Declining need for permanent pacemaker insertion with the bicaval technique of orthotopic heart transplantation.
Bibliographic record
Abstract
BACKGROUND: The bicaval technique of orthotopic heart transplantation, in contrast to the standard biatrial technique, may better preserve right atrial anatomy and, thus, may be associated with less sinus node dysfunction and less atrioventricular valve dysfunction. OBJECTIVES: To compare the requirement for permanent pacemaker insertion and the incidence of atrioventricular valve dysfunction following heart transplantation with either the standard or the bicaval technique. PATIENTS AND METHODS: A retrospective analysis was conducted of a consecutive cohort of 105 patients, older than 18 years of age, undergoing heart transplantation with either the standard (n=48) or the bicaval (n=57) technique from December 1998 to December 2001. RESULTS: Cross-clamp (100 min versus 112 min; P=0.012) and donor ischemic (222 min versus 276 min; P=0.005) times were significantly prolonged in the bicaval group. Perioperative morbidity and mortality were statistically similar between the groups. Bicaval transplantation resulted in a significant decrease in the requirement for permanent pacemaker insertion at 30 days (13% versus 0%; P=0.008) and 90 days (17% versus 1.8%; P=0.01) after transplantation. There was a nonsignificant trend toward a decreased degree of tricuspid valve regurgitation (mean 1.81 versus 1.36; P=0.141) and mitral valve regurgitation (mean 1.04 versus 0.79; P=0.348) with the bicaval technique. CONCLUSIONS: Although associated with longer cross-clamp and donor ischemic times, the data demonstrated a significant reduction in the need for permanent pacemaker insertion at 30 and 90 days post-transplantation with the bicaval technique. There was no statistically significant difference in the degree of mitral and tricuspid valve regurgitation between the two groups.
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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) | 0.000 | 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) | 0.000 | 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".