Left Main protection during very high risk Transcatheter Aortic Valve-in-Valve procedure. A Collaborative Registry.
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
<p><strong>Background.</strong> Surgically implanted aortic bio-prostheses are prone to degeneration and eventually failure within 10 to 20 years. Transcatheter aortic valve replacement “valve-in-valve” (TAVR-VIV) is an effective treatment for patients deemed at prohibitive risk for surgical redo. However, Mitroflow, Freedom, Toronto and Freestyle bioprostheses pose a high risk of left main obstruction and are only marginally represented in available literature.</p><p><strong>Methods and Results.</strong> After evaluation of local Heart Team, TAVR-VIV implantation was performed in 20 patients with a failed Mitroflow (8), Freedom (5), Toronto SPV (3), Freestyle (2), Trifecta (1), or Mosaic (1) bioprostheses. Patients/prostheses were divided in type A (mainly stenotic, 8 pts), and type B (mainly regurgitant, 12 pts). All patients were managed protecting the left main ostium.</p><p>At 30 days, 2 fatalities (10%) and 2 myocardial infarction (10%) occurred. At a mean follow up of 6 months, 2 further fatalities (cumulative survival rate of 80%) were observed (cumulative incidence of 5%).</p><p><strong>Conclusions.</strong> This registry specifically focusing on extremely high risk TAVR-VIV is a proof of concept. The protection of the left main during the procedure allows patients initially deemed at highest or even prohibitive risk to be successfully treated and further support the use of bioprostheses at the time of the surgical treatment. </p>
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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) | 0.000 | 0.006 |
| 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 it