Recurrent STEMI After Surgical Aortic Valve Replacement
Bibliographic record
Abstract
BACKGROUND: A 63-year-old man underwent surgical aortic valve replacement with an On-X valve using COR-KNOT suturing to facilitate a mini-sternotomy approach. CASE SUMMARY: The patient presented with recurrent inferior ST-segment elevation myocardial infarctions over a few-year period, despite optimal anticoagulation therapy. Repeated coronary angiography showed no obstructive coronary artery disease or thromboembolic occlusion. Intravascular ultrasound showed a filling defect in the ostium of the right coronary artery (RCA). A cardiac computed tomography confirmed the interference between a COR-KNOT and the RCA. Percutaneous coronary intervention of the RCA ostium was performed with good outcomes. DISCUSSION: This is the first case to report a ST-segment elevation myocardial infarction caused by an automated suturing. The combination of mini-sternotomy with COR-KNOT may have contributed to this rare but serious complication. TAKE-HOME MESSAGES: Multimodality imaging is crucial in establishing unusual diagnoses. COR-KNOT may interfere with coronary flow resulting in transient coronary occlusion when used in surgical aortic valve replacement.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| 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".