Abstract 4146853: Factors Associated with Recovery of Right Ventricular Size After Transcatheter Device Closure of Isolated Atrial Septal Defects in Children
Bibliographic record
Abstract
Introduction: Children with significant left-to-right shunting across an isolated atrial septal defect (ASD) may have important right ventricular (RV) dilation. We sought to determine factors associated with RV recovery after percutaneous device closure. Methods: Children who underwent transcatheter device closure of an isolated ASD were included if they had no underlying genetic defect and echocardiography from prior to, immediately after and at follow-up. General linear regression modeling was used to determine factors associated with time-related RV dimensional recovery. Results: Inclusion criteria were met for 385 children (62% females; mean age 8.9 + 4.3 years) whose procedure occurred from 11/1985 to 11/2012. A single defect was present for 85%, with a mean size indexed to BSA of 14.9 + 6.6 mm/m 2 . A single device (Amplatzer for 80%) was used for 97% of the children, with a mild residual shunt present in 14% at the procedure. Mean BSA-indexed RV end-diastolic dimension (RVEDD) immediately post-closure was 2.20 + 0.66 cm/m 2 and decreased at a median follow-up of 1.8 years (range up to 13 years) to 1.71 + 0.48 cm/m 2 (p<0.001), corresponding to a mean BSA-adjusted Z score of +1.51 at follow-up (>+2 for 47% of children). Significant factors associated with a greater reduction in BSA-indexed RV size ( Figure ) included younger age at closure (p<0.001), larger indexed ASD size (p<0.001), greater RV size at closure (p<0.001) and longer follow-up time (p<0.001). Reduction was not associated with the presence of any residual shunt post-closure. QRS duration on ECG did not change significantly from pre-closure (mean 90 + 12 mmsec) to latest ECG (mean 89 + 12; p=035). Conclusions: Despite progressive reductions in RV size after ASD device closure, some children may continue to have RV enlargement. Earlier closure is associated with greater improvements.
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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 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".