clinical outcomes, including freedom from structural valve deterioration (SVD), among relatively younger patients after aortic valve replacement (AVR) with the Freestyle aortic bioprosthesis. METHODS: A total of 725 patients at eight study sites underwent AVR with the Freestyle stentless aortic bioprosthesis. Of these patients, 57 (7.9%) were aged < or = 60 years at the time of surgery. All clinical data were recorded prospectively. RESULTS: The total follow up for the group was 4,900 patient-years; the mean follow up per patient was 6.8 +/- 3.6 years; median 7.2 years; range: 0 to 13.3 years). Survival at 12 years was 65.0 +/- 11.6% for patients aged < or = 60 years at implant, and 33.1 +/- 5.3% for those aged > or = 61 years. Freedom from cardiac death was 94.6 +/- 6.6% and 70.7 +/- 7.5%, respectively. Freedom from SVD at 12 years was 92.4 +/- 8.0% for patients aged < or = 60 years at implant, and 92.3 +/- 5.0% for those aged > or = 61 years (p = 0.58). There was no significant difference in freedom from reoperation at 12 years between the younger and older age groups (p = 0.16). CONCLUSION: The Freestyle stentless aortic bioprosthesis was associated with excellent clinical outcomes through 12 years of follow up. Freedom from cardiac death was excellent. Measures of bioprosthesis durability remained outstanding through 12 years, with no difference in freedom from SVD or from reoperation between patients aged < or = 60 years and those aged > or = 61 years at the time of implant. Inasmuch as valve durability may influence decisions between a tissue and a mechanical valve in younger patients, these data help to support use of the Freestyle valve in patients aged < or = 60 years.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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) | 0.001 | 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".