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<1>
Accession Number
2034348291
Title
The Association Between Renal Desaturation Measured Using Near-Infrared
Spectroscopy and Postoperative Acute Kidney Injury: A Systematic Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(11) (pp 2606-2612),
2024. Date of Publication: November 2024.
Author
Wang B.; Shi H.; Yao Y.; Liu S.; Shi C.
Institution
(Wang, Shi) Department of Anesthesiology, Peking University International
Hospital, Beijing, China
(Shi) Department of Anesthesiology, Shijingshan Hospital, Beijing, China
(Yao) Department of Anesthesiology, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences, Fuwai Hospital, Peking
Union Medical College, Beijing, China
(Liu) Department of Cardiac Surgery, Peking University International
Hospital, Beijing, China
Publisher
W.B. Saunders
Abstract
Objectives: The objective of this systematic review was to clarify the
status of near-infrared spectroscopy (NIRS) in monitoring perioperative
renal regional tissue oxygen saturation (rSO<inf>2</inf>) and determine
whether there is evidence supporting its use in predicting postoperative
acute kidney injury (AKI). Design(s): A systematic search of
electronic databases was conducted to identify all clinical studies that
utilized NIRS to monitor renal rSO<inf>2</inf> during the perioperative
period to observe postoperative AKI. Setting(s): Studies published
online as of May 31, 2024, were included in the review.
 Participant(s): Studies involving human participants undergoing
surgery with a predefined outcome of AKI were included.
 Intervention(s): Regional tissue oxygen saturation was measured using
NIRS. Measurements and Main Results: A total of 144 records were
identified in the primary search after removing duplicates. After
screening, 18 studies were included in the analysis, consisting of 3
case-control studies and 15 prospective cohort studies. Thirteen reports
focused on pediatric surgery, whereas five reports focused on adult
surgery. Sixteen studies involved cardiovascular surgery with
cardiopulmonary bypass, and two studies focused on liver surgery. All
studies received a quality score of 7 or above. Significant heterogeneity
and mostly short follow up periods were noted. Conclusion(s): Renal
desaturation may indicate AKI in patients; however, further studies are
required to substantiate this relationship. Additional clinical trials are
necessary to evaluate normal values and establish the exact threshold of
renal rSO<inf>2</inf> that signifies a meaningful decline in renal
function. Copyright © 2024

<2>
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Accession Number
2034335668
Title
Coronary artery bypass grafting in acute coronary syndromes: modern
indications and approaches.
Source
Current Opinion in Cardiology. 39(6) (pp 485-490), 2024. Date of
Publication: 01 Nov 2024.
Author
Sandner S.; Florian A.; Ruel M.
Institution
(Sandner, Florian) Department of Cardiac Surgery, Medical University of
Vienna, Vienna, Austria
(Sandner) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Acute coronary syndromes (ACS) are a leading cause of
morbidity and mortality worldwide, with approximately 1.2 million
hospitalizations annually in the U.S. This review aims to explore the
contemporary evidence regarding revascularization strategies, including
percutaneous coronary intervention (PCI) and coronary artery bypass
grafting (CABG), in ACS patients. It also addresses the unresolved
questions concerning the optimal procedural aspects of surgery and
antithrombotic therapy for secondary prevention postsurgery. Recent
findings Recent studies highlight that while PCI is generally preferred
for its timeliness in high-risk non-ST-elevation ACS (NSTE-ACS) patients,
CABG offers a benefit in terms of cardiovascular events in those with
multivessel disease, particularly in the presence of diabetes and higher
coronary disease complexity. For ST-elevation myocardial infarction
(STEMI), CABG is less frequently utilized due to the preference for
primary PCI, but it remains crucial for patients with complex anatomy or
failed PCI. Furthermore, the optimal timing and type of antiplatelet
therapy post-CABG remain controversial, with current evidence supporting
the use of dual antiplatelet therapy (DAPT) to reduce ischemic events but
necessitating careful management to balance bleeding risks. Summary In
patients with ACS, the choice between PCI and CABG depends on the
complexity of coronary disease and patient comorbidities. CABG is
particularly beneficial for multivessel disease in NSTE-ACS and specific
STEMI cases where PCI is not feasible. The management of antiplatelet
therapy postsurgery requires a nuanced approach to minimize bleeding risks
while preventing thrombotic complications. Further randomized clinical
trials are needed to solidify these findings and guide clinical
practice. Copyright © 2024 Wolters Kluwer Health, Inc. All rights
reserved.

<3>
Accession Number
2034254619
Title
Comparison Between Histidine-Tryptophan-Ketoglutarate Cardioplegia and
Cold Blood Cardioplegia for Myocardial Protection in Tetralogy of Fallot
Patients Undergoing Surgical Repair: A Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(11) (pp 2643-2650),
2024. Date of Publication: November 2024.
Author
Abdel Twab S.M.; Kamal F.; Fouad A.
Institution
(Abdel Twab, Kamal, Fouad) Department of Anaesthesiology, Intensive Care,
and Pain Management, Faculty of Medicine, Ain Shams University, Cairo,
Egypt
Publisher
W.B. Saunders
Abstract
Objectives: This study was conducted to compare the efficacy of
histidine-tryptophan-ketoglutarate (HTK) cardioplegia and cold blood
cardioplegia (CBC), especially for postoperative right ventricular (RV)
function after tetralogy of Fallot repair. Design(s): Randomized,
double-blinded, parallel-group, controlled clinical trial.
 Setting(s): Ain Shams University Hospitals. Participant(s): A
total of 100 children (1 to 5 years old) scheduled for tetralogy of Fallot
repair. Intervention(s): Patients were allocated (double-blinded 1:1
allocation ratio) to either the HTK group that received HTK cardioplegia
(30 mL/kg via antegrade route) or the CBC group that received cold blood
cardioplegia with blood-to-Ringer solution (4:1) in a volume of 20 mL/kg.
 Measurements and Main Results: The HTK group showed a statistically
significant reduction of the vasoactive inotropic score on admission to
the pediatric intensive care unit (13.0 +/- 4.1) in comparison to the CBC
group (15.5 +/- 5.4), with a p value of 0.011. However, after 24 hours,
the vasoactive-inotropic score was comparable. Lactate level during the
first 24 hours was 6.2 +/- 0.7 mmol/L in the HTK group and 6.9 +/- 0.4
mmol/L in the CBC group (p < 0.0001). Serial troponin measurements were
lower in the HTK group (1.49 +/- 0.45) compared to the CBC group (1.69 +/-
0.18) at the first 72 hours postoperatively (p = 0.005). Postoperative
echocardiographic assessment of RV function by means of tricuspid annular
plane systolic excursion and myocardial performance index were better in
the HTK group than in the CBC grpup (p < 0.05). Conclusion(s): HTK
cardioplegia may offer better cardiac protection to pediatric patients
undergoing tetralogy of Fallot repair than our institutional standard CBC
with better recovery for the hypertrophic RV. Copyright © 2024
Elsevier Inc.

<4>
[Use Link to view the full text]
Accession Number
2034227539
Title
Extracorporeal Cardiopulmonary Resuscitation Use Among Children With
Cardiac Disease in the ICU: A Meta-Analysis and Meta-Regression of Data
Through March 2024.
Source
Pediatric Critical Care Medicine. 25(10) (pp e410-e417), 2024. Date of
Publication: 01 Oct 2024.
Author
Sperotto F.; Daverio M.; Amigoni A.; Gregori D.; Dorste A.; Kobayashi
R.L.; Thiagarajan R.R.; Maschietto N.; Alexander P.M.
Institution
(Sperotto, Kobayashi, Thiagarajan, Maschietto, Alexander) Department of
Cardiology, Boston Children's Hospital, Boston, MA, United States
(Sperotto, Kobayashi, Thiagarajan, Maschietto, Alexander) Department of
Pediatrics, Harvard Medical School, Boston, MA, United States
(Daverio, Amigoni) Pediatric Intensive Care Unit, Department of Women's
and Children's Health, University of Padova, Padova, Italy
(Gregori) Laboratories of Epidemiological Methods and Biostatistics,
Department of Environmental Medicine and Public Health, University of
Padova, Padova, Italy
(Dorste) Boston Children's Hospital Library, Boston Children's Hospital,
Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVE: Epidemiologic data on extracorporeal cardiopulmonary
resuscitation (ECPR) use in children with cardiac disease after
in-hospital cardiac arrest (IHCA) are lacking. We aimed to investigate
trends in ECPR use over time in critically ill children with cardiac
disease. DATA SOURCES: We performed a secondary analysis of a recent
systematic review (PROSPERO CRD42020156247) to investigate trends in ECPR
use in children with cardiac disease. PubMed, Web of Science, Embase, and
Cumulative Index to Nursing and Allied Health Literature were screened
(inception to September 2021). For completeness of this secondary
analysis, PubMed was also rescreened (September 2021 to March 2024). STUDY
SELECTION: Observational studies including epidemiologic data on ECPR use
in children with cardiac disease admitted to an ICU. DATA EXTRACTION: Data
were extracted by two independent investigators. The risk of bias was
assessed using the National Heart Lung and Blood Institutes Quality
Assessment Tools. Random-effects meta-analysis was used to compute a
pooled proportion of subjects undergoing ECPR; meta-regression was used to
assess trends in ECPR use over time. DATA SYNTHESIS: Of the 2664 studies
identified, 9 (17,669 patients) included data on ECPR use in children with
cardiac disease. Eight were cohort studies, 1 was a case-control, 8 were
retrospective, 1 was prospective, 6 were single-center, and 3 were
multicenter. Seven studies were included in the meta-analysis; all were
judged of good quality. By meta-analysis, we found that a pooled
proportion of 21% (95% CI, 15-29%) of pediatric patients with cardiac
disease experiencing IHCA were supported with ECPR. By meta-regression
adjusted for category of patients (surgical vs. general cardiac), we found
that the use of ECPR in critically ill children with cardiac disease
significantly increased over time (p = 0.026). CONCLUSION(S): About
one-fifth of critically ill pediatric cardiac patients experiencing IHCA
were supported with ECPR, and its use significantly increased over time.
This may partially explain the increased trends in survival demonstrated
for this population. Copyright © 2024 by the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies.

<5>
Accession Number
2034072566
Title
The Effects of Corticosteroids on Survival in Pediatric and Nonelderly
Adult Patients Undergoing Cardiac Surgery: A Meta-analysis of Randomized
Studies.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(11) (pp 2783-2791),
2024. Date of Publication: November 2024.
Author
Losiggio R.; Lomivorotov V.; D'Andria Ursoleo J.; Kotani Y.; Monaco F.;
Milojevic M.; Yavorovskiy A.; Lee T.C.; Landoni G.; Oriani A.; Prima
A.L.D.; Mucchetti M.; Ortalda A.; Calabro M.G.; Zangrillo A.
Institution
(Losiggio, D'Andria Ursoleo, Monaco, Landoni) Department of Anesthesia and
Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Lomivorotov) Department of Anesthesiology and Perioperative Medicine,
Penn State College of Medicine, Penn State Milton S. Hershey Medical
Centre, Hershey, PA, United States
(Kotani) Department of Intensive Care Medicine, Kameda Medical Centre,
Kamogawa, Japan
(Milojevic) Department of Cardiothoracic Surgery, Erasmus University
Medical Centre, Rotterdam, Netherlands
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Yavorovskiy) Department of Anesthesiology and Intensive Care, I.M.
Sechenov First Moscow State Medical University of the Russian Ministry of
Health, Moscow, Russian Federation
(Lee) Division of Infectious Diseases, Department of Medicine, McGill
University Health Centre, Montreal, QC, Canada
(Landoni) School of Medicine, Vita-Salute San Raffaele University, Milan,
Italy
(Oriani, Prima, Mucchetti, Ortalda, Calabro, Zangrillo) Department. of
Anesthesia and Intensive Care, IRCCS San RaffaeleScientific Institute,
Milan, Italy
(Zangrillo) School of Medicine, Vita-Salute San Raffaele.University,
Milan, Italy
Publisher
W.B. Saunders
Abstract
Objective: Cardiac surgery can be complicated by the development of a
systemic inflammatory response syndrome related to cardiopulmonary bypass.
This potentially contributes to the occurrence of postoperative morbidity
and mortality. Corticosteroids can be used to reduce such inflammation,
but the overall balance between potential harm and benefit is unknown and
may be age-dependent. The present meta-analysis aims to evaluate the
effects of prophylactic corticosteroids in pediatric and non-elderly adult
cardiac surgery patients. Design(s): Systematic review and
meta-analysis of randomized trials. Setting(s): Cardiac surgery with
cardiopulmonary bypass. Participant(s): Patients younger than 65
years old (pediatric and non-elderly adults). Intervention(s):
Perioperative use of corticosteroids versus placebo or standard care.
 Measurements and Main Results: Two independent investigators searched
PubMed, EMBASE and the Cochrane Library from inception to January 20,
2024. The primary outcome was mortality at the longest follow-up
available. Secondary outcomes included acute kidney injury, atrial
fibrillation, myocardial injury, cerebrovascular events, and infections.
Our search strategy identified a total of 17 randomized trials involving
6,598 patients. Mortality was significantly reduced in the corticosteroid
group (78/3321 [2.3%] vs. 116/3277 [3.5%]; risk ratio = 0.69; 95%
confidence interval, 0.52 to 0.92; P = 0.01; I2 = 0%; NNT = 91). Moreover,
the highest postoperative vasoactive inotropic score (VIS) was
significantly lower in corticosteroid group (MD: -2.07, 95% CI -3.69 to
-0.45, P = 0.01, I2 = 0%). No significant differences in secondary
outcomes between the two treatment groups were recorded.
 Conclusion(s): This meta-analysis of randomized trials highlights the
potential benefits of corticosteroids on survival in cardiac surgery for
patients younger than 65 years old. Copyright © 2024 Elsevier
Inc.

<6>
Accession Number
2033470996
Title
Hypoattenuated Leaflet Thickening: A Comprehensive Review of Contemporary
Data.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(11) (pp 2761-2769),
2024. Date of Publication: November 2024.
Author
Samadzadeh Tabrizi N.; Fishberger G.; Musuku S.R.; Shapeton A.D.
Institution
(Fishberger) University of South Florida Morsani College of Medicine,
Tampa, FL, United States
(Samadzadeh Tabrizi, Musuku) Department of Anesthesiology, Albany Medical
Center, Albany, NY, United States
(Shapeton) Veterans Affairs Boston Healthcare System, Department of
Anesthesia, Critical Care and Pain Medicine, and Tufts University School
of Medicine, Boston, MA, United States
Publisher
W.B. Saunders
Abstract
Nearly one-third of patients who undergo surgical aortic valve replacement
(SAVR) or transcatheter aortic valve replacement (TAVR) develop
hypoattenuated leaflet thickening (HALT) within a year. HALT typically
represents subclinical leaflet thrombosis in asymptomatic patients, and as
a result it often is detected incidentally. However, HALT also may worsen
in severity, resulting in leaflet immobility and/or valve deterioration.
The clinical significance of HALT is a topic of ongoing debate, and
currently there is no consensus on the screening and management of HALT in
patients following TAVR or SAVR. This review provides a comprehensive
evaluation of the available evidence on risk factors, preventative
measures, treatment, and prognosis for this growing patient
cohort. Copyright © 2024 Elsevier Inc.

<7>
Accession Number
2032856250
Title
The Analgesic Effect of Ultrasound-guided Erector Spinae Plane Block in
Median Sternotomy Cardiac Surgery in Adults: A Systematic Review and
Meta-analysis of Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(11) (pp 2792-2800),
2024. Date of Publication: November 2024.
Author
Wang W.; Yang W.; Liu A.; Liu J.; Yuan C.
Institution
(Wang, Yuan) Department of Anesthesiology, Jining No. 1 People's Hospital,
Shandong, Jining, China
(Yang) Department of Anesthesiology, Deyang People's Hospital, Sichuan,
Deyang, China
(Liu) Department of Anesthesiology, Heze Municipal Hospital, Shandong,
Heze, China
(Liu) Department of Emergency Surgery, Jining No. 1 People's Hospital,
Shandong, Jining, China
Publisher
W.B. Saunders
Abstract
Objectives: To assess the analgesic effect of erector spinae plane block
in adults undergoing median sternotomy cardiac surgery. Design and
setting: The Cochrane, Embase, and PubMed databases from inception to
January 2024 were searched. The study has been registered in the
International Prospective Register of Systematic Reviews (CRD42023470375).
 Participant(s): Eight randomized controlled trials involving 543
patients, comparing with no block or sham block, were included, whether it
was a single injection or continuous. Measurements and Main Results:
The primary outcomes were pain scores and opioid consumption. Erector
spinae plane block reduced pain scores immediately after extubation (mean
difference [MD], -1.19; 95% confidence interval [CI], -1.67 to -0.71; p
for heterogeneity = 0.10), at 6 hours after extubation (MD, -1.96; 95% CI,
-2.85 to -1.08; p for heterogeneity < 0.0001), and at 12 hours after
extubation (MD, -0.98; 95% CI, -1.55 to -0.40; p for heterogeneity <
0.00001). The decrease in pain scores reached the minimal clinically
important difference within 6 hours. Opioid consumption 24 hours after
surgery decreased by 35.72 mg of oral morphine equivalents (95% CI, -50.88
to -20.57; p for heterogeneity < 0.0001). Sensitivity analysis confirmed
the stability of results. The quality of primary outcomes was rated as
very low to moderate. Conclusion(s): Erector spinae plane block
decreased pain scores within 12 hours after extubation, reached the
minimal clinically important difference within 6 hours, and decreased
opioid consumption 24 hours after surgery, based on data of very low to
moderate quality. However, high-quality randomized controlled trials are
necessary to validate these findings. Copyright © 2024 Elsevier
Inc.

<8>
Accession Number
2032820479
Title
Zero-contrast left atrial appendage closure, a feasible alternative for
patients with a high risk of contrast-induced nephropathy: Systematic
literature review and meta-analysis.
Source
Heart Rhythm. 21(11) (pp 2136-2147), 2024. Date of Publication: November
2024.
Author
Rodriguez J.F.; Pachon-Londono M.J.; Areiza L.A.; Rodriguez W.G.
Institution
(Rodriguez, Pachon-Londono) Universidad del Rosario, Bogota, Colombia
(Areiza) Hospital Universitario Mayor, Mederi, Bogota, Colombia
(Rodriguez) Colsubsidio Calle 63, Bogota, Colombia
Publisher
Elsevier B.V.
Abstract
Background: Left atrial appendage closure (LAAC) is an alternative to
reduce thrombotic risk in patients with nonvalvular atrial fibrillation.
This procedure conventionally requires the use of a contrast agent. A
significant proportion of patients who undergo this procedure have chronic
kidney disease, with a high risk of contrast-induced nephropathy.
 Objective(s): We aimed to systematically review existing literature
regarding the feasibility and safety of a zero-contrast LAAC technique.
 Method(s): We searched the MEDLINE/PubMed, Embase, and Cochrane
Central Register of Controlled Trials databases for studies comparing a
zero-contrast LAAC technique with conventional LAAC up to April 2024. From
each study, we extracted baseline characteristics, feasibility, and safety
outcomes. A random model meta-analysis was used to compare outcomes
between groups. Result(s): Five studies reporting data from 367
patients were included. A 100% successful implantation rate was reported
in all the zero-contrast groups. The mean number of recaptures reached no
significant difference between the groups (mean difference, -0.15; CI,
-0.67 to 0.37; I2 = 0%; P = .58). The zero-contrast group had a
significantly shorter fluoroscopy time (mean difference, -4.03; CI, -7.72
to -0.34; I2 = 67%; P = .03). Complications related to the
procedure, peridevice leak, and device-associated thrombus rates were not
significantly different between the groups. Conclusion(s):
Zero-contrast LAAC is a feasible alternative. The success and complication
rates are consistent with those of conventional LAAC. Aside from the
inherent benefit of zero-contrast exposure, this technique allows a
reduction in fluoroscopy time. Copyright © 2024 Heart Rhythm
Society

<9>
Accession Number
645494904
Title
SHORT-TERM EFFECTS OF BLOOD PRESSURE LOWERING DRUGS ON CARDIOVASCULAR
EVENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMISED,
PLACEBO-CONTROLLED, DOUBLED-BLIND TRIALS.
Source
International Journal of Hypertension. Conference: 30th Congress of the
International Society of Hypertension - ISH 2024. Cartagena Colombia.
42(Supplement 3) (pp e99), 2024. Date of Publication: September 2024.
Author
Gnanenthiran S.; Kaistha P.; Pant R.; Dhurjati R.; Kumar A.; Haghdoost F.;
Kota V.; Wang N.; Rodgers A.; Salam A.
Institution
(Gnanenthiran, Haghdoost, Wang, Rodgers) George Institute for Global
Health, Sydney, Australia
(Kaistha, Pant, Dhurjati, Kumar, Kota, Salam) George Institute for Global
Health, India
Publisher
Hindawi Limited
Abstract
Background and Objective: There remains uncertainty about the short-term
effects of blood pressure (BP) lowering drugs on cardiovascular events.
This meta-analysis of double-blind, short-term randomised trials,
evaluated the effect of BP-lowering drugs on cardiovascular events
compared to placebo. Method(s): A systematic search was performed in
the following databases: MEDLINE, Cochrane Central Register of Controlled
Trials, and Epistemonikos. Trials satisfying the following criteria were
included: (i) randomized, double-blind placebo-controlled trials of 2-26
weeks published in English language; (ii) adults (age >=18 years) with
hypertension (BP >=140/90 mmHg) or taking BP-lowering drugs; (iii)
intervention: oral fixed dose of BP-lowering drug(s) as either monotherapy
or combination therapy from five major classes (angiotensin converting
enzyme, angiotensin-II receptor blockers, calcium channel blockers,
beta-blockers, and diuretics); (iv) placebo comparator; (v) reported data
on cardiovascular events; (vi). The primary outcome was major adverse
cardiovascular events (MACE), defined as stroke, transient ischaemic
attack (TIA), myocardial infarction, heart failure, angina or coronary
revascularisation. Result(s): 451 trials (93121 participants [mean
age 54yrs, 56% males, mean follow-up 8 weeks] were included. There was no
effect of the intervention compared to placebo on MACE (0.19% versus
0.43%; relative risk [RR] 0.89, 95% CI 0.69-1.14, p=0.35). There was a
significant reduction in stroke (0.01% versus 0.05%; RR 0.37 [0.19-0.72];
p<0.001) and TIA (0.001% versus 0.01%; RR 0.26 [0.08-0.82]; p=0.02).
Subgroup analysis suggested combination therapy provided the most benefit
in stroke reduction (RR 0.21 [0.04-1.01], p=0.05), but benefits were
observed across all anti-hypertensive groups for TIA outcomes. There were
no between group differences in all-cause or cardiovascular mortality,
myocardial infarction, heart failure hospitalization, angina or coronary
secularization. Conclusion(s): This meta-analysis of
placebo-controlled RCTs demonstrated reduced stroke and TIA events with
BP-lowering drugs even at short-term follow up. These findings suggest BP
lowering treatment should be initiated as soon as possible in at risk
individuals because even 8 weeks of treatment can significantly reduce the
risk of stroke/TIA.

<10>
Accession Number
2035053358
Title
Comparative analysis of survival rate and quality of life in axial-flow
pump left ventricular assist devices (LVADs).
Source
Heart and Lung. 69 (pp 127-137), 2025. Date of Publication: 01 Jan 2025.
Author
Savar A.K.; Wang H.; Chen N.; Cheng Y.
Institution
(Savar, Wang, Chen, Cheng) Shanghai Interventional Medical Device
Engineering Technology Research Center, University of Shanghai for Science
and Technology, Shanghai, China
(Savar) University of Shanghai for Science and Technology, 516 Jungong
Road, Phone: +8617821130410
Publisher
Elsevier Inc.
Abstract
Background: The rising heart failure rates globally show the pressing
demand for treatment progress, especially in Left Ventricular Assist
Devices (LVADs). Axial-flow pump LVADs are gaining notice for their small
size, few moving parts, and potential for miniaturization, providing a
vital option for heart transplants during donor shortages.
 Objective(s): Despite several studies on LVADs, there is a notable
lack of research specifically comparing axial-flow pumps with similar
technology. This gap hinders the identification of the most optimal
technology to guide development efforts and meet patient needs. This study
aims to comprehensively compare the most commonly used axial-flow pumps
and provide a detailed analysis focusing on survival rates and quality of
life parameters. Method(s): As a developer of axial-flow pumps
(LVADs), our group conducted a systematic review of the current axial-flow
pump LVADs. We analyzed studies comparing these devices, focusing on key
metrics such as survival rates and quality of life. Result(s): The
HeartMate 2 and Jarvik 2000 show superior survival rates (up to 86.9 % at
6 months, 96.3 % at 3 years) and (6-month survival 67 %-91 %)
respectively, compared to the other axial flow pumps LVAD. The results
underscore the importance of choosing the optimal device and informing the
direction of future developments. Conclusion(s): In this paper, we
aim to inform future studies to enhance their effectiveness and advance
the overall performance of these devices, ultimately benefiting patients
and developers. This review furnishes evidence-based recommendations for
the most appropriate axial-flow pumps based on survival rates and quality
of life parameters. Copyright © 2024 Elsevier Inc.

<11>
Accession Number
2035106108
Title
Letter to the editor regarding "Effect of remimazolam versus propofol on
hypotension after anesthetic induction in patients undergoing coronary
artery bypass grafting: A randomized controlled trial".
Source
Journal of Clinical Anesthesia. 99 (no pagination), 2024. Article Number:
111658. Date of Publication: December 2024.
Author
Wang J.; Wang X.; Huang C.
Institution
(Wang, Wang, Huang) The Second Affiliated Hospital and Yuying Children's
Hospital of Wenzhou Medical University, Department of Anesthesiology and
Perioperative Medicine, Wenzhou, China
Publisher
Elsevier Inc.

<12>
Accession Number
2034913392
Title
High-exchange ULTrafiltration to enhance recovery after paediatric cardiac
surgery (ULTRA): study protocol for a Canadian double-blinded randomised
controlled trial.
Source
BMJ Open. 14(8) (no pagination), 2024. Article Number: e080597. Date of
Publication: 28 Aug 2024.
Author
Bierer J.; Stanzel R.; Henderson M.; Krmpotic K.; Andreou P.; Marshall
J.S.; Sapp J.; Horne D.
Institution
(Bierer, Horne) Division of Cardiac Surgery, Dalhousie University,
Halifax, NS, Canada
(Stanzel, Henderson) Department of Clinical Perfusion, Nova Scotia Health
Authority, Halifax, NS, Canada
(Krmpotic) Department of Critical Care, Dalhousie University, Halifax, NS,
Canada
(Andreou) Department of Community Health and Epidemiology, Dalhousie
University, Halifax, NS, Canada
(Marshall) Department of Microbiology & Immunology, Dalhousie University,
Halifax, NS, Canada
(Sapp) Division of Cardiology, Dalhousie University, Halifax, NS, Canada
Publisher
BMJ Publishing Group
Abstract
Introduction Surgical repair is the standard of care for most infants and
children with congenital heart disease. Cardiopulmonary bypass (CPB) is
required to facilitate these operations but elicits a systemic
inflammatory response, leading to postoperative organ dysfunction,
morbidity and prolonged recovery after the surgery. Subzero-balance
ultrafiltration (SBUF) has been shown to extract proinflammatory cytokines
continuously throughout the CPB exposure. We hypothesize that a
high-exchange SBUF (H-SBUF) will have a clinically relevant
anti-inflammatory effect compared with a low-exchange SBUF (L-SBUF).
Methods and analysis The ULTrafiltration to enhance Recovery After
paediatric cardiac surgery (ULTRA) trial is a randomised, double-blind,
parallel-group randomised trial conducted in a single paediatric cardiac
surgery centre. Ninety-six patients less than 15 kg undergoing cardiac
surgery with CPB will be randomly assigned to H-SBUF during CPB or L-SBUF
during CPB in a 1:1 ratio with stratification by The Society of Thoracic
Surgeons-European Association for Cardio-Thoracic Surgery (STAT) score 1
and STAT score 2-5. The primary outcome is peak postoperative
vasoactive-ventilation-renal score. Time series and peak values of
vasoactive-ventilation renal score, vasoactive-inotrope score, ventilation
index and oxygenation index will be collected. Secondary clinical outcomes
include acute kidney injury, ventilator-free days, inotrope-free days, low
cardiac output syndrome, mechanical circulatory support, intensive care
unit length of stay and operative mortality. Secondary biomarker data
include cytokine, chemokine and complement factor concentrations at
baseline before CPB, at the end of CPB exposure and 24 hours following
CPB. Analyses will be conducted on an intention-to-treat principle. Ethics
and dissemination The study has ethics approval (#1024932 dated August 31,
2021) and enrolment commenced in September 2021. The primary manuscript
and any subsequent analyses will be submitted for peer-reviewed
publication. Copyright © Author(s) (or their employer(s)) 2024.

<13>
Accession Number
645499170
Title
Semaglutide effects on safety and cardiovascular outcomes in patients with
overweight or obesity: a systematic review and meta-analysis.
Source
International journal of obesity (2005). (no pagination), 2024. Date of
Publication: 12 Oct 2024.
Author
Cleto A.S.; Schirlo J.M.; Beltrame M.; Gomes V.H.O.; Acras I.H.; Neiverth
G.S.; Silva B.B.; Juliatto B.M.S.; Machozeki J.; Martins C.M.
Institution
(Cleto) State University of Ponta Grossa, Department of Medicine, Parana,
Brazil
(Schirlo, Beltrame, Gomes, Acras, Neiverth, Silva, Juliatto, Machozeki,
Martins) State University of Ponta Grossa, Department of Medicine, Parana,
Brazil
Abstract
BACKGROUND: Semaglutide is a GLP-1 receptor agonist that provides a
reduction in glycated hemoglobin and weight. The objective was to evaluate
whether the use of semaglutide, in individuals with overweight or obesity,
reduces cardiovascular outcomes and adverse effects (AE). METHOD(S):
The data bases Pubmed, Lilacs, Scielo, Scopus, Web of Science and Cochrane
Library were surveyed. RESULT(S): Initially, 3333 articles were
found, of which 19 articles were included. An additional search included
19 studies, totaling 38 articles. Relative risk (RR) values were
significant for hospitalization due to heart failure (HF) 0.24 95% CI
0.12-0.57 (n=2; 1045 participants; I2=0.18), death due to cardiovascular
causes 0.83 95% CI 0.71-0.98 (n=3; 24 084 participants; I2=0.21), death
from any cause 0.79 95% CI 0.70-0.89 (n=3; 24 084 participants; I2=0.07),
coronary revascularization 0.76 95% CI 0.69-0.85 (n=2;20 951 participants;
I2=0.41), and non-fatal myocardial infarction 0.76 95%CI 0.66-0.88 (n=3;
24 084 participants; I2=0.21), with a difference between the subgroups
(p=0.05), favoring the subcutaneous administration route. The RR of stroke
was 0.65 95% CI 0.44-0.97 for patients with diabetes (n=2; 6480
participants; I2=0.66). There was no difference between the frequency of
constipation and routes of administration, as well as between doses of
oral semaglutide. The RR of adverse effects was only not significant for
discontinuation of treatment for oral semaglutide. CONCLUSION(S): The
use of semaglutide reduced 76% in hospitalization due to HF, 17% deaths
due to cardiovascular causes, 21% deaths due to any cause, 24% non-fatal
myocardial infarction, 24% coronary revascularization and 35% stroke (in
patients with diabetes). The use of semaglutide was associated with a
higher relative risk and frequency of most adverse effects
evaluated. Copyright © 2024. The Author(s), under exclusive
licence to Springer Nature Limited.

<14>
Accession Number
2034942435
Title
3D Transesophageal Echocardiography in the Selection of Occluder Size for
Left Atrial Appendage Occlusion: A Meta-Analysis.
Source
Heart Surgery Forum. 27(9) (pp E1101-E1113), 2024. Date of Publication:
2024.
Author
Zeng Z.; Du J.; You Y.; Xie Y.; Xu K.; Deng N.; Li M.
Institution
(Zeng, Du, You, Xie, Xu, Deng) Department of Ultrasound Medicine, The
Second Affiliated Hospital of Chengdu Medical College, Nuclear Industry
416 Hospital, Sichuan, Chengdu 610051, China
(Li) Department of Ultrasound Medicine, The Affiliated Hospital of
Southwest Medical University, Sichuan, Luzhou 646000, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Left atrial appendage occlusion (LAAO) can effectively reduce
the risk of stroke in atrial fibrillation (AF) patients. However, the
structure of left atrial appendage (LAA) varies greatly among individuals,
and the size of the occluder influences the surgical success rate and
prognosis. This study used a meta-analysis to investigate whether three
dimensional-transesophageal echocardiography (3D-TEE) can prompt
physicians to select the appropriate size of the occluder, thereby
improving prognosis in patients with LAAO. Method(s): Studies on
3D-TEE-assisted selection of occluder sizes in the treatment of LAAO were
searched in pubmed, cochrane, Web of Science, CNKI, Wanfang, and Weipu
public databases from the inception of each database to June 10, 2024. The
QUADAS-2 tool was used to assess the quality of the studies.
 Result(s): 10 studies published between 2016 and 2024 were finally
included, with a total sample size of 552 cases. The maximum opening of
the LAA obtained by 3D-TEE, coronary angiography (CAG) and video-assisted
thoracic surgery (VATS) significantly correlated with the size of the
occluder (p < 0.05). 3D-TEE was superior to 2D-TEE in measuring the
maximum (p = 0.04) and minimum diameters (p = 0.01) of LAA openings, and
to DSA in measuring depth (p = 0.01). Conclusion(s): 3D-TEE can be
applied to obtain LAA opening data close to the size of the occluder with
minimal side effects and to assist physicians in selecting the appropriate
occluder. Copyright © 2024 The Author(s). Published by Forum
Multimedia Publishing, LLC.

<15>
Accession Number
2034818427
Title
Protocol for a phase 3, randomised, active-control study of four-factor
prothrombin complex concentrate versus frozen plasma in bleeding adult
cardiac surgery patients requiring coagulation factor replacement: the
LEX-211 (FARES-II) trial.
Source
BMJ Open. 14(8) (no pagination), 2024. Article Number: e091381. Date of
Publication: 21 Aug 2024.
Author
Karkouti K.; Callum J.; Bartoszko J.; Solomon C.; Knaub S.; Levy J.H.;
Tanaka K.A.
Institution
(Karkouti, Bartoszko) Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Karkouti, Bartoszko) Department of Anesthesia and Pain Management,
University Health Network, Sinai Health, Women's College Hospital,
Toronto, ON, Canada
(Karkouti, Bartoszko) Peter Munk Cardiac Centre, University Health
Network, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Queen's
University, Kingston, ON, Canada
(Solomon, Knaub) Octapharma AG, Lachen, Switzerland
(Levy) Department of Anesthesiology, Duke University, Durham, NC, United
States
(Tanaka) Department of Anesthesiology, The University of Oklahama, Health
Sciences Centre, Oklahoma City, OK, United States
Publisher
BMJ Publishing Group
Abstract
Introduction Reduced thrombin generation is an important component of post
cardiopulmonary bypass (CPB) coagulopathy. To replenish coagulation
factors and enhance thrombin generation in bleeding surgical patients,
frozen plasma (FP) and four-factor prothrombin complex concentrate
(4F-PCC) are used. However, the efficacy-safety balance of 4F-PCC relative
to FP in cardiac surgery is unconfirmed. Methods and analysis LEX-211
(FARES-II) is an active-control, randomised, phase 3 study comparing two
coagulation factor replacement therapies in bleeding adult cardiac
surgical patients at 12 hospitals in Canada and the USA. The primary
objective is to determine whether 4F-PCC (Octaplex/Balfaxar, Octapharma)
is clinically non-inferior to FP for haemostatic effectiveness. Inclusion
criteria are any index (elective or non-elective) cardiac surgery
employing CPB and coagulation factor replacement with 4F-PCC or FP ordered
in the operating room for bleeding management. Patients will be randomised
to receive 1500 or 2000 international units of 4F-PCC or 3 or 4 units of
FP, depending on body weight. The primary endpoint of haemostatic
treatment response is 'effective' if no additional haemostatic
intervention is required from 60 min to 24 hours after the first
initiation of 4F-PCC or FP; or 'ineffective' if any other haemostatic
intervention (including a second dose of study drug) is required. An
estimated 410 evaluable patients will be required to demonstrate
non-inferiority (one-sided alpha of 0.025, power >=90%, non-inferiority
margin 0.10). Secondary outcomes include transfusions, bleeding-related
clinical endpoints, coagulation parameters and safety. Ethics and
dissemination The trial has been approved by the institutional review
boards of all participating centres. Trial completion is anticipated at
the end of 2024, and results will be disseminated via publications in
peer-reviewed journals and conference presentations in 2025. The results
will advance our understanding of coagulation management in bleeding
surgical patients, potentially reducing the need for allogeneic blood
products and improving outcomes in surgical patients. Copyright ©
Author(s) (or their employer(s)) 2024.

<16>
Accession Number
2031725773
Title
Mitral valve repair and replacement in infectious endocarditis: a
systematic review and meta-analysis of clinical outcome.
Source
Egyptian Heart Journal. 76(1) (no pagination), 2024. Article Number: 134.
Date of Publication: December 2024.
Author
Nuthalapati U.; Bathinapattla M.R.; Cardoso R.P.; Jesi N.J.; Singh K.;
Moradi I.; Gostomczyk K.; Afzal M.; Omer M.B.; Mian Z.R.; Patel S.;
Sachdeva P.; Malik M.N.; Abbas M.; Singh J.; Shafique M.A.
Institution
(Nuthalapati, Bathinapattla) Ivano Frankivsk National Medical University,
Ivano-Frankivsk, Ukraine
(Cardoso) AIIMS Jodhpur, Jodhpur, India
(Jesi) Shaheed Syed Nazrul Islam Medical College and Hospital,
Kishoregonj, Bangladesh
(Moradi) School of Medicine, St. Georges' University, St. George's,
Grenada
(Gostomczyk) Collegium Medicum Nicolaus Copernicus University, Bydgoszcz,
Poland
(Singh) Government Medical College Amritsar, Punjab, Amritsar, India
(Afzal) Fatima Jinnah Medical University, Lahore, Pakistan
(Omer, Mian) CMH Lahore Medical College & amp; IOD, Lahore, Pakistan
(Patel) Teaching University Geomedi, Tbilisi, Georgia
(Sachdeva) Punjab Institute of Medical Sciences, Jalandhar, India
(Malik) Bahawal Victoria Hospital, Bahawalpur, Pakistan
(Abbas) CMH Lahore Medical College, Lahore, Pakistan
(Singh) Verde Valley Medical Center, Cottonwood, AZ 86326, United States
(Shafique) Department of Medicine, Jinnah Sindh Medical University, Rafiqi
H J Shaheed Road, Karachi 75510, Pakistan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Infective endocarditis (IE) poses significant clinical
challenges, often necessitating surgical intervention for improved patient
outcomes. The choice between mitral valve repair (MVP) and mitral valve
replacement (MVR) is crucial in managing IE. This systematic review and
meta-analysis aims to compare the effectiveness of MVP and MVR in treating
IE, focusing on outcomes such as postoperative bleeding, mortality,
recurrent endocarditis, and stroke. Main text: A comprehensive literature
search was conducted following PRISMA guidelines. Studies directly
comparing MVP and MVR in IE patients were included. Data extraction and
quality assessment were performed, and meta-analysis was conducted using
RevMan software. Thirty-two studies involving 82,123 patients were
included. MVP was associated with significantly lower rates of
postoperative bleeding (OR: 0.58, 95% CI: 0.40-0.84) and reduced long-term
mortality (OR: 0.40, 95% CI: 0.32-0.51) compared to MVR. However, MVR
showed lower rates of recurrent endocarditis. MVP was also associated with
a decreased likelihood of postoperative stroke (OR: 0.52, 95% CI:
0.40-0.68).2, 4 Conclusion(s): MVP demonstrates advantages over MVR
in reducing postoperative bleeding, long-term mortality, and stroke risk
in IE patients. However, individual patient factors and surgical expertise
must be considered in treatment decisions. Further research, including
randomized controlled trials, is needed to validate these findings and
refine treatment algorithms for IE management. Copyright © The
Author(s) 2024.

<17>
Accession Number
2030960273
Title
Convergent ablation for persistent atrial fibrillation: A UK multicentre
perspective.
Source
Journal of Cardiovascular Electrophysiology. 35(10) (pp 2039-2052), 2024.
Date of Publication: October 2024.
Author
Mannakkara N.N.; Khan I.; Ghazanfar A.; Wijesuriya N.; Mehta V.S.; De Vere
F.; Howell S.; Adhya S.; Porter B.; Child N.; Razavi R.; Rinaldi C.A.;
Bosco P.; Blauth C.; Gill J.S.
Institution
(Mannakkara, Khan, Wijesuriya, Mehta, De Vere, Howell, Adhya, Rinaldi,
Bosco, Blauth, Gill) Department of Cardiovascular Services, Guy's and St.
Thomas' Hospital, London, United Kingdom
(Mannakkara, Wijesuriya, Mehta, De Vere, Howell, Razavi, Rinaldi, Gill)
School of Biomedical Engineering and Imaging Sciences, King's College
London, London, United Kingdom
(Ghazanfar, Child) Department of Cardiology, St. Richard's Hospital,
University Hospitals Sussex NHS Foundation Trust, Worthing, United Kingdom
(Adhya) Department of Cardiology, Medway Maritime Hospital, Gillingham,
United Kingdom
(Porter) South West Cardiothoracic Centre, University Hospitals Plymouth
NHS Trust, Plymouth, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide
and remains a major cause of morbidity and mortality. Unfortunately, a
significant proportion of patients have persistent AF, for which
conventional catheter ablation is less effective. However, convergent
ablation has emerged in recent years as a hybrid treatment targeting both
the epicardium and endocardium in a multidisciplinary joint cardiothoracic
and electrophysiology procedure, with promising efficacy outcomes in
recent studies. This treatment is increasingly being performed in the
United Kingdom. This review article discusses the rationale and evidence
behind convergent ablation, along with factors that need to be considered
when setting up a successful ablation service. Copyright © 2024
The Author(s). Journal of Cardiovascular Electrophysiology published by
Wiley Periodicals LLC.

<18>
Accession Number
2034253555
Title
Postoperative Hydration in Children Using Intermittent Boluses of Balanced
Salt Solution: Results of a Randomized Control Trial.
Source
Journal of Pediatric Surgery. 59(11) (no pagination), 2024. Article
Number: 161660. Date of Publication: November 2024.
Author
Johnston W.R.; Mak Croughan A.L.; Hwang R.; Collins S.; Washington A.;
Neary K.; Mattei P.
Institution
(Johnston, Mak Croughan, Hwang, Collins, Washington, Neary, Mattei)
General, Thoracic, and Fetal Surgery, Children's Hospital of Philadelphia,
Philadelphia, PA, United States
(Johnston) Hospital of the University of Pennsylvania, Philadelphia, PA,
United States
Publisher
W.B. Saunders
Abstract
Background: Postoperative maintenance fluids are traditionally provided
via hypotonic dextrose containing fluids administered intravenously by
continuous infusion. We hypothesized that scheduled weight-based boluses
of balanced salt solution would be more physiologic, reduce fluid volumes,
and improve patient comfort. Method(s): As part of an IRB-approved
randomized controlled trial (Boluses of Ringer's in Surgical Kids, BRiSK),
we randomized patients aged 1-21 years undergoing elective abdominal or
thoracic surgery to post-operatively receive weight-based
D<inf>5</inf>0.45NS+20mEq/L KCl at a continuous rate or intermittent
boluses of Lactated Ringer's solution until oral liquid toleration.
Patients with nephropathy, diabetes, or receiving parenteral nutrition
were excluded. We analyzed electrolytes, urine output, fluid volume, and
adverse events. Result(s): We enrolled and randomized 60 patients: 29
to continuous fluids and 31 to bolus fluids. One patient from the bolus
group dropped out. No patients crossed over due to difficulties with
application of the bolus protocol. There were no baseline differences
between groups with a mean age of 12.6 +/- 1.4yr and weight of 50.9 +/-
7.2 kg. There were no serious adverse events or electrolyte disturbances
in either group. Patients in the bolus group received significantly less
total fluid than those in the continuous group (0.43 mL/kg/h vs 1.1
mL/kg/h, p < 0.001) with no difference in urine output [1.4 +/- 0.2
mL/kg/h vs 1.6 +/- 0.3 mL/kg/h, p = 0.211]. There were two episodes of
mild hypoglycemia in the bolus group compared to seven episodes of mild
hyperglycemia in the continuous group. Conclusion(s): Administration
of post-operative intravenous fluids as boluses of balanced salt solution
is feasible, safe, and results in significantly less fluid administered
compared to a traditional continuous protocol. Level of Evidence:
II. Copyright © 2024 Elsevier Inc.

<19>
Accession Number
2034040359
Title
Effect of Bilateral Erector Spinae Plane Block versus Fentanyl Infusion on
Postoperative Recovery in Cardiac Surgeries via Median Sternotomy: A
Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(11) (pp 2668-2674),
2024. Date of Publication: November 2024.
Author
Sarhan K.; Elshemy A.; Mamdouh S.; Salah M.; Raheem A.A.E.; Gamal M.;
Nawwar K.; Bakry M.
Institution
(Sarhan, Mamdouh, Salah, Raheem, Gamal, Nawwar, Bakry) Department of
Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
(Elshemy) Department of Anesthesia, National Heart Institute, Cairo, Egypt
Publisher
W.B. Saunders
Abstract
Objective: To assess the effect of ultrasound-guided bilateral erector
spinae plane block (ESPB) on the time to extubation in patients who had
undergone cardiac surgery through a midline sternotomy. Design(s):
Randomized controlled trial. Setting(s): Cairo University Hospital
and National Heart Institute, Egypt. Participant(s): Patients aged 18
to 70 years who underwent a cardiac surgical procedure through a midline
sternotomy. Intervention(s): Recruited patients were randomized to
receive either preoperative single-shot ultrasound-guided bilateral ESPB
or fentanyl infusion. Measurements: The primary outcome was the time to
extubation. Other outcomes included total perioperative fentanyl
consumption, pain score using the numerical rating score (NRS), length of
intensive care unit (ICU) stay, and incidence of perioperative
complications. Main Result(s): Two hundred and nineteen patients were
available for final analysis. The mean time to extubation was
significantly shorter In the ESPB group compared to the control group
(159.5 +/- 109.5 minutes vs 303.2 +/- 95.9 minutes; mean difference,
-143.7 minutes; 95% confidence interval, -171.1 to -116.3 minutes; p =
0.0001). Ultra-fast track (immediate postoperative) extubation was
achieved in 23 patients (21.1%) in the ESPB group compared to only 1
patient (0.9%) in the control group. The ICU stay was significantly
reduced in the ESPB group compared to the control group (mean, 47.2 +/-
13.3 hours vs 78.9 +/- 25.2 hours; p = 0.0001). There was a more
significant reduction in NRS in the ESPB group compared to the control
group for up to 24 hours postoperatively (p = 0.001). Conclusion(s):
Among adult patients undergoing cardiac surgery through a midline
sternotomy, the extubation time was halved in patients who received
single-shot bilateral ESPB compared to patients who received fentanyl
infusion. Copyright © 2024 Elsevier Inc.

<20>
Accession Number
2030267343
Title
Perioperative transfusion study (PETS): Does a liberal transfusion
protocol improve outcome in high-risk cardiovascular patients undergoing
non-cardiac surgery? A randomised controlled pilot study.
Source
Transfusion Medicine. 34(5) (pp 398-404), 2024. Date of Publication:
October 2024.
Author
Ali S.; Roubos S.; Hoeks S.E.; Verbrugge S.J.C.; Koopman-van Gemert
A.W.M.M.; Stolker R.J.; van Lier F.
Institution
(Ali, Roubos, Hoeks, Stolker, van Lier) Department of Anaesthesiology,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Verbrugge) Department of Anaesthesiology, Franciscus Gasthuis &
Vlietland, Rotterdam, Netherlands
(Koopman-van Gemert) Department of Anaesthesiology, Albert Schweitzer
Hospital, Dordrecht, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Background: Small studies have shown that patients with advanced coronary
artery disease might benefit from a more liberal blood transfusion
strategy. The goal of this pilot study was to test the feasibility of a
blood transfusion intervention in a group of vascular surgery patients who
have elevated cardiac troponins in rest. Method(s): We conducted a
single-centre, randomised controlled pilot study. Patients with a
preoperative elevated high-sensitive troponin T undergoing non-cardiac
vascular surgery were randomised between a liberal transfusion regime
(haemoglobin >10.4 g/dL) and a restrictive transfusion regime (haemoglobin
8.0-9.6 g/dL) during the first 3 days after surgery. The primary outcome
was defined as a composite endpoint of all-cause mortality, myocardial
infarction or unscheduled coronary revascularization. Result(s): In
total 499 patients were screened; 92 were included and 50 patients were
randomised. Postoperative haemoglobin was different between the
intervention and control group; 10.6 versus 9.8, 10.4 versus 9.4, 10.9
versus 9.4 g/dL on day one, two and three respectively (p < 0.05). The
primary outcome occurred in four patients (16%) in the liberal transfusion
group and in two patients (8%) in control group. Conclusion(s): This
pilot study shows that the studied transfusion protocol was able to create
a clinically significant difference in perioperative haemoglobin levels.
Randomisation was possible in 10% of the screened patients. A large
definitive trial should be possible to provide evidence whether a liberal
transfusion strategy could decrease the incidence of postoperative
myocardial infarction in high risk surgical patients. Copyright ©
2024 The Author(s). Transfusion Medicine published by John Wiley & Sons
Ltd on behalf of British Blood Transfusion Society.

<21>
Accession Number
2034893019
Title
Challenges in congenital heart disease in the Amazon region countries: A
scoping review.
Source
Annals of Pediatric Cardiology. 17(3) (pp 188-195), 2024. Date of
Publication: 2024.
Author
Almeida S.L.D.M.; Da Cunha A.D.S.L.; Silva R.D.C.; Dos Santos R.K.;
Novelleto A.L.M.T.; Estevam T.L.L.; Carvalho L.I.A.D.; Tuda L.T.S.; Souza
C.D.S.M.; Junior E.A.; Amorim L.A.D.R.
Institution
(Almeida, Da Cunha, Silva, Dos Santos, Novelleto, Estevam, Souza, Amorim)
Postgraduate Program in Health Sciences, Medical School, Federal
University of Amazonas, AM, Manaus, Brazil
(Carvalho) Medical School, Amazonas State University (UEA), AM, Manaus,
Brazil
(Tuda) Medical School, Federal University of Amazonas, AM, Manaus, Brazil
(Junior) Department of Obstetrics, Paulista School of Medicine, Federal
University of Sao Paulo (EPM-UNIFESP), SP, Sao Paulo, Brazil
(Junior) Discipline of Woman Health, Municipal University of Sao Caetano
do Sul, SP, Sao Caetano do Sul, Brazil
Publisher
Wolters Kluwer Medknow Publications
Abstract
Introduction: This study aimed to systematically analyze and describe the
main challenges of congenital heart diseases (CHDs) in the countries in
the Amazon region. Method(s): The methodology followed the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses extension for
Scoping Reviews checklist utilizing the Medline, Embase, Lilacs, and
Google Scholar databases. The inclusion criteria were articles addressing
any topic involving CHD in the Amazon region. Incomplete articles, book
chapters, lectures, conference abstracts, and editorials were excluded.
 Result(s): Nine studies were identified, 7 of which were published in
the last decade and were of Colombian and Brazilian origin. The
methodology of the studies was cross-sectional and ecological, evaluating
the regional and epidemiological factors, challenges to diagnosis and
treatment, multidisciplinary team challenges, and the impact of the
COVID-19 pandemic. Studies carried out by surgeons demonstrate more
existing data regarding the challenges of the health-care system.
 Conclusion(s): There is growing interest in analyzing the situation
of CHD in the region. However, only a few studies are available, mostly on
ecological and cross-sectional analysis. These records show the lack of
hospital infrastructure and multidisciplinary teams for the diagnosis and
treatment of CHD in the Amazon region; we see an initiative by specialists
from two countries (Colombia and Brazil) to demonstrate the difficulties
by seeking international training programs and government aid to improve
the health system situation. Copyright © 2024 Annals of Pediatric
Cardiology.

<22>
Accession Number
2034893017
Title
The outcome of surgery for congenital heart disease in India: A systematic
review and metanalysis.
Source
Annals of Pediatric Cardiology. 17(3) (pp 164-179), 2024. Date of
Publication: 2024.
Author
Kadiyani L.; Kalaivani M.; Iyer K.S.; Ramakrishnan S.
Institution
(Kadiyani, Ramakrishnan) Department of Cardiology, All India Institute of
Medical Sciences, New Delhi, India
(Kalaivani) Department of Biostatistics, All India Institute of Medical
Sciences, New Delhi, India, India
(Iyer) Department of Pediatric and Congenital Heart Surgery, Fortis
Escorts Heart Institute, New Delhi, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: The mortality risks of children undergoing various cardiac
surgeries for congenital heart disease (CHD) in India are not well
defined. We conducted a systematic review and meta-analysis to estimate
the inhospital mortality of various common CHD surgeries reported in India
and compared it to representative data from established Western databases.
 Methods and Results: We searched four bibliographic databases for
studies published in India over the last 25 years. In total, 135 studies
met the inclusion criteria and included 30,587 patients aged from 1 day to
65 years. The pooled mortality rate of 43 Indian studies reporting
multiple CHD surgical outcomes is 5.63% (95% confidence interval [CI]:
4.26-7.16; I 2 = 93.9%), whereas the Western data showed a pooled
mortality rate of 2.65% (P value for comparison <0.0001). The pooled
mortality risk for ventricular septal defect closure and tetralogy of
Fallot repair in Indian studies was 2.87% (95% CI: 0.76-5.91; I 2 = 62.4%)
and 4.61% (95% CI: 2.0-8.02; I 2 = 87.4%), respectively. The estimated
mortality risk was higher than the Western databases for all subcategories
studied except for surgeries in the grown-ups with CHD population and
coarctation repair. Conclusion(s): The estimated mortality risks are
higher among Indian patients undergoing cardiac surgery for CHD as
compared to Western data. We need prospective multicentric data to
document whether the observed excess mortality exists after adjusting for
various high-risk features and comorbidities in Indian patients. We need
systemic measures to improve the outcomes of CHD surgeries in
India. Copyright © 2024 Annals of Pediatric Cardiology.

<23>
Accession Number
2035075362
Title
Role of KIM-1 in early diagnosis of contrast-induced nephropathy following
invasive cardiac procedure: A systematic review.
Source
Clinical Epidemiology and Global Health. 30 (no pagination), 2024. Article
Number: 101765. Date of Publication: 01 Nov 2024.
Author
Shuaib M.; Masoom M.; Khan M.A.
Institution
(Shuaib, Masoom, Khan) Department of Translational and Clinical Research,
School of Chemical and Life Sciences (SCLS), Jamia Hamdard, New Delhi
110062, India
Publisher
Elsevier B.V.
Abstract
This systematic review aims to provide a comprehensive analysis of the
diagnostic efficacy of KIM-1 in CI-AKI. We evaluated its potential as a
robust biomarker for the early identification and prediction of AKI
progression. Methodology: To assess KIM-1 as a biomarker for CI-AKI,
relevant databases were searched. Inclusion criteria comprised studies
measuring KIM-1 levels in patients undergoing cardiac procedures with
contrast media and data were extracted. Methodological quality and bias
were evaluated using Quadas-2 tool. Conclusion(s): KIM-1 shows
promise as a biomarker for renal injury. Its upregulation, correlation
with injury severity, and involvement in tissue repair support its
clinical relevance. Prospero registration number:
CRD42023431419. Copyright © 2024 The Authors

<24>
Accession Number
2034837222
Title
Comparison of Alternative Peripheral and Transfemoral Approaches for
Transcatheter Aortic Valve Replacement: A Meta-Analysis of
Propensity-Matched Studies.
Source
Journal of Cardiac Surgery. 2023 (no pagination), 2023. Article Number:
9030702. Date of Publication: 2023.
Author
Mcgrath D.; Sun C.; Kawabori M.; Zhan Y.
Institution
(Mcgrath, Sun) Tufts University School of Medicine, Boston, MA, United
States
(Kawabori, Zhan) CardioVascular Center, Tufts Medical Center, Tufts
University School of Medicine, Boston, MA, United States
Publisher
Wiley-Hindawi
Abstract
Background. Transfemoral (TF) access is the gold standard for
transcatheter aortic valve replacement (TAVR). Alternative peripheral (AP)
artery access such as the carotid or axillary artery is considered when
the feasibility of femoral access is in doubt. The outcomes comparison of
these 2 approaches is unclear due to limited sample sizes in prior
studies. Our aim is to compare the clinical outcomes of TF- and AP-TAVR by
conducting a meta-analysis of propensity-matched studies. Methods. The
PubMed, EMBASE, and Cochrane Library databases from inception up to and
including February 2022 were searched by 3 separate researchers to
identify articles reporting propensity-matched, comparative data on TF vs.
AP-TAVR. Clinical outcomes were extracted from the articles and pooled for
analysis. Results. Seven prior studies, including 9,004 patients, were
included in our study, with 6,729 in the TF group and 2,275 in the AP
group. In all studies, the baseline characteristics of the patients were
highly propensity-matched with the full Newcastle-Ottawa scale.
Meta-analysis revealed higher in-hospital/30-day mortality (3.3% vs. 4.4%;
OR 0.69; 95% CI (0.51, 0.94); P=0.02) as well as the incidence of stroke
(1.9% vs. 3.5%; OR 0.60; 95% CI (0.43, 0.84); P=0.003) for the AP group.
There were no significant differences in the incidence of major vascular
complications, pacemaker implantation, bleeding, or acute kidney injury.
Conclusions. Our meta-analysis of propensity-matched studies showed
AP-TAVR contains an additional 1.1% risk of early mortality and an
additional 1.6% risk of stroke compared to TF-TAVR. These risks should be
considered when deciding on access. Copyright © 2023 Daniel
McGrath et al.

<25>
Accession Number
2035032961
Title
SciScribe: Automating and contextualizing literature reviews in cardiac
surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2024.
Date of Publication: 2024.
Author
Mahboubi R.; Dinkla K.; Weiss A.; Acierto A.; Staar P.; Robinson J.;
Hammoud M.S.; Karamlou T.
Institution
(Mahboubi, Weiss, Robinson, Hammoud, Karamlou) Department of Thoracic and
Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic,
Cleveland, Ohio, United States
(Dinkla, Staar) IBM Research, Zurich, Switzerland
(Acierto) Syracuse University, Syracuse, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The task of writing structured content reviews and guidelines
has grown stronger and more complex. We propose to go beyond search tools
and toward curation tools by automating time-consuming and repetitive
steps of extracting and organizing information. Method(s): SciScribe
is built as an extension of IBM's Deep Search platform, which provides
document processing and search capabilities. This platform was used to
ingest and search full-content publications from PubMed Central (PMC) and
official, structured records from the ClinicalTrials and OpenPayments
databases. Author names and NCT numbers, mentioned within the
publications, were used to link publications to these official records as
context. Search strategies involve traditional keyword-based search as
well as natural language question and answering via large language models
(LLMs). Result(s): SciScribe is a web-based tool that helps
accelerate literature reviews through key features: (1) accumulating a
personal collection from publication sources, such as PMC or other
sources; (2) incorporating contextual information from external databases
into the presented papers, promoting a more informed assessment by
readers; (3) semantic questioning and answering of documents to quickly
assess relevance and hierarchical organization; and (4) semantic question
answering for each document within a collection, collated into tables.
 Conclusion(s): Emergent language processing techniques are opening
new avenues to accelerate and enhance the literature review process, for
which we have demonstrated a use case implementation in cardiac surgery.
SciScribe automates and accelerates this process, mitigates errors
associated with repetition and fatigue, and contextualizes results by
linking relevant external data sources instantaneously. Copyright
© 2024 The American Association for Thoracic Surgery

<26>
Accession Number
645499185
Title
The left atrial appendage exclusion for prophylactic stroke reduction
(leaaps) trial: rationale and design.
Source
American heart journal. (no pagination), 2024. Date of Publication: 10
Oct 2024.
Author
Whitlock R.P.; McCarthy P.M.; Gerdisch M.W.; Ramlawi B.; Alexander J.H.;
Rose D.Z.; Healey J.S.; Sharma Y.A.; Belley-Cote E.P.; Connolly S.J.
Institution
(Whitlock) Department of Surgery, McMaster University, Hamilton, ON, CA;
Population Health Research Institute, Hamilton, ON, CA
(McCarthy) Division of Cardiac Surgery, Department of Surgery, Bluhm
Cardiovascular Institute, Northwestern University Feinberg School of
Medicine and Northwestern Medicine, Chicago, IL, United States
(Gerdisch) Department of Cardiothoracic Surgery, Franciscan Health,
Indianapolis, IN, United States
(Ramlawi) Department of Cardiothoracic Surgery Research, Lankenau
Institute for Medical Research, Wynnewood, PA, United States
(Alexander) Duke Clinical Research Institute, Division of Cardiology, Duke
University, Durham, NC, United States
(Rose) Department of Neurology, University of South Florida Morsani
College of Medicine, Tampa, FL, United States
(Healey, Belley-Cote, Connolly) Population Health Research Institute,
Hamilton, ON, CA
(Sharma) Inc, OH, United States
Abstract
INTRODUCTION: Left atrial appendage exclusion (LAAE) has been shown in
randomized trials to reduce ischemic stroke risk in patients undergoing
cardiac surgery with known atrial fibrillation (AF). Many patients
undergoing cardiac surgery without pre-existing AF are at risk of stroke
and may benefit from LAAE. METHOD(S): Left Atrial Appendage Exclusion
for Prophylactic Stroke Reduction (LeAAPS) is an international,
prospective, randomized, multicenter, blinded trial evaluating the
effectiveness of LAAE in preventing ischemic stroke or systemic embolism
in patients undergoing cardiac surgery at increased risk of AF and
ischemic stroke. The trial will enroll 6500 patients at increased risk of
stroke in whom a cardiac surgery is planned at 250 sites worldwide.
Eligible patients are >=18 years old, have no pre-existing AF but are at
increased risk for AF and stroke (based on age, CHA2DS2-VASc score, left
atrium size or brain natriuretic peptide). Patients are randomized 1:1 to
receive either LAAE with AtriClip or no LAAE during cardiac surgery.
Healthcare providers outside of the operating room and the patient will be
blinded to allocation. The primary effectiveness endpoint is the first
occurrence of ischemic stroke, systemic arterial embolism, or surgical or
endovascular LAA closure. The powered secondary effectiveness endpoint is
ischemic stroke or systemic arterial embolism. The primary safety endpoint
is the occurrence of one of the following events (through 30 days):
pericardial effusion requiring percutaneous or surgical treatment,
peri-operative major bleeding, deep sternal wound infection, or myocardial
infarction. Other endpoints include mortality, rehospitalizations,
clinically diagnosed AF, transient ischemic attack, and cognitive and
quality of life assessments. Follow-up is every 6 months for a minimum of
5 years; primary analysis occurs when 469 patients have had an ischemic
stroke or systemic embolism. CONCLUSION(S): The results of the LeAAPS
trial will demonstrate whether LAAE with AtriClip at the time of other
routine cardiac surgery reduces stroke or systemic arterial embolism
during long-term follow-up in patients at high risk of stroke without
pre-existing AF. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier:
NCT05478304,
https://clinicaltrials.gov/study/NCT05478304?term=%20NCT05478304&rank=1.Copyright © 2024. Published by Elsevier Inc.

<27>
Accession Number
645499047
Title
Left Atrial Appendage Occlusion Devices vs Direct Oral Anticoagulants for
Atrial Fibrillation: an Updated Systematic Review and Meta-Analysis.
Source
Current problems in cardiology. (pp 102880), 2024. Date of Publication:
10 Oct 2024.
Author
Fernandes J.M.; Pinheiro R.P.S.; Serpa F.; de Andrade N.M.; Pereira V.;
Sbardelotto AE.E.; Gomes W.F.
Institution
(Fernandes) Faculdade Israelita de Ciencias da Saude Albert Einstein, Rua
Comendador Elias Jafet, 755- Sao Paulo, Sao Paulo, Brazil, 05653-000
(Pinheiro, Sbardelotto) Universidade Federal do Rio de Janeiro, Praia de
Botafogo, Rio de Janeiro 132-, Brazil
(Serpa) University of Texas Southwestern Medical Center, 5323 Harry Hines
Blvd, Dallas, TX 75390, United States
(de Andrade) Escola Bahiana de Medicina e Saude Publica- Bahia, Av. Dom
Joao VI, 275, Salvador, Bahia, Brazil, 40290-000. Electronic address:
naieli.m.andrade@gmail.com
(Pereira) Facultad Ciencias Biomedicas, Universidad Austral, Pilar, Buenos
Aires 2050-, Argentina
(Gomes) INC Hospital, Department of Interventional Cardiology;
Universidade Federal do Parana; Faculdades Pequeno Principe, Rua Jeremias
Maciel Perretto, 300, Curitiba, Parana, Brazil, 81210-310. Electronic
address: wiltonfg@cardiol.br
Abstract
BACKGROUND: Direct Oral Anticoagulants (DOACs) are the first line
anticoagulation for patients with non-valvular atrial fibrillation (NVAF).
Percutaneous Left Atrial Appendage Occlusion (LAAO) has emerged as a new
therapy and its safety and effectiveness compared with DOACs are still
controversial. METHOD(S): A systematic review of randomized
controlled trials and observational studies was conducted, focusing on
patients with NVAF. Outcomes analyzed included: (1) all-cause mortality;
(2) cardiovascular (CV) mortality; (3) thromboembolic events; (4) stroke
or transient ischemic attack (TIA); (5) bleeding events; and a (6)
composite of death, hemorrhagic, and thromboembolic events. We performed a
subgroup analysis of major bleeding according to different definitions,
according to (1) Bleeding Academic Research Consortium (BARC); (2)
International Society on Thrombosis and Haemostasis (ISTH); and (3) other
definitions. RESULT(S): Ten studies involving 18,507 patients were
included, with 42.35% undergoing LAAO. In pooled analysis, LAAO was
associated with lower rates of all-cause mortality (HR 0.63; 95% CI
0.50-0.80), cardiovascular mortality (HR 0.56; 95% CI 0.45-0.70), and of
the composite outcome (HR 0.73; 95% CI 0.58-0.92). A trend towards lower
stroke/TIA events was observed but not statistically significant. Overall
bleeding events did not significantly differ between groups, using the
ISTH definition, LAAO showed significantly lower incidence of bleeding
events (HR 0.63; 95% CI 0.43-0.91). No significant difference was found in
thromboembolic events. CONCLUSION(S): LAAO was associated with a
significantly lower all-cause mortality and cardiovascular mortality, as
well as the composite of death, hemorrhagic or thromboembolic events, as
compared with DOACs. Copyright © 2024. Published by Elsevier Inc.

<28>
Accession Number
2031772145
Title
Wearable devices as part of postoperative early warning score systems: a
scoping review.
Source
Journal of Clinical Monitoring and Computing. (no pagination), 2024. Date
of Publication: 2024.
Author
Bignami E.G.; Panizzi M.; Bezzi F.; Mion M.; Bagnoli M.; Bellini V.
Institution
(Bignami, Panizzi, Bezzi, Mion, Bagnoli, Bellini) Anesthesiology, Critical
Care and Pain Medicine Division, Department of Medicine and Surgery,
University of Parma, Viale Gramsci 14, Parma 43126, Italy
Publisher
Springer Science and Business Media B.V.
Abstract
Postoperative deterioration is often preceded by abnormalities in vital
parameters, but limited resources prevent their continuous monitoring in
patients with no indication to ICU admission. The development of new
technologies allowed the introduction of wearable devices (WDs), enabling
the possibility of postoperative monitoring in surgical wards. We
performed a Scoping Review to determine the current use of wearable
devices as part of Continuous Remote Early Warning Score (CREWS) systems
and their efficiency during postoperative period. This Scoping Review was
conducted according to PRISMA-ScR guidelines. PICO framework was used
before the search to define the review protocol. Systematic literature
research has been performed on PubMed, MeSH, MEDLINE and Embase,
considering a period between 2018 and February 2024. Prospective and
retrospective studies involving patients undergoing cardiac and
non-cardiac surgery are included. A total of 10 articles were included in
the review. 11 different CE/FDA approved wearable devices were used in the
studies analyzed. In all studies the WDs were applied the day of the
surgery. The use of WDs as part of CREWS systems is feasible and safe.
Furthermore, with the aid of other technologies (LoRa and Artificial
Intelligence), they shorten Length of Stay (LOS) and reduce the number of
ICU admissions with a reduction in healthcare costs. Continuous monitoring
in surgical departments can facilitate the correct and timely
identification of postoperative complications. This article is a starting
point for the development of new protocols and for the application of
these monitoring systems in clinical practice. Copyright © The
Author(s) 2024.

<29>
Accession Number
2031767636
Title
Bariatric surgeries and cardiac structure and function: Systematic review
and network meta-analysis.
Source
Obesity Reviews. (no pagination), 2024. Date of Publication: 2024.
Author
Zhang X.-Q.; Chen K.-N.; Zhang N.-R.; Zheng F.-J.-Y.; Zhou B.; Meng H.;
Zhang Z.-X.; Niu W.-Q.
Institution
(Zhang, Zhang) Graduate School, Beijing University of Chinese Medicine,
Beijing, China
(Zhang, Zhang, Zhang) Department of Pediatrics, China-Japan Friendship
Hospital, Beijing, China
(Chen) Chinese Academy of Medical Sciences & Peking Union Medical College,
Beijing, China
(Chen) Institute of Clinical Medical Sciences, China-Japan Friendship
Hospital, Beijing, China
(Zhang, Zhou, Meng) Department of General Surgery and Obesity and
Metabolic Disease Center, China-Japan Friendship Hospital, Beijing, China
(Zheng, Niu) Center for Evidence-Based Medicine, Capital Institute of
Pediatrics, Beijing, China
(Zhang) International Medical Services, China-Japan Friendship Hospital,
Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Obesity, a global health problem, is causally implicated in
the development of cardiovascular disease. Bariatric surgeries are
effective treatment options for obesity; however, the effectiveness of
different bariatric surgeries on cardiac structure and function is not
fully understood. We undertook a systematic review and network
meta-analysis to comprehensively assess this effectiveness. Data source:
PubMed, Web of Science, and EMBASE were searched from their inception
until November 11, 2023. Studies that compared bariatric surgeries
vis-a-vis non-surgical treatment, placebo, and other bariatric surgeries,
as well as reported changes in left ventricular mass or its index (LVM or
LVMI) or left ventricular ejection fraction (LVEF), were summarized.
 Result(s): Total 19 studies (17 cohort studies and 2 randomized
controlled trials) and 2012 adults were meta-analyzed. Patients receiving
gastric bypass had appreciably lowered LVM (weighted mean difference
[WMD]: -43.86 g, 95% confidence interval [CI] -61.09 to -26.63, p < 0.01)
and LVMI (standardized mean difference: -0.67, 95% CI -1.03 to -0.32, p <
0.01) compared with other bariatric surgeries. No significant improvement
in LVEF was noted across all surgeries. The drop in body mass index was
most pronounced for biliopancreatic diversion with duodenal switch (WMD
-16.33 kg/m2, 95% CI -21.60 to -11.05, p < 0.01).
 Conclusion(s): Our findings of this network meta-analysis indicated
that gastric bypass proved best for the improvement in cardiac structure,
and there was no obvious improvement in cardiac function for all bariatric
surgeries. Further studies are required to better understand the differing
effectiveness of bariatric surgeries on cardiac structure and function and
the underlying molecular mechanisms. Copyright © 2024 World
Obesity Federation.

<30>
Accession Number
2031795447
Title
The role of chronic total occlusions in non-infarct-related arteries in
acute coronary syndrome patients: a systematic review.
Source
Future Cardiology. 20(10) (pp 581-590), 2024. Date of Publication: 2024.
Author
Sliman H.; Sliman R.K.A.; Knaapen P.; Nap A.; Henriques J.; Verouden N.;
Claessen B.E.P.M.
Institution
(Sliman) Department of Cardiology, Carmel Medical Center, Heart Center,
Haifa, Israel
(Sliman) Department of Pediatrics, Clalit Health Care Organization, Carmel
Medical Center, Haifa, Israel
(Knaapen, Nap, Henriques, Verouden, Claessen) Department of Cardiology,
Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences,
Amsterdam 1105 AZ, Netherlands
Publisher
Taylor and Francis Ltd.
Abstract
Aim: This systematic review evaluated the impact of a chronic total
occlusion (CTO) in a non-infarct-related artery (non-IRA) on clinical
outcomes in acute coronary syndrome (ACS) patients and assessed the
benefits of staged revascularization. Method(s): We performed a
comprehensive systematic review to provide further insight into the impact
of a CTO in a non-IRA on clinical outcomes after ACS. Moreover, we review
the currently available evidence on the clinical significance of staged
revascularization for a CTO in a non-IRA patients with ACS and propose
whether prophylactic CTO percutaneous coronary intervention (PCI) could
improve outcomes in patients who subsequently develop an ACS.
 Result(s): Our search identified 999 studies, from which 30 were
selected and ten were included in the analysis. The results showed a trend
of higher all-cause mortality and major adverse cardiac event rates in the
culprit-only-PCI group compared with the multivessel (MV)-PC I group in ST
elevation myocardial infarction patients, with varying statistical
significance across different outcomes. Conclusion(s): This review
highlights the significant impact of non-IRA CTOs in ACS. Successful CTO
revascularization may provide benefits, particularly in ST elevation
myocardial infarction, but the optimal management approach remains
uncertain. The presence of a non-IRA CTO, especially in cardiogenic shock,
predicts worse outcomes. Further research is warranted to determine the
effective strategies to improve survival. Copyright © 2024
Informa UK Limited, trading as Taylor & Francis Group.

<31>
Accession Number
2031760023
Title
Meta-Analysis Comparing Oral Anticoagulant Monotherapy Versus Dual
Antithrombotic Therapy in Patients With Atrial Fibrillation and Stable
Coronary Artery Disease.
Source
Clinical Cardiology. 47(10) (no pagination), 2024. Article Number: e70026.
Date of Publication: October 2024.
Author
Ahmed M.; Ahsan A.; Shafiq A.; Ahmed R.; Alam M.; Sabouret P.; Rana J.S.;
Fonarow G.C.
Institution
(Ahmed) Department of Medicine, Rawalpindi Medical University, Rawalpindi,
Pakistan
(Ahsan) Department of Medicine, Foundation University Medical College,
Islamabad, Pakistan
(Shafiq) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Ahmed) Department of Cardiology, National Heart and Lung Institute,
Imperial College, London, United Kingdom
(Alam) Department of Cardiology, Baylor College of Medicine, Houston, TX,
United States
(Sabouret) Heart Institute and Action Group, Pitie-Salpetriere, Sorbonne
University, Paris, France
(Sabouret) National College of French Cardiologists, Paris, France
(Rana) Division of Cardiology, Kaiser Permanente Northern California,
Oakland, CA, United States
(Rana) Division of Research, Kaiser Permanente Northern California,
Oakland, CA, United States
(Fonarow) Ahmanson-UCLA Cardiomyopathy Center, Division of Cardiology,
University of California Los Angeles, Los Angeles, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Oral anticoagulants (OACs) are routinely used for the
management of atrial fibrillation (AF) while antiplatelet agents are used
in coronary artery disease (CAD). However, data regarding the comparative
clinical outcomes of OAC monotherapy versus dual antithrombotic therapy
(anticoagulant plus antiplatelet agent) in patients with AF and stable CAD
are limited. Method(s): A comprehensive search of major databases
including PubMed/MEDLINE, Cochrane Library, and Embase was performed from
inception to September 1, 2024 to identify randomized control trials
(RCTs) that compared OAC monotherapy with dual antithrombotic therapy in
patients with AF and stable CAD. The risk ratios (RRs) were estimated with
corresponding 95% confidence intervals (CIs) for all outcomes.
 Result(s): A total of three RCTs reported data for 3945 patients with
AF and stable CAD. The mean age of patients was 73.8 (+/-11.85) years and
the mean follow-up was 22 months. OAC monotherapy was associated with a
significantly reduced relative risk of major bleeding (RR: 0.55, 95% CI:
0.32-0.95) compared to dual therapy. The risk of all-cause death (RR:
0.85, 95% CI: 0.49-1.48), cardiovascular death (RR: 0.84, 95% CI:
0.50-1.41), any stroke event (RR: 0.74, 95% CI: 0.46-1.18), and myocardial
infarction (RR: 1.57, 95% CI: 0.79-3.12) remained comparable across the
two groups. Conclusion(s): OAC monotherapy led to a significant
relative risk reduction for major bleeding with similar rates of ischemic
events and mortality compared to dual antithrombotic therapy in patients
with AF and stable CAD. Copyright © 2024 The Author(s). Clinical
Cardiology published by Wiley Periodicals LLC.

<32>
Accession Number
2031735585
Title
Artificial intelligence based real-time prediction of imminent heart
failure hospitalisation in patients undergoing non-invasive telemedicine.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1457995. Date of Publication: 2024.
Author
Hinrichs N.; Meyer A.; Koehler K.; Kaas T.; Hiddemann M.; Spethmann S.;
Balzer F.; Eickhoff C.; Falk V.; Hindricks G.; Dagres N.; Koehler F.
Institution
(Hinrichs, Meyer, Falk) Department of Cardiothoracic and Vascular Surgery,
Deutsches Herzzentrum der Charite, Berlin, Germany
(Hinrichs, Meyer, Balzer) Institute of Medical Informatics, Charite -
Universitatsmedizin Berlin, Berlin, Germany
(Meyer, Falk) Berlin Institute of Health, Charite - Universitatsmedizin
Berlin, Berlin, Germany
(Meyer) Berlin Institute for the Foundations of Learning and Data
(BIFOLD), Technical University of Berlin, Berlin, Germany
(Meyer, Falk, Hindricks) German Centre for Cardiovascular Research (DZHK),
Partner Site Berlin, Berlin, Germany
(Koehler, Kaas, Hiddemann, Koehler) Centre for Cardiovascular
Telemedicine, Deutsches Herzzentrum der Charite, Berlin, Germany
(Spethmann, Hindricks, Dagres) Department of Cardiology, Angiology, and
Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin,
Germany
(Eickhoff) Institute for Bioinformatics and Medical Informatics,
Eberhard-Karls-Universitat Tubingen, Tubingen, Germany
(Falk) Department of Health Sciences and Technology, Translational
Cardiovascular Technologies, Eidgenossische Technische Hochschule Zurich,
Zurich, Switzerland
Publisher
Frontiers Media SA
Abstract
Background: Remote patient management may improve prognosis in heart
failure. Daily review of transmitted data for early recognition of
patients at risk requires substantial resources that represent a major
barrier to wide implementation. An automated analysis of incoming data for
detection of risk for imminent events would allow focusing on patients
requiring prompt medical intervention. Method(s): We analysed data of
the Telemedical Interventional Management in Heart Failure II (TIM-HF2)
randomized trial that were collected during quarterly in-patient visits
and daily transmissions from non-invasive monitoring devices. By
application of machine learning, we developed and internally validated a
risk score for heart failure hospitalisation within seven days following
data transmission as estimate of short-term patient risk for adverse heart
failure events. Score performance was assessed by the area under the
receiver-operating characteristic (ROCAUC) and compared with a
conventional algorithm, a heuristic rule set originally applied in the
randomized trial. Result(s): The machine learning model significantly
outperformed the conventional algorithm (ROCAUC 0.855 vs. 0.727, p <
0.001). On average, the machine learning risk score increased continuously
in the three weeks preceding heart failure hospitalisations, indicating
potential for early detection of risk. In a simulated one-year scenario,
daily review of only the one third of patients with the highest machine
learning risk score would have led to detection of 95% of HF
hospitalisations occurring within the following seven days.
 Conclusion(s): A machine learning model allowed automated analysis of
incoming remote monitoring data and reliable identification of patients at
risk of heart failure hospitalisation requiring immediate medical
intervention. This approach may significantly reduce the need for manual
data review. Copyright 2024 Hinrichs, Meyer, Koehler, Kaas, Hiddemann,
Spethmann, Balzer, Eickhoff, Falk, Hindricks, Dagres and Koehler.

<33>
Accession Number
2031085146
Title
Prognostic value of the stress-hyperglycaemia ratio in patients with
moderate-to-severe coronary artery calcification: Insights from a large
cohort study.
Source
Diabetes, Obesity and Metabolism. 26(11) (pp 4933-4944), 2024. Date of
Publication: November 2024.
Author
Lin Z.; Song Y.; Yuan S.; He J.; Dou K.
Institution
(Lin, Song, Yuan, He, Dou) Department of Cardiology, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
(Lin, Song, Yuan, He, Dou) Cardiometabolic Medicine Center, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
(Lin, Song, Yuan, He, Dou) State Key Laboratory of Cardiovascular Disease,
Beijing, China
(Dou) National Clinical Research Center for Cardiovascular Diseases,
Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Aim: To evaluate the relationship between the stress-hyperglycaemia ratio
(SHR) and the clinical prognosis of patients with moderate-to-severe
coronary artery calcification (MSCAC). Method(s): We consecutively
enrolled 3841 patients with angiography-detected MSCAC. The individuals
were categorized into three groups based on SHR tertiles: T1 (SHR <=
0.77), T2 (0.77 < SHR <= 0.89) and T3 (SHR > 0.89). The SHR value was
calculated using the formula SHR = [admission glucose (mmol/L)]/[1.59 x
HbA1c (%) - 2.59]. The primary outcomes were major adverse cardiovascular
and cerebrovascular events (MACCEs), including all-cause death, non-fatal
myocardial infarction and non-fatal stroke. Result(s): During a
median follow-up of 3.11 years, 241 MACCEs were recorded. Kaplan-Meier
survival analysis showed that the SHR T3 group had the highest incidence
of MACCEs (P <.001). Moreover, findings from the restricted cubic spline
analysis showed a significant and positive association between the SHR and
MACCEs. This correlation remained consistent even after considering other
variables that could potentially impact the results
(P<inf>non-linear</inf> =.794). When comparing SHR T1 with SHR T3, it was
found that SHR T3 was significantly associated with an increased risk of
the primary outcome (adjusted hazard ratio = 1.50; 95% confidence
interval: 1.10-2.03). Conclusion(s): Patients with MSCAC showed a
positive correlation between the SHR and MACCE rate over a 3-year
follow-up period. The study showed that an SHR value of 0.83 is the key
threshold, indicating a poor prognosis. Future large-scale multicentre
investigations should be conducted to determine the predictive value of
the SHR in patients with MSCAC. Copyright © 2024 John Wiley &
Sons Ltd.

<34>
Accession Number
2034908133
Title
Comparison of Removal of Laryngeal Mask Airway in Deeply Anaesthetised and
Awake Paediatric Patients and their Associated Complications: A Randomised
Clinical Study.
Source
Journal of Clinical and Diagnostic Research. 18(5) (pp UC33-UC36), 2024.
Date of Publication: May 2024.
Author
Chhikara M.; Seelwal D.
Institution
(Chhikara, Seelwal) Department of Anaesthesia, PGIMS, Haryana, Rohtak,
India
Publisher
JCDR Research and Publications Pvt Ltd
Abstract
Introduction: The Laryngeal Mask Airway (LMA) is frequently used for
managing paediatric airways for short surgical procedures. While it is
easy to insert, it can lead to several complications if not removed at the
appropriate plane of anaesthesia. Aim(s): To establish better timing
for the removal of the LMA in deeply anaesthetised and awake paediatric
patients by comparing the complications associated with each approach.
 Material(s) and Method(s): The present randomised clinical study,
enrolled 90 American Society of Anaesthesiologists (ASA) I and II
paediatric patients aged 1 to 12 years, posted for elective short surgical
procedures under general anaesthesia with airway management by Classical
LMA. The patients were allocated into two groups: Group D (LMA removal
under a deep plane/ surgical plane of anaesthesia) and Group A (LMA
removal in a fully awake state). At emergence from anaesthesia and during
LMA removal, both groups were studied for complications including cough,
desaturation (SpO<inf>2</inf> <95%), excessive salivation, vomiting, and
laryngospasm. Descriptive statistics were reported using mean+/-standard
deviation or median (range) for continuous variables. Comparison of
continuous variables was done using the Student's t-test or Wilcoxon rank
sum test. Result(s): Demographic data like age, weight, duration of
surgery, heart rate, and respiratory rate were comparable in both groups.
A significantly higher incidence of cough was found in group A compared to
group D (p-value=0.001). The incidences of desaturation (p-value=1.000),
excessive salivation (p-value=0.361), vomiting (p-value=1.000), and
laryngospasm (p-value=0.142) were comparable between the two groups. Cough
was the most frequent complication in group A (16 out of 45 patients),
while laryngospasm was the most frequent complication in group D (8 out of
45 patients). The total number of complications (p-value=0.043) was
significantly higher in group A compared to group D. Conclusion(s):
The removal of the Classical LMA in paediatric patients can be safely
carried out in a deeply anaesthetised state. Based on the results of
present study, the removal of the LMA in deeply anaesthetised paediatric
patients is associated with fewer complications compared to its removal in
the awake state. Copyright © 2024 JCDR Research and Publications
Pvt Ltd. All rights reserved.

<35>
Accession Number
645479394
Title
Effects of oral pregabalin on postoperative sleep of patients after
video-assisted thoracoscopic surgery: a randomized double-blind controlled
trial.
Source
Minerva anestesiologica. 90(10) (pp 872-881), 2024. Date of Publication:
01 Oct 2024.
Author
Liu H.; Wang Q.; Xu Z.; Zhang L.; Liu Y.; Zhao L.
Institution
(Liu, Wang, Xu, Zhang, Liu) Key Laboratory of Anesthesiology, Xuzhou
Medical University, Xuzhou, China
(Liu, Wang, Xu, Zhang, Liu, Zhao) Department of Anesthesiology, Affiliated
Hospital of Xuzhou Medical University, Xuzhou, China
(Liu) Suining County People's Hospital, Xuzhou, China
(Zhao) Key Laboratory of Anesthesiology, Xuzhou Medical University,
Xuzhou, China
Abstract
BACKGROUND: The aim of this study was to explore the effect of oral
pregabalin at varying concentrations on postoperative sleep of patients
undergoing video-assisted thoracic surgery (VATS), and to identify the
optimal dosage. METHOD(S): A total of 120 VATS-treated patients
admitted from June 2023 to October 2023 were randomly assigned to be
orally administered with 75 mg pregabalin, 150 mg pregabalin and starch
capsules (control group) at a 1:1:1 ratio. One capsule of pregabalin (75
mg) and one capsule of placebo with the same shape and odor, two capsules
of pregabalin (150 mg), and two capsules of placebo with the same shape
and odor were administered orally to patients in the three groups on the
night of surgery, and in the morning and evening of postoperative days 2
and 3. The primary outcome was the incidence of postoperative sleep
disturbance (PSD) on postoperative day 1 (POD1). The secondary outcomes
included the St.Mary's Hospital Sleep Questionnaire (SMH), the Pittsburg
Sleep Quality Index (PSQI) and pain intensity measured with a Numerical
Rating Scale (NRS). Multivariate logistic regression analysis was
performed to identify risk factors for PSD in VATS-treated patients.
 RESULT(S): The incidence of PSD on POD1 in the 75 mg pregabalin group
and 150 mg pregabalin group was significantly lower than that of the
control group (45.0% vs. 42.5% vs. 72.5%; P<0.0167 for two-by-two
comparisons of groups A and B with group C, respectively). The SMH scores
at night on POD1-3 were significantly higher in the 75 mg pregabalin group
and 150 mg pregabalin group than those of the control group (P<0.05).
Since there was definitive lower incidence of pain in the experimental
groups,the median NRS scores of the incisional pain on POD2-3 were
significantly lower in the 75 mg pregabalin group and 150 mg pregabalin
group (P<0.05). The incidence of dizziness in the 150 mg pregabalin group
was significantly higher than that of the 75 mg pregabalin group and
control group (55.0% vs. 25.0% vs. 32.5%; P<0.0167 for two-by-two
comparisons of groups A and C with group B, respectively). NRS score on
POD1, preoperative PSQI and Self-Rating Depression Scale scores were risk
factors for PSD in VATS-treated patients. CONCLUSION(S): Oral
administration of 75 mg or 150mg pregabalin for consecutive three days
after VATS effectively reduces the incidence of PSD and improves the
quality of sleep.

<36>
Accession Number
2034935250
Title
Immediate Effect of Breath Stacking and Buteyko Breathing on Physiological
Parameters in post Laparoscopic Cholecystectomy Patients: A Research
Protocol of a Randomised Controlled Trial.
Source
Journal of Clinical and Diagnostic Research. 18(10) (pp YK01-YK04), 2024.
Date of Publication: October 2024.
Author
Mehta D.; Mehra P.; Kaul G.; Verma N.
Institution
(Mehta, Mehra, Kaul, Verma) Department of Physiotherapy, Maharishi
Markandeshwar Medical College and Hospital, Himachal Pradesh, Solan, India
Publisher
JCDR Research and Publications Pvt Ltd
Abstract
Introduction: Laparoscopic cholecystectomy is frequently performed in
acute, chronic, symptomatic, and asymptomatic cholelithiasis. It is
simple, safer, and requires less recovery time than open cholecystectomy,
which is why this procedure is increasingly utilised for various abdominal
surgeries. Patients may experience postoperative pulmonary problems during
the recovery phase and as per available literature there is a noticeable
decline in the vital capacity of the patient. It was observed that Buteyko
breathing and breath stacking breathing techniques has a good impact on
the physiological parameters and vital capacity of patients with
hypertension, asthma, Chronic Obstructive Pulmonary Disease (COPD), and
other respiratory conditions. Need of the study: Buteyko breathing and
breath stacking breathing techniques are effective in different conditions
like hypertension, asthma, and cardiac surgery. The need of the study is
to compare both techniques and find out which one is more effective and
implement that with the standard exercises in the patients to help them
improve their quality of life, reduce hospital stay, and improve lung
capacity. Aim(s): To compare the effects of the Breath Stacking
Technique (BST) and Buteyko Breathing Technique (BBT) on the physiological
parameters of patients undergoing laparoscopic cholecystectomy.
 Material(s) and Method(s): This will be a randomised controlled trial
in which 140 patients will be included using purposive sampling via block
randomisation. The study will be conducted in Surgery Intensive Care Unit
(SICU) of Maharishi Markandeshwar Medical College and Hospital,
Kumarhatti, Solan, from December 2023 to May 2024. Patients in Group-A
will perform the BBT and Group-B will perform the BST. Each cycle of
breathing consists of five repetitions with five sets and 30 seconds of
rest in between. Outcome measures will be taken at baseline and after
intervention on Postoperative Day 1 (POD). The normality of the data will
be checked by Kolmogorov-Smirnov test. A paired t-test will be used if the
data is normal, and the Wilcoxon Signed Rank test will be used if the data
is non-normal. A p-value < 0.05 will be considered
significant. Copyright © 2024 JCDR Research and Publications Pvt
Ltd. All rights reserved.

<37>
Accession Number
2035038346
Title
Impact of Renal and Liver Function on Clinical Outcomes Following
Tricuspid Valve Transcatheter Edge-to-Edge Repair.
Source
Journal of the American College of Cardiology. (no pagination), 2024.
Date of Publication: 2024.
Author
Jorde U.P.; Benza R.; McCarthy P.M.; Ailawadi G.; Whisenant B.; Makkar R.;
Tadros P.; Naik H.; Fam N.; Sauer A.J.; Murthy S.; Kar S.; von Bardeleben
R.S.; Hahn R.T.; Hamid N.; Zbinden J.; Sorajja P.; Adams D.
Institution
(Jorde, Murthy) Montefiore Medical Center, New York, NY, United States
(Benza, Adams) Mount Sinai, New York, NY, United States
(McCarthy) Northwestern Memorial Hospital, Chicago, IL, United States
(Ailawadi) University of Michigan, Ann Arbor, MI, United States
(Whisenant) Intermountain Healthcare, Murray, UT, United States
(Makkar) Cedars Sinai, Los Angeles, CA, United States
(Tadros) University of Kansas, Kansas City, KS, United States
(Naik) Arizona Cardiovascular Research Center, Phoenix, AZ, United States
(Fam) St Michael's Hospital, Toronto, ON, Canada
(Sauer) Saint Luke's Mid America Heart Institute, Kansas City, MO, United
States
(Kar) Los Robles Regional, Thousand Oaks, CA, United States
(von Bardeleben) University Medical Center Mainz, Mainz, Germany
(Hahn) The New York-Presbyterian/Columbia University Irving Medical
Center, New York, NY, United States
(Hamid, Sorajja) Minneapolis Heart Institute, Minneapolis, MN, United
States
(Zbinden) Abbott, Maple Grove, MN, United States
Publisher
Elsevier Inc.
Abstract
Background: The TRILUMINATE Pivotal trial is a prospective, randomized,
controlled study of patients with severe tricuspid regurgitation (TR).
Venous congestion due to TR may lead to end-organ dysfunction and failure.
The potential to reverse or stop further deterioration in end-organ
function is an important goal of treatment. Objective(s): This study
sought to examine changes in end-organ function after tricuspid
transcatheter edge-to-edge repair (TEER) and assess the association of
baseline end-organ function with heart failure (HF) hospitalizations and
mortality. Method(s): Subjects were randomized 1:1 to either the TEER
group (TriClip System + medical therapy) or control group (medical therapy
alone). Laboratory assessments and TR grading were performed at baseline
and at all follow-up visits (discharge, 30 days, 6 months, and 12 months).
An independent echocardiography core laboratory assessed TR severity and
an independent clinical events committee adjudicated adverse events.
 Result(s): A total of 572 subjects were enrolled and randomized (285
TEER, 287 control patients). Patients with moderate-to-severe end-organ
impairment (estimated glomerular ejection fraction [eGFR] <45 mL/min/1.73
m2 or Model for End-Stage Liver Disease excluding INR [MELD-XI]
>15) at baseline had increased incidence of HF hospitalization and death
through 12 months, regardless of treatment. There were no statistically
significant differences between TEER and control patients in eGFR or
MELD-XI at 12 months. In subgroup analyses examining only successful TEER
patients (moderate or less TR at discharge) compared with control
patients, as well as when censoring patients with normal baseline values,
both eGFR (+3.55 +/- 1.04 mL/min/1.73 m2 vs 0.07 +/- 1.10
mL/min/1.73 m2; P = 0.022) and MELD-XI (-0.52 +/- 0.18 vs 0.34
+/- 0.18; P = 0.0007) improved. Conclusion(s): Baseline end-organ
function was associated with HF hospitalization and death in patients with
severe TR. At 12 months, eGFR and MELD-XI scores were not statistically
significantly different between the overall TEER and control groups. In
patients who had successful TEER, statistically significant, yet small,
favorable changes occurred for both eGFR and MELD-XI. Further
investigation is needed to assess whether these changes in end-organ
function after successful TEER are clinically meaningful and reduce HF
hospitalization or death. (Clinical Trial to Evaluate Cardiovascular
Outcomes In Patients Treated With the Tricuspid Valve Repair System
Pivotal [TRILUMINATE Pivotal]; NCT03904147) Copyright © 2024

<38>
Accession Number
2035038244
Title
Dual ProGlide vs ProGlide and Angio-Seal for Femoral Access Hemostasis
After Transcatheter Aortic Valve Replacement: A Randomised Comparative
Trial.
Source
Canadian Journal of Cardiology. (no pagination), 2024. Date of
Publication: 2024.
Author
Yeh C.-F.; Kao H.-L.; Ko T.-Y.; Chen C.-K.; Tsai C.-H.; Huang C.-C.; Chen
Y.-H.; Chan C.-Y.; Lin M.-S.
Institution
(Yeh, Kao, Ko, Chen, Tsai, Huang, Chen, Lin) Division of Cardiology,
Department of Internal Medicine and Cardiovascular Centre, National Taiwan
University Hospital, Taipei, Taiwan (Republic of China)
(Ko, Chen) Graduate Institute of Clinical Medicine, Medical College,
National Taiwan University, Taipei, Taiwan (Republic of China)
(Chen) Department of Internal Medicine, National Taiwan University
Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan (Republic of China)
(Chan) Division of Cardiovascular Surgery, Department of Surgery and
Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan
(Republic of China)
Publisher
Elsevier Inc.
Abstract
Background: Vascular complications increase morbidity and mortality after
transcatheter aortic valve replacements (TAVR), often related to failures
in vascular closure devices (VCDs). We intended to compare the dual
Perclose ProGlide (PP) strategy and the hybrid combination of PP and
Angio-Seal (AS) for femoral access hemostasis after TAVR. Method(s):
A randomised controlled trial with 257 patients comparing dual PP with 1
PP and 1 AS (AS+PP) for vascular closure after transfemoral TAVR was
conducted. The primary end point was the composite of TAVR access
site-related vascular complications and life-threatening type 2/3 or 1
bleeding according to the Valve Academic Research Consortium 3. Secondary
end points included additional VCD use and significant peripheral ischemia
related to arteriotomy closure within 1 year. Modified VCD failure,
defined as failure to achieve hemostasis within 5 minutes or requiring
additional endovascular manoeuvres, was also recorded. Result(s): The
AS+PP combination yielded lower rates of the primary end point (18.2% vs
29.8%; P = 0.0381), vascular complication (18.2% vs 29.8%; P = 0.0381),
additional VCD use (0.8% vs 19.0%; P < 0.0001), and modified VCD failure
(9.9% vs 33.1%; P < 0.0001) than the dual PP. Bleeding complication rates
were similar between the 2 groups. Three-month follow-up vascular duplex
tests showed similar common femoral artery (CFA) diameters and peak
systolic velocities (PSVs) between the 2 groups, but those with additional
intervention had higher PSVs and smaller CFA diameters than those without.
 Conclusion(s): Combined PP+AS for large-bore femoral access
hemostasis after TAVR promises to be more effective and safer than dual PP
in terms of vascular complications. Moreover, additional intervention for
vascular complications resulted in smaller CFA diameters. Clinical Trial
Registration: NCT05491070 Copyright © 2024 Canadian
Cardiovascular Society

<39>
Accession Number
645485086
Title
Protamine Dosing for Heparin Reversal Following Cardiopulmonary Bypass: A
Double-Blinded Prospective Randomized Control Trial Comparing Two
Strategies.
Source
Anesthesiology. (no pagination), 2024. Date of Publication: 10 Oct 2024.
Author
Jain P.; Silva-De Las Salas A.; Bedi K.; Lamelas J.; Epstein R.H.; Fabbro
Ii M.
Institution
(Jain) Department of Anesthesiology, Perioperative Medicine, Pain
Management. University of Miami Miller School of Medicine, Miami, FL,
Puerto Rico
(Silva-De Las Salas) Department of Anesthesiology, Perioperative Medicine,
Pain Management. University of Miami Miller School of Medicine, USA.
Resident PGY-1, Miami, Fl, Puerto Rico
(Bedi) University of Miami, Miller School of Medicine, MS 3, Miami, Fl,
Puerto Rico
(Lamelas) Department of Surgery, University of Miami Miller School of
Medicine, USA. Professor of Surgery, Miami, Fl, Puerto Rico
(Epstein) Department of Anesthesiology, Perioperative Medicine, Pain
Management. University of Miami Miller School of Medicine, Miami, Fl,
Puerto Rico
(Fabbro Ii) Department of Anesthesiology, Perioperative Medicine, Pain
Management. University of Miami, Miller School of Medicine, Miami, Fl,
Puerto Rico
Abstract
BACKGROUND: Drug shortages are a frequent challenge in current clinical
practice. Certain drugs, (e.g., protamine) lack alternatives and
inadequate supplies can limit access to services. Conventional protamine
dosing uses heparin ratio-based calculations for heparin reversal
following CPB and may result in excess protamine utilization, and
potential harm due to its intrinsic anticoagulation. We hypothesized that
a fixed 250-mg protamine dose would be comparable, as measured by the
activated clotting time, to a 1:1 (1 mg for every 100 U) protamine to
heparin ratio-based strategy for heparin reversal and that protamine would
be conserved. METHOD(S): In a single-center, double-blinded trial,
consenting elective adult cardiac surgical patients without pre-existing
coagulopathy or ongoing anticoagulation, and a calculated initial heparin
dose of >= 27500 U were randomized to receive, following CPB, protamine as
a fixed dose (250 mg) or a ratio-based dose (1 mg:100 U heparin). The
primary outcome was the activated clotting time following initial
protamine administration, assessed by Student's t-test. Secondary outcomes
included total protamine, the need for additional protamine, and the
cumulative 24-h chest tube output. RESULT(S): There were 62 and 63
patients in the fixed- and ratio-based dose groups, respectively. The mean
post-protamine ACT was not different between groups (-2.0 s, 95% CI -7.2
to 3.3 s, P = 0.47). Less total protamine per case was administered in the
fixed-dose group (2.1 50-mg vials, 95% CI -2.4 to -1.8, P < 0.0001). There
was no difference in the cumulative 24-h chest tube output (difference =
-77 ml, 95% CI 220 to 65 ml, P = 0.28). CONCLUSION(S): A 1: 1 heparin
ratio-based protamine dosing strategy compared to a fixed 250-mg dose
resulted in the administration of a larger total dose of protamine no
difference in either the initial ACT or the amount postoperative
chest-tube bleeding. Copyright © 2024 American Society of
Anesthesiologists. All Rights Reserved.

<40>
Accession Number
645478332
Title
Transcatheter Aortic Valve Implantation by Valve Type in Women With Small
Annuli: Results From the SMART Randomized Clinical Trial.
Source
JAMA cardiology. (no pagination), 2024. Date of Publication: 09 Oct 2024.
Author
Tchetche D.; Mehran R.; Blackman D.J.; Khalil R.F.; Mollmann H.;
Abdel-Wahab M.; Ben Ali W.; Mahoney P.D.; Ruge H.; Bleiziffer S.; Lin L.;
Szerlip M.; Grubb K.J.; Byku I.; Guerrero M.; Gillam L.D.; Petronio A.S.;
Attizzani G.F.; Batchelor W.B.; Gada H.; Rogers T.; Rovin J.D.; Whisenant
B.; Benton S.; Gardner B.; Padang R.; Althouse A.D.; Herrmann H.C.
Institution
(Tchetche) Department of Interventional Cardiology, Clinique Pasteur,
Toulouse, France
(Mehran) Center for Interventional Cardiovascular Research and Clinical
Trials, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, NY, United States
(Blackman) Department of Cardiology, Leeds Teaching Hospitals, Leeds,
United Kingdom
(Khalil) Department of Cardiology, Allegheny General Hospital, Pittsburgh,
PA, United States
(Mollmann) Department of Cardiology, St Johannes Hospital Dortmund,
Dortmund, Germany
(Abdel-Wahab) Heart Center Leipzig at University of Leipzig, Leipzig,
Germany
(Ben Ali) Department of Surgery, Montreal Heart Institute, Montreal, QC,
Canada
(Mahoney) Department of Structural Interventional Cardiology, Sentara
Heart Hospital, Norfolk, VA, United States
(Ruge) Department of Cardiovascular Surgery, German Heart Center Munich,
School of Medicine & Health, Technical University of Munich, Munich,
Germany
(Bleiziffer) Department of Thoracic and Cardiovascular Surgery, Herz- und
Diabeteszentrum North Rhine-Westphalia ,Ruhr-Universitat Bochum, Bochum,
Germany
(Lin) Department of Interventional Cardiology, Morton Plant Hospital,
Clearwater, FL, Puerto Rico
(Szerlip) Departments of Cardiology and Cardiac Surgery, Baylor Scott and
White Heart Hospital, Plano, TX, United States
(Grubb) Division of Cardiothoracic Surgery, Department of Surgery, Emory
University, Atlanta, Georgia
(Byku) Structural Heart and Valve Center, Division of Cardiology,
Department of Surgery, Emory University, Atlanta, Georgia
(Guerrero) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Gillam) Department of Cardiovascular Medicine, Morristown Medical
Center/Atlantic Health System, Morristown, NJ, United States
(Petronio) Department of Cardiology, University of Pisa, Azienda
Ospedaliera Universitaria Pisana University Hospital, Pisa, Italy
(Attizzani) Division of Cardiology, Harrington Heart and Vascular
Institute, University Hospitals Cleveland Medical Center, OH, United
States
(Batchelor) Interventional Heart Program, Inova Schar Heart and Vascular,
Falls Church, VA, United States
(Gada) Interventional Cardiology, University of Pittsburgh Medical Center,
Harrisburg, PA, United States
(Rogers) Section of Interventional Cardiology, MedStar Washington Hospital
Center, WA, United States
(Rovin) Center for Advanced Valve and Structural Heart Care, Morton Plant
Hospital, Clearwater, FL, Puerto Rico
(Whisenant) Division of Cardiology, Intermountain Medical Center, Murray,
UT, United States
(Benton) Department of Cardiology, Wellspan York Hospital, York, PA,
United States
(Gardner) Department of Structural Heart Disease Cardiology, Intermountain
Medical Center, Murray, UT, United States
(Padang) Echocardiography Core Laboratory, Mayo Clinic, Rochester, MN,
United States
(Althouse) Structural Heart and Aortic, Medtronic, Minneapolis, MN, United
States
(Herrmann) Cardiovascular Division, Department of Medicine, Perelman
School of Medicine at the University of Pennsylvania, Philadelphia, United
States
Abstract
Importance: Historically, women with aortic stenosis have experienced
worse outcomes and inadequate recognition compared to men, being both
underdiagnosed and undertreated, while also facing underrepresentation in
clinical trials. Objective(s): To determine whether women with small
aortic annuli undergoing transcatheter aortic valve replacement have
better clinical and hemodynamic outcomes with a self-expanding valve (SEV)
or balloon-expandable valve (BEV). Design, Setting, Participants: The
Small Annuli Randomized to Evolut or SAPIEN Trial (SMART) was a
large-scale randomized clinical trial focusing on patients with small
aortic annuli undergoing transcatheter aortic valve replacement,
randomized to receive SEVs or BEVs and included 716 patients treated at 83
centers in Canada, Europe, Israel, and the US from April 2021 to October
2022. This prespecified secondary analysis reports clinical and
hemodynamic findings for all 621 women enrolled in SMART. Data for this
report were analyzed from February to April 2024. Intervention(s):
Transcatheter aortic valve replacement with an SEV or a BEV. Main
Outcomes and Measures: The composite coprimary clinical end point
comprised death, disabling stroke, or heart failure-related
rehospitalization. The coprimary valve function end point was the
incidence of bioprosthetic valve dysfunction, both assessed through 12
months. Secondary end points included the incidence of moderate or severe
prosthesis-patient mismatch. Result(s): A total of 621 women (mean
[SD] age, 80.2 [6.2] years; 312 randomized to the SEV group and 309 to the
BEV group) were included in the present analysis. At 12 months, there were
no significant differences in the coprimary clinical end point between the
SEV and BEV groups (9.4% vs 11.8%, absolute risk difference -2.3%; 95% CI
-7.2 to 2.5, P=.35). However, SEV implantation was associated with less
bioprosthetic valve dysfunction (8.4% vs 41.8%; absolute risk difference,
-33.4%; 95% CI, -40.4 to -26.4; P<.001). SEV implantation resulted in
lower aortic valve gradients and larger effective orifice areas at 30 days
and 12 months and less mild or greater aortic regurgitation at 12 months
compared to BEV implantation. Prosthesis-patient mismatch was
significantly lower with SEVs, regardless of the definition used and
adjustment for body mass index. Use of SEVs was associated with better
quality of life outcomes as assessed by the Valve Academic Research
Consortium-3 ordinal quality of life measure. Conclusions and
Relevance: Among women with severe symptomatic aortic stenosis and small
aortic annuli undergoing transcatheter aortic valve replacement, the use
of SEVs, compared to BEVs, resulted in similar clinical outcomes and a
markedly reduced incidence of bioprosthetic valve dysfunction through 12
months, including a lower risk of prosthesis-patient mismatch and better
12-month quality of life. Trial Registration: ClinicalTrials.gov
Identifier: NCT04722250.

<41>
Accession Number
645478286
Title
Does performing cardiac surgery after hours impact postoperative outcomes?
A systematic review and meta-analysis.
Source
The Journal of cardiovascular surgery. (no pagination), 2024. Date of
Publication: 09 Oct 2024.
Author
O'Connell A.; El-Andari R.; Fialka N.M.; Nagendran J.; Meyer S.R.
Institution
(O'Connell, El-Andari, Fialka, Nagendran) Division of Cardiac Surgery,
Department of Surgery, University of Alberta, Edmonton, AL, Canada
(Meyer) Division of Cardiac Surgery, Department of Surgery, University of
Alberta, Edmonton, AL, Canada
Abstract
INTRODUCTION: There has been concern regarding the safety of cardiac
surgical intervention during off-hours. Sleep deprivation, resource
limitations, and an increased case urgency have been postulated to
increase off-hours surgical risk, although outcomes are inconsistent in
the existing literature. In this systematic review and meta-analysis, we
review the literature comparing patients undergoing cardiac surgery during
on and off-hours. EVIDENCE ACQUISITION: PubMed and Embase were
systematically searched for literature published from January
2000-September 2023, comparing outcomes of patients undergoing cardiac
surgery during on and off-hours. Overall, 3540 manuscript titles and
abstracts were screened and 11 articles were included. EVIDENCE SYNTHESIS:
Overall aggregate analysis indicated no significant differences in rates
of in-hospital mortality(OR 1.04; 95% CI, 0.41-2.63; P=0.93) and
perioperative morbidity, including stroke (P=0.52), reoperation (P=0.92),
major bleeding (P=0.10), and renal complications (P=0.55). Composite rates
of sternal wound infection favored on-hours surgery (P=0.01).
 CONCLUSION(S): Although inferior outcomes in patients undergoing
cardiac surgery during off-hours have been noted, aggregate analysis
largely revealed equivalent perioperative morbidity and mortality during
on and off-hours surgery, although with the exclusion of one outlier study
in-hospital mortality and reoperation favored on-hours surgery.
Heterogeneity in outcomes is likely multifactorial, with surgical staff
fatigue, patient preoperative risk, clinical setting, and resource
limitations all contributing. Further investigation is required directly
comparing emergent cardiac surgical intervention during on-hours and
off-hours controlling for baseline surgical risk to elucidate the true
impact of timing of surgery on postoperative outcomes.

<42>
Accession Number
645477922
Title
Extracorporeal Blood Purification and Acute Kidney Injury in Cardiac
Surgery: The SIRAKI02 Randomized Clinical Trial.
Source
JAMA. (no pagination), 2024. Date of Publication: 09 Oct 2024.
Author
Perez-Fernandez X.; Ulsamer A.; Camara-Rosell M.; Sbraga F.;
Boza-Hernandez E.; Moret-Ruiz E.; Plata-Menchaca E.; Santiago-Bautista D.;
Boronat-Garcia P.; Gumucio-Sanguino V.; Penafiel-Munoz J.; Camacho-Perez
M.; Betbese-Roig A.; Forni L.; Campos-Gomez A.; Sabater-Riera J.
Institution
(Perez-Fernandez) Facultat de Medicina Campus de Bellvitge Universitat de
Barcelona L'Hospitalet de Llobregat, Barcelona, Spain
(Perez-Fernandez, Ulsamer, Plata-Menchaca, Gumucio-Sanguino,
Penafiel-Munoz, Sabater-Riera) Institut de Investigacio Biomedica de
Bellvitge L'Hospitalet de Llobregat, Barcelona, Spain
(Perez-Fernandez, Sbraga, Boza-Hernandez, Gumucio-Sanguino, Sabater-Riera)
Hospital universitari de Bellvitge L'Hospitalet de LLobregat, Barcelona,
Spain
(Camara-Rosell, Moret-Ruiz, Santiago-Bautista, Boronat-Garcia,
Campos-Gomez) Hospital universitari Germans Trias i Pujol Badalona,
Barcelona, Spain
(Camacho-Perez, Betbese-Roig) Hospital universitari Santa Creu i Sant Pau,
Barcelona, Spain
(Forni) Royal Surrey NHS Foundation Trust & School of Medicine, University
of Surrey, Guildford, United Kingdom
Abstract
Importance: Cardiac surgery-associated acute kidney injury (CSA-AKI)
remains a significant problem following cardiopulmonary bypass (CPB).
Various strategies are proposed to attenuate CSA-AKI, including
extracorporeal blood purification (EBP), but little is known about the
effect of EBP through an acrylonitrile-sodium
methallylsulfonate/polyethyleneimine membrane during CPB.
 Objective(s): To determine whether the use of an EBP device in a
nonemergent cardiac surgery population reduces CSA-AKI after CPB.
 Design, Setting, and Participant(s): This double-blind, randomized
clinical trial was conducted in 2 tertiary hospitals in Spain. Patients 18
years or older undergoing nonemergent cardiac surgery who were at high
risk for CSA-AKI were enrolled from June 15, 2016, through November 5,
2021, with follow-up data through February 5, 2022. Of 1156 patients
assessed, 343 patients were randomized (1:1) to either receive EBP or
standard care. Intervention(s): Nonselective EBP device connected to
the CPB circuit. Main Outcomes and Measures: The primary outcome was
the rate of CSA-AKI in the 7 days after randomization. Result(s):
Among 343 patients randomized (169 to receive EBP and 174 to receive usual
care), the mean (SD) age was 69 (9) years and 119 were females. The rate
of CSA-AKI was 28.4% (95% CI, 21.7%-35.8%) in the EBP group vs 39.7% (95%
CI, 32.3%-47.3%) in the standard care group (P=.03), with an adjusted
difference of 10.4% (95% CI, 2.3%-18.5%) using a log-binomial model
(P=.01). No significant differences (P>.05) were observed in most of the
predefined clinical secondary end points or post hoc exploratory end
points. In a sensitivity analysis, EBP was found to be more effective in
terms of CSA-AKI reduction in patients with chronic kidney disease,
diabetes, hypertension, low left ventricular ejection fraction (<40%), and
lower body mass index (<30). No differences were observed between the
groups in adverse events tracking. Conclusions and Relevance: The use
of a nonselective EBP device connected to the CPB circuit in a nonemergent
population of patients undergoing cardiac surgery was associated with a
significant reduction of CSA-AKI in the first 7 days after surgery. Trial
Registration: ClinicalTrials.gov Identifier: NCT02518087.

<43>
Accession Number
2034613884
Title
Randomised study for the Optimal Treatment of symptomatic patients with
low-gradient severe Aortic valve Stenosis and preserved left ventricular
ejection fraction (ROTAS trial).
Source
Heart. 110(20) (pp 1223-1230), 2024. Date of Publication: 25 Sep 2024.
Author
Galli E.; Le Ven F.; Coisne A.; Sportouch C.; Le Tourneau T.; Lavie-Badie
Y.; Bernard A.; Eicher J.-C.; Dreyfus J.; Ternacle J.; Baleynaud S.;
Auffret V.; Le Pabic E.; Pibarot P.; Oger E.; Donal E.
Institution
(Galli, Auffret, Donal) Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099,
Rennes, France
(Le Ven) Hopital Cavale Blanche, CHRU Brest, Brest, France
(Coisne) University of Lille, Inserm, CHU Lille, Institut Pasteur de
Lille, Lille, France
(Sportouch) Clinique du Millenaire, Montpellier, France
(Le Tourneau) Nantes Universite, CHU Nantes, CNRS, INSERM, l'Institut du
Thorax, Nantes, France
(Lavie-Badie) Department of Cardiology, Rangueil University Hospital,
Toulouse, France
(Bernard) Service de Cardiologie, CHU Tours, Tours, France
(Eicher) Unite de Rythmologie et Insuffisance Cardiaque, Centre de
Competences des Cardiomyopathies, Service de Cardiologie, Hopital Francois
Mitterrand, CHU Dijon-Bourgogne, Dijon, France
(Dreyfus) Cardiology Department, Centre Cardiologique du Nord, Saint
Denis, France
(Ternacle) Bordeaux University Hospital, Bordeaux, France
(Baleynaud) Department of Cardiology, Centre Hospitalier Bretagne Sud,
Lorient, France
(Le Pabic, Oger) CHU Rennes, Inserm, CIC 1414, Rennes, France
(Pibarot) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec Heart and Lung Institute, Laval University, Quebec, QC,
Canada
Publisher
BMJ Publishing Group
Abstract
Background The best management of symptomatic patients with low-gradient
(LG) severe aortic stenosis (AS) and preserved left ventricular ejection
fraction (LVEF) has not been established. The Randomised study for the
Optimal Treatment of symptomatic patients with low-gradient severe Aortic
valve Stenosis (ROTAS) trial aimed to assess the superiority of aortic
valve replacement (AVR) versus medical treatment (MT) in this specific
group of AS patients. Methods Patients with symptomatic LG severe AS and
preserved LVEF (>50%) underwent dobutamine stress echocardiography and/or
CT-aortic calcium score to confirm AS severity and were then randomised
1:1 to AVR or MT. The primary endpoint was a composite of overall death
and/or cardiovascular hospitalisation. Results The ROTAS study was stopped
early because of insufficient recruitment. In the end, only 52 patients
(age 79+/-7 years; women 54%; NYHA III-IV 27%; median STS score 3.3%) were
included in the study. During follow-up (mean: 14+/-7 months), the primary
endpoint occurred in 12 (23%) patients. Compared with MT, AVR was not
associated with a significant prognostic benefit (events: 5/26 (19%) vs
7/26 (27%) (HR 0.76, 95% CI 0.24 to 2.39, p=0.63). During follow-up, 11
(42%) patients in the MT group developed class I criteria for AVR or
severe symptoms justifying a cross-over to the AVR group. Conclusions
Because of the small number of included patients and short follow-up the
ROTAS trial was underpowered and unable to demonstrate a difference in the
study endpoint between treatment arms. In patients in the MT arm, a
regular echocardiographic and clinical assessment might be useful to
disclose those developing class I indications of AVR or severe AS-related
symptoms. Trial registration number NCT01835028. Copyright ©
Author(s) (or their employer(s)) 2024. No commercial re-use. See rights
and permissions. Published by BMJ.

<44>
Accession Number
2031744187
Title
Volatile vs Total intravenous Anaesthesia for major non-cardiac surgery: a
pragmatic randomised triaL (VITAL).
Source
Trials. 25(1) (no pagination), 2024. Article Number: 414. Date of
Publication: December 2024.
Author
Yeung J.; Jhanji S.; Braun J.; Dunn J.; Eggleston L.; Frempong S.; Hiller
L.; Jacques C.; Jefford M.; Mason J.; Moonesinghe R.; Pearse R.; Shelley
B.; Vindrola C.
Institution
(Jhanji, Braun, Jefford) The Royal Marsden NHS Foundation Trust, London,
United Kingdom
(Yeung, Dunn, Eggleston, Hiller, Jacques) Warwick Clinical Trials Unit,
Warwick Medical School, University of Warwick, Coventry, United Kingdom
(Frempong, Mason) Centre for Health Economics at Warwick, Warwick Medical
School, University of Warwick, Coventry, United Kingdom
(Moonesinghe, Vindrola) University College London, London, United Kingdom
(Pearse) Queen Mary University of London, London, United Kingdom
(Shelley) School of Medicine, University of Glasgow, Glasgow, United
Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Improving outcomes after surgery is a major public health
research priority for patients, clinicians and the NHS. The greatest
burden of perioperative complications, mortality and healthcare costs lies
amongst the population of patients aged over 50 years who undergo major
non-cardiac surgery. The Volatile vs Total Intravenous Anaesthesia for
major non-cardiac surgery (VITAL) trial specifically examines the effect
of anaesthetic technique on key patient outcomes: quality of recovery
after surgery (quality of recovery after anaesthesia, patient satisfaction
and major post-operative complications), survival and patient safety.
 Method(s): A multi-centre pragmatic efficient randomised trial with
health economic evaluation comparing total intravenous anaesthesia with
volatile-based anaesthesia in adults (aged 50 and over) undergoing
elective major non-cardiac surgery under general anaesthesia.
 Discussion(s): Given the very large number of patients exposed to
general anaesthesia every year, even small differences in outcome between
the two techniques could result in substantial excess harm. Results from
the VITAL trial will ensure patients can benefit from the very safest
anaesthesia care, promoting an early return home, reducing healthcare
costs and maximising the health benefits of surgical treatments. Trial
registration: ISRCTN62903453. September 09, 2021. Copyright © The
Author(s) 2024.

<45>
Accession Number
2031700471
Title
Outcomes after noncardiac surgery in patients with left ventricular assist
devices: a systematic review.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1414444. Date of Publication: 2024.
Author
Alamouti-Fard E.; Garg P.; Yazji J.; Brigham T.; Jacob S.; Wadiwala I.J.;
Pham S.M.
Institution
(Alamouti-Fard, Garg, Yazji, Pham) Cardiothoracic Surgery, Mayo Clinic,
Jacksonville, FL, United States
(Brigham) Mayo Clinic Libraries, Mayo Clinic, Jacksonville, FL, United
States
(Jacob) Heart and Lung Transplant National Recovery Program, United
Network for Organ Sharing (UNOS), Jacksonville, FL, United States
(Wadiwala) Division of Vascular Surgery, Oregon Health and Sciences
University, Portland, OR, United States
Publisher
Frontiers Media SA
Abstract
Background: The number of patients living with left ventricular assist
devices (LVADs) has gradually increased in the past decade. Non-cardiac
surgery (NCS) in patients with LVAD poses a unique situation with its
inherent challenges. Aim(s): We conducted a comprehensive review to
investigate the perioperative complications and mortality associated with
emergent or elective NCS in patients with LVAD. Method(s): A
comprehensive literature search for any papers referring to continuous
LVAD patients with NCS. All publications with at least five durable LVAD
patients who had NCS were eligible for inclusion. Result(s): Twenty
articles matching our criteria were found and included in our study. This
systematic review included 6,476 LVAD patients who underwent 6,824 NCS.
There were 5-3,216 LVAD patients with NCS in each study. The median age
was between 39 and 65 years, and most of the patients (78.8%) were male.
Thirty-day postoperative mortality ranged from 0% to 60%. Eight studies
reported no death within the 30 days of the operation. Common
complications include gastrointestinal (GI) bleeding, intracranial
bleeding, infection, acute kidney injury (AKI), urinary tract infection
(UTI), stroke, sepsis, pneumonia, and VAD exchange. Emergent abdominal
surgery had the highest (up to 60%) mortality rate, and vascular and
neurological operations had the highest complication rates. Due to the
diverse range of patients in each publication and the combination of
outcomes presented in various publications, a meta-analysis was not
conducted. Conclusion(s): In LVAD patients, noncardiac surgery may be
performed effectively and safely. LVAD patients who undergo non-cardiac
surgery may require more transfusions due to their complex coagulopathies.
However, perioperative management of LVAD patients undergoing emergent NCS
should be optimized to reduce mortality. Systematic Review Registration:
https://osf.io/fetsb/. Copyright 2024 Alamouti-Fard, Garg, Yazji,
Brigham, Jacob, Wadiwala and Pham.

<46>
Accession Number
2031692035
Title
Pulsed-Field Ablation in Management of Ventricular Tachycardia: A
Systematic Review of Case Reports and Clinical Outcomes.
Source
Clinical Cardiology. 47(10) (no pagination), 2024. Article Number: e70018.
Date of Publication: October 2024.
Author
Askarinejad A.; Kohansal E.; Sabahizadeh A.; Hesami H.; Adimi S.; Haghjoo
M.
Institution
(Askarinejad, Kohansal, Hesami) Rajaie Cardiovascular Medical and Research
Institue, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Sabahizadeh) School of Medicine, Shiraz University of Medical Sciences,
Shiraz, Iran, Islamic Republic of
(Adimi) Cardiovascular Epidemiology Research Center, Rajaie Cardiovascular
Medical and Research Institute, Tehran, Iran, Islamic Republic of
(Haghjoo) Cardiac Electrophysiology Research Center, Rajaie Cardiovascular
Medical and Research Institute, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Haghjoo) Department of Cardiac Electrophysiology, Rajaie Cardiovascular
Medical and Research Institute, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Background: Pulsed-field ablation (PFA) is a cutting-edge technique that
employs non-thermal energy to cause cell death by inducing irreversible
electroporation of cell membranes. This systematic review evaluates the
PFA effectiveness as a potential alternative to radiofrequency and
cryo-ablation for treating ventricular tachycardia. Method(s):
PubMed, Embase, Scopus, and Web of Science were systematically searched
using keywords related to ventricular tachycardia and pulsed-field
ablation. Eligible Studies evaluating this therapeutic approach for
ventricular tachycardia were included in the final analysis.
 Result(s): We included six studies (five case reports and one case
series) in our systematic review. Eight (88.8%) of procedures were
successful with 100% long-term efficacy. No procedural complications or
ventricular tachycardia (VT) recurrence were observed in the cases.
 Conclusion(s): The absence of complications, high effectiveness, and
long-term success rate make PFAs a good VT treatment option. However, PFA
safety and efficacy studies for VT treatment are scarce. Thus, larger
investigations on this topic are urgently needed. Copyright ©
2024 The Author(s). Clinical Cardiology published by Wiley Periodicals,
LLC.

<47>
Accession Number
2034820189
Title
Inclisiran Treatment for Cardiovascular Disease Risk Reduction: A
Systematic Review and Meta-Analysis.
Source
Journal of the College of Physicians and Surgeons Pakistan. 34(9) (pp
1090-1095), 2024. Date of Publication: September 2024.
Author
Chen Y.-F.; Li S.; Wang M.-J.; Wu M.-Y.; Du Z.-C.; Wei L.-P.
Institution
(Chen, Li, Wang, Wu, Du, Wei) Department of Cardiology, Tianjin Union
Medical Center, Tianjin, China
Publisher
College of Physicians and Surgeons Pakistan
Abstract
This study was a meta-analysis of patient data to investigate the
therapeutic effects of inclisiran on LDL-C, PCSK9, and TC in patients with
atherosclerosis. Authors searched the Cochrane Library, Pubmed, EMBASE,
and Web of Science databases for randomised controlled trials. Data of
4,731 subjects from five randomised clinical trials were included in this
analysis. Patients treated with the PCSK9 inhibitor inclisiran had
significantly lower LDL-C levels than those treated with placebo or a
statin (mean difference (MD) -1.477; 95% CI -1.551 to -1.403; p <0.001;
I2 = 7.2%). The average level of PCSK9 was also relatively
lower ((MD) -2.579; 95% CI -2.694 to -2.464; p <0.001; I2 =
36%). They exhibited significant reductions in total cholesterol protein
levels ((MD) -1.477; 95% CI -1.585 to -1.369; p <0.001; I2 =
46.7%). Inclisiran reduced LDL-C and PCSK9 levels as well as TC and Apo B
levels significantly in patients with atherosclerotic cardiovascular
disease (ASCVD). Copyright © 2024 College of Physicians and
Surgeons Pakistan. All rights reserved.

<48>
Accession Number
2034925985
Title
A self-help mobile messaging intervention to improve subthreshold
depressive symptoms among older adults in a socioeconomically deprived
region of Brazil (PRODIGITAL): a pragmatic, two-arm randomised controlled
trial.
Source
The Lancet Regional Health - Americas. 39 (no pagination), 2024. Article
Number: 100897. Date of Publication: November 2024.
Author
Nakamura C.A.; Seward N.; Peters T.J.; Nadaleto Didone T.V.; Moretti F.A.;
Oliveira da Costa M.; Queiroz de Souza C.H.; Macias de Oliveira G.; Souza
dos Santos M.; Aragoni Pereira L.; Mendes de Sa Martins M.; van de Ven P.;
Hollingworth W.; Araya R.; Scazufca M.
Institution
(Nakamura, Nadaleto Didone, Moretti, Oliveira da Costa, Queiroz de Souza,
Macias de Oliveira, Souza dos Santos, Mendes de Sa Martins, Scazufca)
Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de
Sao Paulo, Sao Paulo, Brazil
(Nakamura) Department of Global Health and Social Medicine, Harvard
Medical School, Boston, MA, United States
(Seward, Araya) Health Service and Population Research, Institute of
Psychiatry, Psychology and Neuroscience, King's College London, London,
United Kingdom
(Seward) Department of Clinical Psychology, Health and Social Science,
University of Edinburgh, Edinburgh, United Kingdom
(Peters) Bristol Dental School, University of Bristol, Bristol, United
Kingdom
(Aragoni Pereira, Scazufca) Instituto de Psiquiatria, Hospital das
Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao
Paulo, Brazil
(van de Ven) Health Research Institute, University of Limerick, Limerick,
Ireland
(Hollingworth) Health Economics Bristol, Population Health Sciences,
Bristol Medical School, University of Bristol, Bristol, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Subthreshold depression is a risk factor for major depression
and is associated with increased morbidity and mortality, especially in
older adults. There is emerging evidence that digital interventions,
including self-help interventions, may reduce depressive symptoms. We
aimed to evaluate the effectiveness of a mobile messaging intervention at
reducing subthreshold depressive symptoms among older adults in Brazil.
 Method(s): PRODIGITAL was a single blind, two-arm, individually
randomised controlled trial conducted in 46 primary care clinics in the
city of Guarulhos, Brazil. Individuals aged 60+ years were contacted by
phone following a randomly ordered list for a screening assessment. Those
who presented with anhedonia and/or depressed mood (Patient Health
Questionnaire (PHQ)-2>=1), and who subsequently scored between 5 and 9 on
the PHQ-9 were invited to participate. The intervention arm received the
'Viva Vida' digital self-help intervention consisting of automated
multi-media messages sent via WhatsApp. Forty-eight audio and visual
messages based on psychoeducation and behavioural activation were
automatically delivered over six weeks. The control arm received a single
message containing information about depression. The primary outcome was
the difference in mean PHQ-9 scores between treatment arms at the
three-month follow-up. All primary analyses were performed according to
allocated arm with imputed data. The trial is registered with ReBEC,
RBR-6c7ghfd. Finding(s): Participants were recruited between 8
September 2021 and 19 August 2022. Of the 454 participants enrolled, 223
were randomised to the intervention arm, 231 to the control arm.
Participants' mean age was 65.3 years (SD 5.0) and 64.0% (n = 292) were
female. A total of 385 (84.8%) completed the three-month follow-up
assessment; no difference in mean PHQ-9 scores between the treatment arms
was observed (adjusted difference: -0.61; 95% CI: -1.75, 0.53; p = 0.29).
 Interpretation(s): These results demonstrate that the Viva Vida
digital self-help intervention did not help to improve subthreshold
depressive symptoms amongst older adults. Further research is needed to
understand why this self-help intervention was not effective in this
population, and to explore how it might be adapted to achieve this goal.
 Funding(s): Sao Paulo Research Foundation and UK Joint Global Health
Trials. Copyright © 2024 The Author(s)

<49>
Accession Number
2034908107
Title
Effect of Intensive Nursing Care in Elderly Patients undergoing
Video-assisted Thoracoscopic Lung Cancer Surgery: A Randomised Control
Study.
Source
Journal of Clinical and Diagnostic Research. 18(5) (pp LC15-LC18), 2024.
Date of Publication: May 2024.
Author
Liu L.; Su C.
Institution
(Liu, Su) Department of Division 1 of Thoracic Surgery, Handan Central
Hospital, No. 20 Zhonghua South Street, Hebei Province, Handan City, China
Publisher
JCDR Research and Publications Pvt Ltd
Abstract
Introduction: Lung Cancer (LC) is a prominent cause of death worldwide,
with both non small cell and small cell types increasing in prevalence.
Multiple therapeutic options such as chemotherapy, radiation, and surgery,
including Video-assisted Thoracoscopic Surgery (VATS), have been
developed, although postoperative complications remain a concern. Nursing
care has been advocated as a means to mitigate these adverse effects.
However, the actual association between nursing care and LC postoperative
complications and outcomes remains unknown. Aim(s): To assess the
effects of Intensive Nursing Care (INC) on LC patients treated with VATS.
 Material(s) and Method(s): The present study was a randomised control
study in which a total of 256 Non Small Cell Lung Cancer (NSCLC) patients
over the age of 60 years who underwent VATS in the Division 1 of Thoracic
Surgery at Handan Central Hospital between January 2021 and January 2023
were included. The participants were randomly allocated to different
groups: an INC group (n=126) and a control group receiving normal care
(n=130). Lung function, reported symptoms, hospitalisation duration,
psychological wellbeing (anxiety and depression scores), and occurrence of
postsurgery symptoms (pain, fatigue, insomnia, dyspnea, nausea/vomiting)
were assessed. T-tests or Fisher's-Exact tests were used to compare
baseline and postsurgical variables between the INC and Normal Nursing
Care (NNC) groups using IBM Statistical Package for Social Sciences (SPSS)
version 26.0 software. Result(s): The study population consisted of
53.1% females with an average age of 73.51+/-7.61 years, ranging from 60
to 85 years. INC significantly improved hospitalisation duration {Mean
Difference (MD)=-1.9; 95% Confidence Interval (CI), -2.6 to -1.2; p-value
<0.001}, the occurrence of postsurgery symptoms (p-value <0.001), and
psychological states assessed by both the Self-rating Anxiety Scale (SRAS)
(MD=-17.99; 95% CI, -18.63 to -17.35; p-value=0.001) and the Self-rating
Depression Scale (SRDS) (MD= -9.04; 95% CI, -9.95 to -8.13; p-value=0.008)
in comparison to NNC patients. Conclusion(s): Given the global burden
of LC, it is crucial to emphasise not only the development of treatments
for this illness but also care regimens that alleviate complications
associated with these therapies. In this study, INC as an alternative to
routine nursing care in postsurgery recovery has proven to be more
beneficial to patients by decreasing their hospitalisation stay, the
occurrence of postsurgery symptoms, and by enhancing their mental
state. Copyright © 2024 JCDR Research and Publications Pvt Ltd.
All rights reserved.

<50>
Accession Number
2030646628
Title
Cardiac Rehabilitation in Saudi Arabia: Current Status and Future
Directions.
Source
Current Cardiology Reports. 26(10) (pp 1077-1083), 2024. Date of
Publication: October 2024.
Author
Osailan A.M.
Institution
(Osailan) Department of Health and Rehabilitation Sciences, College of
Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj,
Saudi Arabia
Publisher
Springer
Abstract
Purpose of Review: Cardiovascular diseases (CVDs) are the leading cause of
mortality in Saudi Arabia. Cardiac rehabilitation (CR) is one of the
well-known interventions to control and minimize the burden of CVDs.
Despite recommendations, CR utilization remains suboptimal in Saudi Arabia
due to many reasons, including limited awareness, logistical barriers,
shortage of specialized facilities and trained professionals, and
perceptions about CVDs illness. This review is to evaluate the current
status, effectiveness, accessibility, and challenges of CR utilization in
Saudi Arabia, and to explore potential future directions for improving
these services. The review addresses key questions regarding the incidence
of CVDs, the characteristics of existing CR programs, barriers to CR
access, and stakeholder perspectives. Recent Findings: Recent studies
demonstrate that the effectiveness of CR, particularly exercise training,
in improving outcomes for post-coronary artery bypass grafting (CABG)
patients is well-documented, though data on its impact on other cardiac
conditions is limited. There are significant barriers to CR utilization in
Saudi Arabia, including limited awareness, logistical challenges, a
shortage of specialized facilities and trained professionals, and cultural
perceptions about CVD. Stakeholder perspectives highlight the necessity
for culturally sensitive and inclusive approaches, particularly in
addressing gender-specific needs and enhancing patient-provider
communication. The Saudi Vision 2030 presents opportunities to expand and
enhance CR services in alignment with international standards.
 Summary: This review found that while CR is a crucial intervention
for managing CVDs, its utilization in Saudi Arabia is suboptimal due to
various barriers. To improve CR access and effectiveness, future
strategies should focus on increasing public and professional awareness,
developing infrastructure, training healthcare professionals, and
fostering public-private partnerships. These measures are essential to
making CR more accessible and tailored to the diverse needs of the Saudi
population, ultimately enhancing the quality of cardiovascular care and
patient outcomes in the region. Copyright © The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<51>
Accession Number
2034815168
Title
Aortic root enlargement versus stentless valve implantation for avoidance
of patient-prosthesis mismatch in patients with small aortic root:
protocol for a systematic review.
Source
BMJ Open. 14(8) (no pagination), 2024. Article Number: e090050. Date of
Publication: 17 Aug 2024.
Author
Meneas C.; Voisine P.; Mestres C.; Sall F.; Kabore R.; N'guessan A.;
Yangni-Angate H.; Mohammadi S.; Dagenais F.
Institution
(N'guessan) Human and Social Sciences Unit (SHS), University of Felix
Houphouet-Boigny, Abidjan, Cote D'Ivoire
(Meneas, Yangni-Angate) Department of Cardiovascular and Thoracic Surgery,
Alassane Ouattara University, Bouake, Cote D'Ivoire
(Meneas, Voisine, Mohammadi, Dagenais) Department of Cardiac Surgery,
Laval University, Quebec, QC, Canada
(Mestres) Department of Cardiovascular Surgery, UniversitatsSpital Zurich,
Zurich, Zurich, Switzerland
(Sall) Department of Cardiology, Alassane Ouattara University, Bouake,
Cote D'Ivoire
(Kabore) Bordeaux School of Public Health, University of Bordeaux,
Aquitaine, Talence, France
Publisher
BMJ Publishing Group
Abstract
Introduction Avoiding patient-prosthesis mismatch (PPM) in patients with
small aortic annulus (SAA) during aortic valve replacement (AVR) is still
a challenging surgical problem. Among surgical options available, aortic
root enlargement (ARE) and stentless valve implantation (SVI) are the two
most commonly used strategies. This systematic review will be conducted
searching for superiority evidence based on comparative studies between
these two options. Methods and analysis This systematic review will
include all relevant articles published from 1 January 1946 to 31 March
2024, with available full texts from Medline (Ovid), Embase, Cochrane
Library and Web of Science databases, without any language restriction.
Observational studies and randomised controlled trials comparing surgical
results of ARE versus SVI for AVR in patients with small aortic root will
be screened. Studies will be classified into three groups: group 1 for
studies that reported SVI or other tissue valve outcomes without comparing
them with ARE outcomes; group 2 for studies that reported ARE outcomes
without comparing them with SVI outcomes; and group 3 for studies that
compared ARE outcomes with SVI outcomes. The quality of the evidence of
each study will be evaluated according to Oxford Centre for Evidence-Based
Medicine criteria. Ethics and dissemination Ethical approval is not
required because no primary data are collected. The findings will be
presented at scientific conferences and/or reported in a peer-reviewed
scientific journal. Copyright © Author(s) (or their employer(s))
2024.

<52>
Accession Number
2031771238
Title
Pericardiotomy as a novel treatment for heart failure with preserved
ejection fraction.
Source
Heart Failure Reviews. (no pagination), 2024. Date of Publication: 2024.
Author
Doi S.; Borlaug B.A.
Institution
(Doi, Borlaug) Department of Cardiovascular Disease, Mayo Clinic,
Rochester, MN, United States
(Borlaug) Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN
55905, United States
Publisher
Springer
Abstract
The pericardium plays an important role in modulating cardiac performance
and hemodynamics in patients with heart failure with preserved ejection
fraction (HFpEF). Pericardial constraint increases filling pressures in
patients with HFpEF, particularly those with the obesity phenotype, atrial
myopathy, right ventricular dysfunction, and tricuspid regurgitation.
Preclinical and early stage clinical studies indicate that pericardiotomy
may become a novel treatment for HFpEF. This review summarizes and
discusses the pathophysiology of pericardial restraint and the possibility
of pericardiotomy in HFpEF. Copyright © The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<53>
Accession Number
645475252
Title
A Randomized Controlled Trial Comparing Effectiveness of Different
Fibrinogen Preparations in Restoring Clot Firmness.
Source
Anesthesia and analgesia. (no pagination), 2024. Date of Publication: 09
Oct 2024.
Author
Baryshnikova E.; Aloisio T.; Di Dedda U.; Anguissola M.; Barbaria A.;
Caravella G.; Ranucci M.
Institution
(Baryshnikova, Aloisio, Di Dedda, Anguissola, Barbaria, Ranucci) From the
Departments of Cardiovascular Anesthesia and Intensive Care
(Caravella) Pharmacy Service, IRCCS Policlinico San Donato, San Donato
Milanese (Milan), Italy
Abstract
BACKGROUND: Different preparations of fibrinogen concentrate are currently
available. Two in vitro studies demonstrated the superiority of FibCLOT
(LFB) in increasing clot firmness with respect to RiaSTAP (CSL Behring).
The present trial involved a clinical model to test the hypothesis of
superiority, with the increase in clot firmness as the primary end point.
 METHOD(S): Forty cardiac surgery patients were randomly allocated to
receive a dose of 30 mg/kg FibCLOT or RiaSTAP after protamine
administration in the presence of microvascular bleeding and a FIBTEM
maximum clot firmness (MCF) <10 mm. Viscoelastic parameters were measured
before and after fibrinogen supplementation: FIBTEM MCF, EXTEM MCF, and
EXTEM clotting time (CT). RESULT(S): The mean increase in FIBTEM MCF
was 4 +/- 1.2 mm (mean and standard deviation) in the FibCLOT group and 4
+/- 1.6 mm in the RiaSTAP group (P = 1.000); the mean decrease in CT was
11. 2 +/- 12.2 (mean and standard deviation) seconds in the FibCLOT group
and 14. 8 +/- 13 seconds in the RiaSTAP group (P = .372). In both groups,
fibrinogen supplementation induced a significant (P = .001) increase in
the FIBTEM MCF and EXTEM CT. The proportions of patients who did not
experience an increase of 4 mm in the RiaSTAP group and the FibCLOT group
were not statistically significantly higher (35% vs 20%, respectively,
relative risk 2.15, 95% confidence interval 0.52-9.00, P = .288).
 CONCLUSION(S): In contrast to previous in vitro studies, we found
that the effect of FibCLOT on MCF and CT was not significantly greater
than that of RiaSTAP in cardiac surgery patients. Further studies in other
clinical settings are warranted. Copyright © 2024 International
Anesthesia Research Society.

<54>
Accession Number
645474793
Title
The Impact of the American Association of Thoracic Surgery on Clinical
Trial Development by Cardiothoracic Surgeons.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2024. Date of Publication: 07 Oct 2024.
Author
Narahari A.K.; Horgan T.M.; Chandrabhatla A.S.; Kareddy A.; Gikandi A.;
Zenati M.A.; Harpole D.; Jones D.; Yarboro L.T.; Burt B.; Krupnick A.S.;
Mehaffey J.H.
Institution
(Narahari, Horgan, Chandrabhatla, Kareddy, Yarboro) Division of
Cardiothoracic Surgery, Department of Surgery, University of Virginia
Health
(Gikandi) Harvard Medical School
(Zenati) Division of Cardiac Surgery, Brigham and Women's Hospital and
Harvard Medical School
(Harpole) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University School of Medicine
(Jones) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center
(Burt) Division of Thoracic Surgery, Department of Surgery, Baylor College
of Medicine
(Krupnick) Division of Thoracic Surgery, Department of Surgery, University
of Maryland School of Medicine
(Mehaffey) Division of Cardiac Surgery, Department of Cardiovascular and
Thoracic Surgery, West Virginia University School of Medicine
Abstract
OBJECTIVE: Clinical trials play a critical role in the rapidly evolving
field of cardiothoracic surgery and the American Association of Thoracic
Surgery (AATS) Clinical Trials Methods Course has provided a biannual
symposium led by preeminent surgeons with vast experience in planning,
conducting and analyzing surgical clinical trials. This study hypothesizes
that participation in the course is associated with future success in
clinical trial leadership. METHOD(S): A list of course attendees
(2014-2022) was queried in "ClinicalTrials.gov", a database of clinical
trials funded by the United States Health and Human Services and the
National Institutes of Health. The type of clinical trial and publications
from the trial were collected. Demographic information about the
participants were collected from faculty pages. RESULT(S): A total of
107 participants from various professional backgrounds attended the AATS
Clinical Trials course and led 91 clinical trials. The average time to
starting a clinical trial after attending the workshop was 3.04 years for
participants who had not already been involved with a trial. Of the 107
participants, 36 (36/107; 33.6%) were either the principal investigator or
a sub-investigator for 91 clinical trials. CONCLUSION(S): The AATS
Clinical Trials course provides participants the tools for successfully
leading surgical clinical trials. Although participation has been limited,
those who attend the course and lead a clinical trial do so within
approximately 3 years. The Clinical Trials course provides an excellent
return on investment and the AATS should continue sponsorship of this
program as it supports the develop of future leaders in cardiothoracic
surgery. Copyright © 2024. Published by Elsevier Inc.

<55>
Accession Number
362789110
Title
Comparison of 3 algorithms for basal insulin in transitioning from
intravenous to subcutaneous insulin in stable patients after
cardiothoracic surgery.
Source
Endocrine Practice. 17(5) (pp 753-758), 2011. Date of Publication: 01 Sep
2011.
Author
Dungan K.; Hall C.; Schuster D.; Osei K.
Institution
(Dungan, Hall, Schuster, Osei) Division of Endocrinology, Diabetes, and
Metabolism, Ohio State University, 491 McCampbell Hall, 1581 Dodd Dr,
Columbus, OH 43210, United States
Publisher
American Association of Clinical Endocrinologists
Abstract
Objective: To determine the effectiveness of an algorithm containing 1 of
3 initial subcutaneous doses of insulin detemir and flexible prandial and
supplemental insulin aspart in stable patients who have undergone cardiac
surgery and are being transitioned off intravenous insulin infusion.
 Method(s): Patients were extubated, were not taking vasopressors, and
were otherwise stable, requiring at least 1 unit per hour of intravenous
insulin at least 48 hours after surgery. Patients were randomly assigned
to once-daily insulin detemir at 50%, 65%, or 80% of intravenous basal
insulin requirements and received insulin aspart according to carbohydrate
intake. The dose of insulin detemir was adjusted daily over 72 hours.
 Result(s): Eighty-two patients were included. The percentages of
patients with an initial morning glucose concentration of 80 to 130 mg/dL
were 36%, 63%, and 56% of patients at the 50%, 65%, and 80% doses,
respectively (P = .12). However, the mean overall glucose value at 24 and
72 hours was similar between groups, and 86%, 93%, and 92% of patients in
each group, respectively, achieved a mean glucose concentration of 80 to
180 mg/dL at 72 hours (P = .60). Hypoglycemia (glucose <65 mg/dL) only
occurred in the 65% group (21%) and the 80% group (12%) over the first 72
hours (P = .02 in the 50% group compared with the 65% and 80% groups
combined) with 1 event of a glucose concentration less than 40 mg/dL in
the 80% group. There was no loss of glycemic control by the end of the
once-daily dosing interval. Conclusion(s): Glycemic targets can be
achieved without hypoglycemia by 72 hours in most patients who have
undergone cardiac surgery and require intravenous insulin with a regimen
consisting of an initial insulin detemir dose of 50% of basal intravenous
insulin requirements and prandial and supplemental insulin. Copyright
© 2011 AACE.

<56>
Accession Number
2034938357
Title
Colchicine for secondary prevention of ischaemic stroke and
atherosclerotic events: a meta-analysis of randomised trials.
Source
eClinicalMedicine. 76 (no pagination), 2024. Article Number: 102835. Date
of Publication: October 2024.
Author
Fiolet A.T.L.; Poorthuis M.H.F.; Opstal T.S.J.; Amarenco P.; Boczar K.E.;
Buysschaert I.; Budgeon C.; Chan N.C.; Cornel J.H.; Jolly S.S.; Layland
J.; Lemmens R.; Mewton N.; Nidorf S.M.; Pascual-Figal D.A.; Price C.; Shah
B.; Tardif J.-C.; Thompson P.L.; Tijssen J.G.P.; Tsivgoulis G.; Walsh C.;
Wang Y.; Weimar C.; Eikelboom J.W.; Mosterd A.; Kelly P.J.
Institution
(Fiolet) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Fiolet, Cornel, Mosterd) Dutch Network for Cardiovascular Research (WCN),
Utrecht, Netherlands
(Poorthuis) Department of Neurology, University Medical Center Utrecht,
Utrecht, Netherlands
(Opstal) Department of Cardiology, University Medical Center Amsterdam,
Amsterdam, Netherlands
(Amarenco) Department of Neurology, Bichat University Hospital, Paris,
France
(Amarenco) Population Health Research Institute, McMaster University,
Hamilton, ON, Canada
(Boczar) Department of Cardiology, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Buysschaert) Department of Cardiology, Sint-Jan Hospital, Brugge, Belgium
(Budgeon, Thompson) Cardiovascular Epidemiology Research Centre, School of
Population and Global Health, University of Western Australia, Perth,
Australia
(Chan) Department of Haematology and Thromboembolism, McMaster University,
Hamilton, ON, Canada
(Cornel) Department of Cardiology, Northwest Clinics, Alkmaar, Netherlands
(Cornel) Department of Cardiology, Radboud University Medical Centre,
Nijmegen, Netherlands
(Jolly, Eikelboom) Department of Medicine, McMaster University, Hamilton,
ON, Canada
(Layland) Cardiology, Department of Medicine, Peninsula Health, Peninsula
Clinical School, Central Clinical School, Monash University, VIC,
Australia
(Layland) Peninsula Clinical School, Central Clinical School, Monash
University, VIC, Australia
(Lemmens) Department of Neurology, University Hospitals Leuven, Leuven,
Belgium
(Lemmens) Department of Neurosciences, Experimental Neurology and Leuven
Research Institute for Neuroscience and Disease (LIND), KU Leuven -
University of Leuven, Leuven, Belgium
(Mewton) Department of Cardiology, Institut de Cardiologie des Hospices
Civils de Lyon, Lyon, France
(Nidorf, Thompson) Harry Perkins Institute of Medical Research, Perth,
Australia
(Pascual-Figal) Department of Cardiology, Hospital Virgen de la Arrixaca,
University of Murcia, Murcia, Spain
(Pascual-Figal) Centro Nacional de Investigaciones Cardiovasculares
(CNIC), Madrid, Spain
(Price) Stroke Research Group, Population Health Sciences Institute,
Newcastle University, Newcastle Upon Tyne, United Kingdom
(Shah) VA New York Harbor Healthcare System, New York, United States
(Shah) Leon H Charney Division of Cardiology, NYU Grossman School of
Medicine, New York, NY, United States
(Tardif) Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
(Thompson) Sir Charles Gairdner Hospital, Perth, Australia
(Thompson) Heart and Vascular Research Institute of Western Australia,
Australia
(Tijssen) Department of Cardiology, Amsterdam University Medical Centers,
Amsterdam, Netherlands
(Tsivgoulis) Second Department of Neurology, National & Kapodistrian
University of Athens, "Attikon" University Hospital, Athens, Greece
(Walsh) TCD Biostatistics Unit, Discipline of Public Health and Primary
Care, School of Medicine, Trinity College Dublin, Ireland
(Wang) Department of Neurology, Beijing Tiantan Hospital, Beijing, China
(Weimar) Institute for Medical Informatics, Biometry and Epidemiology,
University Hospital, University Duisburg-Essen, Germany
(Mosterd) Department of Cardiology, Meander Medical Centre, Amersfoort,
Netherlands
(Kelly) Mater Misericordiae University Hospital and School of Medicine,
University College Dublin, Ireland
(Kelly) Health Research Board Stroke Clinical Trials Network Dublin
Ireland, Ireland
Publisher
Elsevier Ltd
Abstract
Background: Guidelines recommend low-dose colchicine for secondary
prevention in cardiovascular disease, but uncertainty remains concerning
its efficacy for stroke, efficacy in key subgroups and about uncommon but
serious safety outcomes. Method(s): In this trial-level
meta-analysis, we searched bibliographic databases and trial registries
form inception to May 16, 2024. We included randomised trials of
colchicine for secondary prevention of ischaemic stroke and major adverse
cardiovascular events (MACE: ischaemic stroke, myocardial infarction,
coronary revascularisation, or cardiovascular death). Secondary outcomes
were serious safety outcomes and mortality. A fixed-effect
inverse-variance model was used to generate a pooled estimate of relative
risk (RR) with 95% confidence intervals (CI). This study is registered
with PROSPERO, CRD42024540320. Finding(s): Six trials involving
14,934 patients with prior stroke or coronary disease were included. In
all patients, colchicine compared with placebo or no colchicine reduced
the risk for ischaemic stroke by 27% (132 [1.8%] events versus 186 [2.5%]
events, RR 0.73 [95% CI 0.58-0.90]) and MACE by 27% (505 [6.8%] events
versus 693 [9.4%] events, with RR 0.73 [0.65-0.81]). Efficacy was
consistent in key subgroups (females versus males, age below versus above
70, with versus without diabetes, statin versus non-statin users).
Colchicine was not associated with an increase in serious safety outcomes:
hospitalisation for pneumonia (109 [1.5%] versus 106 [1.5%], RR 0.99
[0.76-1.30]), cancer (247 [3.5%] versus 255 [3.6%], RR 0.97 [0.82-1.15]),
and gastro-intestinal events (153 [2.1%] versus 135 [1.9%]), RR 1.15
[0.91-1.44]. There was no difference in all-cause death (201 [2.7%] versus
181 [2.4%], RR 1.09 [0.89-1.33]), cardiovascular death (70 [0.9%] versus
80 [1.1%], RR 0.89 [0.65-1.23]), or non-cardiovascular death (131 [1.8%]
versus 101 [1.4%], RR 1.26 [0.98-1.64]). Interpretation(s): In
patients with prior stroke or coronary disease, colchicine reduced
ischaemic stroke and MACE, with consistent treatment effect in key
subgroups, and did not increase serious safety events or death.
 Funding(s): There was no funding source for this study. Copyright
© 2024 The Authors

<57>
Accession Number
2034822365
Title
Components of the Atrial fibrillation Better Care pathway for holistic
care of patients with atrial fibrillation: a win ratio analysis from the
COOL-AF registry.
Source
Europace. 26(9) (no pagination), 2024. Article Number: euae237. Date of
Publication: 01 Sep 2024.
Author
Krittayaphong R.; Treewaree S.; Lip G.Y.H.
Institution
(Krittayaphong, Treewaree) Division of Cardiology, Department of Medicine,
Faculty of Medicine Siriraj Hospital, Mahidol University, 2, Wanglang Rd,
Bangkok 10700, Thailand
(Lip) Liverpool Centre for Cardiovascular Science, University of
Liverpool, Liverpool John Moores University, Liverpool Heart & Chest
Hospital, Liverpool, United Kingdom
(Lip) Danish Center for Health Services Research, Department of Clinical
Medicine, Aalborg University, Aalborg, Denmark
Publisher
Oxford University Press
Abstract
Aims Compliance with integrated care based on the Atrial fibrillation
Better Care (ABC) pathway has been associated with improved clinical
outcomes. The primary objective of this study was to compare clinical
outcomes of AF patients according to the compliant status of each
component of the ABC pathway in a hierarchical win ratio approach. Methods
and results We studied AF patients in the COOL-AF registry. Each patient
was followed every 6 months until 3 years. A win ratio analysis was
performed, as not all clinical outcomes are equivalent. The hierarchical
outcomes were (1) all-cause death, (2) intracranial haemorrhage (ICH), (3)
ischaemic stroke/systemic embolism, (4) non-ICH major bleedings, and (5)
acute myocardial infarction or heart failure. We also assessed win ratio
and win proportion variance over the follow-up time, and the variations
over time. A total of 3405 patients (mean age 67.8 +/- 11.3; 41.8% female)
were studied. Win ratio of ABC-compliant (all three components) vs.
ABC-not-compliant was 1.57 (1.35-1.83), P < 0.001. When adding time in
therapeutic range (TTR) data for compliant criteria for those who were on
warfarin, the win ratio increased to 2.28 (1.89-2.75), P < 0.001. The
A-compliant group (plus TTR data), B-compliant, and C-compliant had the
win ratio of 1.81 (1.51-2.12), 1.82 (1.53-2.16), and 1.39 (1.18-1.62), all
P < 0.001, compared to not compliant group. Conclusion
Management of AF patients according to each component of the ABC pathway
is associated with better clinical outcomes compared to those
non-compliant to ABC pathway. This finding underscores the importance of a
holistic management approach strategy for AF patients. Copyright
© The Author(s) 2024.

<58>
Accession Number
2031637517
Title
A multi-center, double-blind, placebo-controlled, randomized,
parallel-group, non-inferiority study to compare the efficacy of
goal-directed tranexamic acid administration based on viscoelastic test
versus preemptive tranexamic acid administration on postoperative bleeding
in cardiovascular surgery (GDT trial).
Source
Trials. 25(1) (no pagination), 2024. Article Number: 623. Date of
Publication: December 2024.
Author
Nam J.-S.; Oh C.-S.; Kim J.-Y.; Choi D.-K.; Oh A.R.; Park J.; Lee J.-H.;
Yun S.-C.; Kim K.W.; Jang M.U.; Kim T.-Y.; Choi I.-C.
Institution
(Nam, Kim, Choi, Choi) Department of Anesthesiology and Pain Medicine,
Asan Medical Center, University of Ulsan College of Medicine, Seoul, South
Korea
(Oh, Kim) Department of Anesthesiology, Konkuk University Medical Center,
Konkuk University School of Medicine, Seoul, and Institution for
Patient-Centered Goal-Directed Strategy, Chungju, South Korea
(Oh, Kim) Institution for Patient-Centered Goal-Directed Strategy, Konkuk
University, Chungju, South Korea
(Oh, Park, Lee) Department of Anesthesiology and Pain Medicine, Samsung
Medical Center, Sungkyunkwan University School of Medicine, Seoul, South
Korea
(Yun) Department of Biostatistics, Asan Medical Center, University of
Ulsan College of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Soonchunhyang
University Seoul Hospital, Seoul, South Korea
(Jang) Cheorwon Public Health Center, Cheorwon-Gun, Gangwon-Do, South
Korea
Publisher
BioMed Central Ltd
Abstract
Background: Tranexamic acid (TXA) effectively attenuates hyperfibrinolysis
and preemptive administration has been employed to reduce bleeding and
blood transfusions in various surgical settings. However, TXA
administration could be associated with adverse effects, such as seizures
and thromboembolic risks. While patients with fibrinolysis shutdown showed
greater thromboembolic complications and mortality, TXA administration may
aggravate the degree of shutdown in these patients. Selective TXA
administration based on the results of rotational thromboelastometry
(ROTEM) would be non-inferior to preemptive TXA administration in reducing
postoperative bleeding and beneficial in reducing its risks in patients
undergoing cardiovascular surgery. Method(s): This non-inferiority,
randomized, double-blind, placebo-controlled, multicenter trial will be
performed in 3 tertiary university hospitals from August 2023 to March
2025. Seven hundred sixty-four patients undergoing cardiovascular surgery
will be randomly allocated to get TXA as a preemptive (Group-P) or
goal-directed strategy (Group-GDT) in each institution (with a 1:1
allocation ratio). After anesthesia induction, TXA (10 mg/kg and 2
mg/kg/h) and a placebo are administered after anesthesia induction in
Group-P and Group-GDT, respectively. ROTEM tests are performed immediately
before weaning from CPB and at the considerable bleeding post-CPB period.
After getting the test results, a placebo is administered in Group-P
(regardless of the test results). In Group-GDT, placebo or TXA is
administered according to the results: placebo is administered if the
amplitude at 10 min (A10-EXTEM) is >= 40 mm and lysis within 60 min
(LI60-EXTEM) of EXTEM assay is >= 85%, or TXA (20 mg/kg) is administered
if A10-EXTEM is < 40 mm or LI60-EXTEM is < 85%. The primary outcome is
inter-group comparisons of postoperative bleeding (for 24 h). The
secondary measures include comparisons of perioperative blood transfusion,
coagulation profiles, reoperation, thromboembolic complications, seizures,
in-hospital mortality, fibrinolysis phenotypes, and hospital costs.
 Discussion(s): The absence of inter-group differences in
postoperative bleeding would support the selective strategy's
non-inferiority in reducing postoperative bleeding in these patients. The
possible reduction in thromboembolic risks, seizures, and fibrinolysis
shutdown in Group-GDT would support its superiority in reducing
TXA-induced adverse events and the cost of their management. Trial
registration: This trial was registered at ClinicalTrials.gov with the
registration number NCT05806346 on March 28, 2023. Trial status:
recruiting. Issue date: 2023 March 28 (by Tae-Yop Kim, MD, PhD). The trial
was registered in the clinical registration on March 28, 2023
(ClinicalTrials.gov, NCT05806346) and revised to the latest version of its
protocol (version no. 8, August 26, 2024) approved by the institutional
review boards (IRBs) of all 3 university hospitals (Konkuk University
Medical Center, 2023-07-005-001, Asan Medical Center, 2023-0248, and
Samsung Medical Center, SMC 2023-06-048-002). Its recruitment was started
on August 1, 2023, and will be completed on December 31, 2024. Protocol
amendment number: 08 (protocol version 08, August 26, 2024). Revision
chronology: 2023 March 28:Original. 2023 April 10:Amendment No 01. The
primary reason for the amendment is the modification of Arms (adding one
arm for sub-group analyses) and Interventions, Outcome Measures, Study
Design, Study Description, Study Status, Eligibility, and Study
Identification. 2023 May 03:Amendment No 02. The primary reason for the
amendment is to modify the Outcome Measures and update the study status.
2023 July 06:Amendment No 03. The primary reason for amendment is to
update the chronological study status. 2023 July 07:Amendment No 04. The
primary reason for the amendment is the modification of study information
(the treatment category was changed to diagnostic, and Phase 4 was changed
to not applicable) and a chronological update on the study status. 2023
September 12:Amendment No 06. The primary reason for the amendment is a
chronological update in the study status and the inclusion of additional
information regarding contacts/locations and oversight. 2023 December
29:Amendment No 07. The primary reason for the amendment is to modify the
outcome measures (including detailed information on outcome measures,
addition of extra secondary measures, and chronological updates in study
status). 2024 August 26:Amendment No 08. The primary reason for the
amendment is to add detailed descriptions regarding data handling and the
names and roles of the participating institutions and to update the
chronological process of the trial. Copyright © The Author(s)
2024.

<59>
Accession Number
2031637516
Title
Trial Of Pathogen-reduced Cryoprecipitate vs. Cryoprecipitated AHF to
Lower Operative Transfusions (TOP-CLOT): study protocol for a single
center, prospective, cluster randomized trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 625. Date of
Publication: December 2024.
Author
Cushing M.M.; Cohen T.; Fitzgerald M.M.; Rand S.; Sinfort A.; Chen D.;
Keltner N.; Ong S.; Parra P.; Benabdessadek D.; Jimenez A.; Haas T.; Lau
C.; Girardi N.I.; DeSimone R.A.
Institution
(Cushing, Cohen, Rand, Sinfort, Jimenez, DeSimone) Department of
Pathology, Weill Cornell Medicine, 1300 York Avenue, New York, NY, United
States
(Fitzgerald, Girardi) Department of Anesthesiology, Weill Cornell
Medicine, 1300 York Avenue, New York, NY, United States
(Chen, Ong, Parra, Benabdessadek) Transfusion Medicine Department,
NewYork-Presbyterian Hospital/Weill Cornell Medicine Center, New York, NY,
United States
(Keltner) Cerus Corporation, 1220 Concord Ave Suite 600, Concord, CA,
United States
(Haas) Department of Anesthesiology, University of Florida School of
Medicine, 1600 SW Archer Rd, Gainesville, FL, United States
(Lau) Department of Cardiothoracic Surgery, Weill Cornell Medicine, 1300
York Avenue, New York, NY, United States
Publisher
BioMed Central Ltd
Abstract
Background: Intraoperative hemorrhage in cardiac surgery increases risk of
morbidity and mortality. Low pre-operative and perioperative levels of
fibrinogen, a key clotting factor, are associated with severity of
hemorrhage and increased transfusion of blood components. The ability to
supplement fibrinogen during hemorrhagic resuscitation is delayed 45-60
min because cryoprecipitated antihemophilic factor (cryo AHF) is stored
frozen, due to a short post-thaw shelf life. Pathogen Reduced
Cryoprecipitated Fibrinogen Complex (INTERCEPT Fibrinogen Complex, IFC)
can be kept thawed, at room temperature, for up to 5 days, making it
possible to be immediately available for hemorrhaging patients. This trial
will investigate if earlier correction of acquired hypofibrinogenemia with
IFC in hemorrhaging cardiac surgery patients reduces the total number of
perioperatively transfused allogeneic blood products (red blood cells,
plasma, and platelets) as compared to cryo AHF. Method(s): This is a
single center, prospective, cluster randomized trial with an adaptive
design. Acquired hypofibrinogenemia will be assessed by rotational
thromboelastometry (ROTEM) and the threshold for cryo AHF/IFC transfusion
defined as FIBTEM A10 <= 10 mm in bleeding patients. IFC/cryo AHF will be
randomized by 1-month blocks. Cardiac surgery patients will be enrolled in
the study if they have an eligible procedure and at least one dose of a
cryo AHF/IFC product (approximately 2 g fibrinogen) is transfused. Data
from the electronic health record, including the blood bank and lab
information systems, will be prospectively collected from the health
system's data warehouse. Discussion(s): This trial aims to provide
evidence of the clinical efficacy of utilizing readily available thawed
IFC during acute bleeding in the cardiac surgery setting compared to
traditional cryo AHF. Trial registration: ClinicalTrials.gov NCT05711524.
Feb 3, 2023. Copyright © The Author(s) 2024.

<60>
Accession Number
2031631645
Title
The association between introduction of the micro-axial flow pump Impella
in hospitals and in-hospital mortality in patients treated with
extracorporeal membrane oxygenation: interrupted time-series analyses.
Source
Annals of Intensive Care. 14(1) (no pagination), 2024. Article Number:
151. Date of Publication: December 2024.
Author
Nakata J.; Ohbe H.; Takiguchi T.; Nishimoto Y.; Nakajima M.; Sasabuchi Y.;
Isogai T.; Matsui H.; Yamamoto T.; Yokobori S.; Asai K.; Yasunaga H.
Institution
(Nakata, Yamamoto, Asai) Division of Cardiovascular Intensive Care, Nippon
Medical School, Tokyo, Japan
(Ohbe, Nakajima, Isogai, Matsui, Yasunaga) Department of Clinical
Epidemiology and Health Economics, School of Public Health, The University
of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 1130033, Japan
(Takiguchi, Yokobori) Department of Emergency and Critical Care Medicine,
Nippon Medical School, Tokyo, Japan
(Nishimoto) Division of Cardiology, Osaka General Medical Center, Osaka,
Japan
(Nakajima) Emergency and Critical Care Center, Tokyo Metropolitan Hiroo
Hospital, Tokyo, Japan
(Sasabuchi) Department of Real-World Evidence, Graduate School of
Medicine, The University of Tokyo, Tokyo, Japan
(Isogai) Department of Cardiology, Tokyo Metropolitan Tama Medical Center,
Tokyo, Japan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The micro-axial flow pump Impella, a new mechanical
circulatory device for cardiogenic shock, is still only available in a
limited number of hospitals, due to the facility certification
requirements and insufficient evidence of the benefit of introducing
Impella in hospitals. This study aimed to evaluate the impact of
introducing Impella in hospitals on in-hospital mortality of patients
treated with extracorporeal membrane oxygenation (ECMO). Method(s):
Using a nationwide Japanese inpatient database, we identified patients who
received ECMO during hospitalization between 1 April 2014 and 31 March
2021. A hospital-level propensity score-matched cohort was created
matching hospitals that introduced Impella (exposure group) to those that
did not introduce Impella (control group). The inclusion period in each
hospital was divided into two time periods according to the time of
Impella introduction in the exposure group and the corresponding hospital
in the control group (before and after exposure). The primary outcome was
in-hospital mortality. Uncontrolled and controlled interrupted time-series
analyses involved before-after exposure comparison and exposure-control
comparison. Result(s): Out of 34,379 eligible patients, we created a
matched cohort of 8351 patients from 86 hospitals with Impella
introduction (exposure group) and 7230 patients from 86 hospitals without
Impella introduction (control group). In-hospital mortality before and
after exposure was 62.5% and 59.3, respectively, in the exposure group;
and 66.8% and 63.7%, respectively, in the control group. Uncontrolled
interrupted time-series analysis showed no significant level change or
trend change in the before-after exposure comparison in both the exposure
and the control groups. Controlled interrupted time-series analysis also
showed no significant level change (-0.01%; 95% confidence intervals
-5.36% to + 5.33%) or trend change (+ 0.10%, -0.30% to + 0.40%) after
exposure in the exposure-control comparison. Conclusion(s): This
nationwide inpatient database study showed no association between Impella
introduction in hospitals and in-hospital mortality of patients who
underwent ECMO. Because this study confined itself to analze of the impact
of the introduction of Impella solely at the hospital level, further
detailed studies are warranted to assess its efficacy at the patient
level. Copyright © The Author(s) 2024.

<61>
Accession Number
644752957
Title
Home-based transitional cardiac telerehabilitation in older adults post
coronary artery bypass grafting: A randomized controlled trial.
Source
Geriatric nursing (New York, N.Y.). 59 (pp 139-149), 2024. Date of
Publication: 01 Sep 2024.
Author
Mahfouz Khalil M.I.; El-Monshed A.H.; Shaala R.S.; El-Sherif S.M.; Mousa
E.F.S.
Institution
(Mahfouz Khalil) Department of Gerontological Nursing, Faculty of Nursing,
Alexandria University, Egypt
(El-Monshed) Department of Nursing, College of Health and Sport Sciences,
University of Bahrain, Manama, Bahrain; Department of Psychiatric and
Mental Health Nursing, Faculty of Nursing-Mansoura University, Egypt.
Electronic address: ahmed_elmonshed@mans.edu.eg
(Shaala) Department of Internal Medicine, Geriatric Unit, Faculty of
Medicine, Alexandria University, Egypt
(El-Sherif) Department of Physical Medicine, Rheumatology and
Rehabilitation, Faculty of Medicine, Alexandria University, Egypt
(Mousa) Department of Geriatric Medicine and Gerontology, Faculty of
Medicine, Helwan University, Egypt
Abstract
This randomized controlled trial evaluated the effectiveness of a 12-week
home-based transitional cardiac telerehabilitation (Hb-T-CTR) program on
health-related quality-of-life and therapeutic self-care in older adults'
post-Coronary Artery Bypass Grafting (CABG). The intervention group (n =
57) underwent Hb-T-CTR, incorporating preoperative counseling,
postoperative education, a culturally adapted video, home visits, and
telephone counseling, while the control group (n = 61) received standard
care. Using the Coronary Revascularization Outcome Questionnaire and the
Sidani Doran Therapeutic Self-Care Measure, data were collected at three
time points. Results showed significant improvements in overall scores for
both health-related quality of life (t1=3.386, P = 0.001; t2=4.224, P <
0.001) and therapeutic self-care (t1=7.104, P < 0.001; t2=4.242, P <
0.001) in the intervention group compared to controls. This telehealth
approach provides convenient and accessible rehabilitation services for
older adults' post-CABG and highlights the importance of integrating
Hb-T-CTR into routine care for personalized rehabilitation. This study
underscores the potential of telehealth tools in overcoming barriers and
enhancing patient-centered interventions. Copyright © 2024
Elsevier Inc. All rights reserved.

<62>
Accession Number
2031764556
Title
Cerebral Embolic Protection: Is There a Benefit for Left Atrial and Mitral
Valve Procedures?.
Source
Current Cardiology Reports. (no pagination), 2024. Date of Publication:
2024.
Author
Besir B.; Kapadia S.R.
Institution
(Besir, Kapadia) Department of Cardiovascular Medicine, Heart, Vascular
and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-3,
Cleveland, OH 44195, United States
Publisher
Springer
Abstract
Purpose of Review: This review aims to highlight the current evidence on
the use of cerebral embolic protection devices (CEPD) in left atrial and
transcatheter mitral valve procedures. It also aims to summarize the
antithrombotic management of patients undergoing such procedures. Recent
Findings: Ischemic stroke is one of the most devastating complications of
structural heart procedures. The manifestation of periprocedural stroke
can range from asymptomatic and detectable only through brain imaging to
major stroke with neurological deficits. CEP devices were initially
developed to mitigate the risk of stroke associated with transcatheter
aortic valve replacement (TAVR). However, the efficacy of such devices
during different cardiac interventions is yet to be fully demonstrated,
especially in left atrial appendage closure (LAAO), and mitral valve
interventions. Few studies demonstrated that the risk of periprocedural
strokes after LAAO and mitral valve interventions is not negligible and is
highest during the periprocedural period and then falls. The majority of
patients undergoing those procedures have cerebral ischemic injuries
detected on diffusion-weighted magnetic resonance imaging (DW-MRI).
Moreover, a reasonable number of those patients had debris embolization on
the filters of the CEPD. Pharmacological therapy with antithrombotic
agents before, during, or after structural heart interventions is crucial
and should be tailored to each patient's risk of bleeding and ischemia.
Close monitoring that includes a full neurological assessment and frequent
follow-up visits with cardiac echocardiography are important.
 Summary: The risk of periprocedural stroke in left atrial and
transcatheter mitral valve procedures is not negligible. Pharmacological
therapy with antithrombotic agents before, during, or after structural
heart interventions is important to mitigate the risk of stroke,
especially the long-term risk. More prospective studies are needed to
assess the efficacy of CEPD in such procedures. Copyright © The
Author(s) 2024.

<63>
Accession Number
2018431506
Title
Prognostic value of cardiac magnetic resonance derived global longitudinal
strain analysis in patients with ischaemic and non-ischaemic dilated
cardiomyopathy: a systematic review and meta-analysis.
Source
International Journal of Cardiovascular Imaging. 38(12) (pp 2707-2721),
2022. Date of Publication: December 2022.
Author
Fong L.C.W.; Lee N.H.C.; Poon J.W.L.; Chin C.W.L.; He B.; Luo L.; Chen C.;
Wan E.Y.F.; Pennell D.J.; Mohiaddin R.; Ng M.-Y.
Institution
(Fong, Lee, Ng) Department of Diagnostic Radiology, School of Clinical
Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong,
Queen Mary Hospital Hong Kong, Hong Kong
(Poon) Department of Medicine, Ruttonjee and Tang Shiu Kin Hospitals, Hong
Kong
(Chin) Department of Cardiology, National Heart Centre Singapore,
Singapore, Singapore
(He, Luo, Chen, Ng) Department of Medical Imaging, The University of Hong
Kong-Shenzhen Hospital, Shenzhen, China
(Wan) Department of Family Medicine and Primary Care, Li Ka Shing Faculty
of Medicine, The University of Hong Kong, Hong Kong
(Pennell, Mohiaddin) Royal Brompton Hospital, Guy's and St Thomas' NHS
Foundation Trust, London, United Kingdom
(Pennell, Mohiaddin) Imperial College, London, United Kingdom
(Wan) Centre for Safe Medication Practice and Research, Department of
Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University
of Hong Kong, Hong Kong
(Wan) Laboratory of Data Discovery for Health (D24H), Hong Kong
(Chin) Cardiovascular ACP, Duke-NUS Medical School, Singapore, Singapore
Publisher
Springer Science and Business Media B.V.
Abstract
Cardiac magnetic resonance (CMR) derived left ventricular global
longitudinal strain (LV-GLS) for evaluating dilated cardiomyopathy
patients has been addressed in studies with contradictory results. We
therefore performed the first systematic review evaluating evidence on the
prognostic value of CMR derived LV-GLS for ischaemic (IDCM) and
non-ischaemic dilated cardiomyopathy (NDCM) patients. Systematic review
(PROSPERO CRD42020171582) identified studies up to January 2021 that
measured LV-GLS for predicting major adverse cardiac events among dilated
cardiomyopathy patients. Studies were identified from MEDLINE, Embase and
PubMed by two independent reviewers. 2099 studies were screened. Three
prospective and three retrospective observational studies comprising of
1758 patients (29% IDCM patients; 71% NDCM patients) with a weighted mean
follow up of 3 years (SD = 1 year) were identified. All six studies
included mortality in the primary composite outcome. LV-GLS was associated
with increase primary composite outcome among mild to moderately impaired
left ventricular ejection fraction (LVEF) IDCM and NDCM patients (> 30%)
in univariable and multivariable analysis. Association was lost among
severely impaired LVEF patients (< 30%). From sensitivity analysis, LV-GLS
showed significant association with death among NDCM patients (HR 1.27;
95% CI 1.10-1.46; p = 0.001; I2 = 59%) but insignificant for
heart transplant outcome (HR 1.23; 95% CI 0.46-3.33; p = 0.68,
I2 = 44%). LV-GLS threshold for effectively stratifying
patients is - 12.5% to - 13.5%. LVEF in IDCM and NDCM became an
insignificant prognostic marker in multivariable analysis. CMR LV-GLS
shows promise as an independent predictor of mortality in IDCM and NDCM
patients. However, in patients with LVEF < 30% LV-GLS may have less
prognostic value. Prospero Registration: CRD42020171582. Copyright
© The Author(s), under exclusive licence to Springer Nature B.V.
2022.

<64>
Accession Number
2018020858
Title
Fractal dimension of the aortic annulus: a novel predictor of paravalvular
leak after transcatheter aortic valve implantation.
Source
International Journal of Cardiovascular Imaging. 38(11) (pp 2469-2478),
2022. Date of Publication: November 2022.
Author
Stachel G.; Abdel-Wahab M.; de Waha-Thiele S.; Desch S.; Feistritzer
H.-J.; Kitamura M.; Farhan S.; Eitel I.; Kurz T.; Thiele H.
Institution
(Stachel, Abdel-Wahab, Desch, Feistritzer, Kitamura, Thiele) Department of
Internal Medicine/Cardiology and Leipzig Heart Institute, Heart Center
Leipzig at University of Leipzig, Leipzig, Germany
(de Waha-Thiele) Department of Cardiac Surgery, Heart Center Leipzig at
University of Leipzig, Strumpellstr. 39, Leipzig 04289, Germany
(Desch, Eitel, Kurz) University Clinic Schleswig-Holstein, University
Heart Center Luebeck, Lubeck, Germany
(Farhan) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Eitel) DZHK (German Centre for Cardiovascular Research), Partner Site
Hamburg/Luebeck/Kiel, Lubeck, Germany
Publisher
Springer Science and Business Media B.V.
Abstract
To evaluate the prognostic relevance of aortic annulus (AA) and left
ventricular outflow tract (LVOT) Fractal dimension (FD). FD is a
mathematical concept that describes geometric complexity of a structure
and has been shown to predict adverse outcomes in several contexts.
Computed tomography (CT) scans from the SOLVE-TAVI trial, which, in a 2 x
2 factorial design, randomized 447 patients to TAVI with the
balloon-expandable Edwards Sapien 3 or the self-expanding Medtronic Evolut
R, and conscious sedation or general anesthesia, were analyzed
semi-automatically with a custom-built software to determine border of AA
and LVOT. FD was measured by box counting using grid calibers between 0.8
and 6.75 mm and was compared between patients with none/trivial and
mild/moderate paravalvular regurgitation (PVR). Overall, 122 patients had
CT scans sufficient for semi-automatic PVR in 30-day echocardiography. PVR
was none in 65(53.3%) patients, trace in 9(7.4%), mild in 46(37.7%),
moderate in 2(1.6%) and severe in 0 patients. FD determined in diastolic
images was significantly higher in patients with mild/moderate PVR (1.0558
+/- 0.0289 vs. 1.0401 +/- 0.0284, p = 0.017). Annulus eccentricity was the
only conventional measure of AA and LVOT geometry significantly correlated
to FD (R = 0.337, p < 0.01). Area under the curve (AUC) of diastolic
annular FD for prediction of mild/moderate PVR in ROC analysis was 0.661
(0.542-0.779, p = 0.014). FD shows promise in prediction of PVR after
TAVI. Further evaluation using larger patient numbers and refined
algorithms to better understand its predictive performance is warranted.
Trial Registration:www.clinicaltrials.gov, identifier: NCT02737150, date
of registration: 13.04.2016. Copyright © The Author(s) 2022.

<65>
Accession Number
2034939302
Title
COST-EFFECTIVENESS OF AN INTRAOPERATIVE ANTIBACTERIAL ENVELOPE IN
PREVENTING CARDIAC IMPLANTABLE ELECTRONIC DEVICE ASSOCIATED INFECTIONS: A
SYSTEMATIC REVIEW.
Source
Canadian Journal of Cardiology. Conference: Canadian Cardiovascular
Congress 2024 Meeting. Vancouver Convention Centre, Vancouver Canada.
40(10 Supplement) (pp S67-S68), 2024. Date of Publication: October 2024.
Author
Mudigonda S.; Hagarty E.; Lei L.; Rennert-May E.; Raj S.
Institution
(Mudigonda, Hagarty, Lei, Rennert-May, Raj) CalgaryABCanada
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Infection is a major complication following surgery for
cardiac implantable electronic devices (CIEDs) and associated with
significant patient morbidity and mortality. A large randomized control
trial demonstrated that an intraoperative antibacterial envelope used at
time of implantation significantly reduces the risk of CIED infection.
Given the high costs associated the use of the antimicrobial envelope, the
objective of this systematic review was to synthesize the published
economic literature on the cost-effectiveness of the antibacterial
envelope compared to usual care. METHODS AND RESULTS: We conducted a
systematic electronic search of available economic evaluations from
inception to June 2023 using the following databases: MEDLINE (1946-),
EMBASE (Excerpta Medica Database 1974-), the Cochrane Library, and the UK
National Health Services Economic Evaluation Database. We included
economic evaluations (i.e. cost-utility, cost-effectiveness, cost-benefit
studies) comparing the antibacterial envelope compared with standard of
care in preventing CIED infection. Reviewers screened articles and
abstracted data independently and in duplicate. We assessed study quality
by appraising methodology using Consensus of Health Economic Criteria. Of
104 unique citations, 6 studies met the inclusion criteria for qualitative
synthesis. All cost-effectiveness studies were conducted from the health
care payer perspective in US, Canada, and Western Europe. The estimated
value proposition of the antimicrobial envelope compared to standard of
care was variable. Half of the included economic studies (N=3) reported
additional health benefits (reduced infection and increased
quality-adjusted life expectancy) for increased costs at accepted societal
thresholds for good value in health care (Table). Cost effectiveness of
the antimicrobial envelope was highly dependent on the base infection risk
and assumptions regarding the effect on mortality. That is, the value
proposition of the antibacterial envelope improved as base infection rates
increased. At base infection rates exceeding 6%, the envelope was
associated with a cost savings. CONCLUSION(S): There is limited
economic literature on the cost-effectiveness of intraoperative
antibacterial envelope in preventing CIED infections. Despite substantial
variability in the economic modelling and results of included studies, the
weight of the evidence suggests that intraoperative use of an
antimicrobial envelope may potentially be economically attractive compared
to usual care at current device pricing, particularly when the base
infection risk is high. [Formula presented] Copyright © 2024

<66>
Accession Number
2034939295
Title
PERCUTANEOUS CORONARY INTERVENTION VERSUS CORONARY ARTERY BYPASS GRAFTING
FOR LEFT MAIN CORONARY ARTERY REVASCULARIZATION IN PATIENTS WITH CHRONIC
KIDNEY DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Canadian Journal of Cardiology. Conference: Canadian Cardiovascular
Congress 2024 Meeting. Vancouver Convention Centre, Vancouver Canada.
40(10 Supplement) (pp S19), 2024. Date of Publication: October 2024.
Author
Yousaf H.; Sharma A.; Islam S.; Katib H.; Ali Khan A.; Shahid R.; Malik
J.; Singh S.; Hanif M.; Hasnain H.
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Left main coronary artery (LMCA) revascularization in patients
with chronic kidney disease (CKD) with either percutaneous coronary
intervention (PCI) or coronary artery bypass grafting (CABG) is still
unclear. We conducted a systematic review and meta-analysis to evaluate
optimal revascularization therapy for left main coronary artery disease
(LMCAD) in the CKD population. METHODS AND RESULTS: Methods We
electronically searched studies focusing on the revascularization of LMCA
by PCI or CABG in patients with CKD using PubMed and Embase databases. All
studies comparing therapeutic effects and clinical adverse events of PCI
versus CABG for revascularization of LMCA in patients with CKD published
in the last 10 years were screened. Primary outcomes included major
adverse cardiac and cerebrovascular events (MACCE). Secondary outcomes
were all-cause mortality, cardiac mortality, cerebrovascular event (CVA),
myocardial infarction (MI), repeat revascularization, and bleeding. A
total of 9 studies (6 retrospective, 2 randomized controlled trials
(RCTs), and 1 prospective) with a total of 10,635 patients were screened
and analyzed. Primary Outcome: Our study did not show any significant
difference in MACCE for patients treated with PCI as compared to the CABG
group [odds ratio (OR) 1.05, confidence interval (CI) 0.68-1.61, p-value
(P) 0.81]. Secondary Outcomes: Patients undergoing PCI were found to
have lower CVAs as compared to the CABG group [OR 0.49, CI 0.33-0.74, P <
0.01]. However, repeat revascularizations were lower in the CABG group as
compared to PCI [OR 3.15, CI 1.03-9.69, P 0.05]. No significant difference
was noted in all-cause mortality [OR 0.84, CI 0.48-1.46, P 0.48], MI [OR
1.47, CI 0.50-4.31, P 0.41], bleeding [OR 0.27, CI 0.05-1.35, P 0.07],
cardiac mortality [OR 0.78, CI 0.22-2.80, P 0.59] between two groups.
 CONCLUSION(S): PCI is comparable with CABG for revascularization of
LMCA in patients with CKD. However, PCI was associated with a lower risk
of CVA, and a higher risk of repeat revascularization as compared to the
CABG group. Our findings further need to be validated by more prospective
RCTs to identify optimal Revascularization strategy for LMCAD in the CKD
population. [Formula presented] Copyright © 2024

<67>
Accession Number
2034939274
Title
THE RELATIONSHIP BETWEEN FRAILTY AND POSTOPERATIVE ATRIAL FIBRILLATION IN
PATIENTS UNDERGOING CARDIAC SURGERY: A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Canadian Journal of Cardiology. Conference: Canadian Cardiovascular
Congress 2024 Meeting. Vancouver Convention Centre, Vancouver Canada.
40(10 Supplement) (pp S150-S151), 2024. Date of Publication: October 2024.
Author
Bohne L.; Dorey T.; Duttchen K.; Wilton S.; Chun R.
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) occurs in roughly one
third of patients who have undergone cardiac surgery, resulting in
increased mortality, morbidity, and costs to the healthcare system.
Frailty, a clinical syndrome of physiological decline, is highly
associated with increased risk of poor outcomes after cardiac surgery.
Whether frailty is associated with POAF rates has not been established.
METHODS AND RESULTS: We systematically searched MEDLINE and Embase from
inception to January 2024 for studies reporting preoperative frailty
scores and rates of POAF following cardiac surgery. Studies reporting
frailty in patients undergoing transcatheter aortic valve replacement were
assessed for POAF rates separately. Pooled risk ratios (RR) and 95%
confidence intervals (CI) were estimated for frail vs. non-frail patients
using a random-effect model. Sixteen studies involving 6,662 patients who
underwent coronary artery bypass, surgical valve replacement, or a
combination were identified. These studies used a variety of frailty
assessments with the prevalence of frailty ranging from 7.7% to 76.7%.
Meta-analysis indicated that frailty was associated with higher risk of
POAF following cardiac surgery (RR 1.23; 95% CI 1.11-1.36, P=0.0001).
Subgroup analysis assessing patient age, study design, surgery type, and
sample size, showed consistent effects of frailty on POAF. Interestingly,
subgroup analysis found that risk of POAF was higher in studies that
assessed frailty by clinical scales (RR 1.30; 95% CI 1.14-1.48, P< 0.0001)
compared to those that assessed frailty by surrogate imaging/lab-based
modalities (RR 1.10; 95% CI 0.94-1.30, P=0.24). In contrast to cardiac
surgery, meta-analysis of 3 studies on patients (n=1,279) who underwent
TAVR showed no association between frailty and POAF (RR 1.24; 95% CI
0.81-1.88, P=0.32). CONCLUSION(S): Overall, this meta-analysis
highlights the strong link between frailty and increased POAF risk in
patients undergoing cardiac surgery. Despite the limitations associated
with varied frailty assessment methods among studies, clinically evaluated
frailty showed a stronger association with POAF compared to surrogate
markers. This underscores the importance of comprehensive clinical frailty
assessments in preoperative evaluations to identify high-risk patients and
tailor perioperative management strategies accordingly. Copyright
© 2024

<68>
Accession Number
2034939129
Title
PATIENT-REPORTED OUTCOMES ARE UNDERUTILIZED IN VALVULAR CARDIAC SURGERY
RANDOMIZED CLINICAL TRIALS: A SCOPING REVIEW.
Source
Canadian Journal of Cardiology. Conference: Canadian Cardiovascular
Congress 2024 Meeting. Vancouver Convention Centre, Vancouver Canada.
40(10 Supplement) (pp S146-S147), 2024. Date of Publication: October 2024.
Author
Rahmouni El Idrissi K.; Hryciw N.; Abdul S.; Szabo N.; Voisine P.
Publisher
Elsevier Inc.
Abstract
BACKGROUND: The importance of using patient-reported outcome (PRO)
measures in clinical trials is being increasingly recognized. However,
there is a paucity of knowledge on the extent to which PROs are
incorporated and adequately reported in the cardiac surgery literature.
This study aims to establish the proportion of recent randomized
controlled trials (RCTs) in adult valvular cardiac surgery RCTs that
include PRO measures in their trial endpoints and to evaluate the
completeness of PRO reporting in this setting. METHODS AND RESULTS: A
scoping review was conducted searching MEDLINE, EMBASE and Cochrane
Central Register of Controlled Trials (CENTRAL). Studies were eligible for
inclusion if they were RCTs in cardiac surgery comparing intraoperative
valvular interventions in adult patients (>= 18 years old), published
between January 2014 and February 2024. Non-English studies and studies
comparing valve surgeries to interventional cardiology procedures were
excluded. Screening, full-text review and data extraction was carried out
in duplicate. Studies including PROs as primary or secondary outcomes were
evaluated for completeness of reporting as per the recommendations of the
CONSORT-PRO extension guideline. Data was synthesized descriptively and
summarized in tables and figures. Of the 51 studies included, one-third of
trials (31.4%) incorporated PROs (Figure 1). The most commonly reported
PRO measure was the EuroQoL 5 dimensions (EQ-5D) (36.7%). Most PRO
measures (73.3%) used were generic rather than disease-specific, and the
majority were secondary endpoints (80.0%). Completeness of reporting in
reference to the CONSORT-PRO was limited (Table 1). Overall, only 7 of 14
trials reported 50% or more of the relevant CONSORT-PRO specific items. No
studies met all reporting criteria. The domain of PROs most frequently
evaluated was quality of life, representing 76.7% of all PRO measures
used. CONCLUSION(S): In this scoping review, the use of PROs in
valvular cardiac surgery RCTs was low and reporting on PROs is incomplete
in reference to the CONSORT-PRO extension. Reported PROs primarily focus
on quality-of-life measures, potentially missing other important domains
relevant to the design of a patient-centered trial. The results of this
study highlight the need for improvement in PRO incorporation and
reporting in valvular cardiac surgery trials. Further review of PRO
inclusion in other cardiac surgery subspecialties is required. [Formula
presented] [Formula presented] Copyright © 2024

<69>
Accession Number
2034939092
Title
DANGER SHOCK IN CONTEXT: AN UPDATED META-ANALYSIS OF IMPELLA PERCUTANEOUS
MECHANICAL CIRCULATORY SUPPORT IN ACUTE MYOCARDIAL INFARCTION ASSOCIATED
CARDIOGENIC SHOCK.
Source
Canadian Journal of Cardiology. Conference: Canadian Cardiovascular
Congress 2024 Meeting. Vancouver Convention Centre, Vancouver Canada.
40(10 Supplement) (pp S12-S13), 2024. Date of Publication: October 2024.
Author
Ouazani Chahdi H.; Boivin-Proulx L.; Noiseux N.; Matteau A.; Mansour S.;
Gobeil F.; Jolicoeur E.; Drullinsky D.; Potter B.
Institution
(Ouazani Chahdi, Boivin-Proulx, Noiseux, Matteau, Mansour, Gobeil,
Jolicoeur, Drullinsky, Potter) Saint-HubertQCCanada
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Cardiogenic shock (CS) continues to be a significant cause of
morbidity and mortality among patients experiencing acute myocardial
infarction (AMI) despite prompt coronary revascularization, with mortality
rates for individuals with AMI-CS ranging 30-50%. The recently published
DanGer Shock Trial has, for the first time, shown a mortality advantage of
early Impella percutaneous mechanical circulatory support (pMCS) in
AMI-CS, albeit with a limited sample size. The results of DanGer must
therefore be interpreted in the context of other existing evidence.
METHODS AND RESULTS: We updated our previous meta-analysis, originally
published in 2022, comparing pMCS to standard medical care in cases of
AMI-CS. Apart from the DanGer Shock trial, no other original studies
assessing pMCS in the context of AMI-CS meeting our selection criteria has
been published since. We performed a random-effects pooled analysis
examining both in-hospital and 30-day mortality rates, as well as major
bleeding events (defined as BARC>=3). Including the DanGer Shock trial,
five references meeting our selection critera have compared the effect of
Impella support to conventional therapy alone in the management of
patients suffering from AMI-CS. Among these, three studies demonstrated a
significant improvement in mortality with the Impella device, with DanGer
Shock being the largest among them, while the other two much larger
studies did not show an improvement. Meta-analysis of the included studies
did not reveal a significant mortality benefit with Impella use (pooled
odds ratio [OR] 0.64; 95% CI 0.34-1.22). Notably, there was a high degree
of heterogeneity (I2 = 0.81), suggesting potential variations in patient
populations and/or methodological differences between studies. It must be
noted that DanGer Shock was the only prospective randomized trial among
the references and showed a mortality benefit at 6 months follow-up, but
not at 30 dasy. Most other references only reported mortality up to
hospital discharge or 30 days. Of the 5 references, three reported on
bleeding complications and consistently showed an increase in BARC>=3
bleeding (pooled OR of 3.28; 95% CI 1.8-5.98). CONCLUSION(S): While
the DanGer Shock trial showed a mortality benefit of early implementation
of Impella support in AMI-CS, the efficacy of pMCS in AMI-CS necessitates
further validation when considering other existing evidence, particularly
given the increased risk of device-related and other complications in this
population. Future studies must examine mortality at 6-12 months in order
to fully capture all the downstream effects of early pMCS use. [Formula
presented] [Formula presented] Copyright © 2024

<70>
Accession Number
2034939084
Title
PREVENTION OF POST-OPERATIVE ATRIAL FIBRILLATION AFTER NON-CARDIAC SURGERY
USING AMIODARONE OR BETA BLOCKADE: A META-ANALYSIS OF RANDOMIZED
CONTROLLED TRIALS.
Source
Canadian Journal of Cardiology. Conference: Canadian Cardiovascular
Congress 2024 Meeting. Vancouver Convention Centre, Vancouver Canada.
40(10 Supplement) (pp S81), 2024. Date of Publication: October 2024.
Author
AlTurki A.; Alturki H.; Dawas A.; Joza J.; Essebag V.; Huynh T.
Institution
(AlTurki, Alturki, Dawas, Joza, Essebag, Huynh) VerdunQCCanada
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Post-operative atrial fibrillation (POAF) after non-cardiac
surgery is associated with an increased risk of stroke and mortality. Both
amiodarone and beta blockers have been shown to prevent POAF after cardiac
surgery. Our objective was to assess the efficacy and safety of beta
blocker or amiodarone prophylaxis prior to non-cardiac surgery. To this
end, we performed a meta-analysis of randomized controlled trials. METHODS
AND RESULTS: We searched electronic databases for all randomized
controlled trials (RCT)s comparing the use of amiodarone and/or beta
blocker to placebo or any other comparative agents, including no
treatment, for the prevention of POAF after non-cardiac surgery. Two
reviewers performed independently the literature search and extraction. We
used random-effects models to summarize the studies. The primary efficacy
outcome was the incidence of in-hospital POAF. POAF was defined as atrial
fibrillation for greater than 30 seconds. Safety outcomes consisted of
drug-related post-operative hypotension or bradycardia, which required
treatment or temporary drug interruption. There were 10 RCTs enrolling
9,808 patients in the final analysis. The mean age ranged from 61 to 69
years, and the proportions of females ranged from 15% to 48%. Of the 10
included RCTs, five evaluated beta blockers and five were trials of
amiodarone. In the amiodarone RCTs, 20%-30% of patients were also
receiving beta blockers in both treatment arms. Compared to controls
(placebo, no treatment or magnesium sulphate), patients who received
prophylaxis with amiodarone or beta blockers had a lower incidence of POAF
(risk ratio [RR]= 0.38, 95% confidence interval [CI] = 0.24- 0.59; p <
0.0001). Similar results were found when restricting the analysis to only
one therapy: either amiodarone alone or beta blockers alone. However,
prophylaxis with either amiodarone or beta blockers was associated with
increased risk of post-operative bradycardia with (RR= 2.04, 95% CI =
1.08- 3.85; p=0.03). There was no difference in post-operative hypotension
between the two treatment arms (RR= 1.22, 95% CI = 0.95- 1.56; p=0.12).
 CONCLUSION(S): Compared to placebo or no treatment, prophylaxis with
beta blocker, and/or amiodarone was associated with marked reduction in
the incidence of POAF following non-cardiac surgery. In patients at
increased risk of POAF following non-cardiac surgeries, prophylaxis of
either amiodarone or beta-blockers may be considered. Copyright ©
2024

<71>
Accession Number
2034939083
Title
DECISION AIDS FOR PATIENTS WITH STABLE CORONARY ARTERY DISEASE: A
SYSTEMATIC REVIEW.
Source
Canadian Journal of Cardiology. Conference: Canadian Cardiovascular
Congress 2024 Meeting. Vancouver Convention Centre, Vancouver Canada.
40(10 Supplement) (pp S55), 2024. Date of Publication: October 2024.
Author
Gessese S.; MacArthur L.; Stanzel A.; Sterling E.; Charlebois A.; McLaren
J.; MacPhee E.; Chong A.
Institution
(Gessese, MacArthur, Stanzel, Sterling, Charlebois, McLaren, MacPhee,
Chong) OttawaONCanada
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Patients with stable coronary artery disease (CAD) who undergo
an angiogram are faced with challenging decisions regarding their
treatment options. Decision aids (DAs) are essential tools in guiding
patients through these complex decisions and facilitating their
understanding of the risks and benefits associated with each option. This
systematic review aims to evaluate web- or paper-based DAs developed to
assist patients with stable CAD in making informed decisions regarding
medical management, percutaneous coronary intervention (PCI), or coronary
artery bypass grafting (CABG). This review will focus on assessing the
impact of these DAs on informed decision-making, patient satisfaction, and
bridging knowledge gaps among patients undergoing an angiogram. METHODS
AND RESULTS: A search was conducted across Medline, Embase, Scopus, and
CINAHL databases for studies that developed a DA for stable CAD patients
considering PCI, CABG, or medical management. Eligible articles, published
electronically between 2016 and the present, needed to be full-text, in
English, and include clearly defined patient outcomes. Three independent
reviewers screened and extracted data. The quality of the DAs was assessed
using the Critical Appraisal Skills Programme (CASP) checklist. 716
studies were initially identified, with 30 full-text articles screened
through Covidence, leading to the inclusion of 2 articles for the analysis
(see appendix A). The first article provided a paper-based DA designed to
assist stable CAD patients in making treatment decisions between PCI and
medical management. The findings demonstrate statistically significant
improvement in patient knowledge concerning PCI and medical management
compared to standard care (60% DA; 40% usual care; p=0.034). Additionally,
patients reported feeling more informed about their treatment options
(p=0.043). The second article developed a web-based DA to assist patients
in deciding between PCI, CABG, and medical management. The findings
demonstrate improved performance on a 6-item knowledge scale (p < 0.01)
and increased interest in shared decision-making. CONCLUSION(S): This
systematic review reveals a gap in evaluated DAs for stable CAD patients
facing treatment decisions. The first DA focused solely on PCI and medical
management, whereas the second DA addressed all three options but was
inaccessible online for review. Although both DAs demonstrate improvement
in patient knowledge, there is an absence of available DAs tailored to
guide decisions for all three treatment modalities. This emphasizes the
importance of developing and evaluating a comprehensive tool for stable
CAD patients. [Formula presented] Copyright © 2024

<72>
Accession Number
2034939079
Title
SURVIVAL AND OUTCOMES OF CORONARY ARTERY BYPASS SURGERY IN PATIENTS WITH
EXTREMELY LOW EJECTION FRACTION (LESS THAN 20%) - A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Canadian Journal of Cardiology. Conference: Canadian Cardiovascular
Congress 2024 Meeting. Vancouver Convention Centre, Vancouver Canada.
40(10 Supplement) (pp S107-S108), 2024. Date of Publication: October 2024.
Author
Hou W.; Liu I.; Barat J.; Aboelnazar N.; Nagpal D.
Institution
(Hou, Liu, Barat, Aboelnazar, Nagpal) OakvilleONCanada
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Lower ejection fraction (EF) has been identified as a risk
factor for increased mortality and morbidity following coronary artery
bypass grafting (CABG). Patients with extremely low EF (<=20%) have been
historically underrepresented in studies of surgical revascularization,
and the role of CABG for these patients with heart failure remains debated
in the current era of excellent outcomes following the placement of
durable mechanical circulatory support. The aim of this systematic review
is to quantitatively aggregate published outcomes and potential benefits
of CABG for these patients. METHODS AND RESULTS: We performed a
librarian-assisted systematic search of MEDLINE, EMBASE, and CENTRAL via
OVID for both randomized control trials and cohort studies involving
patients with EF <= 20% undergoing CABG, including results from 1995 to
December 2023, with no language restrictions. We also included EF <= 20%
subgroups that were part of larger studies. We performed random-effects
prevalence meta-analysis using the meta library in R. Outcome prevalence
was logit-transformed and pooled using a generalised linear mixed-effects
model. The presence of heterogeneity was assessed using Cochran's Q test
with a significance of P < 0.10 following Cochrane Handbook
recommendations and further quantified using I2 statistics. A total of 29
studies involving 6523 patients were included in this analysis. The pooled
prevalence of perioperative mortality was 9% (CI: 0.08-0.11, I2=45%), with
no temporal correlation on visual inspection (Figure 1). Postoperative
myocardial infarction and stroke prevalence were 2% (CI: 0.01-0.04,
I2=53%) and 3% (CI: 0.02-0.03, I2=0%), respectively. Low cardiac output
syndrome definition varied across studies, and its pooled prevalence was
16% (CI: 0.11-0.22, I2=84%), with corresponding postoperative mechanical
circulatory support requirement at 9% (CI: 0.03-0.21, I2=90%). The pooled
actuarial 5-year survival rate was 74% (CI: 0.69-0.78, I2=37%), with no
temporal relationship on visual inspection (Figure 2). CONCLUSION(S):
In this meta-analysis of mostly cohort studies, we demonstrate that CABG
for extremely low ejection fraction (<= 20%) patients have higher than
average perioperative mortality and morbidity risk, yet may derive
considerable long-term survival benefit, comparable to that of durable
Left Ventricular Assist Device placement in selected patients. More
long-term data is needed in this patient population to elucidate the
relative risks and benefits of CABG versus advanced heart failure
therapies at 5 years and beyond. [Formula presented] [Formula
presented] Copyright © 2024

<73>
Accession Number
2034939023
Title
THE EMERGING ROLE OF COMBINED TRANSCATHETER MULTIVALVE INTERVENTIONS - A
SYSTEMATIC REVIEW.
Source
Canadian Journal of Cardiology. Conference: Canadian Cardiovascular
Congress 2024 Meeting. Vancouver Convention Centre, Vancouver Canada.
40(10 Supplement) (pp S59), 2024. Date of Publication: October 2024.
Author
Gedeon T.; Alquraishi H.; Zgheib A.; Martucci G.; Spaziano M.; Piazza N.;
Mousavi N.
Institution
(Gedeon, Alquraishi, Zgheib, Martucci, Spaziano, Piazza, Mousavi)
MontrealQCCanada
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Treatment strategies for multivalve disease remain uncertain
due to a noticeable gap in guideline-based recommendations. Elevated
mortality rates of double valve surgery prompted the emergence of
percutaneous valve interventions. This review synthesizes the evidence on
transcatheter interventions for the most frequent combinations of valve
pathology: mitral regurgitation (MR) with aortic stenosis (AS) and MR with
tricuspid regurgitation (TR). METHODS AND RESULTS: PubMed/MEDLINE were
searched until February 2024. Relevant studies were identified through
title screening and snowballing references of included articles. MR and AS
Persistent significant MR after transcatheter aortic valve replacement
(TAVR) carries an increased mortality risk. A registry analysis
demonstrated that TAVR patients with residual significant MR who underwent
staged transcatheter mitral valve intervention (TMVI) had a lower
mortality rate than those treated medically. The data on feasibility and
safety of concomitant transcatheter mitral valve intervention (TMVI) and
TAVR remains however scarce and conflicting. A report of 627 patients
undergoing TAVR demonstrated no significant difference in hospital
mortality in patients who underwent TMVI during the index or subsequent
hospitalization (p=0.12). In-hospital complication rates, however, were
significantly higher in the former probably a result of multimorbidity and
cardiogenic shock. In contrast, Sagheer et al. demonstrated that TAVR
patients who underwent TMVI during the index hospitalization had
significantly higher hospital mortality rates than those who underwent the
procedure during a subsequent hospitalization (p=0.04). Considering the
limitations of retrospective studies, for patients who continue to have
significant MR post-TAVR, TMVI should be recommended and is feasible to
perform either during the index hospitalization or as a scheduled
post-discharge procedure. Clinical status and comorbidities play an
important role in outcomes. MR and TR Secondary TR post TMVI carries an
increased mortality risk. Although timing and outcomes of surgical
tricuspid valve repair are often debatable, it is even more so for
transcatheter tricuspid valve interventions. A pooled analysis of 2
nonrandomized registries (TriValve and TRAMI) suggested a two-fold
reduction in adjusted mortality (p=0.035) for patients who underwent
combined transcatheter mitral/tricuspid valve interventions (TMTVI) as
opposed to isolated TMVI in the setting of significant TR. Currently, data
on combined TMTVI is limited and randomized studies should be pursued.
 CONCLUSION(S): Despite increasing interest in multivalve
interventions, evidence remains scarce. Multivalve interventions are often
performed in patients with high baseline mortality - as a "last-ditch"
effort. Further studies are required to refine patient selection, to
determine optimal timing of intervention and to compare the advantages of
simultaneous versus sequential procedures. [Formula
presented] Copyright © 2024

<74>
Accession Number
2034938934
Title
RHYTHM VERSUS RATE CONTROL FOR PERIOPERATIVE ATRIAL FIBRILLATION AFTER
NONCARDIAC SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Canadian Journal of Cardiology. Conference: Canadian Cardiovascular
Congress 2024 Meeting. Vancouver Convention Centre, Vancouver Canada.
40(10 Supplement) (pp S84-S85), 2024. Date of Publication: October 2024.
Author
Razeghi G.; Wang M.; Baskaran G.; Park L.; Vuong K.; Blum S.; Heo R.;
Devereaux P.; McIntyre W.; Healey J.; Prystajecky M.; Conen D.
Institution
(Razeghi, Wang, Baskaran, Park, Vuong, Blum, Heo, Devereaux, McIntyre,
Healey, Prystajecky, Conen) HamiltonONCanada
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Uncontrolled perioperative atrial fibrillation (POAF) after
noncardiac surgery can lead to increased hemodynamic instability, length
of hospitalization, and need for intensive care (ICU). The efficacy of a
rhythm control versus a rate control strategy for management of POAF
remains uncertain. METHODS AND RESULTS: We searched MEDLINE, EMBASE, and
CENTRAL for randomized controlled trials (RCTs) and observational studies
that included >=10 adults with POAF after noncardiac surgery and reported
outcomes in patients treated with a rhythm control strategy versus either
a rate control or no treatment strategy. Outcomes of interest included the
proportion of patients achieving conversion to sinus rhythm, length of
hospitalization, length of ICU stay, and all-cause mortality. For the
outcome of conversion to sinus rhythm, we used the longest follow-up time
available for each study. Studies were pooled using random-effects models.
Sixteen observational cohort studies and one RCT met our inclusion
criteria, consisting of 1,946 patients with POAF. Studies included
patients undergoing thoracic surgery (7 studies), thoracic/abdominal
surgery (3 studies), and other combinations of surgeries (7 studies).
Rhythm control strategies included the use of amiodarone alone (6
studies), class I antiarrhythmics alone (2 studies), or multiple rhythm
control therapies (9 studies). Of the observational studies, a rhythm
control strategy was associated with a higher proportion of patients
achieving conversion to sinus rhythm compared to a rate control strategy
(82% versus 63%; Odds Ratio (OR) 1.93, 95% Confidence Interval (CI) 1.25
to 2.97; I2 = 0%; 9 studies) (Figure). There were no significant
differences between rhythm and rate control strategies in length of
hospitalization (12.2 versus 13.9 days; Mean Difference (MD) -1.67, 95%CI
-7.10 to 3.76; I2 = 0%; 2 studies), length of ICU stay (11.6 versus 13.5
days; MD -1.90, 95%CI -7.62 to 3.82; 1 study), or all-cause mortality
(12.7% versus 7.1%; OR 1.14, 95%CI 0.56 to 2.32; I2 =0%; 5 studies). A
single RCT demonstrated a higher proportion of patients achieving
conversion to sinus rhythm using magnesium compared to amiodarone (78%
versus 44%; OR 4.50; 95%CI 1.02 to 19.90; n=42). CONCLUSION(S):
Mostly low-quality observational studies suggest that rhythm control
strategies for POAF are associated with higher success rates for
conversion to sinus rhythm when compared to rate control strategies.
[Formula presented] Copyright © 2024

<75>
Accession Number
645454700
Title
Real-world study on the application of enhanced recovery after surgery
protocol in video-assisted thoracoscopic day surgery for pulmonary nodule
resection.
Source
BMC surgery. 24(1) (pp 288), 2024. Date of Publication: 05 Oct 2024.
Author
Zhang H.; Chen W.; Wang J.; Che G.; Huang M.
Institution
(Zhang, Chen, Huang) Day Surgery Center, General Practice Medical Center,
West China Hospital, Sichuan University/West China School of Nursing,
Sichuan University, Sichuan Province, Wuhou District 610041, China
(Wang) Department of Rehabilitation Medicine, West China Hospital, Sichuan
University, Chengdu, China
(Che) Lung Cancer Centre, West China Hospital, Sichuan University,
Chengdu, China
Abstract
OBJECTIVE: This study aims to evaluate the real-world effectiveness of
applying different levels of Enhanced Recovery After Surgery (ERAS)
guidelines to video-assisted thoracic day surgery (VATS). The goal is to
determine the optimal degree of ERAS protocols and management requirements
to improve postoperative recovery outcomes. METHOD(S): It was
designed as a single-centre, prospective pragmatic randomized controlled
trial (PRCT), including patients who underwent VATS at the Day Surgery
Center of West China Hospital, between January 2021 and November 2022.
Patients were divided into Group A and Group B through convenience
sampling to implement different levels of ERAS management protocols. Data
collection included the baseline characteristics (gender, age, marital
status, education level, BMI, PONV risk score, ASA classification),
surgery-related indicators (type of surgery, pathological results,
hospitalization costs, duration of surgery, intraoperative blood loss,
intraoperative rehydration volume), postoperative recovery indicators
(postoperative chest tube duration time, time to first postoperative
ambulation and urination, postoperative complications, follow-up
condition), pain-related indicators (pain threshold score, pain score at 6
h postoperatively, bedtime, and predischarge), psychological state
indicators (anxiety level), Athens Insomnia Scale (AIS) scores, and social
support scores. Propensity score matching (PSM) was utilized and
statistical analyses were conducted using R version 4.4.1. Comparisons of
categorical variables were performed using the chi2 test, while
comparisons of continuous variables were conducted using ANOVA or the
Kruskal-Wallis rank-sum test. A significance level of alpha=0.05 was set
for statistical tests. RESULT(S): A total of 340 patients were
included, with 187 in Group A and 153 in Group B. After propensity score
matching (PSM), there were 142 patients in Group A and 105 in Group B,
with no significant baseline differences. Group A had a significantly
higher proportion of chest tube removals within 24 h postoperatively
(P<0.001) and earlier mobilization (P<0.001). Despite a higher pain
threshold in Group A (P=0.016), their postoperative pain scores were not
higher than those in Group B. Additionally, Group A had a lower incidence
of postoperative complications. CONCLUSION(S): The more comprehensive
ERAS protocol significantly improved postoperative recovery, confirming
its value in day-case VATS and supporting its clinical adoption. However,
the study has limitations; future research should focus on standardizing
ERAS protocols and expanding their application to a broader patient
population to validate these findings further. TRAIL REGISTRATION: This
study underwent review by the Ethics Committee of West China Hospital of
Sichuan University under No. 2020 (1001). It has been officially
registered with the China Clinical Trial Registry, TRN: ChiCTR2100051372
and registration date is Sept. 22, 2021. Copyright © 2024. The
Author(s).

<76>
Accession Number
2034882537
Title
Efficacy of Sentinel Cerebral Embolic Protection Device in Transcatheter
Aortic Valve Replacement: A Meta-Analysis of Randomized Controlled Trials
and Propensity Score-Matched Studies.
Source
Cardiology in Review. (no pagination), 2024. Article Number:
10.1097/CRD.0000000000000797. Date of Publication: 2024.
Author
Jain H.; Pervez N.; Dey D.; Odat R.M.; Jain J.; Goyal A.; Saggar A.;
Hussein A.M.; Mathur A.; Khanna S.; Ahmed R.; Shahid F.
Institution
(Jain, Jain) Department of Internal Medicine, All India Institute of
Medical Sciences (AIIMS), Jodhpur, India
(Pervez) Department of Internal Medicine, Dow University of Health
Sciences, Karachi, Pakistan
(Dey) Department of Internal Medicine, Medical College and Hospital,
Kolkata, India
(Odat) Department of Internal Medicine, Faculty of Medicine, Jordan
University of Science and Technology, Irbid, Jordan
(Goyal) Department of Internal Medicine, Seth GS Medical College and KEM
Hospital, Mumbai, India
(Saggar) Department of Internal Medicine, Punjab Institute of Medical
Sciences, Jalandhar, India
(Hussein) Department of Internal Medicine, Faculty of Medicine, Al-Balqa'
Applied University, Salt, Jordan
(Mathur) Department of Internal Medicine, Jhalawar Hospital and Medical
College, Rajasthan, Jhalawar, India
(Khanna) Department of Internal Medicine, University College of Medical
Sciences, Guru Teg Bahadur Hospital, New Delhi, India
(Ahmed) Department of Cardiology, National Heart and Lung Institute,
Imperial College London, London, United Kingdom
(Shahid) Department of Interventional Cardiology, Queen Elizabeth
Hospital, Birmingham, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Transcatheter aortic valve replacement (TAVR) is frequently associated
with stroke due to debris embolization. Although the risk of stroke with
newer-generation devices is lower, stroke still represents a significant
cause of mortality and morbidity post-TAVR. The Sentinel cerebral embolic
protection device (CEPD) is a dual-embolic filter device designed to
capture debris dislodged during TAVR. A systematic literature search was
performed on the major bibliographic databases to retrieve studies that
compared TAVR with and without Sentinel CEPD. Pooled odds ratios (ORs)
with 95% confidence intervals (CIs) were calculated using the
DerSimonian-Laird random-effects model, with a P value of <0.05 considered
statistically significant. This meta-analysis included 6 studies with
25,130 patients undergoing TAVR (12,608: Sentinel CEPD; 12,522: without
Sentinel CEPD). The use of the Sentinel CEPD in TAVR was associated with a
statistically significant lower risk of acute kidney injury (OR: 0.89; 95%
CI: 0.81-0.97; P = 0.01]. The use of Sentinel CEPD in TAVR was associated
with a statistically insignificant trend toward a reduction in stroke (OR:
0.80; 95% CI: 0.58-1.10; P = 0.18), all-cause mortality (OR: 0.74; 95% CI:
0.51-1.07; P = 0.11), and major vascular complications (OR: 0.74; 95% CI:
0.46-1.19; P = 0.21). The use of Sentinel CEPD in patients undergoing TAVR
does not lead to a statistically significant reduction in stroke,
all-cause mortality, or major vascular complications; however, the risk of
acute kidney injury is lower. Further randomized studies are warranted to
confirm these findings. Copyright © 2024 Wolters Kluwer Health,
Inc. All rights reserved.

<77>
Accession Number
2034847592
Title
Comparison of Ultrathin- Versus Thin-Strut Stents in Patients with High
Bleeding Risk PCI: Results from the COMPARE 60/80 HBR Trial: An
Open-Label, Randomized, Controlled Trial.
Source
Circulation: Cardiovascular Interventions. (no pagination), 2024. Article
Number: e014042. Date of Publication: 2024.
Author
Smits P.C.; Tonino P.A.L.; Hofma S.H.; Van Kuijk J.-P.; Spano F.; Al
Mafragi A.; Pisters R.; Polad J.; Bogaerts K.; Oemrawsingh R.M.; Paradies
V.
Institution
(Smits, Paradies) Department of Cardiology, Maasstad Hospital, Rotterdam,
Netherlands
(Smits) Center of European Cardiovascular Research, Massy, France
(Tonino) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(Hofma) Department of Cardiology, Medical Center Leeuwarden, Netherlands
(Van Kuijk) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(Spano) Department of Cardiology, Meander Hospital, Amersfoort,
Netherlands
(Al Mafragi) Department of Cardiology, Zorgsaam Hospital, Terneuzen,
Netherlands
(Pisters) Department of Cardiology, Rijnstate Hospital, Arnhem,
Netherlands
(Polad) Department of Cardiology, Jeroen Bosch Hospital, Den Bosch,
Netherlands
(Bogaerts) Department of Public Health and Primary Care, KU Leuven,
Leuven, Belgium
(Oemrawsingh) Department of Cardiology, Albert Schweitzer Hospital,
Dordrecht, Netherlands
(Bogaerts) I-BioStat, Hasselt, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: No randomized data exist on ultrathin-strut stents in patients
at high bleeding risk (HBR) undergoing an abbreviated dual antiplatelet
therapy after coronary stenting. The aim of this study was to compare the
safety and effectiveness of the ultrathin-strut biodegradable-polymer
sirolimus-eluting Supraflex Cruz stent with the thin-strut
biodegradable-polymer sirolimus-eluting Ultimaster Tansei stent in
patients at HBR with abbreviated dual antiplatelet therapy after stenting.
 METHOD(S): In the investigator-initiated, randomized, open-label
COMPARE 60/80 HBR trial (Comparison of the Supraflex Cruz 60 Micron Stent
Strut Versus the Ultimaster Tansei 80 Micron Stent Strut in HBR
Percutaneous Coronary Intervention Population), 741 patients at HBR
according to the Academic Research Consortium HBR criteria were randomized
to receive either the ultrathin-strut biodegradable-polymer
sirolimus-eluting Supraflex Cruz stent or thin-strut biodegradable-polymer
sirolimus-eluting Ultimaster Tansei stent. Dual antiplatelet therapy was
recommended according to the applicable guidelines and trial data for
patients at HBR. The primary outcome was net adverse clinical events, the
composite of cardiovascular death, myocardial infarction, target vessel
revascularization, stroke, and major bleeding, and was powered for
noninferiority with an absolute margin of 4.0% at 1-sided 2.5% alpha.
 RESULT(S): Between September 2020 and August 2022, 371 patients were
randomized to the ultrathin-strut biodegradable-polymer sirolimus-eluting
Supraflex Cruz stent and 370 patients to the thin-strut
biodegradable-polymer sirolimus-eluting Ultimaster Tansei stent at 11
sites in the Netherlands. At 1 year, the primary outcome was observed in
56 (15.4%) patients in the ultrathin-strut biodegradable-polymer
sirolimus-eluting Supraflex Cruz stent group and 61 (17.1%) in the
thin-strut biodegradable-polymer sirolimus-eluting Ultimaster Tansei stent
group (risk difference, -1.65%; upper boundary of the 1-sided 95% CI,
3.74; P=0.02 for noninferiority at a 0.025 significance level and P=0.55
for 2-sided superiority at a 0.05 significance level). CONCLUSION(S):
Among patients at HBR with abbreviated dual antiplatelet therapy
post-stenting, the use of an ultrathin-strut biodegradable-polymer
sirolimus-eluting Supraflex Cruz stent was noninferior compared with the
use of a thin-strut biodegradable-polymer sirolimus-eluting Ultimaster
Tansei stent. Copyright © 2024 The Authors.

<78>
Accession Number
645463587
Title
Left Atrial Appendage Occlusion vs Standard of Care After Ischemic Stroke
Despite Anticoagulation.
Source
JAMA neurology. (no pagination), 2024. Date of Publication: 23 Sep 2024.
Author
Maarse M.; Seiffge D.J.; Werring D.J.; Boersma L.V.A.; Aarnink E.W.;
Fierro N.; Mazzone P.; Beneduce A.; Tondo C.; Gasperetti A.; Pracon R.;
Demkow M.; Zielinski K.; de Backer O.; Korsholm K.; Nielsen-Kudsk J.E.;
Estevez-Loureiro R.; Caneiro-Queija B.; Benito-Gonzalez T.; de Prado A.P.;
Nombela-Franco L.; Salinas P.; Holmes D.; Almakadma A.H.; Berti S.; Romeo
M.R.; Alvarez X.M.; Arzamendi D.; Alla V.M.; Agarwal H.; Eitel I.;
Paitazoglou C.; Freixa X.; Cepas-Guillen P.; Chothia R.; Badejoko S.O.;
Bergmann M.W.; Spoon D.B.; Maddux J.T.; El-Chami M.; Ram P.; Branca L.;
Adamo M.; Suradi H.S.; van Dijk V.F.; Rensing B.J.W.M.; Zietz A.;
Paciaroni M.; Caso V.; Koga M.; Toyoda K.; Kallmunzer B.; Cappellari M.;
Wilson D.; Engelter S.; Swaans M.J.
Institution
(Maarse, Boersma, Aarnink, van Dijk, Rensing, Swaans) Department of
Cardiology, Sint Antonius Ziekenhuis, Nieuwegein, Netherlands
(Maarse, Boersma, Aarnink) Department of Cardiology, Location AMC,
Amsterdam, Netherlands
(Seiffge) Department of Neurology, Inselspital University Hospital Bern,
Bern, Switzerland
(Werring) UCL London, UCL Queen Square Institute of Neurology, United
Kingdom
(Fierro) De Gasperis Cardio Center, Interventional Cardiology Unit,
Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano
Niguarda, Milan, Italy
(Mazzone) Arrhythmia Unit and Electrophysiology Laboratories, Azienda
Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda,
Milan, Italy
(Beneduce) IRCCS, San Raffaele Scientific Institute, Milan, Italy
(Tondo, Gasperetti) Department of Clinical Electrophysiology & Cardiac
Pacing, Centro Cardiologico Monzino, IRCCS, Milan, Italy
(Tondo) Department of Biomedical, Surgical and Dental Sciences University
of Milan, Milan, Italy
(Gasperetti) Department of Cardiology, Johns Hopkins University,
Baltimore, MD, Liberia
(Pracon, Demkow, Zielinski) Department of Coronary and Structural Heart
Diseases, National Institute of Cardiology, Warsaw, Poland
(de Backer) Heart Center, Rigshospitalet, Copenhagen, Denmark
(Korsholm, Nielsen-Kudsk) Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark
(Estevez-Loureiro, Caneiro-Queija) Interventional Cardiology Unit,
University Hospital Alvaro Cunqueiro, Vigo, Spain
(Benito-Gonzalez, de Prado) Department of Cardiology, University Hospital
of Leon, Leon, Spain
(Nombela-Franco, Salinas) Cardiovascular Institute, Hospital Clinico San
Carlos, IdISSC, Madrid, Spain
(Holmes, Almakadma) Department of Cardiology, Mayo Clinic, Rochester, MN,
United States
(Berti, Romeo) Fondazione Toscana "G. Monasterio," Massa, Italy Italy
(Alvarez, Arzamendi) Cardiology Department, Sant Pau Research institute
(IIB Sant Pau), Barcelona, Spain
(Alla, Agarwal) Creighton University School of Medicine, Omaha, NE, United
States
(Eitel, Paitazoglou) University Heart Center Lubeck, Medical Clinic II,
Lubeck, Germany
(Eitel, Paitazoglou) German Center for Cardiovascular Research (DZHK),
Partner Site Hamburg - Kiel - Lubeck, Lubeck, Germany
(Freixa, Cepas-Guillen) Department of Cardiology, Institut Clinic
Cardiovascular, Hospital Clinic of Barcelona, Barcelona, Spain
(Chothia, Badejoko) St Joseph's Medical Center, Stockton, CA, United
States
(Bergmann) Department of Cardiology, Hamburg, Germany
(Spoon, Maddux) Department of Cardiology, Providence Heart Institute,
Missoula, MT, Bulgaria
(El-Chami, Ram) Department of Cardiology, Emory University Hospital,
Atlanta, Georgia
(Branca, Adamo) Cardiology and Cardiac Catheterization Laboratory, ASST
Spedali Civili di Brescia, Department of Medical and Surgical Specialties,
Radiological Sciences, Public Health, University of Brescia, Brescia,
Italy
(Suradi) Division of Cardiovascular Medicine, Rush University Medical
Center, Chicago, IL, United States
(Zietz, Engelter) Department of Neurology, University Hospital Basel,
Switzerland
(Paciaroni, Caso) Stroke Unit - Internal Vascular and Emergency Medicine,
Santa Maria Della Misericordia Hospital, University of Perugia, Perugia,
Italy
(Koga, Toyoda) Department of Cerebrovascular Medicine, National Cerebral
and Cardiovascular Center, Osaka, Japan
(Kallmunzer) Stroke Unit, Department of Neuroscience, Azienda Ospedaliera
Universitaria Integrata, Verona, Italy
(Cappellari) Department of Neurology, University Hospital Erlangen,
Friedrich-Alexander-University Erlangen - Nuremberg (FAU), Erlangen,
Germany
(Wilson) Department of Neurology, Christchurch Hospital, Christchurch, New
Zealand
(Wilson) New Zealand Brain Research Institute, Christchurch, New Zealand
(Engelter) Neurology and Neurorehabilitation, University Department of
Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
Abstract
Importance: Patients with atrial fibrillation (AF) who have ischemic
stroke despite taking oral anticoagulation therapy (OAT) have a very high
risk of recurrence. Left atrial appendage occlusion (LAAO) is a mechanical
stroke prevention strategy that may provide additional protection in
patients with thromboembolic events under OAT. Objective(s): To
compare percutaneous LAAO with continuing OAT alone regarding stroke
prevention in patients with AF who had a thromboembolic event despite
taking OAT. Design, Setting, and Participant(s): This cohort study
was a propensity score-matched comparison of the STR-OAC LAAO cohort, an
international collaboration of 21 sites combining patients from multiple
prospective registries of patients who underwent LAAO between 2010 and
2022. STR-OAC LAAO cohort patients who had follow-up longer than 3 months
were propensity score-matched to a previously published control cohort
comprising patients from an established international collaboration of
investigator-initiated prospective studies. This control cohort included
patients with nonvalvular AF, recent ischemic stroke or transient ischemic
attack, and follow-up longer than 3 months who were taking OAT before the
index event. Analyses were adjusted for imbalances in gender, age,
hypertension, diabetes, and CHA2 DS2-VASc score. Exposure: Left atrial
appendage occlusion vs continuation of oral anticoagulation therapy alone
(control group). Main Outcomes and Measures: The primary outcome was
time to first ischemic stroke. Result(s): Four hundred thirty-three
patients from the STR-OAC LAAO cohort (mean [SD] age, 72 [9] years; 171
[39%] females and 262 [61%] males; mean [SD] CHA2 DS2-VASc score, 5.0
[1.6]) were matched to 433 of 1140 patients (38%) from the control group.
During 2-year follow-up, 50 patients experienced ischemic stroke: an
annualized event rate of 2.8% per patient-year in the STR-OAC LAAO group
vs 8.9% per patient-year in the control group. Left atrial appendage
occlusion was associated with a lower risk of ischemic stroke (hazard
ratio, 0.33; 95% CI, 0.19-0.58; P<.001) compared with the control group.
After LAAO, OAT was discontinued in 290 patients (67%), and the remaining
143 patients (33%) continued OAT after LAAO as an adjunctive therapy.
 Conclusions and Relevance: In patients with nonvalvular AF and a
prior thromboembolic event despite taking OAT, LAAO was associated with a
lower risk of ischemic stroke compared with continued OAT alone.
Randomized clinical trial data are needed to confirm that LAAO may be a
promising treatment option for this population with a very high risk of
stroke.

<79>
Accession Number
645463440
Title
Prospective study on the impact of different anti-thrombotic therapies on
subclinical leaflet thickening and its temporal dynamics in transcatheter
aortic valves - The NOTION-4 trial: Anti-thrombotic therapy and TAV-HALT.
Source
American heart journal. (no pagination), 2024. Date of Publication: 05
Oct 2024.
Author
Thuraiaiyah J.; Jorgensen T.H.; Jensen J.M.; Fuchs A.; Willemen Y.;
Terkelsen C.J.; Kofoed K.F.; Sondergaard L.; Norgaard B.; De Backer O.
Institution
(Thuraiaiyah, Jorgensen, Fuchs, Willemen, Kofoed, De Backer) Heart Center,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
(Jensen, Terkelsen, Norgaard) Department of Cardiology, Aarhus University
Hospital, SkejbyAarhus, Denmark
(Sondergaard) The Heart Center, Rigshospitalet, Copenhagen University
Hospital, Copenhagen, Denmark; Abbott, Santa Clara, USA
Abstract
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has become the
standard-of-care treatment for a majority of patients with severe,
symptomatic aortic stenosis. The post-procedural anti-thrombotic
therapeutic management is still a topic of debate and could affect the
incidence of HALT, a phenomenon which can be assessed by four-dimensional
computed tomography (4DCT). TRIAL DESIGN: The NOTION-4 trial is a
randomized controlled trial comprising TAVR patients with no indication
for oral anticoagulant (OAC) therapy, comparing lifelong single
anti-platelet therapy (standard arm) versus early 3-month direct oral
anticoagulant (DOAC) therapy followed by single anti-plateletet therapy
(experimental arm). The incidence of HALT and clinical endpoints will be
evaluated in both groups at 3 months, 1 year and 5 years after
randomization. The primary endpoint is the number of patients with at
least one bioprosthetic aortic valve leaflet with HALT as assessed by
cardiac 4DCT imaging at 1 year. The trial is powered for superiority
testing and started enrollment in 2021. In total, 324 patients will be
included. The last patient is expected to be enrolled by the end of 2024
and the primary endpoint is to be presented in 2026. CONCLUSION AND
PERSPECTIVE: The NOTION-4 trial aims to study whether an early 3-month
DOAC therapy after TAVR can result in a sustained lower incidence of HALT
in transcatheter aortic valves. This trial holds the potential to give
valuable insights into whether early OAC therapy should be integrated in
future guidelines for post-TAVR anti-thrombotic therapeutic management.
TRIAL REGISTRATION: NOTION-4, ClinicalTrials.gov ID NCT06449469,
https://clinicaltrials.gov/study/NCT06449469. Copyright © 2024.
Published by Elsevier Inc.

<80>
Accession Number
645461010
Title
Comparable bleeding and inflammation outcomes between heparin-coated and
uncoated minimal invasive extracorporeal circuits in isolated coronary
artery bypass surgery - A double-blinded randomized control trial.
Source
Perfusion. (pp 2676591241290924), 2024. Date of Publication: 07 Oct 2024.
Author
Jenni H.; Kovacic B.; Mihalj M.; Huber M.; Rieben R.; Carrel T.; Siepe M.;
Kadner A.; Erdoes G.
Institution
(Jenni, Mihalj, Carrel, Siepe, Kadner) Department of Cardiac Surgery,
University of Bern, University Hospital Bern, Bern, Switzerland
(Kovacic, Rieben) Department of BioMedical Research, University of Bern,
Bern, Switzerland
(Mihalj) Department of Advanced Cardiopulmonary Therapies and
Transplantation, University of Texas Health Science Center, Houston, TX,
United States
(Huber, Erdoes) Department of Anesthesiology and Pain Medicine, University
of Bern, University Hospital Bern, Bern, Switzerland
Abstract
OBJECTIVE: Minimally invasive extracorporeal circulation has been shown to
be non-inferior or even superior to conventional cardiopulmonary bypass
circuits in isolated coronary artery bypass grafting, but there is little
evidence whether the addition of a heparin-coated circuit can further
reduce the inflammatory response and amount of bleeding in these patients.
 METHOD(S): A single-center randomized control trial enrolled 49 adult
patients scheduled to undergo isolated coronary artery bypass grafting
with minimally invasive extracorporeal circulation (MiECC) between January
2015 and December 2018. Patients were randomized 1:1 to either the
heparin-coated circuit group, or the uncoated (control) circuit group. The
primary outcome was chest tube output 18 h after weaning from MiECC, and
secondary outcomes included inflammatory (TNF-alpha, IL-6, IL-8, IL-10)
and complement (C3a, C4d, C5a, sC5b-9) biomarkers, platelet count and
function (D2D, TAT, SDC1, PF4), number of transfused blood products, and
30-day survival. RESULT(S): Patients were randomized to undergo
myocardial revascularization using heparin-coated circuits (n = 25), and
to the uncoated MiECC circuit (n = 24), with comparable baseline
demographics. No significant difference was observed in chest tube output
and for all secondary outcomes. IL-6 and IL-8 were increased from baseline
at 18 h after weaning (effect size 0.29 and 0.05, respectively) and sC5b-9
was lower (effect size 0.11) in the heparin-coated than in the uncoated
MiECC, although not significantly different. CONCLUSION(S): Compared
with an uncoated MiECC circuit, heparin-coated MiECC circuit was not
associated with a reduction in postoperative bleeding, transfusion,
inflammation, complement activation, and platelet biomarkers, following
isolated coronary artery bypass grafting.

<81>
Accession Number
645460973
Title
Effect of perioperative erythropoietin on postoperative morbidity and
mortality after cardiac surgery: A meta-analysis of randomized controlled
trials.
Source
Anaesthesia, critical care & pain medicine. (pp 101428), 2024. Date of
Publication: 02 Oct 2024.
Author
Abraham D.; Leviner D.B.; Ronai T.; Schwartz N.; Levi A.; Erez Sharoni
M.D.
Institution
(Abraham) Department of Cardiothoracic Surgery, Carmel Medical Center,
Haifa; The Ruth & Baruch Rappaport Faculty of Medicine, Technion, Haifa.
Electronic address: drorleviner@gmail.com
(Leviner, Erez Sharoni) Department of Cardiothoracic Surgery, Carmel
Medical Center, Haifa; The Ruth & Baruch Rappaport Faculty of Medicine,
Technion, Haifa
(Ronai) Ruth & Baruch Rappaport Faculty of Medicine, Technion, Haifa,
Israel
(Schwartz) Research Authority, Carmel Medical Center, Haifa; School of
Public Health-University of Haifa
(Levi) Department of Cardiology, Rabin Medical Center, Petach Tikva;
School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Abstract
OBJECTIVE: Cardiac surgery is known to have high rates of perioperative
red blood cell (RBC) transfusions which are associated with increased
postoperative mortality and morbidity. Perioperative erythropoietin (EPO)
has been suggested to lower perioperative RBC transfusions, and the effect
on postoperative morbidity or mortality is unknown. METHOD(S): The
registered study protocol is available on PROSPERO (CRD42022314538). We
searched the Pubmed, EMbase, and Cochrane CENTRAL databases for randomized
controlled trials (RCT) of EPO in cardiac surgery. Outcomes were
short-term mortality, acute kidney injury (AKI), re-operation,
cerebrovascular accident (CVA), perioperative myocardial infarction (MI),
infectious complications, and RBC transfusions. RCT studies of
perioperative EPO that reported at least one prespecified outcome of
interest were included. RESULT(S): A total of 21 RCT's (n=2,763
patients) were included. Mortality analysis included 17 studies (EPO 1,272
patients, control 1,235) and showed no significant difference (risk
difference (RD) 0.0004, 95%CI: -0.016, 0.009). EPO did not reduce the
incidence of AKI (RD -0.006, 95% CI: -0.038, 0.026) and reoperation (RD
0.001, 95% CI: -0.013, 0.015). The incidence of CVA (RD -0.004, 95% CI:
-0.015, 0.007) and perioperative MI (RD -0.008, 95% CI: -0.021, 0.005) was
similar between the groups. CONCLUSION(S): Although EPO had been
proven to reduce perioperative RBC transfusions, we did not find that it
reduces the incidence of postoperative short-term mortality, AKI, and
reoperation. The study results support that perioperative EPO is also
safe, with no rise in thrombotic events, including CVA and perioperative
MI. Copyright © 2024. Published by Elsevier Masson SAS.

<82>
Accession Number
645459654
Title
International incidence of melanoma in heart transplant recipients: a
meta-analysis.
Source
Melanoma research. (no pagination), 2024. Date of Publication: 07 Oct
2024.
Author
Campillo P.; Kesler A.; Ramirez C.A.; Ramirez C.J.; Daher J.C.; Grimm M.;
Sabina M.; Bizanti A.
Institution
(Campillo) Department of Internal Medicine, Lakeland Regional Health
Medical Center, Lakeland, FL, United States
Abstract
The incidence of heart transplants in the USA has increased by 85.8% since
2011, resulting in a growing population of recipients requiring long-term
immunosuppressive therapy. While essential for preventing organ rejection,
this therapy significantly increases melanoma risk. This meta-analysis
investigates the incidence and risk factors of melanoma in heart
transplant recipients. A systematic review and meta-analysis were
conducted following Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines, including observational studies reporting
melanoma incidence in heart transplant recipients. Relative risk (RR) was
synthesized from standardized incidence ratios, hazard ratios, incidence
rate ratios, and standardized mortality ratios. The meta-analysis
incorporated 10 studies, including 22 415 heart transplant recipients. The
pooled RR was 2.21 (95% confidence interval: 1.32-3.71; P = 0.003),
indicating a significantly elevated melanoma risk. This study highlights
the critical need for preventive dermatological strategies in heart
transplant recipients and calls for further research into the impact of
different immunosuppressive regimens on melanoma risk. Despite
limitations, these findings offer valuable insights for optimizing
long-term patient care. Copyright © 2024 The Author(s). Published
by Wolters Kluwer Health, Inc.

<83>
Accession Number
645458151
Title
Bifurcated Endografts for the Treatment of Aortoiliac Disease a Systematic
Review and Individual Patient Data (IPD) Meta-Analysis.
Source
Journal of endovascular therapy : an official journal of the International
Society of Endovascular Specialists. (pp 15266028241283721), 2024. Date
of Publication: 07 Oct 2024.
Author
Manaki V.; Bontinis V.; Bontinis A.; Giannopoulos A.; Kontes I.; Ktenidis
K.
Institution
(Manaki, Bontinis, Bontinis, Giannopoulos, Kontes, Ktenidis) Department of
Vascular Surgery, AHEPA University General Hospital, Aristotle University
of Thessaloniki, Thessaloniki, Greece
Abstract
BACKGROUND: This review aimed to assess the efficacy and safety of
bifurcated endografts in the treatment of aortoiliac disease (AOID).
 METHOD(S): A systematic search on PubMed, Scopus, and Web of Science
was performed. The primary endpoint was primary patency, whereas secondary
endpoints included reintervention, technical, clinical success, and
overall postoperative complications. RESULT(S): Ten studies with a
total of 365 patients were included in this review. Most included studies
used the AFX unibody endograft, one study the Excluder endograft, and one
the Powerlink endograft. The majority of included patients displayed
TransAtlantic InterSociety Consensus (TASC) D aortoiliac lesions (56.1%
205/365). The pooled primary patency estimates at 12, 24, and 36 months
were 93.93% (95% confidence interval [CI]: 87.7-100), 91.46% (95% CI:
84.6-98.8), and 90.25% (95% CI: 82.6-98.6), respectively. The mean primary
patency time was 85.74 months (95% CI: 71.99-86.88). The pooled freedom
from reintervention estimates at 12, 24, and 36 months were 91.94% (95%
CI: 81.4-100), 91.03% (95% CI: 79.8-100), and 91.03% (95% CI: 79.8-100),
respectively. The pooled estimates of major complications (rupture, graft
thrombosis, amputation) were 11.12% (95% CI, 0.05%-3.03%), 3.76%
(0.32%-9.45%), and 0.38% (0%-2.59%), whereas the pooled estimates for
minor complications (hematoma, groin infection, dissection) and overall
mortality were 5.27% (95% CI, 1.11%-11.38%), 6.93% (95% CI, 2.94%-12.16%),
2.19% (95% CI, 0.06%-6.14%), and1.57% (95% CI, 0.13-3.97), respectively.
Technical and clinical success estimates were 99.92% (95% CI: 98.86%-100%)
and 99.47% (95% CI: 94.92%-100%), respectively. CONCLUSION(S): The
application of bifurcated endografts may present a safe and viable option
in the treatment of AOID, with preliminary results indicating promising
primary patency outcomes. However, the definitive assessment of their
efficacy and safety will be better determined through long-term follow-up
studies and high-quality randomized controlled trials, which are essential
to substantiate these initial findings. CLINICAL IMPACT: Bifurcated
endograft application may be a safe and viable alternative for high-risk
patients with complex AOID TASC C and D lesions with encouraging primary
patency outcomes potentially comparable to those of open surgery.
Non-negligible postoperative complication rates were also noted.
High-quality randomized controlled trials and studies comparing CERAB,
kissing stenting, and the use bifurcated endografts for the treatment of
AOID is necessary to draw more definite conclusions.

<84>
Accession Number
645457178
Title
Clinical Outcomes of Concomitant Secondary Chordal Cutting to Surgical
Myectomy in HOCM.
Source
The Thoracic and cardiovascular surgeon. (no pagination), 2024. Date of
Publication: 04 Oct 2024.
Author
Heeringa T.J.P.; Hegeman R.R.; van Houwelingen L.; Hoogerwerf M.; Stecher
D.; Kelder J.C.; van der Harst P.; Swaans M.J.; Mokhles M.M.; Vaartjes I.;
Klein P.; van der Kaaij N.P.
Institution
(Heeringa, Hoogerwerf) Cardiothoracic surgery, University Medical Centre
Utrecht, Utrecht, Netherlands
(Hegeman, Klein) Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein,
Netherlands
(van Houwelingen, Mokhles, van der Kaaij) Cardiothoracic Surgery,
University Medical Centre Utrecht, Utrecht, Netherlands
(Stecher) Cardiothoracic Surgery, Medical Centre Leeuwarden, Leeuwarden,
Netherlands
(Kelder) Clinical epidemiology, St Antonius Hospital, Nieuwegein,
Netherlands
(van der Harst) Cardiology, University Medical Centre Utrecht, Utrecht,
Netherlands
(Swaans) Cardiology, St Antonius Hospital, Nieuwegein, Netherlands
(Vaartjes) Cardiovascular Epidemiology, Julius Center for Health Sciences
and Primary Care, Utrecht, Netherlands
(Klein) Cardiothoracic Surgery, Amsterdam University Medical Centres,
Amsterdam, Netherlands
(van der Kaaij) Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam,
Netherlands
Abstract
OBJECTIVES: In patients who underwent surgical septal myectomy for
hypertrophic obstructive cardiomyopathy (HOCM), additional mitral valve
repair may offer additional benefits in terms of further reducing left
ventricle outflow tract (LVOT) gradients, systolic anterior motion (SAM)
and mitral regurgitation (MR). We performed a systematic review of the
literature to evaluate the evidence of surgical myectomy with additional
secondary chordal cutting in patients with HOCM. METHOD(S): A
systematic literature search in MEDLINE and EMBASE was performed until
April 2024. The primary outcome studied was postoperative
echocardiographic LVOT-gradient. A random effects meta-analysis of means
was performed for the primary outcome. The secondary outcomes studied were
postoperative residual MR-grade, 30-day new permanent pacemaker
implantation, and in-hospital mortality. RESULT(S): From 1911 unique
publications, a total of 6 articles fulfilled the inclusion criteria and
comprised 471 patients with a pooled mean preoperative resting LVOT
gradient of 84 mmHg (95% CI: 76-91). The postoperative pooled mean
LVOT-gradient was 11 mmHg (95% CI: 10 - 12) with a low heterogeneity (I2 =
44%). The residual LVOT gradient exceeding 30 mmHg was present in 9 (1%)
patients. MR-grade 3 or 4 at hospital discharge was present in 7 (1%)
patients. The 30-day new permanent pacemaker implantation rate was 7% and
the in-hospital mortality was 0.4%. CONCLUSION(S): This systematic
review and meta-analysis demonstrate that combining surgical septal
myectomy with secondary chordal cutting can be performed safely and
effectively eliminate LVOT obstruction in HOCM patients. Further studies
are needed to determine the additive effectiveness of additional secondary
chordal cuttings. Copyright The Author(s). This is an open access
article published by Thieme under the terms of the Creative Commons
Attribution License, permitting unrestricted use, distribution, and
reproduction so long as the original work is properly cited.
(https://creativecommons.org/licenses/by/4.0/).

<85>
Accession Number
645454654
Title
Ablation Strategies for Repeat Procedures in Atrial Fibrillation
Recurrences Despite Durable Pulmonary Vein Isolation: The Prospective
Randomized ASTRO AF Multicenter Trial.
Source
Circulation. (no pagination), 2024. Date of Publication: 07 Oct 2024.
Author
Schmidt B.; Bordignon S.; Metzner A.; Sommer P.; Steven D.; Dahme T.;
Busch M.; Tilz R.R.; Schaack D.; Rillig A.; Sohns C.; Sultan A.;
Weinmann-Emhardt K.; Hummel A.; Vogler J.; Fink T.; Lueker J.; Pott A.;
Heeger C.; Chun K.-R.J.
Institution
(Schmidt, Bordignon, Schaack, Chun) Cardioangiologisches Centrum
Bethanien, Germany (B.S., S.B., D. Schaack, Frankfurt
(Schmidt) Universitatsklinikum Frankfurt, Medizinische Klinik 3-Klinik fur
Kardiologie, Germany (B.S.), Frankfurt
(Metzner, Rillig) University Heart and Vascular Center Hamburg (UHZ),
Germany (A.M., Germany
(Sommer, Sohns, Fink) Clinic for Electrophysiology, Herz- und
Diabeteszentrum Nordrhein-Westfalen, Germany (P.S., C.S., Ruhr-Universitat
Bochum, Bad Oeynhausen, Germany
(Steven, Sultan, Lueker) University Hospital Cologne-Heart Center, Germany
(D. Steven, A.S
(Dahme, Weinmann-Emhardt, Pott) Uniklinik Ulm, Klinik fur Innere Medizin
II, Germany (T.D., Ulm, United States
(Dahme) Klinikum Esslingen, Klinik fur Kardiologie, Angiologie und
Pneumologie, Germany (T.D.), Esslingen, Germany
(Busch, Hummel) Universitaetsmedizin Greifswald, Germany (M.B., Germany
(Busch) Helios Hanseklinikum Stralsund, Klinik fur Innere Medizin und
Kardiologie, Germany (M.B.), Germany
(Tilz, Vogler, Heeger) Schleswig-Holstein University Clinic, Lubeck
Campus, Germany (R.R.T., Germany
(Pott) Bonifatius Hospital Lingen, Klinik fur Kardiologie und
Rhythmologie, Germany (A.P.), Germany
Abstract
BACKGROUND: Ablation strategies for patients with symptomatic atrial
fibrillation and isolated pulmonary veins vary and their effects on
arrhythmia recurrence remain unclear. A prospective randomized German
multicenter trial sought to compare 2 ablation strategies in this patient
cohort. METHOD(S): Patients with atrial fibrillation despite durable
pulmonary vein isolation were randomly assigned at 7 centers to undergo
low-voltage area ablation using 3-dimensional mapping and irrigated
radiofrequency current ablation (group A) or empirical left atrial
appendage isolation (LAAI) using the cryoballoon followed by staged
interventional left atrial appendage closure (group B). The primary end
point was freedom from atrial tachyarrhythmias between 91 and 365 days
after index ablation. The study was powered for superiority of LAAI
compared with low-voltage area. RESULT(S): Patients (40% women; mean
age, 68.8+/-8 years) with paroxysmal (32%) or persistent atrial
fibrillation (68%) were randomized to undergo low-voltage area ablation
(n=79) or cryoballoon-guided LAAI (n=82). After a planned interim
analysis, enrollment was halted for futility on January 10, 2023. In the
LAAI group, 77 of 82 left atrial appendages were successfully isolated
with subsequent left atrial appendage closure in 57 patients.
Procedure-related complications occurred in 4 (5%) and 11 (13.5%) patients
in group A and B, respectively (P=0.10). The median follow-up was 367 days
(interquartile range, 359-378). The Kaplan-Meier point estimate for
freedom from atrial tachyarrhythmias was 51.7% (CI, 40.9%-65.4%) for group
A and 55.5% (CI, 44.4%-69.2%; P=0.8069) for group B. CONCLUSION(S):
The current study did not detect superiority of cryoballoon-guided LAAI
over low-voltage area ablation in patients with atrial fibrillation
despite durable PVI. REGISTRATION: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT04056390.

<86>
Accession Number
645454552
Title
Nursing-Based Sleep Promotion Intervention Effectiveness for Post Cardiac
Surgery Patients: Systematic Review.
Source
Journal of clinical nursing. (no pagination), 2024. Date of Publication:
06 Oct 2024.
Author
Hweidi I.M.; Jebreel O.H.; Alhawatmeh H.N.; Jarrah M.I.; Abu-Awwad A.A.;
Hweidi M.I.
Institution
(Hweidi, Jebreel, Alhawatmeh, Abu-Awwad) Adult Health Nursing Department,
Faculty of Nursing, Jordan University of Science and Technology, Irbid,
Jordan
(Jarrah) Department of Internal Medicine, Faculty of Medicine, Jordan
University of Science & Technology, Irbid, Jordan
(Hweidi) Faculty of Medicine, Medicine Student, Jordan University of
Science & Technology, Irbid, Jordan
Abstract
BACKGROUND: Sleep is a fundamental prerequisite for physical and mental
health. Poor quality of sleep is common among post-cardiac surgery
patients and leads to serious health conditions. OBJECTIVE(S): To
conduct a systematic review that investigates the effectiveness of eye
masks, earplugs and deep-breathing exercise on sleep quality among
post-cardiac surgery patients. DESIGN: A systematic review of
interventional studies was established to meet the PRISMA guidelines.
 METHOD(S): PRISMA guidelines were used to assess the findings of 11
selected studies that met the inclusion criteria, published between 2007
and 2023 across four databases: CINAHL, JDNR, MEDLINE and PubMed. The
search was conducted on 23 November 2023. RESULT(S): The 11 most
eligible studies were analysed. All of them were interventional,
encompassing a total of 787 participants. Randomised controlled trials
were the most common design. Interventions included eye masks, earplugs
and deep-breathing exercises. The Richards-Campbell Sleep Questionnaire
was the most used assessment scale. Most of the reviewed studies found
that the use of non-pharmacological interventions (eye masks, earplugs and
deep-breathing exercise) significantly improves the quality of sleep.
These interventions were also found to have potentially positive effects
on reducing pain and delirium experienced by patients after undergoing
cardiac surgery. CONCLUSION(S): Non-pharmacological interventions
(eye masks, earplugs and deep-breathing exercise) were found to be
cost-effective interventions that could be easily applied in the clinical
setting and are effective in improving the quality of sleep among patients
after cardiac surgery. Copyright © 2024 John Wiley & Sons Ltd.

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