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 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 | 0.001 | 0.002 |
| 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 | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".