Closure of a large pulmonary arterio-venous fistula with Amplatzer vascular plug I
Bibliographic record
Abstract
A 55-year-old female patient, with a long-standing history of rheumatic mitral valve disease and atrial fibrillation, complains of shortness of breath and decreased effort tolerance, despite being compliant to medical treatment. On presentation, the patient was cyanotic (bluish discolouration of finger tips, lips, and tongue) with warm periphery and no clubbing; her arterial oxygen saturation was 73% on room air. Chest X-ray revealed a homogenous, well-circumscribed opacity in the left lung (Figure 1A), so pulmonary computed tomography angiography was done and revealed a huge left pulmonary arterio-venous fistula (PAVF) (Figure 1B–D). So the decision was to close the PAVF with an Amplatzer vascular plug. Conventional pulmonary angiography (CPA) revealed the large PAVF in the left lower lobe. Feeding artery was 14 mm in diameter and followed by a very large saccular pouch, which empties into the left superior pulmonary vein (Figure 1E). Occlusion of the feeding artery by the 16-mm Amplatzer vascular plug I was done, and the complete thrombosis of the PAVF was demonstrated within 10min (Figure 1F). Arterial oxygen saturation increased immediately from 73 to 97%. Figure 1: (A) Chest X-ray: homogenous, well-circumscribed opacity in the left lung. (B) An axial zero angle image (2D) showing a left lung vascular dense lesion. (C) The coronal MIP reconstructed image showing a fistula between the lingual branch of the left pulmonary artery and left superior pulmonary vein. (D) Volume rendered (3D) image showing a large PAVF. (E) CPA showing the left lung PAVF, in the antero-posterior view. (F) CPA showing a complete thrombosis of the PAVF 10 min after the deployment of the plug.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| 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".