Hydrodynamic Assessment of a Small Intestinal Submucosa Tubular Mitral Valve
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 While the RF was higher than bioprosthetic valves (RF ~ 6.5%; unpublished observation performed under similar conditions in our laboratory), it was nonetheless considerably less compared to clinically categorized mild mitral valve RF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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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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) | 0.001 | 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".