Bicuspid valve CT Registry of balloon expandable TAVR: BETTER TAVR Registry
Bibliographic record
Abstract
Abstract Objectives We evaluated determinants of stent geometry in bicuspid valves treated with balloon expandable TAVR. Background The anatomic substrate of bicuspid valves may lead to suboptimal TAVR stent expansion and geometry. Methods A multicentre observational registry of patients who underwent post TAVR CT to determine stent area (vs nominal valve area) and stent ellipticity (maximum diameter/minimum diameter). Predictors of relative stent expansion (minimum area/average of inflow + outflow area) and stent ellipticity were evaluated in a multivariable regression model including valve calcium volume, presence of raphe calcium, sinus diameters indexed for area derived annular diameter, and performance of pre-dilation and post-dilation. Results The registry enrolled 101 patients from 4 centres. Minimum stent area (vs nominal area) was 88.1% and maximum ellipticity was 1.10 with both observed near the midframe of the valve in all cases. Relative stent expansion ≥90% was observed in 64/101 patients. The only significant predictor of relative stent expansion ≥90% was performance of post-dilation (p<0.01). Relative stent expansion ≥90% was seen in 86% of patients with post dilation compared to 57% of without (p<0.001). The stent ellipticity ≥ 1.1 was observed in 47/101 patients. The significant predictors of stent ellipticity ≥1.1 was the presence of raphe calcification (p=0.02) and intercommisural diameter at 4 mm above the annular plane (p=0.004). Conclusion Relative stent expansion ≥90% was associated with the performance of post-dilation and stent ellipticity was associated with the presence of calcified raphe and sinus dimensions (Intercommisural diameter at 4 mm above the annular plane). Further studies to determine optimal deployment strategies in bicuspid valves are needed. Abstract Figure Graphical abstract Predictors of stent expansion and ellipticity from a multicenter registry of patients with bicuspid anatomy undergoing TAVR with balloon expandable valves.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".