Novel Mother-in-Child Technique to Implant Coronary Sinus Reducer in a Challenging Anatomy
Bibliographic record
Abstract
BACKGROUND: A 73-year-old woman with a history of complete revascularization for coronary artery disease presented with refractory angina despite multiple antianginal treatments. CASE SUMMARY: Repeated coronary angiography revealed no significant obstructive lesions. Functional invasive coronary assessment confirmed coronary microvascular dysfunction. An A-Flux coronary sinus reducer (VahatiCor) was proposed. Given a very vertically oriented coronary sinus, device deployment was challenging. We then employed a novel mother-in-child technique using a 10 F Oscor Adelante Breezaway 120 degrees catheter (Oscor) to optimize support during A-Flux implantation. DISCUSSION: Coronary sinus reducers may provide a favorable hemodynamic response in patients with microvascular angina. The A-Flux device's design may facilitate navigation in complex anatomies, although inadequate support remains a potential limitation. The mother-in-child technique may help overcome this challenge. TAKE-HOME MESSAGES: Insufficient support during coronary sinus reduction procedures is a major challenge for interventionists. Using the mother-in-child technique with a 10 F Oscor Adelante Breezaway 120 degrees catheter may help address this issue in certain patients.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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".