Hydrodynamic Assessment of a Small Intestinal Submucosa Tubular Mitral Valve
Why this work is in the frame
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Bibliographic record
Abstract
Objective: For young children with critical valve defects, and for older patients who are contra-indicated for receiving mechanical and bioprosthetic valves, treatment options are extremely limited. The purpose of this study was to determine whether tubular porcine small intestinal submucosa (PSIS) bio-scaffold valves can facilitate robust mitral valvular hydrodynamic function and serves as a potential treatment option for the aforementioned patient sub-sets. Methods: A 26-mm PSIS tubular valve (CorMatrix Cardiovascular Inc., Roswell, GA) was sutured to a custom, 3-D printed valve holder along its ring and its two posts on the distal end (150° separation distance; Fig. 1A). Hydrodynamic testing was performed using a pulse duplicator system (Vivitro Labs Inc., Victoria, BC, Canada) filled with 0.9% saline solution, with the PSIS valve mounted in the mitral position. A flow probe was affixed between the atrial and ventricular chamber and pressure transducers were inserted in the atrial, ventricular, and aortic locations (AMpack, Vivitro Labs). Tests utilized a stroke volume of 71.8 mL, heart rate of 70 BPM, and input flow waveform comprising of a 35% systolic-65% diastolic configuration (S35 Waveform, Vivitest software, Vivitro Laboratories). Results: Tests revealed a root mean square volumetric flow rate (QRMS) of 139 mL/s, an effective orifice area (EOA) of 1.18 cm2, transvalvular pressure of 6.88 mmHg and a regurgitation factor (RF) of 16%. While the RF was higher than bioprosthetic valves (RF ~ 6.5%; unpublished observation performed under similar conditions in our laboratory), it was nonetheless considerably less compared to clinically categorized mild mitral valve RF of < 30%.1Zoghbi WA Enriquez-Sarano M Foster E et al.Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and doppler echocardiography.J Am Soc Echocardiogr. 2003; 16 (doi:10.1016/S0894-7317(03)00335-3.): 777-802Google Scholar Conclusions: The tubular PSIS mitral valve appears to facilitate robust hydrodynamic valve function and may concomitantly serve as a scaffold for de novo valvular tissue growth by the host after implantation. KEYWORD: ICTEHV-O-14 The authors do not declare any conflict of interest.
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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 | 0.002 |
| 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 it