Bibliographic record
Abstract
The author reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. We have a responsibility in academic surgery to dissociate objective findings with the personal impressions we have gathered related to our clinical practice. Among the most important recurring lessons I have tried to impart to trainees relates to the importance and responsibility of investigators to present just the facts and to provide ample opportunity for potential readers to derive valid conclusions from the information presented. Kattach and colleagues1Kattach H.D. Barlow C.W. Ohri S.K. Structural valve deterioration a pericardial bioprosthesis.J Thorac Cardiovasc Surg Open. 2022; 9: 84-85Scopus (2) Google Scholar have identified concerns with a presentation by Lehmann and colleagues2Lehmann S. Jawad K. Dieterlen M.T. Hoyer A. Garbade J. Davierwala P. et al.Durability and clinical experience using a bovine pericardial prosthetic aortic valve.J Thorac Cardiovasc Surg. 2021; 161: 1742-1749Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar regarding clinical outcomes after the implantation of the Trifecta bioprosthesis (St Jude Medical, St Paul, Minn). I will go so far as to suggest that the original authors' use of the word excellent as an adjective triggered, perhaps appropriately, the ensuing criticism of the proposed conclusions. Selective identification of supportive studies regarding comparative bioprosthesis degeneration in the Carpentier-Edwards Perimount Magna Ease (Edwards Lifesciences, Irvine, Calif) population contributed to their skepticism with regard to the authors' conclusions in the original article. This is an important lesson for all of us. The use of adjectives must be carefully considered because they impart merely opinions in terms of the consolidation of the data before us. When mentoring in the art of manuscript preparation, I teach my trainees to focus on the question, the methodology, and the results; keeping the conclusions concise, perhaps humble, and unbiased to ultimately allow reviewers to help shape the message of the article but always leaving space for a reader to draw his or her own conclusions. There is strong evidence that the Trifecta valve produces superb early hemodynamic parameters; however, I agree with Kattach and colleagues1Kattach H.D. Barlow C.W. Ohri S.K. Structural valve deterioration a pericardial bioprosthesis.J Thorac Cardiovasc Surg Open. 2022; 9: 84-85Scopus (2) Google Scholar that there is growing evidence of premature bioprosthetic degeneration in this valve. There is still an appropriate place and patient in which this valve is best suited, such as in elderly female patients with very small left ventricular outflow tracts. However, in those patients with a reasonable prognosis of long-term survival, alternative valves may be more appropriate. I disagree with the conclusion that degeneration of the Trifecta, even in small sizes (21 mm), cannot be approached with valve-in-valve technology. We have had several cases at our institution in which this strategy was successful even though the annular ring is rigid and cannot be fractured. We need to take into context the understanding that in patients in whom a 21-mm Trifecta valve was originally inserted, the alternative would have been a small or smaller alternative pericardial valve that produces worse hemodynamic parameters and potentially patient–prosthesis mismatch. Are we certain that the original operation would not have resulted in a more challenging outcome? Distancing results from the conclusion to provide readers with more flexibility in drawing their own inferences calms the waters. Academics are responsible for presenting data. We have to be clear that our conclusions are merely opinions and provide the space for readers to bring their own interpretations to the table. Structural valve deterioration of a pericardial bioprosthesisJTCVS OpenVol. 9PreviewLehmann and colleagues1 claim “excellent” outcomes for the Trifecta bioprosthesis (Abbott Structural Heart) in mid- to long-term follow-up. However, their article contains some concerns that make us question their conclusion. Full-Text PDF Open Access
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 | 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 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".