Remote Tamponade After Percutaneous Left Atrial Appendage Closure
Bibliographic record
Abstract
BACKGROUND: The use of percutaneous left atrial appendage closure (LAAC) among patients with nonvalvular atrial fibrillation at high thromboembolic risk and contraindication to or high risk for bleeding with oral anticoagulation is increasing. CASE SUMMARY: The authors present a case of acute hemorrhagic tamponade 7 months after LAAC. Intraoperative findings showed device-related microperforation of the LAA and erosion of the adjacent pulmonary artery. DISCUSSION: Remote tamponade after LAAC has been reported with an incidence <1%, occurring more frequently in nitinol plug devices than in nitinol cage devices. Management ranges from conservative with cessation of antithrombotic agents to invasive with surgical repair. TAKE-HOME MESSAGES: Remote tamponade after LAAC is a rare but potentially fatal complication. Routine use of cardiac computed tomography in addition to transesophageal echocardiography for preprocedural planning, especially for nitinol plug devices, can identify patients at risk of delayed tamponade and can guide device selection, modified implantation technique, or alternative management strategies.
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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 | 0.000 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 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".