Abstract 16152: The Mustard Operation for Transposition of the Great Arteries: Challenges During Adulthood
Bibliographic record
Abstract
Background Survivors of the Mustard operation have largely transitioned to adulthood, yet their prognosis is uncertain. Methods We investigated all 205 patients who underwent Mustard operation for d-TGA (1963-1991) and transitioned to our adult services. Outcomes were analyzed by parametric competing risks and repeated measures analysis of ECGs (2776), echos (1363), cardiopulmonary tests (321) and MRIs (288). Results Attrition was constant (~1%/year); 20 years after transitioning to adulthood 79% were alive with a systemic RV circulation. Only 8 underwent transplantation. Intact ventricular septum was associated with improved late survival during adulthood (85% versus 69%, P=.05). The systemic RV gradually dilated over time (figure). This was associated with progressive decline in qualitative contractility (P Conclusions Gradual deteriorations in RV and tricuspid performance account for a high incidence of congestive heart failure in adults surviving Mustard operation. Nevertheless, very late survival is impressive, transplantation is rare and tricuspid or baffle interventions are infrequent. Inexorable RV dilatation will pose future management dilemmas.
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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 | 0.002 |
| 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) | 0.001 | 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".