Up-to-date review on concomitant mitral transcatheter edge-to-edge repair and left atrial appendage occlusion
Bibliographic record
Abstract
In patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER), atrial fibrillation is a common comorbidity. While oral anticoagulation is the mainstay of stroke prevention therapy in most patients with atrial fibrillation, patients undergoing M-TEER might have a unique opportunity to undergo concomitant left atrial appendage occlusion (LAAO). LAAO is an alternative to oral anticoagulation that reduces the long-term risk of stroke and major bleeding, but it comes with upfront peri-procedural risk. M-TEER and LAAO share numerous procedural characteristics including large-bore venous access, transseptal puncture, general anesthesia, and real-time imaging of the left atrium with echocardiography. Therefore, performing concomitant LAAO at the time of M-TEER might be an attractive option for patients to lessen the cumulative peri-procedural risk, repeated anesthetic, and hospital visits from separate procedures. With rapidly evolving device technologies and an increasing evidence base for LAAO use, there is still limited data evaluating the safety and feasibility of concomitant M-TEER and LAAO. This up-to-date narrative review on concomitant M-TEER and LAAO aims to summarize the current body of literature, review practical procedural considerations, and review the unmet research questions limiting the widespread adoption of this concomitant intervention.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.005 |
| 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 | 0.001 | 0.001 |
| 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".