101 * AORTIC VALVE REPAIR IN ACUTE TYPE A AORTIC DISSECTION
Bibliographic record
Abstract
Objectives: Repair and preservation of the aortic valve (AV) in type A aortic dissection remains controversial. We performed a meta-analysis of outcomes for AV repair and preservation in acute type A aortic dissection focusing on long-term valve-related events. Methods: Structured searches were performed in Embase (1980-2012) and PubMed (1966-2012) for studies reporting AV repair or preservation in acute type A aortic dissection. Early mortality and linearized rates for late mortality and valve-related events were derived. Outcome data were pooled with an inverse-variance weighted random-effects model. Results: Of 5325 screened articles, 19 observational studies met eligibility criteria, consisting of 2402 patients with a median follow-up of 4.1 years (range 3.1-12.6, total 13 733 patient-years). The cohort was principally male (median = 68.1%, 39-89) with a median age of 59 years (range 55-68) and Marfan syndrome was present in 2.5%. AV resuspension was performed in 85% and the remainder underwent valve-sparing root replacement. Pooled early and late mortality were 18.7% (CI 12.2-26.2), and 4.7%/patient-year (CI 3.3-6.4), respectively. Linearized rate for AV reintervention was 2.8%/patient-year (CI 1.5-4.4), recurrent AI (>2+) was 4.6%/patient-year (CI 3.1-6.2), and endocarditis was 0.5%/patient-year (CI 0.08-1.3). The composite rate of thromboembolism and bleeding was 1.4%/patient-year (CI 0.7-2.3). Conclusions: Repair of acute type A aortic dissection is associated with poor long-term survival. Preservation and repair of the aortic valve is associated with a moderate risk of reoperation and recurrent AI and a low risk of thromboembolism, bleeding, and endocarditis.
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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 | 0.009 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.018 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".