Mitral valve repair: late mortality, favorable and unfavorable characteristics.
Bibliographic record
Abstract
OBJECTIVES: Review late mortality experience associated with surgical repair of regurgitant myxomatous mitral valves. Identify mortality associated with favorable and unfavorable characteristics for surgical mitral valve repair (MVR). METHODS: Overall mortality associated with MVR reported by several North American centers since 1980 is assessed. Mortality from additional studies on MVR associated with favorable and unfavorable preoperative characteristics is also determined. Standard mortality methodology is used and expectant mortality determined from the appropriate population life tables. RESULTS: Averaged (weighted for numbers of entrants) overall morality ratios (MR) for MVR from the Mayo Clinic and University of Toronto at 5, 10, and 15 years were 106%, 113% and 145%. Favorable characteristics included isolated posterior leaflet repairs (MR at 5, 10 and 15 years: 97%, 106% and 130%) and asymptomatic preoperative status, defined as New York Heart Association (NYHA) Functional Class I or II (MR at 5, 10 and 15 years: 69%, 50% and 93%). Unfavorable characteristics included isolated anterior mitral leaflet repairs (MR: 202%, 212% and 188%) and preoperative symptomatic NYHA Functional Class III or IV (MR: 142%, 130% and 127%). When reoperation was required, mild or moderate underlying myxomatous degeneration was favorable, usually enabling re-repair (MR at 12 years: 77%). Reoperation when severe myxomatous degeneration was present usually required prosthetic valve insertion (MR at 12 years: 187%). Coronary artery bypass grafting done at the time of MVR demonstrates an associated minimal increase in late mortality. CONCLUSIONS: Surgical repair of myxomatous mitral valves produces durable long-term results with mild to modest overall increases in mortality. Favorable preoperative characteristics may be associated with near standard mortality risk.
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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 | 0.000 |
| Bibliometrics | 0.002 | 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 | 0.000 |
| 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".