Simplified Surgical Conversion of Mechanical to Bioprosthetic Bentall With Leaflet Fracture Technique
Bibliographic record
Abstract
We report a case of simplified surgical conversion from a prior mechanical composite valved conduit to a bioprosthetic aortic valve using a leaflet fracture technique. A 69-year-old man presented with progressive heart failure 7 years after aortic root replacement for bicuspid aortic stenosis and root aneurysm. Imaging revealed severe prosthetic valve stenosis and suspected pannus formation. Given significant comorbidities, a simplified approach was chosen to avoid full root re-replacement. Following redo sternotomy and graft incision, the mechanical valve leaflets were fractured and removed. A Foley balloon inserted into the left ventricular outflow tract prevented leaflet embolization. Pannus excision revealed a hypertrophic subvalvular septum, prompting a septal myectomy. A 23-mm bioprosthetic valve was implanted above the retained mechanical housing using interrupted mattress sutures. The patient's postoperative course was uneventful, and echocardiography confirmed good valve function. This case highlights the utility of leaflet fracture as a safe and efficient option in high-risk reoperative settings and underscores the added benefit of direct subvalvular visualization for detecting underlying anatomic contributors to prosthetic dysfunction not detected preoperatively.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| 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".