Transcatheter Aortic Valve Replacement After Coronary Artery Bypass Graft Is Associated With Increased Pacemaker Implantation but Not Reduced Overall Survival
Bibliographic record
Abstract
BACKGROUND: A history of coronary artery bypass graft (CABG) is a common compelling indication for transcatheter aortic valve replacement (TAVR). However, there is little data on how these patients compare to other TAVR patients. In this study, the short and long-term outcomes of these TAVR patients after CABG are defined. METHODS: A retrospective chart review case-control study of 337 consecutive patients who underwent a TAVR for severe aortic stenosis at Sanford Health in Fargo ND was performed to determine if a history of prior CABG was associated with worse outcomes after TAVR as compared to a TAVR cohort without a history of CABG. RESULTS: Despite higher predicted surgical risk, patients with a history of CABG had no significant difference overall survival at 1 month (98% vs. 93%, P = 0.112), 6 months (94% vs. 87%, P = 0.094), 1 year (85% vs. 77%, P = 0.206) or 2 years (70% vs. 57%, P = 0.135) post-TAVR. However, a history of CABG was associated with an increase in post-TAVR permanent pacemaker (PPM) implantation (15% vs. 6%, P = 0.015). CONCLUSIONS: This study gives evidence to suggest that patients with a history of prior CABG do not have any difference in overall survival as other TAVR patients, despite higher predicted surgical risk and differences in preprocedural comorbidities. Our study also confirms the safety of TAVR in this specific population in lower volume centers.
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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 | 0.001 |
| 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".