Right anterior mini-thoracotomy for isolated aortic valve replacement: An international and multicenter study
Bibliographic record
Abstract
Background: Right anterior mini thoracotomy (RAMT) is a sternum-sparing approach for aortic valve replacement (AVR). Single-center studies have found RAMT AVR to be safe; however, there is a paucity of large, multicenter, all-comer, and real-world data for this surgical strategy. Methods: This retrospective study investigated the outcomes of isolated RAMT AVR at 6 centers in the United States, Canada, and Europe. Primary outcomes were death and disabling stroke within 30 days of surgery. Secondary outcomes included rate of conversion to sternotomy, prosthetic used, operative times, residual paravalvular leak, rate of permanent pacemaker (PPM) implantation, incidence of new onset postoperative atrial fibrillation (POAF), rate of blood transfusion, and intensive care unit and hospital length of stay. Results: Seven hundred and sixteen patients underwent isolated RAMT AVR between January 2012 and December 2024 across 6 centers. Four hundred and twenty-eight were male, and the mean age of the cohort was 68.1 ± 10.7 years. Six patients (0.8%) died and 3 (0.4%) experienced a disabling stroke. Thirteen patients (1.8%) required emergent reoperation to control bleeding, while 45 (6.3%) received transfused blood products. One hundred and thirty patients (18.2%) experienced POAF. The incidence of permanent pacemaker implantation after a sutured valve replacement was 2.51% (n = 18 patients). The median intensive care unit and hospital length of stay was 1 day and 5 days, respectively. Conclusions: The findings of this study, the largest multicenter study on RAMT AVR reported to date, suggest that this is a safe operation associated with excellent outcomes.
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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 | 0.000 | 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".