B-56 | Impact of Persistent Iatrogenic Atrial Septal Defect Following Transcatheter Mitral Valve Repair: A Meta-Analysis
Bibliographic record
Abstract
Long-term outcomes in patients with persistent iatrogenic atrial septal defect (iASD) after transcatheter mitral valve intervention (TMVR) have not been thoroughly explored. Our meta-analysis focuses on investigating the cardiovascular outcomes in this population. A systematic literature search of PubMed/MEDLINE and Google Scholar was performed (2005 - 2023) to identify studies reporting cardiovascular outcomes in patients with persistent iASD following TMVR. Odds of major adverse cardiovascular and cerebrovascular event (MACCE), mortality, heart failure hospitalizations (HFH) and stroke were calculated using a random-effects model. Heterogeneity was assessed using the I2 statistics. Leave one out method was used for sensitivity analysis. A p value < 0.05 was considered statistically significant. Of the six studies included in the final meta-analysis, 854 (iASD=257, no iASD 597) had undergone TMVR (61.6% males, mean age 76.8 years, mean follow up duration 19.7 months). Patients with persistent iASD had a significantly higher MACCE events (aOR 4.23, CI 1.27-14.15, p=0.02), HFH (aOR 3.61, CI 1.77 - 7.34, p<0.01), and trend towards increased mortality (aOR 1.41, CI 0.75 - 2.67, p=0.41). However, there was no association between stroke (aOR 0.81, 95% CI 0.35-1.90, p=0.63). (Figure 1) We found higher rates of MACCE, HFH, and trend towards increased mortality. Patients with persisting iASD post-MVR had no association with stroke at 19 months. Prospective studies on events after iASD closure are required to understand etiology and long-term cardiovascular consequences.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | Meta-epidemiology (broad) Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Meta-analysis | low |
| gpt | no category Domain: not available · Genre: Review About the Canadian research system: no · About a Canadian topic: no | Meta-analysis | low |
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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 1.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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, unvalidatedLabeled directly by 2 models reading the full record.
The models disagree on parts of this classification; every voice is preserved in the section at the end of the page.
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".