Minimally Invasive Redo-Coronary Artery Bypass Grafting to the Left Anterior Descending Artery
Bibliographic record
Abstract
Reoperation in cardiac surgery is associated with increased morbidity and mortality. The proximity of cardiovascular structures such as the right ventricle, aorta, and/or grafts to the posterior table of the sternum increases the risk of inadvertent injury. Here, we present the case of a 71-year-old gentleman who was admitted with exertional angina (Canadian Cardiovascular Society III/IV) following coronary artery bypass graft over 30 years ago. Coronary angiogram demonstrated an atretic chronically occluded left internal thoracic artery graft and an acutely occluded saphenous vein graft, and computed tomography revealed that the right ventricle and pulmonary artery were closely adherent to the posterior table of the sternum. We outline a minimally invasive approach to ensure arterial revascularization of the left anterior descending artery while avoiding high-risk resternotomy, cardiopulmonary bypass, and aortic manipulation.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| 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".