Surgical Pathology of Atrial Appendages Removed During the Cox-Maze Procedure
Bibliographic record
Abstract
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Some patients are managed surgically (Cox-maze procedure) with removal of 1 or both atrial appendages. A retrospective review was performed on surgically excised atrial appendages from 86 consecutive patients with AF (2004 to 2005), at Mayo Clinic in Rochester, MN. These were compared with atrial appendages removed from 2 autopsy control groups without a history of AF (26 without heart disease, and 20 with heart disease). Compared with the 2 control groups, appendages from patients with AF contained more myocyte vacuolization, fatty infiltration, and myocardial inflammation. Among the AF patients, left atrial appendages (LAA) were larger and more likely to show fatty infiltration, endocardial fibroelastosis, and mural thrombus than were right atrial appendages (RAA); in contrast, RAA were more likely to show myocyte hypertrophy and interstitial fibrosis than were LAA. In the LAA, myocyte hypertrophy and interstitial fibrosis were more often seen in patients with long-term AF recurrence than were those who remained in normal sinus rhythm postoperatively (P=0.045 and 0.036, respectively). Given the potential clinical relevance of these findings, it is recommended that the presence or absence of hypertrophy and fibrosis, and their extent, be incorporated into the surgical pathology report of all patients undergoing resection of an atrial appendage.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| 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".