Bilateral Pulmonary Artery Banding ± Ductal Stenting (Hybrid Palliation) for Infants with Critical Left Heart Obstruction: A Multi-Institutional Outcomes Analysis
Bibliographic record
Abstract
Bilateral pulmonary artery banding ± ductal stenting (hybrid palliation) is an established initial management option for infants with critical left heart obstruction. We determined patient/procedural characteristics, subsequent outcomes, and associated factors for 214 infants who underwent hybrid palliation from 2005-2019 across 24 institutions. Parametric multivariable hazard modeling with competing risk methodology was performed to determine risk and factors associated with the various endpoints. At 5 years, 9% had biventricular repair, 36% had Fontan, 12% had transplantation, 35% died, and 8% were alive without an endpoint. High-risk patient characteristics and anatomic factors relevant to critical left heart obstruction were associated with mortality and/or achieved surgical pathway. Procedural and interstage mortality are high after initial hybrid palliation. Nonetheless, hybrid palliation may be used as a strategy both to facilitate biventricular repair for some infants, and for others, as stabilization for intended functional univentricular palliation or primary transplantation.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| 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".