The SJM Toronto Bioprosthesis: Up to 20 Years Follow-Up in Patients Aged 60 or Younger
Bibliographic record
Abstract
Objectives: A retrospective long-term evaluation of the stentless Toronto bioprosthesis in patients aged 60 years or younger. Methods: From 1994 to 1997, 47 patients underwent implantation of the prosthesis. Patients mean age at surgery was 55.0 ± 5.6 years. Follow-up data were acquired by patient file research and telephone interview. Evaluated were morbidity and mortality with time-to-event analyses using the Kaplan-Meier-method. Proportional hazard models were used to determine risk factors for reoperation. Results: Total follow-up was 578.5 patient-years with a maximum of 20.0 years. Associated procedures were performed in 13 patients (27.7%), including coronary artery bypass grafting, mitral valve replacement and replacement of the ascending aorta. Overall actuarial long-term survival at 10 and 20 years was 82.7% ± 5.9% and 63.0% ± 8.0%, respectively (Fig. 1). Reoperations started 4.4 years after implantation and were performed due to: valve degeneration with regurgitation in 79.2% and stenosis in 12.5%, endocarditis in 4.2% and sinus valsalva aneurysm in 4.2% of the cases. Freedom from reoperation at 10 and 15 years was 67.4% ± 7.8% and 45.2% ± 9.2%, respectively. Multivariate risk stratification revealed only body-mass-index > 30 as risk factor for reoperation, while renal insufficiency, diabetes mellitus and arterial hypertension were not. Fig. 1 Long-term survival with the SJM Toronto. Conclusion: In patients aged 60 or younger the Toronto-bioprosthesis provides reliable long-term survival despite limited durability.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".