Bibliographic record
Abstract
We developed a simple composite-sequential grafting strategy which preserves the left interior mammary artery (LIMA) inflow to the left anterior descending (LAD) while expanding its reach to other diseased anterolateral vessels [1–4]. The surgical design uses a small saphenous vein graft bridge interposed between the LAD and 1 (or more) other anterolateral target(s). Technically, the other anterolateral coronary targets presenting stenoses ≥70% (mainly diagonals, ramus intermedius, or high first circumflex marginal) are grafted first in an end-to-side fashion with a short carefully selected saphenous vein graft (SVG) segment-oriented caudaly. The vein graft is then brought to the LAD and anastomosed in an end-to-side fashion therefore completing the SVG bridge. The LIMA is then grafted on the hood of the SVG bridge anastomosis on the LAD, closer as possible to the LAD (reducing SVG interposition). In this surgical design, the direction of flow and vein valves (if any) is from the LAD towards the other anterolateral targets. Due to the short length of the SVG bridge and the selection of a segment without varicosities, SVG bridge seldomly presents venous valves. As properly described by Filho et al. [5], this novel composite bridge grafting strategy is reproducible, safe, efficient and associated with several advantages including better mammary artery flow with recruitment of a larger outflow bed, shorter vein requirement and usefulness of the bridge as a combined vein patch angioplasty for severely diseased, calcified or intramyocardial coronaries. According to our experience [2] and randomized trial [4], the mammary artery can provide more flow when anastomosed as a composite graft. Other benefits of the technique may include complete avoidance of the ascending aorta if the surgery is performed off-pump (52% of our earlier experience was off-pump) [2, 3], reduced shear stress on the vein graft compared to aortocoronary grafts and paracrine infusion of nitric oxide from LIMA in the SVG bridge. The composite bridge grafting strategy can also facilitate minimally invasive CABG techniques through a small left minithoracotomy. In younger patients where a radial artery is harvested, the saphenous vein bridge could be replaced with a short radial artery bridge while preserving sufficient radial artery length to perform other grafts.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.002 |
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 teacher head, 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".