[The effect of transmyocardial laser revascularization on anginal symptoms and clinical results in patients with incomplete surgical revascularization].
Bibliographic record
Abstract
OBJECTIVES: We evaluated the effect of transmyocardial laser revascularization (TMR) on anginal symptoms and clinical results in patients in whom coronary artery bypass grafting (CABG) surgery was not sufficient to provide complete revascularization. STUDY DESIGN: This retrospective study included 45 patients who underwent CABG surgery with incomplete revascularization between 2003 and 2006. Of these, 35 patients (mean age 61.7 years) had CABG alone, while 10 patients (mean age 62 years) underwent TMR at the same session as an adjunct to CABG. All the patients were assessed by transthoracic echocardiography and myocardial perfusion scintigraphy at three months and after a mean follow-up period of 22.3+/-6.1 months. Anginal symptoms were assessed using the CCS (Canadian Cardiovascular Society) classification system. RESULTS: Preoperative variables were similar in both groups. All the patients were symptomatic preoperatively with mean CCS scores of 2.6+/-0.5 and 2.3+/-0.8 in the TMR and CABG-alone groups, respectively. The duration of cardiopulmonary bypass (CPB) was significantly longer in the TMR group (p=0.022). During weaning from CPB, the need for inotropic support was significantly less in the TMR group (10% vs. 48.6%; p=0.034). While there was no early mortality, late mortality occurred in three patients (1 in TMR, 2 in CABG-alone groups; p=0.329). At three months, 50% (n=5) of the TMR patients were asymptomatic, compared to 14.3% (n=5) in the CABG-alone group (p=0.016). Patients in the TMR group had significantly lower CCS angina scores at three months (1.2+/-0.6 vs. 2.2+/-0.7; p=0.001) and at the end of the follow-up (1+/-0.6 vs. 2+/-0.7; p=0.001). There were no significant differences between the two groups with regard to the findings of myocardial perfusion scintigraphy and echocardiography. CONCLUSION: Patients with incomplete surgical revascularization benefit from TMR in terms of decreased need for inotropic support during weaning from CPB and short- and mid-term relief of angina symptoms.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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) | 0.001 | 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".