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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| 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) | 0.000 | 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 teacher head, 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".