Off-pump coronary artery bypass: the Sudbury experience.
Bibliographic record
Abstract
OBJECTIVE: To examine factors relating to outcomes with off-pump coronary artery bypass (OPCAB) and to assess methods to improve the effectiveness of this approach SETTING: A small northern Ontario community hospital where surgical assistance, nursing familiarity with OPCAB and even anesthesiologist comfort varied DESIGN: Prospective collection of data with incremental audit of results and retrospective analysis of events METHODS: One hundred twenty-four consecutive patients, operated on by the same surgeon between April 1996 and June 2002, were selected on the basis of coronary anatomy. Progressively more complex multivessel revascularization, including that to the posterior wall, was undertaken over the course of the study period. Every attempt was made not to compromise use of arterial conduits, quality of anastomoses or completeness of revascularization. This represents the 'learning curve' of this study. MAIN RESULTS: Approximately 6% of patients developed a hemodynamic crisis requiring acute on-pump conversion. This tended to occur in patients undergoing complex multivessel OPCAB surgery and was associated with subsequent increased blood transfusion rate, operative time and mortality (2.8%), and poorer angiographic graft patency. This has led to a more cautious strategy including making the decision to proceed with OPCAB only after intraoperative assessment. CONCLUSION: 'Simple' OPCAB on easily accessible coronary arteries resulted in excellent early outcomes. Complex multivessel OPCAB for triple vessel disease involving difficult to access arteries was more demanding with higher perioperative complications and less effectiveness. Early enthusiasm for complex multivessel surgery has been gradually replaced with a more conservative use of OPCAB with improved intraoperative procedures, both of which have led to more favourable outcomes.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".