USE OF RIGHT ATRIAL APPENDAGE FOR PULMONARY VALVE RECONSTRUCTION IN TETRALOGY OF FALLOT REPAIR: A SINGLE-CENTER STUDY
Bibliographic record
Abstract
Preventing postoperative pulmonary regurgitation (PR) is critical for favorable outcomes following Tetralogy of Fallot (TOF) repair. The right atrial appendage (RAA) valve for right ventricular outflow tract (RVOT) reconstruction is a novel technique that offers a promising alternative when the native pulmonary valve cannot be preserved. This cross-sectional study evaluated the use of the RAA valve in 102 consecutive patients who underwent TOF repair at our institution between December 2023 and May 2025. The mean age was 6.5 years (range: 4 months–32 years). There were four deaths, none attributed to RAA valve use. Early postoperative echocardiography revealed trivial or no PR in 61 patients, mild PR in 33, and moderate PR in 8, with no severe PR. None developed significant RVOT obstruction. The mean tricuspid annular plane systolic excursion (TAPSE) was 14 mm. The average cardiopulmonary bypass and aortic cross-clamp times were 98 and 78 minutes, respectively. Postoperative complications included two re-openings for bleeding or tamponade, three strokes, six reintubations, five cases of renal dysfunction (one requiring dialysis), one heart block not requiring pacemaker, and one superficial wound infection. Overall, RAA valve reconstruction appears feasible, safe, and effective in reducing early PR, with encouraging short-term outcomes. Longer follow-up is warranted to assess durability and its role in delaying pulmonary valve replacement.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".