Giant aneurysm of a saphenous vein graft causing compression of cardiac structures in a patient with lung tumour: who is doing what?
Bibliographic record
Abstract
(A) Left lateral and frontal chest X-rays showing a right-sided mediastinal, hilar calcified mass (69 × 83 mm). (B) 3D Cardiac CT angiogram reconstruction showing the origins of the SVG (55 mm diameter) anastomosis (thin arrow) and the RCA (thick arrow), with right atrial compression. (C) Cardiac CT sagittal view showing the giant SVG aneurysm, which is heavily calcified and partially thrombosed (T) but with a discernible, patent lumen (P). (D) Cardiac CT sagittal view showing the native RCA compressed by the giant SVG aneurysm. (E) Cardiac CT axial view showing the RA and RV compressions. SVG, saphenous vein graft; RCA, right coronary artery; T, thrombosed lumen; P, patent lumen; RA, right atrium; RV, right ventricle. Figure 1B shows a giant aneurysm of the SVG anastomosed to the right coronary artery (RCA), estimated to be 55 mm in diameter. Figure 1C shows the giant SVG aneurysm, which is heavily calcified and partially thrombosed (T) but with a discernible, patent lumen (P), originating immediately at the level of the aorto-saphenous anastomosis (thin arrow). The native RCA (Figure 1D), the right atrium (RA), and right ventricle (RV) are visualized to be compressed by the giant SVG aneurysm (Figure 1E; see Supplementary data online, Video S1). Late aneurysmal dilatation of SVGs remains a rare phenomenon (0.1% reported incidence). Their development mechanism is poorly understood, ranging from atherosclerotic degeneration, contributing to weakening of the vessel wall and graft dilatation, to graft endothelial dysfunction and changes in medial smooth muscle cell orientation in the vicinity of valve sites. Natural history includes mechanical complications, myocardial infarction, aneurysm rupture, and/or death. The optimal treatment approach is still unclear, traditionally surgical although becoming increasingly diverse with refinement of percutaneous techniques. Subsequent investigations confirmed the diagnosis of an aggressive pulmonary neoplasia. Potential therapeutic options were discussed with the patient while taking into consideration the inherent risks of redo-cardiac surgery, the absence of angina, and the prognosis of his lung cancer. The patient chose not to undergo invasive care, preferring to pursue conservative management for both his pulmonary and cardiac conditions. Supplementary data are available at European Heart Journal – Cardiovascular Imaging online. H.Q.L. receives funding from the Montreal Heart Institute Foundation, the Fonds de Recherche en Santé du Québec, and the DesGroseillers et Bérard Chair in Interventional Cardiology from Université de Montréal. F.P. receives funding from French Federation of Cardiology. Conflict of interest: None declared.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| 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".