Evaluation of Two Methods of Left Atrial Appendage (LAA) Closure and its Proximity to the Circumflex Artery
Bibliographic record
Abstract
Patients with atrial fibrillation have an increased risk of stroke due to thrombi originating in the left atrial appendage (LAA). The standard for LAA closure is epicardial excision, which can leave a residual LAA volume thereby undermining its effectiveness. Moreover, the circumflex artery runs close to the base of the LAA, making it susceptible to damage during surgery. This study aims to compare residual volume in the LAA after epicardial excision to that left by a novel pericardial patch exclusion technique, and to track the circumflex artery around the base of the LAA. It is hypothesized that the exclusion will leave less volume than excision. Male and female fixed (n=18) and fresh (n=9) cadaveric hearts underwent both methods of obliteration. After each procedure, the residual volume of the LAA was measured by water and agarose gel. The proximity of the circumflex artery was plotted using a clock‐face. The excision method left a mean residual volume of 0.95 mL (24% of the original), whereas the pericardial patch exclusion left 0.17 mL (4% of original) (p<0.0002). The circumflex artery was closest to the LAA at the 4 o'clock position. The results suggest i) that the novel pericardial patch exclusion technique is more effective than excision, and ii) that surgeons should be most aware of the circumflex artery at the 4 o'clock position around the LAA base. This may lead to changes in the way closure of the LAA is performed.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| 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".