Management of a Sixth-Time Reoperation for Aortic Valve Disease With Aortic Pseudoaneurysm Invading the Sternum
Bibliographic record
Abstract
OBJECTIVES: Reoperative cardiac surgery is technically demanding. We describe the case of a 57-year-old woman found to have an ascending aortic pseudoaneurysm invading the sternum at the time of her sixth cardiac reoperation. KEY STEPS: In cases of considerably challenging sternal re-entry, the following steps are imperative: 1) peripheral establishment of cardiopulmonary bypass; 2) systemic cooling; 3) circulatory arrest followed by sternotomy; and 4) rapid establishment of cerebral perfusion. POTENTIAL PITFALLS: The proximity and adherence of mediastinal structures to the posterior table of the sternum is of paramount significance when considering sternal re-entry. Completion of the sternotomy prior to systemic cooling and circulatory arrest carries an extremely high risk for exsanguination and mortality. TAKE-HOME MESSAGES: This case describes the operative management of a patient undergoing a sixth sternotomy with an aortic pseudoaneurysm invading the sternum. Although challenging, this case could be performed successfully with careful attention to preoperative imaging, planning, and team communication.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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, unvalidatedMachine predicted; a candidate call from one teacher head, 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".