Experience of adults with congenital heart disease during the COVID-19 pandemic
Bibliographic record
Abstract
Purpose: Dilated aortic root is a well-known sequela after arterial switch operation (ASO) in adults with transposition of the great arteries (TGA).This aortopathy in TGA is multifactorial.4D flow MRI enables the quantification of instantaneous viscous energy loss (EL), which is a marker of prominent secondary aortic flow structural abnormality and cardiac workload.Elevated EL suggests potential ventriculo-arterial decoupling, which is a novel concept of fluid dynamics.We aimed to assess quantitatively aortic flow profiles and EL in TGA adults after ASO (Jatene procedure with LeCompte maneuver) using 4D flow MRI.Methods: Prospectively, 9 consecutive adults (30.2 AE 6.6 years) after ASO (Jatene operation with LeCompte technique), 13 consecutive adults (34.3 AE 7.2 years) after the atrial switch operation with Senning procedure, and 8 agematched control patients, who underwent turbo field echo (TFE) echo planner imaging (EPI) 4D flow MRI, were enrolled.Abnormal aortic structure (the diameter ratio of the sinus of Valsalva and the ascending aorta, and acute aortic arch angle), abnormal aortic flow profiles, and EL were evaluated.Results: TGA after ASO showed a markedly dilated sinus of Valsalva, compared to TGA after atrial switch operation (26.6.AE 4.9 vs. 18.6.AE 1.5 mm/cm2).Energy loss/Cardiac index (EL/CI) and helicity in the aortic root in TGA after Jatene procedure were the greatest among the three.EL was relevant to the diameter ratio of the sinus of Valsalva and the AAO (r¼0.78,P¼0.03).Conclusions: Abnormal aortic structure as well as histologically vulnerable neoaortic root after Jatene procedure may play an adjunctive role in promoting aortopathy and elevating EL.The cause and effect relationship is always challenging to discuss between abnormal aortic profile and aortopathy; however, it is highly possible that abnormal flow dynamics aggravate aortopathy secondarily.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".