Late outcomes after pulmonary valve balloon dilatation in neonates, infants and children.
Bibliographic record
Abstract
OBJECTIVES: This review was designed to document late outcomes after percutaneous balloon dilation (PBD) of the pulmonary valve (PV) on infants and children. BACKGROUND: PBD is the treatment of choice for PV stenosis. While short and intermediate term results are excellent, late outcomes, with respect to growth of the right heart are poorly defined. METHODS: Clinical data and serial echocardiograms were reviewed for children who had PBD between 1984 and 1992. RESULTS: One-hundred and fifty children were identified. PV gradients decreased from 62+/-29 to 23+/-20 mmHg (p<0.0001) and remained low during a mean follow-up of 11.9+/-3.1 (range 3.7 to 19.3 years). Freedom from re-intervention at 1, 10 and 15 years were: 90%, 83%, and 77%. Pulmonary regurgitation (PR) increased during follow-up such that 57% of children had moderate or severe PR at last follow-up. These children tended to have a smaller body surface area (0.52 vs. 0.82 m2, p=0.04), were younger (3.1 vs. 5.9 years, p=0.004), and less likely to be syndromic (p=0.04). Only children with severe PR demonstrated a significant increase in right ventricular (RV) size. Tricuspid and pulmonary annuli grew with the child's growth, the PV demonstrating catch-up growth (PV z-score: negative 1.3 vs. negative 0.7 at last follow-up, p=0.04). CONCLUSIONS: Following PBD in childhood, gradient reduction persists and RV structures grow appropriately in the majority of children. Although late PR occurs commonly, it is well tolerated. While life-long follow-up is essential, excellent outcome can be anticipated.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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) | 0.001 | 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".