Mid-term Clinical and Hemodynamic Outcomes in Patients Treated for Aortic Regurgitation and/or Ascending Aorta Aneurysm: The 3-Year Flight of the AVIATOR Registry
Bibliographic record
Abstract
Background There are few prospective and large registries on outcomes after aortic valve repair/sparing or replacement in patients with aortic valve regurgitation (AR), with or without ascending aorta aneurysm. Methods A total of 2,026 patients enrolled prospectively in The Aortic Valve Insufficiency and ascending aorta Aneurysm InternATiOnal Registry (AVIATOR) were included in this analysis. The primary endpoint was the composite of all-cause death or aortic valve and/or aorta reintervention. Results 1,630 (80%) received surgical repair/sparing versus replacement in 396 (20%). During a mean follow-up of 3.8 ± 1.9 years, 187 (9.2%) events occurred, including 106 reinterventions and 81 deaths. The incidence of the composite endpoint was higher in the replacement versus repair group (25.3% vs. 11.8%; log-rank p < 0.001). In particular, the incidence of death was higher in the replacement versus repair group (21.9% vs. 4.5%; p < 0.001), while the incidence of reintervention was comparable between groups (8.2% vs. 5.1%; p = 0.16). AR ≥ grade 2 (mild-to-moderate) at discharge (2.9%) was more common in repair versus replacement (3.5% vs. 0.3%; p < 0.0001). AR (Grade 2) at discharge was significantly associated with higher incidence of the primary endpoint (adjusted HR: 2.60 [95% CI 1.01–6.74]; p = 0.04). Conclusion Surgical repair was associated with better survival than replacement at mid-term follow-up without increased risk of reoperation. However, the incidence of postoperative AR ≥ grade 2 was higher in repair than in replacement surgery. AR ≥ grade 2 at discharge was a strong predictor for reintervention during follow-up, stressing the importance of achieving complete correction of AR at the time of aortic valve repair.
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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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".