Percutaneous Debulking of Bioprosthetic Mitral Valve Vegetations
Bibliographic record
Abstract
BACKGROUND: Infective endocarditis involving a prosthetic mitral valve carries high morbidity, especially when complicated by embolic events. Repeat surgery is often not feasible in high-risk patients. CASE SUMMARY: An 81-year-old man with a mitral valve bioprosthesis presented with recurrent infective endocarditis due to Streptococcus mutans, with enlarging vegetations and embolic strokes. Given prohibitive surgical risk, he underwent successful percutaneous debulking using the AngioVac system via transseptal approach under transesophageal echocardiographic and fluoroscopic guidance. Long-term suppressive antibiotics were continued. At the 30-month follow-up, the valve was structurally intact with no evidence of recurrent endocarditis. DISCUSSION: This case highlights the utility of AngioVac debulking of left-sided prosthetic valve vegetations in nonsurgical candidates. Successful imaging-guided aspiration minimized embolic risk and preserved valve function. TAKE-HOME MESSAGE: Vacuum-assisted debulking with AngioVac via a transseptal approach is a viable option in high-risk patients with prosthetic mitral valve endocarditis, offering an alternative to reoperation.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".