Impact of Truncal Valve Repair on Survival, Reintervention, and Left Ventricular Function
Bibliographic record
Abstract
Background Truncal valve insufficiency (TVI) is one of the risk factors for death in neonatal primary repair for common arterial trunk (CAT). Methods In this single-center retrospective case-matched controlled study, 16 consecutive CAT patients from 2000 to 2018 with moderate to severe truncal valve regurgitation (TVR2-3), undergoing primary CAT surgery with truncal valve repair, were matched to 16 CAT patients with none or mild truncal valve regurgitation (TVR1-0). Results The TVR2-3 group had 11 (69%) patients with moderate and 5 (31%) patients with severe TVI, with an operative median age of 7 (4-19) days. Survival at median follow-up of 17 years after repair was 70% and 80% in the TVR2-3 and TVR0-1 groups, respectively ( P > .99), with 2 early deaths in the TVR2-3 group occurring after reintervention for residual TVI. Rate of surgical truncal valve reintervention at 5 years postoperatively was 67% for TVR2-3 ( P = .005). TVR2-3 experienced greater residual TVI at discharge and 1 year after repair, with severity of truncal valve dysfunction converging between groups as more patients in TVR0-1 developed mild to moderate TVI over time and TVR2-3 patients underwent reintervention for clinically significant TVI. Significant left ventricular (LV) dilation was observed in the TVR2-3 group after 3 years from repair ( P = .001), but LV ejection fraction was comparable between groups. Conclusions Truncal valve reintervention burden (ie, repair or replacement) is greater in the TVR2-3 population, with higher truncal valve–related early death. Progressive LV enlargement in the TVR2-3 group due to residual TVI was well tolerated. Ventricular remodeling did not have a notable impact on LV ejection fraction or clinical status.
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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 | 0.003 |
| 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 | 0.001 | 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".