Encuesta multinacional y transversal sobre las controversias del reemplazo de la raíz aórtica con conservación valvular
Bibliographic record
Abstract
Background: The valve-sparing aortic root replacement (VSAR) has been established as a successful procedure for aortic rootaneurysms, Marfan's syndrome, bicuspid valves, and aortic dissections. However, there is a need for a consensus opinionregarding key aspects of VSAR.Methods: A literature review was performed regarding the most frequent debates and controversies in VSAR. An online surveywas developed based on this information, and sent to surgeons with known expertise in VSAR regarding their opinion onpatient-related factors, technical aspects, echocardiography, research, training, and the future of VSAR.Results: Twenty surgeons completed the survey. The reduction of left ventricular ejection fraction was considered a contraindication to VSAR when severe by 14/20 surveyed. The aortic annulus diameter cutoff point for the remodeling was heterogenousamong participants. All of them felt that VSAR is safe for the Marfan´s syndrome population and bicuspid valves.For type A dissections, 11/20 preferred this procedure only in young patients. Regarding to graft sizing, the height of theinterleaflet triangle (8/20) and the sino-tubular diameter (7/20) were the more frequent considered parameters. Surgeonsreported a 7% of failure rate, leading to conversion to Bentall surgery, and a 26% change of strategy intraoperatively. A minimallyinvasive approach was not considered to improve results. Most of the surgeons agreed that VSAR should be performedby high-experienced surgeons.Conclusions: The VSAR has been accepted as a treatment option for the aortic root´s aneurysms, and even though there isstill not possible to reach a final consensus, a valuable experience from the most relevant surgeons in the field is presented. How to cite this article: Fortunato GA, Misfeld M, Tirone D, Feindel CM, Schäfers HJ, Borger MA et al. Multinational and Cross-Sectional Survey on Valve-Sparing Aortic Replacement Controversies. Rev Argent Cardiol 2023;91:118-9https://doi.org/10.7775/rac.v91.i2.20612
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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 | 0.019 | 0.024 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
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".