Invasive management of unroofed coronary sinus: A systematic review
Bibliographic record
Abstract
Unroofed coronary sinus (UCS) is a rare congenital anomaly, constituting under 1 % of atrial septal defects. Caused by partial or complete deficiency of the coronary sinus roof, UCS is often difficult to diagnose. While surgery remains the standard treatment, transcatheter approaches are emerging. We conducted a systematic review to evaluate outcomes of surgical and transcatheter approaches to UCS repair. Studies from MEDLINE, Embase, SCOPUS, and Web of Science were screened and selected based on predefined criteria. We extracted data on patient demographics, operative techniques, associated defects, and outcomes. Thirteen studies involving 293 patients with UCS were included. Majority (66.4 %) were male, with a mean age of 17.5 ± 11.5 years. UCS type 1A, marked by the presence of a persistent left superior vena cava and absent coronary sinus, was the most common subtype (50.4 %). Surgical repair was performed in 95.2 % of patients, with intracardiac baffle (34.1 %) and patch repair (21.9 %) being the predominant techniques. The remaining 4.8 % of patients underwent transcatheter repair, typically using Amplatzer® Septal Occluder device, with no reported procedural complications. In-hospital mortality rate was 2.7 %, and 30-day mortality was 3.0 %. Postoperative complications were rare, including residual defects (0.42 %), atrial fibrillation (2.9 %), and complete heart block requiring pacemaker (1.2 %). There were no cases of ischemic stroke. Surgical repair of UCS is associated with low postoperative mortality and complication rates, affirming its status as the standard of care. Transcatheter techniques may be feasible for select patients, though further studies are needed to to assess long-term outcomes and optimize criteria for patient selection.
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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 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.005 |
| Bibliometrics | 0.007 | 0.008 |
| 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) | 0.004 | 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".