Long-term Outcomes Following Reoperations for Stentless Aortic Valves.
Bibliographic record
Abstract
Background : There is limited data on the long-term outcomes in patients who have undergone a reoperation following a failing stentless aortic valve. Methods : Between 2006-2016, a retrospective analysis was performed on 24 patients that underwent open aortic valve replacement surgery for a failed stentless aortic valve prosthesis at Health Sciences North, Sudbury, Ontario, Canada. The primary outcome was low mortality from cardiac related deaths after 5 years. Results : All patients underwent an insertion of a Medtronic Freestyle bioprosthesis implanted in the modified subcoronary technique for their initial operation. The interval from the first operation to the stentless redo surgery ranged from 6-13 years. Aortic valve reoperation was performed for structural valve deterioration in 96% (n= 23) of the cases. Reoperations involved a removal of the stented valve leaflets and stented valve-in-valve implantation in 20% (n= 5) of the cases, with the remaining cases requiring complete removal of the stentless prosthesis and aortic valve replacement. In those where a complete removal of the stentless valve was possible (n=19), there was no disruption of the native aortic root, and a 0% conversion to a Bentall procedure. There was no intraoperative mortality. The 30-day and 10-year operative mortality was 4% and 16%, respectively. Conclusions : Redo surgery for failing stentless valves can be done with relatively low-risk and with acceptable long-term outcomes without resorting to root replacement techniques.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".