Mitroflow Aortic Bioprosthesis Failure in Type B Aortic Dissection: Preventive Left Main Stenting in Transapical Transcatheter Aortic Valve Implantation Strategy
Bibliographic record
Abstract
Mitroflow aortic prosthesis dysfunction in case of complex vascular disease is considered a challenging scenario. Because of the high risk for surgical reoperation and the presence of chronic aortic dissection originated from a calcified Kommerel diverticulum, we considered to perform a transapical valve-in-valve transcatheter aortic valve implantation (TAVI) procedure. Myocardial ischemia is a dreadful complication reported in valve-in-valve TAVI procedures, mainly in patients with degenerated Mitroflow aortic bioprostheses. Because of the narrow shape of Valsalva sinuses and the short distance between Mitroflow annulus and left coronary ostium, to overcome the risk of possible Mitroflow leaflets displacement during TAVI expansion thus overlapping coronary ostia, we performed a preventive angioplasty. Then, we implanted a bare metal stent on the left main protruding in the aortic root. At 3 years follow-up the patient was in good clinical conditions.
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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 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".