Abstracts and Posters of the XXXVII Annual Meeting of The Association for European Paediatric Cardiology, Porto, 15–18 May, 2002
Bibliographic record
Abstract
Introduction: Elevated coronary sinus pressure may contribute to late post-operative cardiac failure after a Fontan Operation.The current study was designed to investigate the impact of coronary sinus drainage on coronary flow reserve (CFR) and myocardial function in patients after a modified Fontan operation.Methods: 36 unselected patients (age 17.6 6.5 y) with univentricular circulation (DILV = 1 1 , TA =12, other complex cardiac lesions = 13) 9.7 4.2 after a Fontan operation (RA-RV anastomosis = 9, RA-PA anastomosis = 17, TCPC = 10) were examined.Cardiac catheterization was performed under general anesthesia.Coronary flow reserve (FloWire, Cardiometrics, Inc.) was determined after intracoronary application of papaverine.Results: Measurement of CFR in the right coronary artery (RCA) was possible in 26/36 and in the left coronary artery (LCA) in 32/36 patients.Mean CFR-RCA was 3.95 1.2 and mean CFR-LCA was 4.2 1.6.Coronary sinus drainage into the systemic -or pulmonary venous compartment did not significantly affect CFR.41% CFR-values were <3.5.There was a significant correlation between CFR-RCA and pulmonary arteriolar resistance (p < 0.05).Systolic ventricular function was significantly higher in patients with a morphologic left ventricle (p = 0.02) but was not correlated with CFR-values."Coronary arterial fistulas" were seen in 33% of the patients.Conclusion: Coronary flow reserve is frequently reduced in patients after a Fontan operation.Site of coronary drainage into the "high pressure" systemic atrium or the "low pressure" pulmonary venous atrium did not significantly affect CFR.Elevated coronary sinus pressure may lead to increased Thebesian venous flow.This may be an explanation for the high incidence of "coronary arterial fistulas".Explanation of the correlation between CFR and pulmonary resistance demands further evaluation.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.178 | 0.056 |
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".