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<1>
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Accession Number
2022080804
Title
Survival after Invasive or Conservative Management of Stable Coronary
Disease.
Source
Circulation. 147(1) (pp 8-19), 2023. Date of Publication: 03 Jan 2023.
Author
Hochman J.S.; O'Brien S.M.; Rosenberg Y.; Kirby R.; Lopez-Sendon J.;
Newman J.D.; Berger J.S.; Sidhu M.S.; White H.D.; Harrington R.A.; Boden
W.E.; Stone G.W.; Mark D.B.; Spertus J.A.; Maron D.J.; Reynolds H.R.;
Bangalore S.; Mavromichalis S.; Chang M.; Contreras A.; Esquenazi-Karonika
S.; Gilsenan M.; Gwiszcz E.; Mathews P.; Mohamed S.; Naumova A.; Roberts
A.; Vanloo K.; Anthopolos R.; Xu Y.; Troxel A.B.; Lu Y.; Huang Z.;
Broderick S.; Selvanayagam J.; Lopes R.D.; Goodman S.G.; Steg G.; Juliard
J.-M.; Doerr R.; Keltai M.; Bhargava B.; Thomas B.; Sharir T.; Nikolsky
E.; Maggioni A.P.; Kohsaka S.; Escobedo J.; Pracon R.; Bockeria O.; Senior
R.; Banfield A.; Shaw L.J.; Phillips L.; Berman D.; Kwong R.Y.; Picard
M.H.; Chaitman B.R.; Ali Z.; Min J.; Mancini G.B.J.; Leipsic J.; Guzman
L.; Hillis G.; Thambar S.; Joseph M.; Selvnayagam J.; Beltrame J.; Lang
I.; Schuchlenz H.; Huber K.; Goetschalckx K.; Hueb W.; Caramori P.R.; De
Quadros A.; Smanio P.; Mesquita C.; Lopas R.D.; Vitola J.; Marin-Neto J.;
Da Silva E.R.; Tumelero R.; Andrade M.; Alves A.R.; Dall'Orto F.;
Polanczyk C.; Figueiredo E.; Howarth A.; Gosselin G.; Cheema A.; Bainey
K.; Phaneuf D.; Diaz A.; Garg P.; Mehta S.; Wong G.; Lam A.; Cha J.;
Galiwango P.; Uxa A.; Chow B.; Hameed A.; Udell J.; Chema A.; Hamid M.;
Hauguel-Moreau M.; Furber A.; Goube P.; Steg P.-G.; Barone-Rochette G.;
Thuaire C.; Slama M.; Doer R.; Nickenig G.; Bekeredjian R.; Schulze P.C.;
Merkely B.; Fontos G.; Vertes A.; Varga A.; Bhargva B.; Kumar A.; Nair
R.G.; Grant P.; Manjunath C.; Moorthy N.; Satheesh S.; Nath R.K.; Wander
G.; Christopher J.; Dwivedi S.; Oomman A.; Mathur A.; Gadkari M.; Naik S.;
Punnoose E.; Kachru R.; Christophar J.; Kaul U.; Sharer T.; Kerner A.;
Tarantini G.; Perna G.P.; Racca E.; Mortara A.; Monti L.; Briguori C.;
Leone G.; Amati R.; Salvatori M.; Di Chiara A.; Calabro P.; Galvani M.;
Provasoli S.; Fukuda K.; Koshaka S.; Nakano S.; Laucevicius A.; Kedev S.;
Khairuddin A.; Escobdo J.; Riezebos R.; Timmer J.; Heald S.; Stewart R.;
Ramos W.M.; Demkow M.; Mazurek T.; Drozdz J.; Szwed H.; Witkowski A.;
Ferreira N.; Pinto F.; Ramos R.; Popescu B.; Pop C.; Bockeria L.; Bockerya
O.; Demchenko E.; Romanov A.; Bershtein L.; Jizeeri A.; Stankovic G.;
Apostolovic S.; Adjic N.C.; Zdravkovic M.; Beleslin B.; Dekleva M.;
Davidovic G.; Chua T.; Foo D.; Poh K.K.; Ntsekhe M.; Sionis A.; Marin F.;
Miro V.; Blancas M.G.; Gonzalez-Juanatey J.; Fernandez-Aviles F.; Peteiro
J.; Luena J.E.C.; Held C.; Aspberg J.; Rossi M.; Kuanprasert S.; Yamwong
S.; Johnston N.; Donnelly P.; Moriarty A.; Roxy R.; Elghamaz A.;
Gurunathan S.; Karogiannis N.; Shah B.N.; Trimlett R.H.J.; Rubens M.B.;
Nicol E.D.; Mittal T.K.; Hampson R.; Gamma R.; De Belder M.; Nageh T.;
Lindsay S.; Mavromatis K.; Miller T.; Banerjee S.; Reynolds H.; Nour K.;
Stone P.
Institution
(Hochman, Anthopolos, Reynolds, Bangalore, Xu, Mavromichalis, Chang,
Contreras, Newman, Berger, Troxel) NYU Grossman School of Medicine, New
York, NY, United States
(O'Brien, Lopes, Mark) Duke Clinical Research Institute, Durham, NC,
United States
(Rosenberg, Kirby) National Institutes of Health, Bethesda, MD, United
States
(Bhargava) All India Institute of Medical Sciences, New Delhi, India
(Senior, Banfield) Northwick Park Hospital, London, United Kingdom
(Senior) Imperial College London, Royal Brompton Hospital, United Kingdom
(Goodman) St Michael's Hospital, University of Toronto, Canada
(Pracon) Department of Coronary and Structural Heart Diseases, National
Institute of Cardiology, Warsaw, Poland
(Lopez-Sendon) IdiPaz Research Institute and Hospital, Universitario la
Paz, Madrid, Spain
(Maggioni) Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO)
Research Center, Florence, Italy
(Sidhu) Albany Medical College, NY, United States
(White) Te Whatu Ora Health New Zealand, Te Toki Tumai, Green Lane
Cardiovascular Services, University of Auckland, New Zealand
(Harrington, Maron) Stanford University, Department of Medicine, CA,
United States
(Boden) Veterans Affairs New England Healthcare System, Boston University
School of Medicine, MA, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri, Kansas City, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The ISCHEMIA trial (International Study of Comparative Health
Effectiveness With Medical and Invasive Approaches) compared an initial
invasive versus an initial conservative management strategy for patients
with chronic coronary disease and moderate or severe ischemia, with no
major difference in most outcomes during a median of 3.2 years. Extended
follow-up for mortality is ongoing. Method(s): ISCHEMIA participants
were randomized to an initial invasive strategy added to
guideline-directed medical therapy or a conservative strategy. Patients
with moderate or severe ischemia, ejection fraction >=35%, and no recent
acute coronary syndromes were included. Those with an unacceptable level
of angina were excluded. Extended follow-up for vital status is being
conducted by sites or through central death index search. Data obtained
through December 2021 are included in this interim report. We analyzed
all-cause, cardiovascular, and noncardiovascular mortality by randomized
strategy, using nonparametric cumulative incidence estimators, Cox
regression models, and Bayesian methods. Undetermined deaths were
classified as cardiovascular as prespecified in the trial protocol.
 Result(s): Baseline characteristics for 5179 original ISCHEMIA trial
participants included median age 65 years, 23% women, 16% Hispanic, 4%
Black, 42% with diabetes, and median ejection fraction 0.60. A total of
557 deaths accrued during a median follow-up of 5.7 years, with 268 of
these added in the extended follow-up phase. This included a total of 343
cardiovascular deaths, 192 noncardiovascular deaths, and 22 unclassified
deaths. All-cause mortality was not different between randomized treatment
groups (7-year rate, 12.7% in invasive strategy, 13.4% in conservative
strategy; adjusted hazard ratio, 1.00 [95% CI, 0.85-1.18]). There was a
lower 7-year rate cardiovascular mortality (6.4% versus 8.6%; adjusted
hazard ratio, 0.78 [95% CI, 0.63-0.96]) with an initial invasive strategy
but a higher 7-year rate of noncardiovascular mortality (5.6% versus 4.4%;
adjusted hazard ratio, 1.44 [95% CI, 1.08-1.91]) compared with the
conservative strategy. No heterogeneity of treatment effect was evident in
prespecified subgroups, including multivessel coronary disease.
 Conclusion(s): There was no difference in all-cause mortality with an
initial invasive strategy compared with an initial conservative strategy,
but there was lower risk of cardiovascular mortality and higher risk of
noncardiovascular mortality with an initial invasive strategy during a
median follow-up of 5.7 years. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT04894877. Copyright © 2023 Lippincott Williams and Wilkins.
All rights reserved.

<2>
Accession Number
2002101577
Title
Estrogen replacement therapy is not a recommended therapy for
postmenopausal women with coronary heart disease: A meta-analysis.
Source
Clinical and Experimental Obstetrics and Gynecology. 46(2) (pp 219-226),
2019. Date of Publication: 2019.
Author
Zheng Y.; Zhang H.; Lu W.; Liu Z.; Niu G.
Institution
(Zheng, Zhang, Liu) Department of Drug Branch, Liaocheng People's
Hospital, Liaocheng, Shandong, China
(Niu) Department of Endocrinology, Liaocheng People's Hospital, Liaocheng,
Shandong, China
(Lu) Department of Obstetrics and Gynecology, Liaocheng People's Hospital,
Liaocheng, Shandong, China
Publisher
S.O.G. CANADA Inc.
Abstract
Aim: This study was to investigate the effect of estrogen replacement
therapy (ERT) on clinical outcomes for postmenopausal women with
established coronary heart disease (CHD). Material(s) and Method(s):
The authors conducted a meta-analysis using 12 eligible studies. The
overall odds ratios (OR) or standardized mean difference (SMD) and their
corresponding 95% confidence interval (CI) were calculated.
 Result(s): For the incidence of adverse events, significant
difference was observed in the occurrence rates of CHD death (OR = 1.166,
95% CI: 1.000-1.360, p = 0.050) and death of any cause (OR = 1.221, 95%
CI: 1.057-1.410, p = 0.007) in postmenopausal women with CHD between ERT
and placebo groups, whereas there was no significant difference (p > 0.05)
in the occurrence rates of CHD events, myocardial infarction (MI),
revascularization, unstable angina (UA), venous thromboembolic event,
stroke/transient ischemic attack, and congestive heart failure between two
groups. With respect to the alterations of other clinical outcomes, the
SMD for the alteration of TC level was -0.192 (95% CI: -0.346-0.047, p =
0.015), and a significant difference was detected between the two groups,
whereas there was no significant difference (p > 0.05) in the alterations
of MLD and TG in patients between the two groups. Additionally, patients
treated with ERT had lower LDL and higher HDL levels. Conclusion(s):
This meta-analysis suggests that postmenopausal women with CHD receiving
ERT are more likely to suffer from CHD death, death of any cause, lower
LDL, and higher HDL and TC levels. Therefore, ERT should not be
recommended to postmenopausal women with CHD for the secondary prevention
of cardiovascular disease (CVD) clinically. Copyright © 2019
S.O.G. CANADA Inc.. All rights reserved.

<3>
Accession Number
2028997674
Title
Effect of percutaneous cerebral oximetry-guided anaesthetic management on
postoperative delirium in older adults undergoing off-pump coronary artery
bypass grafting: study protocol for a single-centre prospective randomised
controlled trial in a tertiary academic hospital in China.
Source
BMJ Open. 13(12) (no pagination), 2023. Article Number: e076419. Date of
Publication: 09 Dec 2023.
Author
Tian L.; Wang H.; Jia Y.; Jin L.; Zhou C.; Zhou H.; Yuan S.
Institution
(Tian, Wang, Jia, Jin, Zhou, Yuan) Department of Anesthesiology, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences, Peking Union Medical College, Beijing, China
(Zhou) Department of Intensive Care Unit, Fuwai Hospital, National Center
for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking
Union Medical College, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium is a prominent and clinically
important complication in older adults after coronary artery bypass
grafting (CABG) surgery, resulting in prolonged hospital stay, long-term
cognitive impairment and increased morbidity and mortality. Many studies
have shown that cerebral desaturation is associated with increased risk of
postoperative delirium during on-pump cardiac surgery. However, few
studies have focused on the effect of optimising regional cerebral oxygen
saturation (rSO 2) on postoperative delirium during off-pump CABG. The
purpose of this study is to investigate whether intraoperative anaesthetic
management based on percutaneous cerebral oximetry monitoring decreases
the incidence of postoperative delirium in older adults undergoing
off-pump CABG. Methods This single-centre randomised controlled trial will
randomly assign 200 patients to the intervention group or the control
group at a ratio of 1:1. The patients in the intervention group will be
observed by percutaneous cerebral oximetry monitoring that the
desaturation (a drop of more than 20% from baseline value or rSO 2 less
than 55% for >60 consecutive seconds at either probe) during the procedure
triggered the intervention strategies, while the cerebral oximetry data of
the control group will be hidden from the clinical team and patients will
be anaesthetised by the usual anaesthetic management. The primary outcome
will be the incidence of postoperative delirium during the first 7 days
after off-pump CABG. Delirium will be comprehensively evaluated by the
combination of the Richmond Agitation Sedation Scale and the Confusion
Assessment Method for the intensive care unit. The secondary outcomes will
include the incidence of postoperative acute kidney injury and myocardial
infarction during the hospital stay, as well as the intensive care unit
and hospital length of stay. Ethics and dissemination This study was
approved by the Ethics Committee of the Chinese Academy of Medical
Sciences, Fuwai Hospital (No 2022-1824). Written informed consent will be
obtained from each patient or their legal representatives before
enrolment. The results of this trial will be published in an international
peer-reviewed scientific journal. Trial registration number
ChiCTR2300068537. Copyright © The Author(s) 2023.

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Accession Number
2028718517
Title
The Effect of CytoSorb on Inflammatory Markers in Critically Ill Patients:
A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Source
Critical Care Medicine. 51(12) (pp 1659-1673), 2023. Date of Publication:
01 Dec 2023.
Author
Heymann M.; Schorer R.; Putzu A.
Institution
(Heymann, Schorer, Putzu) Division of Anesthesiology, Department of
Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine,
Geneva University Hospitals, Geneva, Switzerland
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: The effectiveness of CytoSorb at removing inflammatory
mediators in critically ill patients is controversial. DATA SOURCES:
Electronic databases were searched from inception to May 2023. STUDY
SELECTION: Randomized controlled trials reporting the effects of CytoSorb
therapy on inflammatory parameters in critically ill patients with
hyperinflammatory conditions were included. DATA EXTRACTION: Two authors
screened articles for eligibility, extracted data, and assessed the risk
of bias, conflicts of interest, and certainty of evidence (CoE). The
primary outcome was interleukin (IL)-6 at 1 day after initiation of the
therapy. Secondary outcomes included various inflammatory markers at 1, 2,
3, and 5 days and mortality. Data were pooled if at least three trials
reported the outcome of interest. We conducted meta-analyses of the data
using a random-effects model. DATA SYNTHESIS: Seventeen trials (n = 855)
were included. Fourteen trials were judged to have notable concern about
conflicts of interest. Seven trials were performed in medical ICU patients
with hyperinflammatory conditions and 10 in complex cardiovascular surgery
under cardiopulmonary bypass. Hemoadsorption with CytoSorb was not
associated with lower IL-6 at 1 day (mean difference -5.98 [95% CI, -30.44
to 18.48] pg/mL), 2 days, 3 days, or 5 days after initiation of the
treatment, as well as the concentration of procalcitionin. The levels of
C-reactive protein were not lower with CytoSorb at 1, 2, and 3 days. The
use of CytoSorb was associated with higher mortality at latest follow-up
(relative risk = 1.22 [95% CI, 1.02-1.45]) and at 30 days. CoE ranged from
low to very low. CONCLUSION(S): The use of CytoSorb hemoadsorption in
a mixed population of critically ill patients with hyperinflammatory
conditions does not exhibit a consistent decrease in IL-6 and other
inflammatory parameters within the first 5 days of treatment. The
significant uncertainty surrounding these findings highlights the need for
further investigations. Copyright © 2023 Lippincott Williams and
Wilkins. All rights reserved.

<5>
Accession Number
2028023573
Title
Mollicutes-related infections in thoracic surgery including lung and heart
transplantation: A systematic review.
Source
Journal of Heart and Lung Transplantation. 43(1) (pp 169-180), 2024. Date
of Publication: January 2024.
Author
Farfour E.; Vasse M.; Vallee A.
Institution
(Farfour, Vasse) Service de Biologie Clinique, Hopital Foch, Suresnes,
France
(Vasse) Universite Paris-Saclay, INSERM Hemostase Inflammation Thrombose
HITH U1176, Le Kremlin-Bicetre, France
(Vallee) Departement d'Epidemiologie et de Sante Publique, Hopital Foch,
Suresnes, France
Publisher
Elsevier Inc.
Abstract
Background: Urogenital Mollicutes, that is, Mycoplasma hominis and
Ureaplasma spp., can colonize the urogenital tract. While urogenital
colonization is frequent, infections are rare but should not be missed.
Furthermore, extragenital infections are even rarer. Over the past years,
they have been increasingly documented as a cause of hyperammonemia
syndrome (HS) and post-surgical infections. We review the literature on
studies focused on post-surgical infections and HS involving urogenital
Mollicutes after thoracic surgery including lung (LTR) and heart (HTR)
transplantation. Method(s): A systematic review was performed by
searching PubMed/Medline case reports, case series, cohort studies, and
clinical trials. Cases of infections and HS by urogenital Mollicutes after
HTR and LTR transplantations were reported. Result(s): Overall,
urogenital Mollicutes were associated with 15 HS, 31 infections in HTR and
LTR, and 18 post-thoracic surgical infections in another context.
Post-surgical infections were reported in all contexts. They were mainly
due to M hominis, the only species that could cultivate on standard
enriched agar forming pinpoint colonies after 3-5 days of incubation.
Microbiologists should be prompted to pinpoint colonies even if the
examination of Gram-staining is negative. The patients' management
required surgical treatment and antimicrobials, almost always
tetracyclines and/or fluoroquinolones. Conversely, HS occurred almost
exclusively in bilateral LTR and is more likely due to Ureaplasma spp. As
Ureaplasma spp. do not cultivate on standard media, the microbiological
diagnosis was performed using molecular methods. Conclusion(s):
Infections involving urogenital Mollicute should be considered in LTR with
HS. The overall rate of mortality is high and might be due in part to
delay in etiologic diagnosis. Post-surgical infections were reported in
all contexts. The route of contamination with Mollicutes remains unknown
in HTR and non-transplant surgery, but evidence of transmission from
donors has been documented for LTR. Copyright © 2023

<6>
Accession Number
2019632272
Title
Preliminary Report from a Randomized Controlled Trial Comparing Two Bovine
Pericardial Valves.
Source
Thoracic and Cardiovascular Surgeon. 71(8) (pp 648-655), 2022. Date of
Publication: 28 Jan 2022.
Author
Sohn S.H.; Choi J.W.; Lee J.H.; Kim J.S.; Lim C.; Hwang H.Y.
Institution
(Sohn, Kim, Choi, Hwang) Department of Thoracic and Cardiovascular
Surgery, Seoul National University Hospital, Seoul, South Korea
(Lee, Kim, Lim) Department of Thoracic and Cardiovascular Surgery, Seoul
National University, Bundang Hospital, Seongnam, South Korea
Publisher
Georg Thieme Verlag
Abstract
Background A randomized controlled trial was designed to compare 1-year
hemodynamic profiles and clinical outcomes after bioprosthetic aortic
valve replacement (AVR) using a recently introduced (study group) and
world-widely used (control group) bovine pericardial bioprostheses. This
study evaluated early postoperative outcomes as a preliminary analysis.
Methods The primary end point of the trial was the mean pressure gradient
across the aortic valve (AVMPG) at 1 year after surgery. Patients were
screened to enroll 70 patients in each group based on a noninferiority
design. Early postoperative hemodynamic and clinical outcomes were
compared between the two groups. Results There were no differences in
baseline characteristics, including sex and body surface area (1.64 +/-
0.18 vs. 1.65 +/- 0.15 m 2) between the two groups. The AVMPG
on early postoperative echocardiography was 15.2 +/- 4.6 mm Hg and 16.5
+/- 6.2 mm Hg in the study and control groups, respectively (p = 0.177).
Although AVMPG of the 19 mm prostheses was lower in the study group than
in the control group (17.0 +/- 6.3 mm Hg vs. 22.8 +/- 6.6 mm Hg, p =
0.039), there were no significant differences in the effective orifice
area in all patients (1.57 +/- 0.41 cm 2vs. 1.53 +/- 0.34 cm
2, p = 0.568), and each valve size. The effective orifice area
index was also similar between the two groups in overall (p = 0.352), and
in each valve size. There were no significant differences in clinical
outcomes including operative mortality and postoperative complications
between the two groups. Conclusion Early postoperative hemodynamic and
clinical results after AVR using a recently introduced bovine pericardial
valve were comparable with those using the control valve
(NCT03796442). Copyright © 2022 Georg Thieme Verlag. All rights
reserved.

<7>
Accession Number
2029157674
Title
Effect of Mechanical Ventilation Mode Type on Postoperative Pulmonary
Complications After Cardiac Surgery: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Li X.-F.; Mao W.-J.; Jiang R.-J.; Zhang M.-Q.; Yu H.
Institution
(Li, Yu, Zhang, Yu) Department of Anesthesiology, West China Hospital,
Sichuan University, Chengdu, China
(Mao) Department of Anesthesiology, Jianyang People's Hospital, Jianyang,
China
(Jiang) Department of Anesthesiology, Chengdu Second People's Hospital,
Chengdu, China
Publisher
W.B. Saunders
Abstract
Objectives: It is unknown whether there is a difference in pulmonary
outcome in different intraoperative ventilation modes for cardiac surgery
with cardiopulmonary bypass (CPB). The aim of this trial was to determine
whether patients undergoing cardiac surgery with CPB could benefit from
intraoperative optimal ventilation mode. Design(s): This was a
single-center, prospective, randomized controlled trial. Setting(s):
The study was conducted at a single-center tertiary-care hospital.
 Participant(s): A total of 1,364 adults undergoing cardiac surgery
with CPB participated in this trial. Intervention(s): Patients were
assigned randomly (1:1:1) to receive 1 of 3 ventilation modes:
volume-controlled ventilation (VCV), pressure-controlled ventilation
(PCV), and pressure-controlled ventilation-volume guaranteed (PCV-VG). All
arms of the study received the lung-protective ventilation strategy.
 Measurements and Main Results: The primary outcome was a composite of
postoperative pulmonary complications (PPCs) within the first 7
postoperative days. Pulmonary complications occurred in 168 of 455
patients (36.9%) in the PCV-VG group, 171 (37.6%) in the PCV group, and
182 (40.1%) in the VCV group, respectively. There was no statistical
difference in the risk of overall pulmonary complications among groups (p
= 0.585). There were no significant differences in the severity grade of
PPCs within 7 days, postoperative ventilation duration, intensive care
unit stay, postoperative hospital stay, or 30-day postoperative mortality.
 Conclusion(s): Among patients scheduled for cardiac surgery with CPB,
intraoperative ventilation mode type did not affect the risk of
postoperative pulmonary complications. Copyright © 2023

<8>
Accession Number
2029132759
Title
A review of the conservative versus invasive management of ischemic heart
failure with reduced ejection fraction.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102347. Date of Publication: February 2024.
Author
Matta A.; Ohlmann P.; Nader V.; Levai L.; Kang R.; Carrie D.; Roncalli J.
Institution
(Matta, Nader, Levai) Department of Cardiology, Civilian Hospital of
Colmar, Colmar, France
(Ohlmann) Department of Cardiology, University Hospital of Strasbourg,
Strasbourg, France
(Kang, Carrie, Roncalli) Department of Cardiology, University Hospital of
Toulouse, Toulouse, France
Publisher
Elsevier Inc.
Abstract
Heart failure is increasing in terms of prevalence, morbidity, and
mortality rates. Clinical trials and studies are focusing on heart failure
as it is the destiny end-stage for several cardiovascular disorders.
Recently, medical therapy has dramatically progressed with novel classes
of medicines providing better quality of life and survival outcomes.
However, heart failure remains a heavy impactful factor on societies and
populations. Current guidelines from the American and European cardiac
societies are not uniform with respect to the class and level of treatment
recommendations for coronary artery disease patients with heart failure
and reduced ejection fraction. The discrepancy among international
recommendations, stemming from the lack of evidence from adequately
powered randomized trials, challenges physicians in choosing the optimal
strategy. Hybrid therapy including optimal medical therapy with
revascularization strategies are commonly used for the management of
ischemic heart failure. Coronary artery bypass graft (CABG) has proved its
efficacy on improving long term outcome and prognosis while no large
randomized clinical trials for percutaneous coronary intervention (PCI)
are still available. Regardless of the lack of data and recommendations,
the trends of performing PCI in ischemic heart failure prevailed over CABG
whereas lesion complexity, chronic total occlusion and complete
revascularization achievement are limiting factors. Lastly, regenerative
medicine seems a promising approach for advanced heart failure enhancing
cardiomyocytes proliferation, reverse remodeling, scar size reduction and
cardiac function restoration. Copyright © 2023 Elsevier Inc.

<9>
Accession Number
2028851647
Title
Efficacy and safety of bempedoic acid among patients with and without
diabetes: prespecified analysis of the CLEAR Outcomes randomised trial.
Source
The Lancet Diabetes and Endocrinology. 12(1) (pp 19-28), 2024. Date of
Publication: January 2024.
Author
Ray K.K.; Nicholls S.J.; Li N.; Louie M.J.; Brennan D.; Lincoff A.M.;
Nissen S.E.
Institution
(Ray) Imperial Centre for Cardiovascular Disease Prevention, Department of
Primary Care and Public Health, Imperial College London, London, United
Kingdom
(Nicholls) Victorian Heart Institute, Monash University, Melbourne, VIC,
Australia
(Li, Louie) Esperion Therapeutics, Ann Arbor, MI, United States
(Brennan, Lincoff, Nissen) Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Ltd
Abstract
Background: Statins reduce LDL cholesterol and cardiovascular events among
those with or without diabetes but have been reported to increase
new-onset diabetes. The CLEAR Outcomes trial demonstrated that bempedoic
acid reduced the risk of major adverse cardiovascular events among
statin-intolerant patients at high cardiovascular risk. In this
prespecified analysis, our dual aims were to evaluate the cardiovascular
benefits of bempedoic acid, an ATP-citrate lyase inhibitor, in individuals
with diabetes, and to evaluate the risk of new-onset diabetes and
HbA<inf>1c</inf> among those without diabetes in the CLEAR Outcomes trial.
 Method(s): CLEAR Outcomes was a randomised, double-blind,
placebo-controlled trial conducted across 1250 primary care and outpatient
sites in 32 countries. Patients with or without cardiovascular disease who
were unwilling or unable to take guideline-recommended doses of statins
and an LDL cholesterol of 2.59 mmol/L or more were randomly assigned (1:1)
in a double-blinded manner to either bempedoic acid 180 mg once per day or
placebo. In this prespecified analysis, the efficacy endpoint was a
time-to-event analysis of four-component major adverse cardiovascular
event (MACE-4), which is the composite of cardiovascular death, nonfatal
myocardial infarction, nonfatal stroke, or coronary revascularisation,
using the intention-to-treat population stratified by baseline glycaemia
status. The prespecified analysis of risk of new-onset diabetes and
HbA<inf>1c</inf> increase was evaluated in patients without diabetes at
baseline. The CLEAR Outcomes trial was completed on Nov 7, 2022, and is
registered with ClinicalTrials.gov (NCT02993406). Finding(s): Between
Dec 22, 2016, and Nov 7, 2022, 13 970 patients were screened and randomly
assigned; 6373 (45.6%) with diabetes, 5796 (41.5%) with prediabetes, and
1801 (12.9%) with normoglycaemia. Over a median of 3.4 years follow up,
patients with diabetes had significant relative and absolute
cardiovascular risk reductions in MACE-4 endpoints with bempedoic acid (HR
0.83; 95% CI 0.72-0.95; absolute risk reduction of 2.4%) compared to
placebo, with no statistical evidence of effect modification across
glycaemic strata (interaction p=0.42). The proportion of patients who
developed new-onset diabetes were similar between the bempedoic acid and
placebo groups, with 429 of 3848 (11.1%) with bempedoic acid versus 433 of
3749 (11.5%) with placebo (HR 0.95; 95% CI 0.83-1.09). HbA<inf>1c</inf>
concentrations at month 12 and the end of the study were similar between
randomised groups in patients who had prediabetes and normoglycaemia.
Placebo-corrected LDL cholesterol concentrations and high-sensitivity
C-reactive protein at 6 months were reduced in each glycaemic stratum
(diabetes, prediabtes, and normoglycaemia) for patients randomly assigned
to bempedoic acid (all p<0.001). Interpretation(s): Among patients
with diabetes, bempedoic acid reduces LDL cholesterol and high-sensitivity
C-reactive protein and risk of cardiovascular events. Patients without
diabetes had no increase in new-onset diabetes or worsening
HbA<inf>1c</inf> with bempedoic acid. The efficacy and cardiometabolic
safety profile of bempedoic acid makes it a clinical option for those with
and without diabetes. Funding(s): Esperion
Therapeutics. Copyright © 2024 The Author(s). Published by
Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0
license

<10>
Accession Number
2027251621
Title
Impact of preoperative chemotherapy on cutaneous wound healing in lung
cancer patients: A meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Zhao J.; Cui H.; Qu M.; Xu Z.; Zhang Y.; Ma C.
Institution
(Zhao, Qu, Xu, Zhang, Ma) Department of Cardiothoracic Surgery,
Heilongjiang Provincial Hospital, Harbin, China
(Cui) Department of Respiratory Medicine, Heilongjiang Provincial
Hospital, Harbin, China
Publisher
John Wiley and Sons Inc
Abstract
As part of their treatment, lung cancer patients frequently endure
thoracic oncological surgery, with preoperative chemotherapeutic
interventions being the common approach. However, the potential impact of
these chemotherapeutic regimens on cutaneous wound healing outcomes
following surgery remains the topic of considerable clinical interest.
This meta-analysis sought to evaluate comprehensively the effect of
preoperative chemotherapeutic regimens on cutaneous wound healing in lung
cancer patients following thoracic oncological surgery. Extensive
literature searches were conducted using the leading databases PubMed,
Embase, Cochrane Library and Scopus. Eight studies out of 1342 identified
satisfied the inclusion criteria. Consideration was given to both
randomized controlled trials (RCTs) and observational studies. Data
pertaining to study characteristics, patient demographics,
chemotherapeutic regimens and wound healing outcomes were extracted with
great attention to detail. The examination of these varied studies
provided insights into the fluctuations in rates of recovery following
treatment, incidences of wound infections and frequencies of surgical
complications. The research studies provided odds ratios for recovery that
varied significantly in magnitude from 0.95 to 0.38, with regard to the
probability of wound infection. Furthermore, a range of odds ratios for
complications were disclosed, with certain odds ratios displaying narrow
confidence intervals. The complexity of the effect of preoperative
chemotherapy on wound closure subsequent to thoracic oncologic surgery is
highlighted by our findings. The results underscore the need for
individualized treatment strategies for lung cancer patients undergoing
surgical procedures that strike a balance between patient safety and
optimal clinical outcomes. Copyright © 2023 The Authors.
International Wound Journal published by Medicalhelplines.com Inc and John
Wiley & Sons Ltd.

<11>
Accession Number
2027244600
Title
A systematic review and meta-analysis of the efficacy and safety of
Mavacamten therapy in international cohort of 524 patients with
hypertrophic cardiomyopathy.
Source
Heart Failure Reviews. (no pagination), 2023. Date of Publication: 2023.
Author
Yacoub M.S.; El-Nakhal T.; Hasabo E.A.; Shehata N.; Wilson K.; Ismail
K.H.; Bakr M.S.; Mohsen M.; Mohamed A.; Abdelazim E.; Ali H.T.; Soliman
Z.; Sayed A.; Abdelsayed K.; Caliskan K.; Soliman O.
Institution
(Yacoub, Hasabo, Soliman) Discipline of Cardiology, Saolta Healthcare
Group, Health Service Executive, Galway University Hospital, Galway,
Ireland
(Yacoub, Hasabo, Soliman) CORRIB Research Centre for Advanced Imaging and
Core Laboratory, Clinical Science Institute, University of Galway, Galway
H91 TK33, Ireland
(El-Nakhal) University Hospitals of Leicester NHS Trust, Leicester, United
Kingdom
(Shehata, Wilson, Ismail, Sayed) Faculty of Medicine, Ain Shams
University, Cairo, Egypt
(Bakr) Faculty of Medicine, New Mansoura University, Coast Road, New
Mansoura, Egypt
(Bakr) Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt
(Mohsen) School of Medicine, University of Jordan, Amman, Jordan
(Mohamed, Ali, Soliman, Abdelsayed) Faculty of Medicine, South Valley
University, Qena, Egypt
(Abdelazim) Faculty of Medicine, Misr University for Science and
Technology, Giza, Egypt
(Caliskan) Erasmus MC University Medical Center, Rotterdam, Netherlands
(Soliman) CURAM Centre for Medical Devices, Galway, Ireland
(Soliman) Euro Heart Foundation, Schiedam, Netherlands
Publisher
Springer
Abstract
Hypertrophic cardiomyopathy (HCM) is the most common heritable myocardial
disorder worldwide. Current pharmacological treatment options are limited.
Mavacamten, a first-in-class cardiac myosin inhibitor, targets the main
underlying pathology of HCM. We conducted a systematic review and
meta-analysis to evaluate the efficacy and safety of Mavacamten in
patients with HCM. PRISMA flow chart was utilized using PubMed, SCOPUS,
and Cochrane databases for all up-to-date studies using pre-defined
keywords. Pre-specified efficacy outcomes comprised several parameters,
including an improvement in peak oxygen consumption (pVO2) and >= 1 NYHA
class, the need for septal reduction therapy (SRT), change from baseline
in Kansas City Cardiomyopathy Questionnaire (KCCQ), changes in biochemical
markers and LVEF, along with peak left ventricular outflow tract gradient
at rest and after Valsalva maneuver. Safety outcomes included morbidity
and serious adverse events. This systematic review included five studies,
four RCTs and one non-randomized control trial comprised a total of 524
(Mavacamten [273, 54.3%] vs placebo [230, 45.7%] adult (>= 18 years)
patients with a mean age of 56 years. The study. comprised patients with
Caucasian and Chinese ethnicity and patients with obstructive (oHCM) and
non-obstructive (nHCM) HCM. Most baseline characteristics were similar
between the treatment and placebo groups. Mavacamten showed a
statistically significant increase in the frequency of the primary
composite endpoint (RR = 1.92, 95% CI [1.28, 2.88]), >= 1 NYHA class
improvement (RR = 2.10, 95% CI [1.66, 2.67]), a significant decrease in
LVEF, peak left ventricular outflow tract gradient at rest and after
Valsalva maneuver. Mavacamten also showed a significant reduction in SRT
rates (RR = 0.29, 95% CI [0.21, 0.40], p < 0.00001), KCCQ clinical summary
scores (MD = 8.08, 95% CI [4.80, 11.37], P < 0.00001) troponin levels and
N-terminal pro-B-type natriuretic peptide levels. However, there was no
statistically significant difference between Mavacamten and placebo
regarding the change from baseline peak oxygen consumption. Mavacamten use
resulted in a small increase in adverse events but no statistically
significant increment in serious adverse events. Our study showed that
Mavacamten is a safe and effective treatment option for Caucasian and
Chinese patients with HCM on the short-term. Further research is needed to
explore the long-term safety and efficacy of Mavacamten with HCM. In
addition, adequately powered studies including patients with nHCM is
needed to ascertain befits of Mavacamten in those patients. Copyright
© 2023, The Author(s), under exclusive licence to Springer
Science+Business Media, LLC, part of Springer Nature.

<12>
Accession Number
2027208007
Title
Comparison of six percent hydroxyethyl starch 130/0.4 and ringer's lactate
as priming solutions in patients undergoing isolated open heart valve
surgery: A double-blind randomized controlled trial.
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
2023.
Author
Sheikhi B.; Rezaei Y.; Baghaei Vaji F.; Fatahi M.; Hosseini Yazdi M.;
Totonchi Z.; Banar S.; Peighambari M.M.; Hosseini S.; Mestres C.A.
Institution
(Sheikhi, Fatahi, Hosseini Yazdi, Totonchi) Rajaie Cardiovascular Medical
and Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Rezaei, Baghaei Vaji, Totonchi, Banar, Hosseini) Heart Valve Disease
Research Center, Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Peighambari) Cardiovascular Intervention Research Center, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Mestres) Department of Cardiothoracic Surgery and the Robert WM Frater
Cardiovascular Research Centre, The University of the Free State
Bloemfontein, Bloemfontein, South Africa
Publisher
SAGE Publications Ltd
Abstract
Objectives: Colloids are added to the priming solution of the
cardiopulmonary bypass (CPB) pump to maintain colloid osmotic pressure and
prevent fluid overload. This study aimed to compare the effects of 6%
hydroxyethyl starch (HES) 130/0.4 and ringer's lactate (RL) priming
solution on patients' outcomes undergoing isolated heart valve surgery
with CPB. Method(s): This randomized clinical trial included one
hundred and 20 patients undergoing heart valve surgery, and those were
allocated into two groups. Patients in the RL group received 1500 mL of
RL, and those in the RL + HES group were given 500 mL of HES and 1000 mL
of RL. Result(s): The patients' median age was 52 (IQR 42-60) and 50
(IQR 40-61) years in the RL + HES and the RL group, respectively (p =.71).
The number of cases that required blood product transfusion in both the
operating room and intensive care unit was also significantly higher in
the RL + HES group compared to the RL group (RR 2.04, 95% CI 1.50-2.76; p
<.01 and RR 1.42, 95% CI 1.01-2.01; p =.05, respectively). Declines in
postoperative creatinine levels and platelet counts were higher in the RL
+ HES compared to the RL group (between-subjects effect p =.007 and p
=.038, respectively), while the incidence of acute kidney injury was
comparable between groups (RR 0.66, 95% CI 0.13-3.30; p =.55).
 Conclusion(s): Among patients undergoing heart valve surgery with
CPB, 6% HES added to RL for priming compared with only RL increased the
risk of the need for blood product transfusion over the hospitalization
period. Copyright © The Author(s) 2023.

<13>
Accession Number
2027197590
Title
Use of intraoperative haemoadsorption in patients undergoing heart
transplantation: a proof-of-concept randomized trial.
Source
ESC Heart Failure. (no pagination), 2023. Date of Publication: 2023.
Author
Nemeth E.; Soltesz A.; Kovacs E.; Szakal-Toth Z.; Tamaska E.; Katona H.;
Racz K.; Csikos G.; Berzsenyi V.; Fabry S.; Ulakcsai Z.; Tamas C.; Nagy
B.; Varga M.; Merkely B.
Institution
(Nemeth, Soltesz, Kovacs, Szakal-Toth, Tamaska, Katona, Racz, Csikos,
Berzsenyi, Fabry, Ulakcsai, Tamas, Merkely) Heart and Vascular Center,
Semmelweis University, Budapest, Hungary
(Nemeth, Soltesz, Kovacs, Tamaska, Katona, Racz, Csikos, Berzsenyi, Fabry,
Ulakcsai) Department of Anaesthesiology and Intensive Therapy, Semmelweis
University, Budapest, Hungary
(Nagy) Department of Pathology and Experimental Cancer Research,
Semmelweis University, Budapest, Hungary
(Varga) Department of Laboratory Medicine, Semmelweis University,
Budapest, Hungary
Publisher
John Wiley and Sons Inc
Abstract
Aims: The aim of this trial was to compare the clinical effects of
intraoperative haemoadsorption versus standard care in patients undergoing
orthotopic heart transplantation (OHT). Methods and Results: In a
randomized, controlled trial, OHT recipients were randomized to receive
intraoperative haemoadsorption or standard care. Outcomes were
vasoactive-inotropic score (VIS), frequency of vasoplegic syndrome (VS) in
the first 24 h; post-operative change in procalcitonin (PCT) and
C-reactive protein (CRP) levels; intraoperative change in mycophenolic
acid (MPA) concentration; frequency of post-operative organ dysfunction,
major complications, adverse immunological events and length of
in-hospital stay and 1-year survival. Sixty patients were randomized
(haemoadsorption group N = 30, control group N = 25 plus 5 exclusions).
Patients in the haemoadsorption group had a lower median VIS and rate of
VS (VIS: 27.2 [14.6-47.7] vs. 41.9 [22.4-63.2], P = 0.046, and VS: 20.0%
vs. 48.0%, P = 0.028, respectively), a 6.4-fold decrease in the odds of
early VS (OR: 0.156, CI: 0.029-0.830, P = 0.029), lower PCT levels,
shorter median mechanical ventilation (MV: 25 [19-68.8] hours vs. 65
[23-287] hours, P = 0.025, respectively) and intensive care unit stay (ICU
stay: 8.5 [8.0-10.3] days vs. 12 [8.5-18.0] days, P = 0.022, respectively)
than patients in the control group. Patients in the haemoadsorption versus
control group experienced lower rates of acute kidney injury (AKI: 36.7%
vs. 76.0%, P = 0.004, respectively), renal replacement therapy (RRT: 0%
vs. 16.0%, P = 0.037, respectively) and lower median per cent change in
bilirubin level (PCB: 2.5 [-24.6 to 71.1] % vs. 72.1 [11.2-191.4] %, P =
0.009, respectively) during the post-operative period. MPA concentrations
measured at pre-defined time points were comparable in the haemoadsorption
compared to control groups (MPA pre-cardiopulmonary bypass: 2.4
[1.15-3.60] mug/mL vs. 1.6 [1.20-3.20] mug/mL, P = 0.780, and MPA 120 min
after cardiopulmonary bypass start: 1.1 [0.58-2.32] mug/mL vs. 0.9
[0.45-2.10] mug/mL, P = 0.786). The rates of cardiac allograft rejection,
30-day mortality and 1-year survival were similar between the groups.
 Conclusion(s): Intraoperative haemoadsorption was associated with
better haemodynamic stability, mitigated PCT response, lower rates of
post-operative AKI and RRT, more stable hepatic bilirubin excretion, and
shorter durations of MV and ICU stay. Intraoperative haemoadsorption did
not show any relevant adsorption effect on MPA. There was no increase in
the frequency of early cardiac allograft rejection related to
intraoperative haemoadsorption use. Copyright © 2023 The Authors.
ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<14>
Accession Number
643035516
Title
Comparing outcomes between coronary artery bypass grafting and
percutaneous coronary intervention in octogenarians with left main or
multivessel disease.
Source
Scientific reports. 13(1) (pp 22323), 2023. Date of Publication: 15 Dec
2023.
Author
Kirov H.; Caldonazo T.; Riedel L.L.; Tasoudis P.; Moschovas A.; Diab M.;
Farber G.; Doenst T.
Institution
(Kirov, Caldonazo, Riedel, Moschovas, Diab, Farber, Doenst) Department of
Cardiothoracic Surgery, Friedrich-Schiller-University, Jena, Germany
(Tasoudis) Division of Cardiothoracic Surgery, University of North
Carolina, Chapel Hill, United States
(Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Am Klinikum 1, Jena 07747, Germany
Abstract
Mechanisms of coronary artery bypass grafting (CABG) and percutaneous
coronary intervention (PCI) differ as CABG provides surgical
collateralization and may prolong life by preventing future myocardial
infarctions (MI). However, CABG benefits are unclear in octogenarians,
where surgical risk is often perceived as higher and PCI is chosen more
liberally. We performed a meta-analysis of studies comparing outcomes in
octogenarians with left main or multivessel disease who underwent CABG or
PCI. Primary outcome was late mortality (>5 years). Secondary outcomes
were perioperative mortality, MI, re-revascularization (R-R), acute renal
failure (ARF), and stroke. Fourteen studies with 17,942 patients were
included. CABG was associated with lower late mortality (hazard ratio, HR:
1.23, 95% confidence interval: CI 1.05-1.44, p<0.01). In the pooled
Kaplan-Meier analysis CABG showed significantly lower risk of death in the
follow-up compared to PCI (HR: 1.08, 95%CI 1.02-1.41, p=0.005). Landmark
analyses confirmed the survival advantage of CABG over PCI after 21.5
months of follow-up (HR: 1.31, 1.19-1.44, p<0.0001), but suggested
advantage of PCI over CABG in the first 30-days (HR: 0.72, 0.64-0.82,
p<0.0001) and comparable survival from 1 to 21.5 months (HR: 0.98,
0.92-1.05, p=0.652). We found lower risk for MI and R-R after CABG but
higher perioperative mortality and no differences in ARF and stroke. CABG
appears superior to PCI over time in octogenarians with complex CAD. This
survival advantage is associated with fewer events of MI and R-R; however,
it comes with an increased risk in perioperative mortality. Copyright
© 2023. The Author(s).

<15>
Accession Number
2029072530
Title
Long-Term Outcomes After Hybrid Coronary Revascularization Versus Coronary
Artery Bypass Grafting: Meta-Analysis of Kaplan-Meier-Derived Data.
Source
American Journal of Cardiology. 212 (pp 13-22), 2024. Date of Publication:
01 Feb 2024.
Author
Shimamura J.; Miyamoto Y.; Hibino M.; Fukuhara S.; Takayama H.; Itagaki
S.; Takagi H.; Kuno T.
Institution
(Shimamura) Division of Cardiothoracic Surgery, Westchester Medical
Center, Valhalla, New York, United States
(Miyamoto) Division of Nephrology and Endocrinology, University of Tokyo,
Tokyo, Japan
(Hibino) Division of Cardiothoracic Surgery, Emory University, Atlanta,
Georgia
(Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Takayama) Division of Cardiothoracic Surgery, Department of Surgery, New
York Presbyterian Hospital, Columbia University Medical Center, New York,
New York, United States
(Itagaki) Department of Cardiovascular Surgery, Icahn School of Medicine
at Mount Sinai, New York, New York, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
Medical College, Bronx, NY, United States
(Kuno) Division of Cardiology, Jacobi Medical Center, Albert Einstein
Medical College, Bronx, NY, United States
Publisher
Elsevier Inc.
Abstract
Hybrid coronary revascularization (HCR) is an alternative option to
conventional coronary artery bypass grafting (CABG), but the long-term
outcomes of HCR versus CABG remain unclear. We aimed to analyze the
long-term outcomes after HCR and CABG for patients with multivessel
coronary artery disease using meta-analysis. A systemic literature search
of PubMed and EMBASE was performed from inception to March 2023. Studies
reporting Kaplan-Meier curves with follow-up >=1 year were included. The
primary outcome was all-cause mortality, and the secondary outcomes were
major adverse cardiac and cerebrovascular events (MACCEs) and repeat
revascularization. In total, 13 studies (1 randomized controlled trial and
12 propensity-score matched observational studies) were analyzed. The mean
follow-up period was 5.1 +/- 3.1 years. HCR was associated with similar
overall mortality (hazard ratio [HR] 1.09, 95% confidence interval [CI]
0.87 to 1.36), significantly higher incidence of MACCEs (HR 1.49, 95% CI
1.07 to 2.06), and repeat revascularization (HR 2.01, 95% CI 1.53 to 2.64)
compared with CABG. In phase-specific analysis, the mortality rate was
similar, and the incidence of repeat revascularization was higher in HCR
regardless of phases. The incidence of MACCEs was higher in HCR during the
mid-term phase (1 to 5 years), but it was similar during the long-term
phase (long-term: >=5 years). In conclusion, despite the higher incidence
of MACCEs and repeat revascularization compared with CABG, HCR offered a
similar long-term survival. Even longer-term follow-up and randomized
controlled trials with a large population are warranted to investigate the
role of HCR for multivessel coronary artery disease. Copyright ©
2023 Elsevier Inc.

<16>
Accession Number
2029192956
Title
Long-Term Outcomes of Valve-in-Valve Transcatheter Aortic Valve
Implantation Versus Redo Surgical Aortic Valve Replacement: Meta-Analysis
of Kaplan-Meier-Derived Data.
Source
American Journal of Cardiology. 212 (pp 30-39), 2024. Date of Publication:
01 Feb 2024.
Author
Sa M.P.; Jacquemyn X.; Serna-Gallegos D.; Makani A.; Kliner D.; Toma C.;
West D.; Ahmad D.; Yousef S.; Brown J.A.; Yoon P.; Kaczorowski D.; Bonatti
J.; Chu D.; Sultan I.
Institution
(Sa, Serna-Gallegos, West, Ahmad, Yousef, Brown, Yoon, Kaczorowski,
Bonatti, Chu, Sultan) Department of Cardiothoracic Surgery, University of
Pittsburgh, Pittsburgh, PA, United States
(Sa, Serna-Gallegos, Makani, Kliner, Toma, West, Ahmad, Yousef, Brown,
Yoon, Kaczorowski, Bonatti, Chu, Sultan) UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Makani, Kliner, Toma) Department of Interventional Cardiology, University
of Pittsburgh, Pittsburgh, PA, United States
Publisher
Elsevier Inc.
Abstract
Valve-in-valve (ViV) transcatheter aortic valve implantation (ViV-TAVI) in
patients with failed bioprostheses arose as an alternative to redo
surgical aortic valve replacement (SAVR). To evaluate all-cause mortality
in ViV-TAVI versus redo-SAVR, we performed a study-level meta-analysis of
reconstructed time-to-event data from Kaplan-Meier curves of nonrandomized
studies published by August 2023. A total of 16 studies met our
eligibility criteria, with a total of 4,373 patients (2,204 patients
underwent ViV-TAVI and 2,169 patients underwent redo-SAVR). Pooling all
the studies, ViV-TAVI showed a lower risk of all-cause mortality in the
first 6 months (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.46
to 0.73, p <0.001), with an HR reversal after this time point favoring
redo-SAVR (HR 1.92, 95% CI 1.58 to 2.33, p <0.001). Pooling only the
matched populations (which represented 64.6% of the overall population),
ViV-TAVI showed a lower risk of all-cause mortality in the first 6 months
(HR 0.56, 95% CI 0.43 to 0.73, p <0.001], with a reversal after 6 months
favoring redo-SAVR (HR 1.55, 95% CI 1.25 to 1.93, p <0.001). The
meta-regression analyses revealed a modulating effect of the following
covariates: age, coronary artery disease, history of coronary artery
bypass graft surgery, and implanted valves <25 mm. In conclusion, ViV-TAVI
is associated with better survival immediately after the procedure than
redo-SAVR; however, this primary advantage reverses over time, and
redo-SAVR seems to offer better survival at a later stage. Because these
results are pooled data from observational studies, they should be
interpreted with caution, and randomized controlled trials are
warranted. Copyright © 2023 Elsevier Inc.

<17>
Accession Number
2029265778
Title
The Effect of Peri-Device Leaks on Ischaemic Stroke/Transient Ischaemic
Attack/Systemic Embolism after Left Atrial Appendage Closure: A Systematic
Review and Meta-Analysis.
Source
Cardiology (Switzerland). 148(6) (pp 581-592), 2023. Date of Publication:
01 Dec 2023.
Author
He Y.-G.; Yang S.-H.; Xu L.; Wang Y.; Qin X.-T.; Chen P.-P.; Zhao Y.-J.
Institution
(He, Yang, Xu, Wang, Qin, Chen, Zhao) Department of Cardiology, Zhengzhou
No. 7 People's Hospital, Zhengzhou, China
Publisher
S. Karger AG
Abstract
Background: Left atrial appendage closure (LAAC) is a safe and effective
method for preventing embolic events in patients with non-valvular atrial
fibrillation. However, peri-device leaks (PDLs) are sometimes unavoidable.
Controversy exists regarding whether PDLs lead to embolic events.
 Objective(s): This study aimed to explore the association between
PDLs and embolic events, including ischaemic stroke, transient ischaemic
attacks (TIAs), and systemic embolism (SE). Method(s): We conducted a
systematic search of the PubMed, Web of Science, MEDLINE, and Cochrane
Library databases for studies published up to September 25, 2022, to
compare the rate of ischaemic stroke/TIA/SE between the PDL group and the
non-PDL group after LAAC. Result(s): Thirteen studies comprising
54,405 patients were included in the meta-analysis. The PDL group detected
by transoesophageal echocardiography (TEE) had a significantly higher rate
of ischaemic stroke/TIA/SE than the non-PDL group (OR: 1.20, 95% CI:
1.08-1.33, p = 0.0009). However, no difference in ischaemic stroke/TIA/SE
was found between the PDL and non-PDL subgroups of the cardiac computed
tomography angiography (CCTA) group (OR: 1.12, 95% CI: 0.51-2.50, p =
0.77). CCTA and TEE showed different rates of PDL detection, with the CCTA
group having a higher rate of PDL detection (p < 0.0001), especially for
trivial leaks. Conclusion(s): PDL detected by TEE increases the risk
of embolic events after LAAC. However, no association was found between
PDL and ischaemic stroke/TIA/SE in the CCTA group, which showed a higher
rate of PDL detection than TEE, particularly for trivial leaks. In the
future, CCTA may be used to explore the relationship between PDL size and
ischaemic stroke/TIA/SE. Copyright © 2023 S. Karger AG. All
rights reserved.

<18>
Accession Number
2029191622
Title
Aortic valve repair in neonates, infants and children: a systematic
review, meta-analysis and microsimulation study.
Source
European Journal of Cardio-thoracic Surgery. 64(3) (no pagination), 2023.
Article Number: ezad284. Date of Publication: 01 Sep 2023.
Author
Notenboom M.L.; Rhellab R.; Etnel J.R.G.; van den Bogerd N.; Veen K.M.;
Taverne Y.J.H.J.; Helbing W.A.; van de Woestijne P.C.; Bogers A.J.J.C.;
Takkenberg J.J.M.
Institution
(Notenboom, Rhellab, Etnel, van den Bogerd, Veen, Taverne, van de
Woestijne, Bogers, Takkenberg) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Helbing) Department of Paediatrics, Div. of Cardiology, Erasmus
University Medical Centre, Rotterdam, Netherlands
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: To support clinical decision-making in children with aortic
valve disease, by compiling the available evidence on outcome after
paediatric aortic valve repair (AVr). METHOD(S): A systematic review
of literature reporting clinical outcome after paediatric AVr (mean age at
surgery <18 years) published between 1 January 1990 and 23 December 2021
was conducted. Early event risks, late event rates and time-to-event data
were pooled. A microsimulation model was employed to simulate the lives of
individual children, infants and neonates following AVr. RESULT(S):
Forty-one publications were included, encompassing 2 623 patients with 17
217 patient-years of follow-up (median follow-up: 7.3 years; range:
1.0-14.4 years). Pooled mean age during repair for aortic stenosis in
children (<18 years), infants (<1 year) or neonates (<30 days) was 5.2 +/-
3.9 years, 35 +/- 137 days and 11 +/- 6 days, respectively. Pooled early
mortality after stenosis repair in children, infants and neonates,
respectively, was 3.5% (95% confidence interval: 1.9-6.5%), 7.4%
(4.2-13.0%) and 10.7% (6.8-16.9%). Pooled late reintervention rate after
stenosis repair in children, infants and neonates, respectively, was
3.31%/year (1.66-6.63%/year), 6.84%/year (3.95-11.83%/year) and 6.32%/year
(3.04-13.15%/year); endocarditis 0.07%/year (0.03-0.21%/year), 0.23%/year
(0.07-0.71%/year) and 0.49%/year (0.18-1.29%/year); and valve thrombosis
0.05%/year (0.01-0.26%/year), 0.15%/year (0.04-0.53%/year) and 0.19%/year
(0.05-0.77%/year). Microsimulation-based mean life expectancy in the first
20 years for children, infants and neonates with aortic stenosis,
respectively, was 18.4 years (95% credible interval: 18.1-18.7 years;
relative survival compared to the matched general population: 92.2%), 16.8
years (16.5-17.0 years; relative survival: 84.2%) and 15.9 years
(14.8-17.0 years; relative survival: 80.1%). Microsimulation-based 20-year
risk of reintervention in children, infants and neonates, respectively,
was 75.2% (72.9-77.2%), 53.8% (51.9-55.7%) and 50.8% (47.0-57.6%).
 CONCLUSION(S): Long-term outcomes after paediatric AVr for stenosis
are satisfactory and dependent on age at surgery. Despite a high hazard of
reintervention for valve dysfunction and slightly impaired survival
relative to the general population, AVr is associated with low
valve-related event occurrences and should be considered in children with
aortic valve disease. Copyright © The Author(s) 2023. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<19>
Accession Number
2029295273
Title
Acute kidney injury in the critically unwell patient.
Source
Anaesthesia and Intensive Care Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Slattery L.; Flood L.
Institution
(Slattery, Flood) St Vincent's University Hospital, Dublin, Ireland
(Slattery, Flood) Tallaght University Hospital, Dublin, Ireland
Publisher
Elsevier Ltd
Abstract
Acute kidney injury (AKI) is commonly encountered in the critical care
setting. It is associated with prolonged hospitalization, progression to
chronic kidney disease and is an independent risk factor for mortality in
the critical care setting. There are multiple possible aetiologies for AKI
in the critical care population including sepsis, major surgery, low
cardiac output states and nephrotoxic agents. There are a number of
classification systems for AKI which we will consider in this article.
Many supportive therapies are employed to minimize the degree of renal
impairment once recognized: maintenance of an adequate mean arterial
pressure to enable adequate renal perfusion pressure is the cornerstone of
treatment. However, if renal failure becomes established, then renal
replacement therapy (RRT) may be needed to maintain homeostasis. The
timing of initiation and cessation of RRT and dosing practices have been
subject to numerous randomized controlled trials, however there is no
consensus guideline in this respect; we will discuss the pros and cons of
the various options. Copyright © 2023

<20>
Accession Number
643064152
Title
Topical Antibiotic Prophylaxis for Preventing Surgical Site Infections of
Clean Wounds: A Systematic Review and Meta-Analysis.
Source
Surgical infections. (no pagination), 2023. Date of Publication: 19 Dec
2023.
Author
Lin W.-L.; Wu L.-M.; Nguyen T.-H.-Y.; Lin Y.-H.; Chen C.-J.; Huang W.-T.;
Guo H.-R.; Chen Y.-H.; Chuang C.-H.; Chang P.-C.; Hung H.-K.; Chen S.-H.
Institution
(Lin, Chen) Center for Quality Management, Department of Surgery, Chi Mei
Medical Center, Liouying, Taiwan (Republic of China)
(Lin, Wu) School of Nursing, Kaohsiung Medical University, Kaohsiung,
Taiwan (Republic of China)
(Wu) Department of Medical Research, Kaohsiung Medical University
Hospital, Kaohsiung, Taiwan (Republic of China)
(Nguyen, Guo) Department of Environmental and Occupational Health,
National Cheng Kung University Hospital, Tainan, Taiwan (Republic of
China)
(Lin) Infection Control Center, Department of Surgery, Chi Mei Medical
Center, Liouying, Taiwan (Republic of China)
(Huang) Division of Hematology and Oncology, Department of Internal
Medicine, Department of Surgery, Chi Mei Medical Center, Liouying, Taiwan
(Republic of China)
(Guo) Department of Occupational and Environmental Medicine, National
Cheng Kung University Hospital, Tainan, Taiwan (Republic of China)
(Chen) Pharmacy Department, Department of Surgery, Chi Mei Medical Center,
Liouying, Taiwan (Republic of China)
(Chuang) Division of General Surgery, Department of Surgery, Chi Mei
Medical Center, Liouying, Taiwan (Republic of China)
(Chang) Department of Infectious Diseases, Department of Surgery, Chi Mei
Medical Center, Liouying, Taiwan (Republic of China)
(Hung) Division of Plastic Surgery, Department of Surgery, Chi Mei Medical
Center, Liouying, Taiwan (Republic of China)
(Chen) National Institute of Cancer Research, National Health Research
Institutes, Tainan, Taiwan (Republic of China)
(Chen) Department of Oncology, National Cheng Kung University Hospital,
College of Medicine, National Cheng Kung University, Tainan, Taiwan
(Republic of China)
Abstract
Background: Topical antibiotic agents are not generally indicated for
preventing of surgical site infections (SSIs) in clean incisions, and the
drug concentrations that should be delivered to local incision sites
remain uncertain. The aim of this study was to critically assess the
efficacy of topical antibiotic agents in comparison with non-antibiotic
agents for preventing SSIs in clean incisions by performing a systematic
review and meta-analysis. Method(s): We conducted a search of
literature in PubMed, Embase, and Cochrane Databases and included
randomized controlled trials (RCTs) on topical antibiotic use for patients
with clean post-surgical incisions. The primary outcome was the incidence
of SSI, presented as the event rate. Eleven RCTs were included.
 Result(s): Using random-effects modeling, the pooled risk ratio (RR)
of developing a post-surgical incisions infection was 0.83 (95% confidence
interval [CI], 0.61-1.16; I2, 0%). In subgroup analyses, no reductions in
SSI were observed when topical antibiotic agents were used to treat
incisions due to spinal (RR, 0.75; 95% CI, 0.40-1.38; I2, 0%), orthopedic
(RR, 0.69; 95% CI, 0.37-1.29; I2, 0%), dermatologic (RR, 0.77; 95% CI,
0.39-1.55; I2, 65%), or cardiothoracic surgeries (RR, 1.31; 95% CI,
0.83-2.06; I2: 0%). The incidence of SSI across different operative phases
did not differ for the application of topical antibiotic agents compared
with non-antibiotic agents (RR, 0.80; 95% CI, 0.56-1.14; I2, 0%).
 Conclusion(s): The results of this meta-analysis show that topical
antibiotic agents provide no clinical benefit for preventing SSI in clean
incisions.

<21>
Accession Number
643058925
Title
Canadian Cardiovascular Society/Canadian Association of Interventional
Cardiology 2023 Focused Update of the Guidelines for the Use of
Antiplatelet Therapy.
Source
The Canadian journal of cardiology. (no pagination), 2023. Date of
Publication: 29 Oct 2023.
Author
Bainey K.R.; Marquis-Gravel G.; Belley-Cote E.; Turgeon R.D.; Ackman M.L.;
Babadagli H.E.; Bewick D.; Boivin-Proulx L.-A.; Cantor W.J.; Fremes S.E.;
Graham M.M.; Lordkipanidze M.; Madan M.; Mansour S.; Mehta S.R.; Potter
B.J.; Shavadia J.; So D.F.; Tanguay J.-F.; Welsh R.C.; Yan A.T.; Bagai A.;
Bagur R.; Bucci C.; Elbarouni B.; Geller C.; Lavoie A.; Lawler P.; Liu S.;
Mancini J.; Wong G.C.
Institution
(Bainey, Welsh) Mazankowski Alberta Heart Institute, University of
Alberta, Edmonton, AB, Canada
(Marquis-Gravel, Boivin-Proulx, Tanguay) Institut de Cardiologie de
Montreal, Universite de Montreal, Montreal, Quebec, Canada
(Belley-Cote, Mehta) Population Health Research Institute, McMaster
University, Hamilton Health Sciences, Hamilton, Ontario, Canada
(Turgeon) University of British Columbia, St Paul's Hospital PHARM-HF
Clinic, Vancouver, BC, Canada
(Ackman) Alberta Health Services, Edmonton, AB, Canada
(Babadagli) Pharmacy Services, Alberta Health Services, Mazankowski
Alberta Heart Institute, Edmonton, AB, Canada
(Bewick) Division of Cardiology, Department of Medicine, Dalhousie
University, Saint John Regional Hospital, Saint John, New Brunswick,
Canada
(Cantor) Southlake Regional Health Centre, University of Toronto, Toronto,
ON, Canada
(Fremes) University of Toronto, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Graham) Division of Cardiology, Faculty of Medicine and Dentistry,
University of Alberta, Edmonton, AB, Canada
(Lordkipanidze) Faculte de pharmacie, Research Center, Montreal Heart
Institute, Universite de Montreal, Montreal, Quebec, Canada
(Madan) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Mansour, Potter) Centre Hospitalier de l'Universite de Montreal,
Montreal, Quebec, Canada
(Shavadia) College of Medicine, University of Saskatchewan, Saskatoon, SK,
Canada
(So) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Yan) Division of Cardiology, Unity Health Toronto, St Michael's Hospital,
Toronto, ON, Canada
(Bagai) Terrence Donnelly Heart Centre, St Michael's Hospital, University
of Toronto, Toronto, ON, Canada
(Bagur) London Health Sciences Centre, Western University, London, ON,
Canada
(Bucci) Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Elbarouni, Liu) Department of Medicine, St Boniface Hospital, University
of Manitoba, Winnipeg, MB, Canada
(Geller) University of Ottawa, Centretown Community Health Centre, Ottawa,
ON, Canada
(Lavoie) Prairie Vascular Research Inc, Regina, SK, Canada
(Lawler) Peter Munk Cardiac Centre, Toronto General Hospital, University
of Toronto, Toronto, ON, Canada
(Mancini, Wong) Division of Cardiology, Department of Medicine, University
of British Columbia, Vancouver, BC, Canada
Abstract
Antiplatelet therapy (APT) is the foundation of treatment and prevention
of atherothrombotic events in patients with atherosclerotic cardiovascular
disease. Selecting the optimal APT strategies to reduce major adverse
cardiovascular events, while balancing bleeding risk, requires ongoing
review of clinical trials. Appended, the focused update of the Canadian
Cardiovascular Society/Canadian Association of Interventional Cardiology
guidelines for the use of APT provides recommendations on the following
topics: (1) use of acetylsalicylic acid in primary prevention of
atherosclerotic cardiovascular disease; (2) dual APT (DAPT) duration after
percutaneous coronary intervention (PCI) in patients at high bleeding
risk; (3) potent DAPT (P2Y12 inhibitor) choice in patients who present
with an acute coronary syndrome (ACS) and possible DAPT de-escalation
strategies after PCI; (4) choice and duration of DAPT in ACS patients who
are medically treated without revascularization; (5) pretreatment with
DAPT (P2Y12 inhibitor) before elective or nonelective coronary
angiography; (6) perioperative and longer-term APT management in patients
who require coronary artery bypass grafting surgery; and (7) use of APT in
patients with atrial fibrillation who require oral anticoagulation after
PCI or medically managed ACS. These recommendations are all on the basis
of systematic reviews and meta-analyses conducted as part of the
development of these guidelines, provided in the Supplementary
Material. Copyright © 2023 Canadian Cardiovascular Society.
Published by Elsevier Inc. All rights reserved.

<22>
Accession Number
643058019
Title
Respect versus Resect Approaches for Mitral Valve Repair - A Meta-Analysis
of Reconstructed Time-to-event Data.
Source
The American journal of cardiology. (no pagination), 2023. Date of
Publication: 15 Dec 2023.
Author
Caldonazo T.; Pompeu Sa M.; Jacquemyn X.; Van den Eynde J.; Kirov H.;
Harik L.; Fischer J.; Vervoort D.; Bonatti J.; Sultan I.; Doenst T.
Institution
(Caldonazo) Department of Cardiothoracic Surgery, Jena University
Hospital, Jena, Germany
(Pompeu Sa, Bonatti, Sultan) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, United States.; UPMC Heart and
Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh,
United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Kirov, Fischer, Doenst) Department of Cardiothoracic Surgery, Jena
University Hospital, Jena, Germany
(Harik) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York City, NY, United States
(Vervoort) Division of Cardiac Surgery, University of Toronto, Toronto,
Ontario, Canada; Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, Ontario, Canada
Abstract
Mitral valve repair (MVr) has been associated with superior long-term
survival and freedom from valve-related complications compared with mitral
valve replacement (MVR) for primary mitral regurgitation (MR). The two
main approaches for MVr are chordal replacement ("respect approach") and
leaflet resection ("resect approach"). We performed a systematic review
and a meta-analysis using three search databases to compare long-term
endpoints between both approaches. The primary endpoint was long-term
survival. The secondary endpoints were long-term MR recurrence and
reoperation. After reconstruction of time-to-event data for the individual
survival analysis, pooled Kaplan-Meier curves for the endpoints were
generated. Fourteen studies (5,565 patients) were included in the
analysis. The "respect approach" was associated with superior survival
compared to the "resect approach" in the overall sample (HR=0.73, 95% CI
0.56-0.96, p=0.024; N=3,901 patients) but not in the risk-adjusted sample
(HR=1.00, 95% CI 0.55-1.82, p=0.991; N=620 patients). There was no
difference between aproaches in the rate of MR recurrence in the overall
sample (HR=1.39, 95% CI 0.92-2.08, p=0.116; N=1,882 patients) or in the
risk-adjusted sample (HR=1.62, 95% CI 0.76-3.47, p=0.211; N=288 patients).
Data for reoperation were only available in the overall sample and did not
reveal a difference (HR=0.92, 95% CI 0.62-1.35, p=0.663; N=3,505
patients). In conclusion, the current evidence suggests no difference in
long-term mortality, MR recurrence, or reoperation between the "resect"
and "respect" approaches for MVr after adjusting for patient risk factors.
More long-term follow-up data are warranted. Copyright © 2023.
Published by Elsevier Inc.

<23>
Accession Number
643057826
Title
Acute hemodynamic compromise after Transcatheter Aortic Valve Replacement
due to Dynamic Left Ventricle Obstruction: A systematic review.
Source
The American journal of cardiology. (no pagination), 2023. Date of
Publication: 14 Dec 2023.
Author
Barzallo D.; Torrado J.; Benites-Moya C.J.; Sturla M.; Echarte-Morales J.;
Scotti A.; Kharawala A.; Terre J.; Sugiura T.; Wiley J.M.; Goldberg Y.;
Latib A.
Institution
(Barzallo, Benites-Moya, Kharawala) Department of Internal Medicine,
Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY,
United States
(Torrado, Sturla, Echarte-Morales, Scotti, Latib) Department of
Cardiology, Montefiore Medical Center, Bronx, NY, United States
(Terre, Wiley) Section of Cardiology, Department of Medicine, Tulane
University School of Medicine, New Orleans, LA, United States
(Sugiura) Department of Cardiothoracic surgery, Montefiore Medical Center,
Bronx, NY, United States
(Goldberg) Department of Cardiology, Section of Structural
Echocardiography, Lenox Hill Hospital and Western Region, Northwell
Health, New York, NY
Abstract
Acute hemodynamic compromise post-TAVR due to dynamic left ventricle
obstruction (LVO), also known as "Suicide left ventricle" is an infrequent
but severe complication of transcatheter aortic valve replacement (TAVR)
that is poorly defined in the literature. Understanding this complication
is essential for its prompt diagnosis and optimal treatment. We conducted
a systematic literature review using PubMed, Embase, Web of Science and
Medline databases for studies describing acute hemodynamic compromise
post-TAVR due to dynamic LVO or suicide left ventricle. Each study was
reviewed by two authors individually for eligibility, and a third author
resolved disagreements. From a total of 506 studies, 25 publications were
considered for the final analysis. The majority of patients suffering from
this condition were women, demonstrating a hypertrophic septum, a small
ventricle, and hyperdynamic contractility on pre-TAVR echocardiographic
assessment. An intraventricular gradient pre-TAVR was found in half of the
cases. Acute hemodynamic compromise post-TAVR due to dynamic LVO
manifested mainly as significant hypotension and occurred most often
immediately after valve deployment. The left ventricle outflow tract
(LVOT) was the most common site of obstruction. Advanced therapies were
required in nearly 65% of the cases. In conclusion, acute hemodynamic
compromise post-TAVR due to dynamic LVO occurred almost invariably in
women. Echocardiography prior to TAVR may offer essential information to
anticipate this complication. LVOT obstruction appears to carry the
highest risk of developing this phenomenon. Advanced therapies should be
promptly considered as a bailout strategy in patients with hemodynamic
collapse refractory to medical therapy. Copyright © 2023.
Published by Elsevier Inc.

<24>
Accession Number
2016458597
Title
Effects of Remifentanil and Sufentanil Anesthesia on Cardiac Function and
Serological Parameters in Congenital Heart Surgery.
Source
Journal of Healthcare Engineering. 2021 (no pagination), 2021. Article
Number: 4650291. Date of Publication: 2021.
Author
Qin Z.; Xu Y.
Institution
(Qin) Surgical Anesthesia Center, TaiKang Tongji (Wuhan) Hospital, Hubei,
Wuhan 430000, China
(Xu) Department of Anesthesiology, Wuhan Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Hubei, Wuhan
430030, China
Publisher
Hindawi Limited
Abstract
In this study, we have investigated feasibility of remifentanil and
sufentanil anesthesia in children with congenital heart disease surgery
and its effects on cardiac function and serological parameters. For this
purpose, a retrospective study was conducted on 120 children with
congenital heart disease who underwent repair of ventricular septum or
atrial septum in our hospital, specifically from January 2016 to January
2018, and 60 patients in each group were randomly divided into the control
and treatment groups, respectively. The control group was anesthetized
with sufentanil, and the treatment group was anesthetized with
remifentanil. The heart function, serological indexes, and adverse
reactions were observed and compared. We have observed that there was no
significant difference in HR levels between these groups (P>0.05), but SDP
and DBP values of the two groups were decreased after anesthetic induction
(P<0.05). ACH, cortisol, and lactic acid in the treatment group were
significantly lower than those in the control group, and the difference
was statistically significant (P<0.05). The incidence of bradycardia,
nausea and vomiting, hypotension, muscle rigidity, and respiratory
depression in the treatment group was 16.67% lower than that in the
control group (P<0.05). Remifentanil has less influence on hemodynamics
and a better analgesic effect than fentanyl in inhibiting stress response
in congenital heart surgery, which provides reference and basis for
children congenital heart surgery. Copyright © 2021 Zhigang Qin
and Younian Xu.

<25>
Accession Number
2028994548
Title
The prognostic impact of diastolic dysfunction after transcatheter aortic
valve replacement: A systematic review and meta-analysis.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102228. Date of Publication: February 2024.
Author
Stalikas N.; Anastasiou V.; Botis I.; Daios S.; Karagiannidis E.; Zegkos
T.; Karamitsos T.; Vassilikos V.; Ziakas A.; Kamperidis V.; Giannakoulas
G.; Giannopoulos G.
Institution
(Stalikas, Anastasiou, Botis, Daios, Zegkos, Karamitsos, Ziakas,
Kamperidis, Giannakoulas) AHEPA Hospital, Medical School, Aristotle
University, St. Kiriakidi 1, Thessaloniki GR54636, Greece
(Karagiannidis, Vassilikos, Giannopoulos) Ippokratio General Hospital,
Medical School, Aristotle University, Thessaloniki, Greece
Publisher
Elsevier Inc.
Abstract
Background: Diastolic dysfunction (DD) is a long-established marker of
disease progression in patients with aortic valve stenosis (AS),
indicating valvular myocardial damage. Recently, substantial observational
data have emerged demonstrating that worse pre-operative DD assessed using
echocardiography is associated with adverse long-term clinical outcomes
after transcatheter aortic valve replacement (TAVR). Aim(s): To
systematically appraise and quantitatively synthesize current evidence on
the prognostic impact of echocardiographic severe DD derived by
echocardiography before TAVR. Method(s): A systemic literature review
was undertaken in electronic databases to identify studies reporting the
predictive value of severe DD in AS subjects undergoing TAVR. A
random-effects meta-analysis was conducted to quantify the adjusted and
unadjusted hazard ratios (HRs) for all-cause mortality and major adverse
cardiovascular events (MACEs) for the presence of severe DD.
 Result(s): Ten studies were deemed eligible for inclusion. Of those,
9 provided appropriate quantitative data for the meta-analysis,
encompassing a total of 4,619 patients. The presence of severe DD was
associated with increased risk for all-cause mortality (pooled unadjusted
HR=2.56 [1.46-4.48]; p<0.01; I2=76 %) and MACEs (pooled
unadjusted HR=1.82 [1.29-2.58]; p<0.01; I2=86 %). When adjusted
for clinically-relevant parameters, the presence of severe DD retained
independent association with all-cause mortality (pooled adjusted HR=2.35
[1.26-4.37]; p<0.01; I2=79 %) and MACEs (pooled adjusted HR=
2.52 [1.72-3.65]; p<0.01; I2=0 %). In subgroup analysis there
was no difference on post-TAVR risk between the use of different diastolic
function grading scores. Conclusion(s): Presence of severe DD
assessed by echocardiography pre-TAVR is a major determinant of long-term
adverse outcomes after the procedure. Copyright © 2023 Elsevier
Inc.

<26>
Accession Number
2028970659
Title
No randomized trial has confirmed significantly better long-term survival
for either radial artery or saphenous vein graft recipients in coronary
artery bypass grafting surgery.
Source
European Journal of Cardio-thoracic Surgery. 64(4) (no pagination), 2023.
Article Number: ezad326. Date of Publication: 01 Oct 2023.
Author
Nezic D.
Institution
(Nezic) Department of Cardiac Surgery, "Dedinje" Cardiovascular Institute,
Belgrade, Serbia
Publisher
European Association for Cardio-Thoracic Surgery

<27>
Accession Number
2028970648
Title
5-Year haemodynamic performance of three aortic bioprostheses. A
randomized clinical trial.
Source
European Journal of Cardio-thoracic Surgery. 64(2) (no pagination), 2023.
Article Number: ezad261. Date of Publication: 01 Aug 2023.
Author
Cruces L.M.; Alcazar M.C.; Camargo D.P.; Carnicer J.C.; Fernandez P.C.;
Lacruz F.J.R.; Castellanos L.C.M.
Institution
(Cruces, Alcazar, Camargo, Carnicer, Fernandez, Lacruz, Castellanos)
Department of Cardiovascular Surgery, Clinico San Carlos Hospital, Madrid,
Spain
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The Carpentier Perimount (CP) Magna Ease, the Crown
Phospholipid Reduction Treatment (PRT) and the Trifecta bovine pericardial
valves have been widely used worldwide. The primary end point of this
study was to compare the haemodynamic performance quantified by in vivo
echocardiograms of these 3 aortic prostheses. METHOD(S): The
"BEST-VALVE" (comparison of 3 contemporary cardiac bioprostheses: mid-term
valve haemodynamic performance) was a single-centre randomized clinical
trial to compare the haemodynamic and clinical outcomes of the
aforementioned bioprostheses. The 5-year results are assessed in this
manuscript.
RESULTS: A total of 154 patients were included. The CP Magna Ease (n = 48,
31.2%), Crown PRT (n = 51, 32.1%) and Trifecta (n = 55, 35.7%) valves were
compared. Significant differences were observed among the 3 bioprostheses
5 years after the procedure. The following haemodynamic differences were
found between the CP Magna Ease and the Crown PRT bioprostheses [mean
aortic gradient: 12.3 mmHg (interquartile range {IQR} 7.8-17.5) for the CP
Magna Ease vs 15 mmHg (IQR 10.8-31.9) for the Crown PRT, P < 0.001] and
between the CP Magna Ease and the Trifecta prostheses [mean aortic
gradient: 12.3 mmHg (IQR 7.8-17.5) for the CP Magna Ease vs 14.7 mmHg (IQR
8.2-55) for the Trifecta, P < 0.001], with a better haemodynamic
performance of the CP Magna Ease. The cumulative incidence of severe
structural valve degeneration was 9.5% in the Trifecta group at 6 years of
follow-up. The 1-, 3- and 5-year survival from all-cause mortality was
91.5%, 83.5% and 74.8%, respectively (log rank P = 0.440). Survival from
the composite event at the 1-, 3- and 5-year follow-up was 92.8%, 74.6%
and 59%, respectively (log rank P = 0.299). CONCLUSION(S): We
detected significant differences between the 3 bioprostheses; the CP Magna
Ease had the best haemodynamic performance at the 5-year
follow-up. Copyright © 2023 European Association for
Cardio-Thoracic Surgery. All rights reserved.

<28>
Accession Number
2028563686
Title
Prognosis of Elevated Mitral Valve Pressure Gradient After Transcatheter
Edge-to-Edge Repair: Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102095. Date of Publication: February 2024.
Author
Du Y.; Han H.; Zhang T.; Shen H.; Han W.; Jia S.; Yu Y.; Guo Y.; Wang Z.;
Liu Y.; Shi D.; Zhou Y.
Institution
(Du, Han, Zhang, Shen, Han, Jia, Yu, Guo, Wang, Liu, Shi, Zhou) Department
of Cardiology, Beijing Anzhen Hospital, Capital Medical University,
Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key
Laboratory of Precision Medicine of Coronary Atherosclerotic Disease,
Clinical Center for Coronary Heart Disease, Capital Medical University,
Beijing, China
Publisher
Elsevier Inc.
Abstract
Elevation in mitral valve pressure gradient (MVPG) after mitral valve
transcatheter edge-to-edge repair (M-TEER) is common, however, evidence on
its prognosis is scarce and debatable. Thus, this study aims to
investigate the impact of increased MVPG after M-TEER on outcomes. Studies
reporting the associations between the elevated MVPG after M-TEER and
outcomes were identified in a systematic search of published literatures.
Associations were pooled by meta-analysis using a random-effects model.
The primary outcome was the composite of all-cause mortality and heart
failure (HF) hospitalization. Seven observational studies with 2,730
patients (mean age, 77.7 +/- 9.3 years; male, 64.4%; functional mitral
regurgitation [MR], 65.2%) were eligible for the present analysis. M-TEER
was performed entirely using the MitraClip system (Abbott), followed by
29.7% of patients having increased MVPG. Elevated postprocedural MVPG was
not associated with a higher risk of the primary outcome, compared to low
MVPG [hazard ratio (HR) = 1.22; 95% confidence interval (CI) 0.95-1.58; p
= 0.12; I2 = 53.5%). However, the prognosis of elevated MVPG
was observed in degenerative MR patients (HR = 1.37; 95% CI 1.03-1.84; p =
0.03; I2 = 0%), whereas not in functional MR patients. Patients
with low MVPG + high residual MR had a higher risk of the primary outcome
than those with high MVPG + low residual MR after M-TEER (HR = 1.50; 95%
CI 1.10-2.03; p = 0.01; I2 = 13%). In conclusion, elevated MVPG
seems to predict adverse outcomes mainly in patients with degenerative MR.
Future studies are needed to prove these findings. Copyright ©
2023 Elsevier Inc.

<29>
Accession Number
2027014469
Title
Risk Factors for Surgical Site Infection in Patients Undergoing Pediatric
Cardiac Surgery.
Source
Arquivos Brasileiros de Cardiologia. 120(12) (no pagination), 2023.
Article Number: e20220592. Date of Publication: 2023.
Author
Ribeiro A.C.L.; Siciliano R.F.; Lopes A.A.; Strabelli T.M.V.
Institution
(Ribeiro, Lopes) Instituto do Coracao do Hospital das Clinicas da
Faculdade de Medicina da Universidade de Sao Paulo-Cardiologia Pediatrica
e Cardiopatias Congenitas do Adulto, SP, Sao Paulo, Brazil
(Siciliano, Strabelli) Equipe de Controle de Infeccao-Instituto do Coracao
do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao
Paulo, SP, Sao Paulo, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Background: Surgical site infection is an important complication after
pediatric cardiac surgery, associated with increased morbidity and
mortality. Objective(s): We sought to identify risk factors for
surgical site infection after pediatric cardiac surgeries. Method(s):
A case-control study included patients aged between 1 year and 19 years
and 11 months of age, submitted to cardiac surgery performed at a tertiary
cardiac center from January 1st, 2011, through December 31,
2018. Charts were reviewed for pre-, intra, and postoperative variables.
We identified two randomly selected control patients with the same
pathophysiological diagnosis and underwent surgery within thirty days of
each index case. Univariate and multivariate logistic regression analyses
were performed to identify risk factors. Statistical significance was
defined as p<0.05. Result(s): Sixty-six cases and 123 controls were
included. Surgical site infection incidence ranged from 2% to 3.8%. The
following risk factors were identified: Infant age (OR 3.19, 95% CI 1.26
to 8.66, p=0.014), presence of genetic syndrome (OR 6.20, CI 95% 1.70 to
21.65, p=0.004), categories 3 and 4 of RACHS-1 (OR 8.40, CI 95% 3.30 to
21.34, p<0.001), 48 h C-reactive protein level range was detected as a
protective factor for this infection (OR 0.85, 95% CI 0.73 to 0.98,
p=0.023). Conclusion(s): The risk factors defined in this study could
not be modified. Therefore, additional surveillance and new preventive
strategies need to be implemented to reduce the incidence of surgical site
infection. The increased CRP in the postoperative period was a protective
factor that needs further understanding. Copyright © 2023,
Sociedade Brasileira de Cardiologia. All rights reserved.

<30>
Accession Number
2026876511
Title
Myocardial protection with phosphocreatine in high-risk cardiac surgery
patients: a randomized trial.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 389. Date
of Publication: December 2023.
Author
Lomivorotov V.; Merekin D.; Fominskiy E.; Ponomarev D.;
Bogachev-Prokophiev A.; Zalesov A.; Cherniavsky A.; Shilova A.; Guvakov
D.; Lomivorotova L.; Lembo R.; Landoni G.
Institution
(Lomivorotov, Guvakov) Department of Anesthesiology and Perioperative
Medicine, Penn State College of Medicine, Penn State Milton S. Hershey
Medical Center, Hershey, PA, United States
(Lomivorotov, Merekin, Ponomarev, Shilova, Lomivorotova) Department of
Anesthesiology and Intensive Care, E. Meshalkin National Medical Research
Center, Novosibirsk, Russian Federation
(Fominskiy, Lembo, Landoni) Department of Anesthesia and Intensive Care,
IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132,
Italy
(Bogachev-Prokophiev, Zalesov) Department of Heart Valve Surgery, E.
Meshalkin National Medical Research Center, Novosibirsk, Russian
Federation
(Cherniavsky) Department of Aortic and Coronary Artery Surgery, E.
Meshalkin National Medical Research Center, Novosibirsk, Russian
Federation
(Landoni) Vita-Salute San Raffaele University, Milan, Italy
Publisher
BioMed Central Ltd
Abstract
Background: This study was conducted to test the hypothesis that
phosphocreatine (PCr), administered intravenously and as cardioplegia
adjuvant in patients undergoing cardiac surgery with prolonged aortic
cross clamping and cardiopulmonary bypass (CPB) time, would decrease
troponin I concentration after surgery. Method(s): In this
randomized, double-blind, placebo-controlled pilot study we included 120
patients undergoing double/triple valve repair/replacement under
cardiopulmonary bypass in the cardiac surgery department of a tertiary
hospital. The treatment group received: intravenous administration of 2 g
of PCr after anesthesia induction; 2.5 g of PCr in every 1 L of
cardioplegic solution (concentration = 10 mmol/L); intravenous
administration of 2 g of PCr immediately after heart recovery following
aorta declamping; 4 g of PCr at intensive care unit admission. The control
group received an equivolume dose of normosaline. Result(s): The
primary endpoint was peak concentration of troponin I after surgery.
Secondary endpoints included peak concentration of serum creatinine, need
for, and dosage of inotropic support, number of defibrillations after
aortic declamping, incidence of arrhythmias, duration of Intensive Care
Unit (ICU) stay, length of hospitalization. There was no difference in
peak troponin I concentration after surgery (PCr, 10,508 pg/ml [IQR
6,838-19,034]; placebo, 11,328 pg/ml [IQR 7.660-22.894]; p = 0.24). There
were also no differences in median peak serum creatinine (PCr, 100
micromol/L [IQR 85.0-117.0]; placebo, 99.5 micromol/L [IQR 90.0-117.0]; p
= 0.87), the number of patients on vasopressor/inotropic agents (PCr, 49
[88%]; placebo, 57 [91%]; p = 0.60), the inotropic score on postoperative
day 1 (PCr, 4.0 (0-7); placebo, 4.0 (0-10); p = 0.47), mean SOFA score on
postoperative day 1 (PCr, 5.25 +/- 2.33; placebo, 5,45 +/- 2,65; p =
0.83), need for defibrillation after declamping of aorta (PCr, 22 [39%];
placebo, 25 [40%]; p = 0.9), duration of ICU stay and length of
hospitalization as well as 30-day mortality (PCr, 0 (0%); placebo,1
(4.3%); p = 0.4). Conclusion(s): PCr administration to patients
undergoing double/triple valve surgery under cardiopulmonary bypass is
safe but is not associated with a decrease in troponin I concentration.
Phosphocreatine had no beneficial effect on clinical outcomes after
surgery. Trial registration: The study is registered at ClinicalTrials.gov
with the Identifier: NCT02757443. First posted (published):
02/05/2016. Copyright © 2023, The Author(s).

<31>
Accession Number
2026261306
Title
Concurrent coronary artery disease and immune thrombocytopenia: a
systematic review.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1213275.
Date of Publication: 2023.
Author
Rahhal A.; Provan D.; Shunnar K.; Najim M.; Ahmed A.O.; Rozi W.;
Al-Khabori M.; Marashi M.; AlRasheed M.; Osman H.; Yassin M.
Institution
(Rahhal) Pharmacy Department, Hamad Medical Corporation, Doha, Qatar
(Provan) Barts and The London School of Medicine, Queen Mary University of
London, London, United Kingdom
(Shunnar) Cardiology Department, Hamad Medical Corporation, Doha, Qatar
(Najim) Internal Medicine Department, Rochester Regional Health-Unity
Hospital, New York, NY, United States
(Ahmed, Rozi) Internal Medicine Department, Hamad Medical Corporation,
Doha, Qatar
(Al-Khabori) Hematology Department, Sultan Qaboos University, Muscat, Oman
(Marashi) Dubai Academic Health Corporation and Mediclinic Hospital,
Dubai, United Arab Emirates
(AlRasheed) Hematology Department, AlAdan Hospital, Hadiya, Kuwait
(Osman) Hematology and Oncology Department, Tawam Hospital, Abu-Dhabi,
United Arab Emirates
(Yassin) Hematology Department, National Centre for Cancer Care and
Research, Hamad Medical Corporation, Doha, Qatar
Publisher
Frontiers Media SA
Abstract
Introduction: Coronary artery disease (CAD) management in the setting of
immune thrombocytopenia (ITP) remains very challenging to clinicians as a
reasonable balance between bleeding and thrombosis risks needs to be
achieved, and the evidence guiding such management is scarce.
 Method(s): We conducted a systematic review following the PRISMA
guidelines to summarize the available literature on the management and
outcomes of CAD coexisting with ITP. We searched PubMed and Embase for
studies published in English exploring CAD and ITP management until 05
October 2022. Two independent reviewers screened and assessed the articles
for inclusion. Patients' characteristics, CAD treatment modalities, ITP
treatment, and complications were reported. Result(s): We identified
32 CAD cases, among which 18 cases were revascularized with percutaneous
coronary intervention (PCI), 12 cases underwent coronary artery bypass
graft surgery (CABG), and two cases were managed conservatively. More than
50% were men, with a mean age of 61 +/- 13 years and a mean baseline
platelet count of 52 +/- 59 x 109/L. Irrespective of the
revascularization modality, most patients were treated with either
corticosteroids alone, intravenous immunoglobulins (IVIG) alone, or in
combination. Among those who underwent PCI, two patients had bleeding
events, and one patient died. Similarly, among those with CABG, one
patient developed bleeding, and one patient died. Conclusion(s): We
found that revascularization with either PCI or CABG with the concurrent
use of corticosteroids and/or IVIG for ITP was feasible, with an existing
non-negligible risk of bleeding and mortality. Copyright © 2023
Rahhal, Provan, Shunnar, Najim, Ahmed, Rozi, Al-Khabori, Marashi,
AlRasheed, Osman and Yassin.

<32>
Accession Number
2017877258
Title
Rivaroxaban After Transcatheter Aortic Valve Replacement: A Critical
Appraisal of the GALILEO Trial.
Source
Cardiovascular Drugs and Therapy. 37(6) (pp 1239-1241), 2023. Date of
Publication: December 2023.
Author
Sulzgruber P.; Hammer A.; Niessner A.
Institution
(Sulzgruber, Hammer, Niessner) Division of Cardiology, Department of
Internal Medicine II, Medical University of Vienna, Waehringer Guertel
18-20, Vienna 1090, Austria
Publisher
Springer
Abstract
Purpose: The anti-thrombotic approach in individuals undergoing
transcatheter aortic valve replacement (TAVR) mirrors a controversial
field in clinical practice. Methods/Results: The aim of this article was
to critically appraise the randomized controlled GALILEO trial, where two
different antithrombotic regimes (10 mg rivaroxaban + 3 months aspirin vs.
aspirin + 3 months clopidogrel) were compared in patients who underwent
TAVR as well as available evidence in literature in this field.
 Conclusion(s): The GALILEO trial was prematurely terminated as a
consequence of increased risk of both death or thromboembolic
complications and a higher risk of bleeding in the anticoagulation arm,
compared to the antiplatelet-based strategy. Various concerns have been
raised that the negative results of the GALILEO trial need to be regarded
with caution. A routine use of oral anticoagulation (OAC) for the
prevention of atherothrombotic events and valve thrombosis after TAVR in
individuals who do not have an indication for oral anticoagulation, can
currently not be recommended when considering the evidence base of
available literature. However, the negative results of the GALILEO trial
need to be interpreted with caution - especially in terms of dose of
rivaroxaban - and should not discourage from performing further trials
investigating safety and efficacy of this therapeutic approach.
Additionally, further dose-finding trials for rivaroxaban should be
considered. Copyright © 2022, The Author(s).

<33>
Accession Number
2027208274
Title
Percutaneous coronary intervention versus coronary artery by-pass grafting
in premature coronary artery disease: What is the evidence? -A narrative
review.
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
2023.
Author
Goulden C.J.
Institution
(Goulden) Liverpool University Hospitals Foundation Trust, Liverpool,
United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Coronary artery disease (CAD) remains one of the leading causes of death
globally. In the United States of America, in 2016, 19% of all patients
under the age of 65 died of cardiovascular disease despite improvements in
primary prevention. The premature clinical onset of symptoms in the young
population (<60 years) is much more aggressive than in the older
population, and the overall long-term prognosis is poor. CAD appears to
have a rapidly progressive form in those under the age of 60 due to
genetic predisposition, smoking, and substance abuse, however, the ideal
management strategy is still yet to be established. The two primary
methods of establishing coronary revascularization are percutaneous
coronary intervention (PCI) and coronary artery bypass graft (CABG).
Despite the increasing prevalence of CAD in the young population, they are
consistently underrepresented in major randomized clinical trials of each
revascularization strategy. Both CABG and PCI are known to have similar
survival rates, but PCI is associated with higher repeat revascularization
rate. Many argue this may be due to the progressive nature of CAD combined
with the vessel patency time required in a patient under 60 with
potentially another 20-30 years of life. There is little in literature
regarding the outcomes of these various revascularization strategies in
populations under 60 years with CAD. This review summarises the current
evidence for each revascularisation strategy in patients under the age of
60 and suggests future avenues of research for this unique age
group. Copyright © The Author(s) 2023.

<34>
Accession Number
2025244589
Title
Analgesic efficacy of erector spinae plane block versus paravertebral
block in lung surgeries-A non-inferiority randomised controlled trial.
Source
Acta Anaesthesiologica Scandinavica. 68(1) (pp 71-79), 2024. Date of
Publication: January 2024.
Author
Andrade Filho P.H.D.; Pereira V.E.; Sousa D.D.E.M.; Costa L.D.G.; Nunes
Y.P.; Taglialegna G.; de Paula-Garcia W.N.; Silva J.M.
Institution
(Andrade Filho, Sousa, Costa, Nunes, Silva) Department of Anaesthesiology,
Hospital do Servidor Publico Estadual de Sao Paulo, Sao Paulo, Brazil
(Andrade Filho, Silva) Postgraduate Programme in Anaesthesiology, Surgical
Sciences, and Perioperative Medicine, University of Sao Paulo Faculty of
Medicine (FMUSP), Sao Paulo, Brazil
(Pereira, Taglialegna, de Paula-Garcia) Orthopedics and Anaesthesiology
Department, Ribeirao Preto Medical School, University of Sao Paulo
(FMRP-USP), Ribeirao Preto, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Background: Pain management plays an essential role in postoperative
recovery after lung surgeries. The Erector Spinae Plane Block (ESPB) is a
widely used regional anaesthesia technique; however, few clinical trials
have compared this block to active control in thoracic surgeries. This
study evaluated the non-inferiority of the analgesia provided by ESPB when
compared to paravertebral block (PVB) in lung surgeries. Method(s):
Randomised, active-controlled, blinded for patients and assessors,
non-inferiority trial. Patients who underwent unilateral lung surgeries
were divided into two groups according to the regional anaesthesia
technique-continuous ESPB or PVB at the T5 level. The primary outcome was
to assess pain using a numerical rating scale (NRS) with a test of the
interaction of three measures over 24 h postoperatively. An NRS score >= 7
was considered analgesia failure, and the prespecified non-inferiority
margin was 10%. Result(s): In the interim analysis that terminated
this study, 120 participants were enrolled. ESPB patients reported higher
mean NRS general values over 24 h, 4.6 +/- 3.2 in the ESPB group versus
3.9 +/- 2.9 in the PVB group, with a difference of -0.67 (-15.2%) and
95%CI: -1.29 to -0.05 (p =.02), demonstrating not non-inferiority. In
addition, the ESPB group presented higher NRS failure of analgesia over 24
h (p <.01) and required more postoperative opioids (p =.01 over 24 h).
There was no difference in patient satisfaction between groups.
 Conclusion(s): This trial demonstrated that a continuous erector
spinae plane block was not non-inferior to a continuous paravertebral
block for analgesia after lung surgery but resulted in higher levels of
postoperative pain and opioid consumption. Copyright © 2023 Acta
Anaesthesiologica Scandinavica Foundation.

<35>
Accession Number
642665709
Title
First-in-human study of the CAPTIS embolic protection system during
transcatheter aortic valve replacement.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
19(11) (pp e948-e952), 2023. Date of Publication: 18 Dec 2023.
Author
Danenberg H.; Vaknin-Assa H.; Makkar R.; Virmani R.; Manevich L.; Codner
P.; Patel V.; Finn A.V.; Landes U.; Rubinshtein R.; Bar A.; Barnea R.;
Mezape Y.; Teichman E.; Eli S.; Weisz G.; Kornowski R.
Institution
(Danenberg, Manevich, Landes, Rubinshtein, Bar) Wolfson Medical Center,
Holon, Israel
(Danenberg, Vaknin-Assa, Manevich, Codner, Landes, Rubinshtein, Bar,
Barnea, Kornowski) Faculty of Medicine, Tel Aviv University, Ramat Aviv,
Tel Aviv, Israel
(Vaknin-Assa, Codner, Barnea, Kornowski) Beilinson Hospital, Rabin Medical
Center, Israel
(Makkar, Patel) Cedars-Sinai Medical Center, Los Angeles, CA, United
States
(Virmani, Finn) CVPath Institute, Gaithersburg, MD, United States
(Mezape, Teichman, Eli, Weisz) CaesareaIsrael
(Weisz) NewYork-Presbyterian Hospital, Columbia University Medical Center,
New York, NY, USA
Abstract
BACKGROUND: Stroke and other clinically significant embolic complications
are well documented in the early period following transcatheter aortic
valve replacement (TAVR). The CAPTIS device is an embolic protection
system, designed to provide neurovascular and systemic protection by
deflecting debris away from the brain's circulation, capturing the debris
and thus avoiding systemic embolisation. AIMS: We aimed to study the
safety and feasibility study of the CAPTIS complete cerebral and full-body
embolic protection system during TAVR. METHOD(S): A first-in-human
study investigated the safety, feasibility and debris capturing ability of
CAPTIS during TAVR. Patients were followed for 30 days. The primary
endpoints were device safety and cerebrovascular events at 72 hours.
 RESULT(S): Twenty patients underwent TAVR using balloon-expandable or
self-expanding valve systems. CAPTIS was successfully delivered,
positioned, deployed, and retrieved in all cases, and TAVR was
successfully completed without device-related complications. No
cerebrovascular events were observed. High numbers of debris particles
were captured in all patients. CONCLUSION(S): The use of the CAPTIS
full-body embolic protection system during TAVR was safe, and it captured
a substantial number of debris particles. No patient suffered from a
cerebrovascular event. A randomised clinical trial is warranted to prove
its efficacy.

<36>
Accession Number
642605707
Title
Assessment of cardiovascular alterations and catecholamines serum
concentration after oral surgery in patients receiving local anesthetics
with epinephrine: a randomized, blind, controlled clinical trial.
Source
Clinical oral investigations. 27(12) (pp 7651-7662), 2023. Date of
Publication: 01 Dec 2023.
Author
da Silveira M.L.M.; da Conceicao Coelho O.D.; Germano A.R.
Institution
(da Silveira) Program of Dental Science of the Federal University of Rio
Grande do Norte (UFRN), Natal, RN, Brazil
(da Conceicao Coelho) Januario Cicco Maternity School (MEJC) of the
Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
(Germano) Department of Oral and Maxillofacial Surgery, Onofre Lopes
University Hospital (HUOL), Av. Nilo Pecanha, 620 - Petropolis, Natal, RN,
59.012-300, Brazil
(Germano) Department of Dentistry of the Federal University of Rio Grande
do Norte (UFRN), Natal, RN, Brazil
Abstract
OBJECTIVES: A randomized controlled clinical trial was developed to
evaluate the cardiovascular effects of local anesthetics with
vasoconstrictors (LAVC) in healthy and hypertensive patients undergoing
teeth extraction with lidocaine 2% with epinephrine 1:100,000. MATERIALS
AND METHODS: Twenty patients were divided into control (CG - normotensive
patients) and experimental groups (EG - hypertensive patients). The
variables analyzed were heart rate (HR), oxygen saturation (SO2), systolic
and diastolic blood pressure (SBP and DBP), serum catecholamine
concentration (dopamine, epinephrine, and norepinephrine), ventricular and
supraventricular extrasystoles (VES and SVES respectively), and ST segment
depression. Data was obtained in three different moments (initial, trans,
and final). Blood samples were taken to measure the catecholamines, and a
Holter device was used to measure data from the electrocardiogram
including a 24-h postoperative evaluation period. The Mann-Whitney test
was used to identify differences between the two groups, and the Friedman
test with the adjusted Wilcoxon posttest was used for intragroup
evaluation for repeated measures. RESULT(S): The EG presented a lower
O2S in the initial period (p=0,001) while the sysBP showed a statistical
difference for the three evaluation periods with the EG presenting the
highest values. The VES was higher for the EG during the 24-h
postoperative evaluation period (p=0,041). The SVES and the serum
catecholamines showed were similar between the groups. The intragroup
analysis revealed significant statistical difference for the sysBP in the
EG with the trans period presenting the highest measurements. The
extrasystole evaluation showed that the 24-h postoperative period
presented most events with only the CG not presenting statistical
difference for the variable VES during this period (p=0,112). No ST
segment depression was noticed for both groups. CONCLUSION(S): Teeth
extraction with LAVC can be safely executed in hypertensive patients.
Blood pressure should be monitored in these patients since the sysBP
presented significant differences during the surgical procedures. Cardiac
arrhythmia and the serum catecholamines concentration levels seem not to
be altered by the surgical procedure. Also, serum catecholamines do not
influence cardiovascular changes in this type of surgery. CLINICAL
RELEVANCE: LAVC can be safely used in hypertensive patients and does not
increase the risk of arrhythmias or cardiac ischemia. Copyright ©
2023. The Author(s), under exclusive licence to Springer-Verlag GmbH
Germany, part of Springer Nature.

<37>
Accession Number
643051897
Title
Hereditary Aortic Aneurysmal Disease: Surgical Therapies and Outcomes.
Source
Journal of the American College of Surgeons. Conference: 9th Owen H
Wangensteen Scientific Forum of the American College of Surgeons Clinical
Congress. Boston, MA United States. 237(5 Supplement 1) (pp S614), 2023.
Date of Publication: November 2023.
Author
Sree Challa A.; Bornak A.; Forghani I.
Institution
(Sree Challa, Bornak, Forghani) University of Miami, Miami, FL, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Several treatment modalities have been outlined for aortic
aneurysms (AAs) in patients with underlying genetic mutations including
open and endovascular repair. However, effective management of heritable
aneurysmal disease remains challenging due to unsatisfactory short and
long term outcomes. Method(s): A literature review of the primary
genetic etiologies of AAs was performed. We summarize the latest advances
in the surgical management of patients with hereditary aortic pathologies,
and evaluate treatment outcomes. Result(s): Mutations in FBN-1,
COL3A1, SMAD2, SMAD3, TGFB2, TGFB3, TGFBR1, or TGFBR2, ACTA2, and MYH11
genes are associated with Marfan Syndrome (MFS), Vascular Ehlers-Danlos
Syndrome (vEDS), Loeys-Dietz Syndrome (LDS), and Familial Thoracic Aortic
Aneurysms, respectively. In patients with connective tissue disorders
(CTDs), endovascular aortic repair remains controversial. Progressive
degeneration of the aorta can lead to endoleaks and subsequently rapid
aneurysm degeneration and rupture. In type vEDS patients, the overall
mortality rate is 63%, with 19% dying during the perioperative period.
Endovascular repair is generally contraindicated in LDS due to stent-graft
failure secondary to progressive degeneration. In a review of 251 patients
that underwent surgery for thoracic aortic diseases, including nine
patients with ACTA2 mutations characteristic of familial thoracic AAs,
histological studies revealed cystic medial necrosis in most cases with
the absence of aortic dilatation for seven years after thoracic
endovascular aortic repair. Other postoperative outcomes include sepsis,
multiorgan failure, paraplegia, and myocardial infarction.
 Conclusion(s): Research catered to the unique genetic predisposition
underlying AAs is necessary to yield personalized identification and
management strategies.

<38>
Accession Number
2029230829
Title
The exercise aNd hEArt transplant (ENEA) trial - a registry-based
randomized controlled trial evaluating the safety and efficacy of cardiac
telerehabilitation after heart transplant.
Source
Contemporary Clinical Trials. 136 (no pagination), 2024. Article Number:
107415. Date of Publication: January 2024.
Author
Pedersini P.; Picciolini S.; Di Salvo F.; Toccafondi A.; Novembre G.;
Gualerzi A.; Cusmano I.; Garascia A.; Tavanelli M.; Verde A.; Masciocco
G.; Ricci C.; Mannini A.; Bedoni M.; Morici N.
Institution
(Pedersini, Picciolini, Di Salvo, Toccafondi, Novembre, Gualerzi, Cusmano,
Tavanelli, Mannini, Bedoni, Morici) IRCCS Fondazione Don Carlo Gnocchi,
Milan, Italy
(Garascia, Verde, Masciocco) Cardiology Department and De Gasperis Cardio
Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
(Ricci) Africa Unit for transdisciplinary Health Research, North-West
University, Potchefstroom, South Africa
Publisher
Elsevier Inc.
Abstract
Background: Heart transplant (HTx) is gold-standard therapy for patients
with end-stage heart failure. Cardiac rehabilitation (CR) is a
multidisciplinary intervention shown to improve cardiovascular prognosis
and quality of life. The aim in this randomized controlled trial is to
explore the safety and efficacy of cardiac telerehabilitation after HTx.
In addition, biomarkers of rehabilitation outcomes will be identified, as
data that will enable treatment to be tailored to patient phenotype.
 Method(s): Patients after HTx will be recruited at IRCCS S. Maria
Nascente - Fondazione Don Gnocchi, Milan, Italy (n = 40). Consenting
participants will be randomly allocated to either of two groups (1:1): an
intervention group who will receive on-site CR followed by 12 weeks of
telerehabilitation, or a control group who will receive on-site CR
followed by standard homecare and exercise programme. Recruitment began on
20th May 2023 and is expected to continue until 20th May 2025.
Socio-demographic characteristics, lifestyle, health status,
cardiovascular events, cognitive function, anxiety and depression
symptoms, and quality of life will be assessed, as well as exercise
capacity and muscular endurance. Participants will be evaluated before the
intervention, post-CR and after 6 months. In addition, analysis of
circulating extracellular vesicles using Surface Plasmon Resonance imaging
(SPRi), based on a rehabilomic approach, will be applied to both groups
pre- and post-CR. Conclusion(s): This study will explore the safety
and efficacy of cardiac telerehabilitation after HTx. In addition, a
rehabilomic approach will be used to investigate biomolecular
phenotypization in HTx patients. Trial registration number:
ClinicalTrials.gov Identifier: NCT05824364. Copyright © 2023 The
Authors

<39>
Accession Number
2027251779
Title
Preventive effect and mechanism of compound Danshen dripping pills on
contrast-induced nephropathy after percutaneous coronary interventional.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1211982. Date of Publication: 2023.
Author
Fu H.; Wang L.; Ying S.; Zhao Z.; Zhang P.
Institution
(Fu) Sir Run Run Shaw Hospital, Zhejiang University School of Medicine,
Hangzhou, China
(Fu, Zhao) Graduate School of Tianjin Medical University, Tianjin, China
(Wang) Sheng Jing Hospital Affiliated, China Medical University, Shenyang,
China
(Ying, Zhang) Department of Cardiology, Tianjin Chest Hospital, Tianjin
University, Tianjin, China
Publisher
Frontiers Media SA
Abstract
Background: Contrast-induced nephropathy (CIN) is one of the most common
complications after coronary stent implantation due to the extensive
development of coronary catheterization technology. Compound Danshen
dripping pills (CDDP) are clinically used as cardiovascular drugs,
relieving systemic inflammatory response. Previous studies have observed
that CDDP can decrease CIN incidence after coronary stent implantation
with uncertain effectiveness. Method(s): We conducted a prospective,
randomized, single-center, single-blind, controlled trial. We enrolled
patients 18 years and older with unstable angina pectoris and NSTEMI who
underwent PCI at the Tianjin Chest Hospital between November 1, 2021, and
November 31, 2022, and followed for 30 days. Patients were randomized to
CDDP and hydration therapy (10 capsules three times/day; N = 411) or
hydration only (N = 411). The primary outcome was the contrast nephropathy
incidence, defined as an elevation in serum creatinine by more than 25% or
44 mumol/L from baseline within 48-72 h of contrast exposure. Secondary
outcomes included major adverse cardiovascular events post-surgery and
during follow-up. Result(s): After 48 h of operation, the two groups
had statistical significance in Scr and BUN values (80.0 +/- 12.59 vs.
84.43 +/- 13.49, P < 0.05; 6.22 +/- 1.01 vs. 6.40 +/- 0.93, P < 0.05). The
difference in Scr in 72 h between the two groups was statistically
significant (76.42 +/- 10.92 vs. 79.06 +/- 11.58, P < 0.05). The CIN
incidence was significantly lower in the CDDP group than in the hydration
group. The CIN risk was significantly elevated in patients with LVEF <50%,
contrast volume >=160 ml, and hypertension, after 48 and 72 h of
operation. The serum inflammation index levels NGAL, TNF-alpha, oxidative
stress indexes SOD, and MDA significantly differed between the two groups.
However, there was no significant difference in serum apoptosis indexes
Bax, Bcl-2, and Casepase-9. Conclusion(s): CDDP pre-treatment could
prevent contrast-induced nephropathy. Inflammatory response and oxidative
stress could be significant in the CDDP mechanism. Copyright 2023 Fu,
Wang, Ying, Zhao and Zhang.

<40>
Accession Number
2029158859
Title
Intravenous albumin in cardiac and vascular surgery: a systematic review
and meta-analysis.
Source
British Journal of Anaesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
Skubas N.J.; Callum J.; Bathla A.; Keshavarz H.; Fergusson D.; Wu B.;
Stanworth S.; Shehata N.
Institution
(Skubas) Department of Cardiothoracic Anaesthesiology, Anaesthesiology
Institute, Cleveland Clinic, and Cleveland Clinic, Lerner College of
Medicine of Case Western Reserve University, Cleveland, OH, United States
(Callum) Department of Pathology and Molecular Medicine, Queen's
University and Kingston Health Sciences Centre, Kingston, ON, Canada
(Bathla) Canadian Blood Services, Toronto, Canada
(Fergusson) Ottawa Hospital Research Institute, Ottawa, ON, Canada
(Wu) Department of Internal Medicine, School of Medicine, Loma Linda
University, Loma Linda, CA, United States
(Stanworth) NHS Blood and Transplant, Bristol, United Kingdom
(Shehata) Departments of Medicine, Laboratory Medicine and Pathobiology,
Institute of Health Policy Management and Evaluation, University of
Toronto, Division of Hematology, Mount Sinai Hospital, Toronto, ON, Canada
(Keshavarz) Canadian Blood Services, Ottawa, Canada
Publisher
Elsevier Ltd
Abstract
Background: Intravenous albumin is commonly utilised in cardiovascular
surgery for priming of the cardiopulmonary bypass circuit, volume
replacement, or both, although the evidence to support this practice is
uncertain. The aim was to compare i.v. albumin with synthetic colloids and
crystalloids for paediatric and adult patients undergoing cardiovascular
surgery for all-cause mortality and other perioperative outcomes.
 Method(s): A systematic review and meta-analysis of randomised
controlled trials (RCTs) of i.v. albumin compared with synthetic colloids
and crystalloids on the primary outcome of all-cause mortality was
conducted. Secondary outcomes included renal failure, blood loss, duration
of hospital or intensive care unit stay, cardiac index, and blood
component use; subgroups were analysed by age, comparator fluid, and
intended use (priming, volume, or both). We searched MEDLINE, Embase, and
Cochrane Central Register of Controlled Trials (CCRT) from 1946 to
November 23, 2022. Result(s): Of 42 RCTs, mortality was assessed in
15 trials (2711 cardiac surgery patients) and the risk difference was
0.00, 95% confidence interval (CI) -0.01 to 0.01, I2=0%. Among
secondary outcomes, i.v. albumin resulted in smaller fluid balance, mean
difference -0.55 L, 95% CI -1.06 to -0.4, I2=90% (nine studies,
1975 patients) and higher albumin concentrations, mean difference 7.77 g
L-1, 95% CI 3.73-11.8, I2=95% (six studies, 325
patients). Conclusion(s): Intravenous albumin use was not associated
with a difference in morbidity and mortality in patients undergoing
cardiovascular surgery, when compared with comparator fluids. The lack of
improvement in important outcomes with albumin and its higher cost
suggests it should be used restrictively. Systematic review protocol:
PROSPERO; CRD42020171876. Copyright © 2023 British Journal of
Anaesthesia

<41>
Accession Number
2028974367
Title
Low-Value Surgical Procedures in Low- and Middle-Income Countries A
Systematic Scoping Review.
Source
JAMA Network Open. (no pagination), 2023. Article Number: e2342215. Date
of Publication: 2023.
Author
Albarqouni L.; Abukmail E.; MohammedAli M.; Elejla S.; Abuelazm M.;
Shaikhkhalil H.; Pathirana T.; Palagama S.; Effa E.; Ochodo E.;
Rugengamanzi E.; AlSabaa Y.; Ingabire A.; Riwa F.; Goraya B.; Bakhit M.;
Clark J.; Arab-Zozani M.; da Silva S.A.; Pramesh C.S.; Vanderpuye V.; Lang
E.; Korenstein D.; Born K.; Tabiri S.; Ademuyiwa A.; Nabhan A.; Moynihan
R.
Institution
(Albarqouni, Abukmail, Ingabire, Riwa, Clark, Moynihan) Institute for
Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond
University, Gold Coast, Australia
(MohammedAli) Medicine & Health Sciences Faculty, Department of Medicine,
An-Najah National University, Nablus, Palestine
(Elejla, Shaikhkhalil) Faculty of Medicine, Islamic University of Gaza,
Gaza, Palestine
(Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
(Pathirana, Palagama) School of Medicine and Dentistry, Griffith
University, Sunshine Coast, Australia
(Effa) Department of Internal Medicine, Faculty of Clinical Sciences,
College of Medical Sciences, University of Calabar, Calabar, Nigeria
(Ochodo) Centre for Global Health Research, Kenya Medical Research
Institute, Kisumu, Kenya
(Ochodo) Centre for Evidence-Based Health Care, Department of Global
Health, Faculty of Medicine and Health Sciences, Stellenbosch University,
Stellenbosch, South Africa
(Rugengamanzi) Department of Clinical Oncology, Muhimbili University of
Health and Allied Sciences, Dar es Salaam, Tanzania
(AlSabaa) Faculty of Medicine, Al-Azhar University of Gaza, Gaza,
Palestine
(Goraya) Princess Margaret Cancer Centre, Toronto, ON, Canada
(Arab-Zozani) Social Determinants of Health Research Center, Birjand
University of Medical Sciences, Birjand, Iran, Islamic Republic of
(da Silva) Department of Epidemiology, HCor Hospital, Sao Paulo, Brazil
(Pramesh) Tata Memorial Centre, Homi Bhabha National Institute, Mumbai,
India
(Vanderpuye) National Centre for Radiotherapy, Oncology and Nuclear
Medicine, Korle Bu Teaching Hospital, Accra, Ghana
(Lang) Department of Emergency Medicine, Cumming School of Medicine,
University of Calgary, Calgary, AB, Canada
(Korenstein) Department of Medicine, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Born) Institute of Health Policy, Management and Evaluation, Dalla Lana
School of Public Health, Faculty of Medicine, University of Toronto,
Toronto, ON, Canada
(Tabiri) Department of Surgery, University for Development Studies, School
of Medicine, Tamale Teaching Hospital, Tamale, Ghana
(Ademuyiwa) Paediatric Surgery Unit, Department of Surgery, Faculty of
Clinical Sciences, College of Medicine, The University of Lagos, Lagos
University Teaching Hospital, Idi Araba, Lagos, Nigeria
(Nabhan) Department of Obstetrics and Gynecology, Faculty of Medicine, Ain
Shams University, Cairo, Egypt
Publisher
American Medical Association
Abstract
IMPORTANCE Overuse of surgical procedures is increasing around the world
and harms both individuals and health care systems by using resources that
could otherwise be allocated to addressing the underuse of effective
health care interventions. In low- and middle-income countries (LMICs),
there is some limited country-specific evidence showing that overuse of
surgical procedures is increasing, at least for certain procedures.
OBJECTIVES To assess factors associated with, extent and consequences of,
and potential solutions for low-value surgical procedures in LMICs.
EVIDENCE REVIEW We searched 4 electronic databases (PubMed, Embase,
PsycINFO, and Global Index Medicus) for studies published from database
inception until April 27, 2022, with no restrictions on date or language.
A combination of MeSH terms and free-text words about the overuse of
surgical procedures was used. Studies examining the problem of overuse of
surgical procedures in LMICs were included and categorized by major focus:
the extent of overuse, associated factors, consequences, and solutions.
FINDINGS Of 4276 unique records identified, 133 studies across 63
countries were included, reporting on more than 9.1 million surgical
procedures (median per study, 894 [IQR, 97-4259]) and with more than 11.4
million participants (median per study, 989 [IQR, 257-6857]). Fourteen
studies (10.5%) were multinational. Of the 119 studies (89.5%) originating
from single countries, 69 (58.0%) were from upper-middle-income countries
and 30 (25.2%) were from East Asia and the Pacific. Of the 42 studies
(31.6%) reporting extent of overuse of surgical procedures, most (36
[85.7%]) reported on unnecessary cesarean delivery, with estimated rates
in LMICs ranging from 12% to 81%. Evidence on other surgical procedures
was limited and included abdominal and percutaneous cardiovascular
surgical procedures. Consequences of low-value surgical procedures
included harms and costs, such as an estimated US $3.29 billion annual
cost of unnecessary cesarean deliveries in China. Associated factors
included private financing, and solutions included social media campaigns
and multifaceted interventions such as audits, feedback, and reminders.
CONCLUSIONS AND RELEVANCE This systematic review found growing evidence of
overuse of surgical procedures in LMICs, which may generate significant
harm and waste of limited resources; the majority of studies reporting
overuse were about unnecessary cesarean delivery. Therefore, a better
understanding of the problems in other surgical procedures and a robust
evaluation of solutions are needed. Copyright © 2023 American
Medical Association. All rights reserved.

<42>
Accession Number
643055370
Title
Mid-Term Clinical Outcomes of Reimplantation Versus Remodelling
Valve-Sparing Aortic Root Replacement in Patients with Connective Tissue
Disorders: A Meta-Analysis.
Source
The American journal of cardiology. (no pagination), 2023. Date of
Publication: 15 Dec 2023.
Author
Burton S.; Reynolds A.C.; King N.; Modi A.; Asopa S.
Institution
(Burton) Faculty of Health Sciences, University of Bristol, United Kingdom
(Reynolds) Swansea University Medical School, United Kingdom
(King) Faculty of Health, University of Plymouth, United Kingdom
(Modi) Wessex Cardiac Centre, Southampton, United Kingdom
(Asopa) Southwest Cardiothoracic Centre, Plymouth, United Kingdom
Abstract
This meta-analysis aimed to compare the mid-term clinical outcomes of
reimplantation versus remodelling techniques for valve-sparing aortic root
replacement (VSARR) in patients with connective tissue disorders (CTD).
Literature was screened and identified following PRISMA guidelines from
PubMed, Web of Science and Embase databases. Forest plots were produced
using Review Manager 5.3. Studies comparing early and mid-term clinical
outcomes of reimplantation versus remodelling VSARR in CTD patients with a
mean age >=18 were included. Sensitivity analysis excluded studies and
subgroups of patients that received ring or suture annuloplasty in
addition to remodelling surgery. Literature selection identified 9
eligible studies. Following analysis of the study period and location for
patient cross-over, 7 retrospective studies consisting of 597 patients
(301 reimplantation, 296 remodelling) were pooled. Pooling revealed no
significant difference in postoperative mortality (estimated mean
follow-up of 10.5 years) (odds ratio [OR], 0.66; 95% confidence interval
[CI], 0.30 to 1.48; I2= 30 %; p=0.32), reoperation (OR, 0.35; CI 0.04 to
3.30; I 2= 81%; p=0.36), or occurrence of postoperative aortic
regurgitation of >=2 (OR, 0.56; CI 0.31 to 1.02; I2= 47%; p=0.06).
Sensitivity analysis excluding annuloplasty demonstrated improved
mortality (OR, 0.19; CI 0.06 to 0.64; I2= 0%; p=0.007) and decreased
aortic regurgitation of >=2 (OR, 0.23; CI 0.10 to 0.53; I2= 47%; p=0.0005)
in reimplantation VSARR. Rates of reoperation remained insignificant in
the sensitivity analysis (OR, 0.43; CI 0.05 to 3.53; I2= 71%; p=0.43). In
conclusion, this meta-analysis has demonstrated no significant difference
in mid-term clinical outcomes of reimplantation versus remodelling
techniques of VSARR. Sensitivity analysis excluding studies and patient
subgroups that received remodelling and annuloplasty suggests remodelling
alone to be inferior to reimplantation in patients with connective tissue
disorders. Further research is required to assess remodelling and
annuloplasty against reimplantation in patients of this demographic, as
the current literature does not allow for sufficient
analysis. Copyright © 2023 The Author(s). Published by Elsevier
Inc. All rights reserved.

<43>
Accession Number
2029145144
Title
Inspiratory muscle training improves cardiopulmonary function in patients
after transcatheter aortic valve replacement: a randomized clinical trial.
Source
European Journal of Preventive Cardiology. 30(2) (pp 191-202), 2023. Date
of Publication: 01 Feb 2023.
Author
Xu L.; Wei J.; Liu J.; Feng Y.; Wang L.; Wang S.; Li Q.; He S.; Chen Y.;
Peng Y.; Bao Y.; Yang X.; He C.; Chen M.; Wei Q.
Institution
(Xu, Liu, Wang, Wang, He, Wei) Rehabilitation Medicine Center, Institute
of Rehabilitation Medicine, West China Hospital, Sichuan University,
Sichuan, Chengdu, China
(Liu, Wang, Wang, He, Wei) Key Laboratory of Rehabilitation Medicine in
Sichuan Province, Sichuan, Chengdu, China
(Wei, Feng, Li, He, Chen, Peng, Bao, Yang, Chen) Department of Cardiology,
West China Hospital, Sichuan University, Chengdu, China
Publisher
Oxford University Press
Abstract
Aims Inspiratory muscle training (IMT) can increase the strength or
endurance of the diaphragm and accessory muscles of inspiration, yet there
is no evidence that endorses the role of IMT in patients of transcatheter
aortic valve replacement (TAVR). This study for the first time tested the
effects of IMT plus usual cardiac rehabilitation (CR) function in patients
after TAVR. Methods A double-blinded, randomized controlled, single-centre
clinical trial was undertaken. Participants who had a confirmed diag- and
results nosis of valve heart disease and were clinically stable after TAVR
were recruited and received a CR programme during the hospital stay. A
total of 96 patients were recruited and randomly assigned to the IMT + CR
group (n = 48) or the CR group (n = 48) in a 1:1 ratio. The group
difference in the primary outcome, the 6-min walk distance at the
discharge of the hospital, significantly favoured the IMT + CR group (mean
difference -33.52, 95% CI: -64.42 to -2.62, P = 0.034). The significant
difference was maintained at the 1-month and 3-month follow-ups (mean
difference: 41.51, 95% CI: 1.82-81.21, P = 0.041). In addition, the mean
hospital stays of subjects in the IMT + CR group was 11 days, which was
significantly shorter than the 12.5 days in the CR group (P = 0.016).
Sensitivity analysis using per-protocol analysis supported these findings.
No adverse treatment-related events were reported. Conclusion Compared
with usual CR, IMT plus CR can effectively improve exercise endurance,
pulmonary ventilation function, and inspiratory muscle strength in
patients after TAVR and shorten the length of hospital stay. Copyright
© The Author(s) 2022. Published by Oxford University Press on behalf
of the European Society of Cardiology. All rights reserved.

<44>
Accession Number
2029145120
Title
Effects of remote patient management on self-care behaviour in heart
failure patients: results from the randomized TIM-HF2 trial.
Source
European Journal of Cardiovascular Nursing. 22(8) (pp 786-794), 2023. Date
of Publication: 01 Nov 2023.
Author
Deckwart O.; Koehler K.; Lezius S.; Prescher S.; Koehler F.; Winkler S.
Institution
(Deckwart, Koehler, Prescher, Koehler, Winkler) Department of Cardiology
and Angiology, Charite-Universitatsmedizin Berlin, Corporate Member of
Freie Universitat Berlin, Humboldt Universitat zu Berlin, Centre for
Cardiovascular Telemedicine, Berlin 10117, Germany
(Deckwart) Department of Cardiology, University Medical Center of the
Johannes Gutenberg University Mainz, Mainz 55131, Germany
(Deckwart) Nurse Practice Development Department, Goethe University,
University Hospital, Frankfurt 60318, Germany
(Lezius) University Medical Center Hamburg-Eppendorf, Institute of Medical
Biometry and Epidemiology, Hamburg 20246, Germany
(Koehler) DZHK (German Centre for Cardiovascular Research), Partner Site
Berlin, Berlin 10785, Germany
(Winkler) Department of Internal Medicine, BG Klinikum Unfallkrankenhaus
Berlin GmbH, Warener Str. 7, Berlin 12683, Germany
Publisher
Oxford University Press
Abstract
Aims Remote patient management (RPM) in heart failure (HF) patients has
beneficial clinical effects. This analysis investigates the effects of RPM
used in the Telemedical Interventional Management in Heart Failure II
(TIM-HF2) trial on HF-specific self-care. Methods From 2013 to 2017, 1538
HF outpatients (age 70.3 +/- 10.5 years, 70% men, 52%/47% NYHA II/III, 65%
LVEF <=45%) with and results a recent HF hospitalization were included to
the study and randomized to usual care (UC) plus RPM (n = 796) or UC only
(n = 775), with a 12-month follow-up. Self-reported self-care behaviour at
baseline and at end of study was assessed with the 9-item European Heart
Failure Self-care Behaviour Scale (EHFScBS-9), obtaining 1321 patients
with valid baseline and follow-up questionnaires for the analysis.
EHFScBS-9 sum scores increased in the RPM group (n = 667) from 78.7 +/- 17
to 84.5 +/- 14 and in the UC group (n = 654) from 79.0 +/- 17 to 80.0 +/-
16 from baseline to 12 months [difference in means (MD) 4.58 (3.02, 6.14);
P < 0.001] with highest improvement [8.66 (3.52; 13.81)] in patients
living alone and having an inadequate (<70) baseline EHFScBS-9. There were
differences between both groups in item 'I weight myself every day' [MD
-1.13 (-1.24, -1.02); P < 0.001] and item 'I take my medication as
prescribed' [MD -0.06 (-0.10, -0.01); P = 0.014]. No correlation was found
between the EHFScBS-9 score and the efficacy of RPM on the TIM-HF2 primary
endpoint of percentage of days lost due to unplanned cardiovascular
hospitalization or death of any cause. Conclusions RPM improves
HF-specific self-care behaviour by achieving a better adherence to
recommended HF regimen. Registration ClinicalTrials.gov:
NCT01878630 Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<45>
Accession Number
2028970669
Title
Optimal management of cardiac surgery patients using direct oral
anticoagulants: recommendations for clinical practice.
Source
European Journal of Cardio-thoracic Surgery. 64(4) (no pagination), 2023.
Article Number: ezad340. Date of Publication: 01 Oct 2023.
Author
Heuts S.; Ceulemans A.; Kuiper G.J.A.J.M.; Schreiber J.U.; van Varik B.J.;
Olie R.H.; Ten Cate H.; Maessen J.G.; Milojevic M.; Maesen B.
Institution
(Heuts, Maessen, Maesen) Department of Cardiothoracic Surgery, Maastricht
University Medical Centre+, Maastricht, Netherlands
(Heuts, Ceulemans, Kuiper, Olie, Ten Cate, Maessen, Maesen) Cardiovascular
Research Institute Maastricht, Maastricht University, Maastricht,
Netherlands
(Ceulemans) Department of Neurology, Maastricht University Medical
Centre+, Maastricht, Netherlands
(Kuiper, Schreiber) Department of Anaesthesiology and Pain Treatment,
Maastricht University Medical Centre+, Maastricht, Netherlands
(van Varik) Department of Internal Medicine, Gelre Ziekenhuizen,
Apeldoorn, Netherlands
(Olie, Ten Cate) Thrombosis Expertise Centre, Maastricht University
Medical Centre+, Maastricht, Netherlands
(Olie, Ten Cate) Department of Internal Medicine, Section Vascular
Medicine, Maastricht University Medical Centre+, Maastricht, Netherlands
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Literature is scarce on the management of patients using
direct oral anticoagulants (DOACs) undergoing elective, urgent and
emergency surgery. Therefore, we summarize the current evidence and
provide literature-based recommendations for the management of patients on
DOACs in the perioperative phase. METHOD(S): A general literature
review was conducted on the pharmacology of DOACs and for recommendations
on the management of cardiac surgical patients on DOACs. Additionally, we
performed a systematic review for studies on the use of direct DOAC
reversal agents in the emergency cardiac surgical setting. RESULT(S):
When surgery is elective, the DOAC cessation strategy is relatively
straightforward and should be adapted to the renal function. The same
approach applies to urgent cases, but additional DOAC activity drug level
monitoring tests may be useful. In emergency cases, idarucizumab can be
safely administered to patients on dabigatran in any of the perioperative
phases. However, andexanet alfa, which is not registered for perioperative
use, should not be administered in the preoperative phase to reverse the
effect of factor Xa inhibitors, as it may induce temporary heparin
resistance. Finally, the administration of (activated) prothrombin complex
concentrate may be considered in all patients on DOACs, and such
concentrates are generally readily available. CONCLUSION(S): DOACs
offer several advantages over vitamin K antagonists, but care must be
taken in patients undergoing cardiac surgery. Although elective and urgent
cases can be managed relatively straightforwardly, the management of
emergency cases requires particular attention. Copyright © The
Author(s) 2023.

<46>
Accession Number
2028970654
Title
Confounding adjustment in observational studies on cardiothoracic
interventions: a systematic review of methodological practice.
Source
European Journal of Cardio-thoracic Surgery. 64(4) (no pagination), 2023.
Article Number: ezad271. Date of Publication: 01 Oct 2023.
Author
Velders B.J.J.; Boltje J.W.T.; Vriesendorp M.D.; Klautz R.J.M.; Cessie
S.L.; Groenwold R.H.H.
Institution
(Velders, Vriesendorp, Klautz) Department of Cardiothoracic Surgery,
Leiden University Medical Center, Leiden, Netherlands
(Velders, Cessie, Groenwold) Department of Clinical Epidemiology, Leiden
University Medical Center, Leiden, Netherlands
(Boltje) Department of Cardiothoracic Surgery, Amsterdam University
Medical Center, Amsterdam, Netherlands
(Cessie, Groenwold) Department of Biomedical Data Science, Leiden
University Medical Center, Leiden, Netherlands
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: It is unknown which confounding adjustment methods are
currently used in the field of cardiothoracic surgery and whether these
are appropriately applied. The aim of this study was to systematically
evaluate the quality of conduct and reporting of confounding adjustment
methods in observational studies on cardiothoracic interventions.
METHODS: A systematic review was performed, which included all
observational studies that compared different interventions and were
published between 1 January and 1 July 2022, in 3 European and American
cardiothoracic surgery journals. Detailed information on confounding
adjustment methods was extracted and subsequently described.
 RESULT(S): Ninety-two articles were included in the analysis. Outcome
regression (n = 49, 53%) and propensity score (PS) matching (n = 44, 48%)
were most popular (sometimes used in combination), whereas 11 (12%)
studies applied no method at all. The way of selecting confounders was not
reported in 42 (46%) of the studies, solely based on previous literature
or clinical knowledge in 14 (16%), and (partly) data-driven in 25 (27%).
For the studies that applied PS matching, the matched cohorts comprised on
average 46% of the entire study population (range 9-82%).
 CONCLUSION(S): Current reporting of confounding adjustment methods is
insufficient in a large part of observational studies on cardiothoracic
interventions, which makes quality judgement difficult. Appropriate
application of confounding adjustment methods is crucial for causal
inference on optimal treatment strategies for clinical practice. Reporting
on these methods is an important aspect of this, which can be
improved. Copyright © 2023 European Association for
Cardio-Thoracic Surgery. All rights reserved.

<47>
Accession Number
2028341509
Title
Transcatheter edge-to-edge repair in mitral regurgitation: A comparison of
device systems and recommendations for tailored device selection. A
systematic review and meta-analysis.
Source
Progress in Cardiovascular Diseases. 81 (pp 98-104), 2023. Date of
Publication: 01 Nov 2023.
Author
Alqeeq B.F.; Al-Tawil M.; Hamam M.; Aboabdo M.; Elrayes M.I.; Leick J.;
Zeinah M.; Haneya A.; Harky A.
Institution
(Alqeeq, Hamam, Aboabdo) Faculty of Medicine, Islamic University of Gaza,
Gaza, Palestine
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Elrayes) Department of Pediatric Surgery, Great Ormond Street Hospital
for Children, London, United Kingdom
(Leick) Department of Cardiology, Heart Center Trier, Trier, Germany
(Zeinah) School of Medicine, Ain Shams University, Cairo, Egypt
(Zeinah, Harky) Department of Cardiothoracic Surgery, Liverpool Heart and
Chest Hospital, Liverpool, United Kingdom
(Haneya) Department of Cardiac and Thoracic Surgery, Heart Center Trier,
Trier, Germany
Publisher
W.B. Saunders
Abstract
Background: Mitral valve transcatheter edge-to-edge repair (M-TEER) is a
minimally invasive method for the treatment of mitral regurgitation (MR)
in patients with prohibitive surgical risks. The traditionally used
device, MitraClip, showed both safety and effectiveness in M-TEER. PASCAL
is a newer device that has emerged as another feasible option to be used
in this procedure. Method(s): We searched for observational studies
that compared PASCAL to MitraClip devices in M-TEER. The electronic
databases searched for relevant studies were PubMed/MEDLINE, Scopus, and
Embase. The primary outcomes were technical success and the grade of MR at
follow-up. Secondary outcomes included all-cause mortality, bleeding,
device success and reintervention. Result(s): Technical success
(PASCAL: 96.5% vs MitraClip: 97.6%, p = 0.24) and MR <= 2 at 30-day
follow-up (PASCAL: 89.4vs MitraClip 89.9%, p = 0.51) were comparable
between both groups. Both devices showed similar outcomes including
all-cause mortality (RR: 0.68 [0.34, 1.38]; P = 0.28), major bleeding (RR:
1.87 [0.68, 5.10]; P = 0.22) and reintervention (RR: 1.02 [0.33, 3.16]; P
= 0.97). Device success was more frequent with PASCAL device (PASCAL: 86%
vs MitraClip 68.5%; P = 0.44), however, the results did not reach
statistical significance. Conclusion(s): Clinical outcomes of PASCAL
were comparable to those of MitraClip with no significant difference in
safety and effectiveness. The choice between MitraClip and PASCAL devices
should be guided by various factors, including mitral valve anatomy,
etiology of regurgitation, and device-specific
characteristics. Copyright © 2023 Elsevier Inc.

<48>
Accession Number
2028083153
Title
Systematic Review of the Use of the 6-Minute Walk Test in Measuring and
Improving Prognosis in Patients With Ischemic Heart Disease.
Source
CJC Open. 5(11) (pp 816-825), 2023. Date of Publication: November 2023.
Author
Coulshed A.; Coulshed D.; Pathan F.
Institution
(Coulshed) Royal Prince Alfred Hospital, Sydney, NSW, Australia
(Coulshed, Pathan) Department of Cardiology, Nepean Hospital, University
of Sydney, Penrith, NSW, Australia
Publisher
Elsevier Inc.
Abstract
Introduction: The 6-minute walk test (6MWT) has been used for over 30
years to assess exercise capacity in patients with respiratory disease,
and more recently, in those with heart failure. However, despite being a
simple and reproducible test of real-world exercise capacity, its use in
patients with ischemic heart disease (IHD) is less well accepted. We
sought to review systematically the evidence surrounding the 6MWT in IHD.
 Method(s): We searched the Medline, PubMed, Embase, and Scopus
databases for the following key terms: "six minute walk test/6 minute walk
test/6MWT" and "angina/coronary artery disease/coronary
disease/IHD/ischemic heart disease." We followed Preferred Reporting Items
for Systematic Reviews and Meta-analysis (PRISMA) guidelines to select
publications for full-text review and analyzed the collated data.
 Result(s): A total of 1228 unique papers were found, of which 71 were
chosen for full-text review and 37 for detailed analysis. Most (23)
concerned the effect on 6MWT distance (6MWTd) of cardiac rehabilitation,
with measurements commenced after an intervention (acute myocardial
infarction, n = 4; open heart surgery (OHS), n = 5; percutaneous coronary
intervention (PCI), n = 3; or other, n = 11). The effect on 6MWTd of OHS
was investigated in 6 studies and of PCI in one study. The 6MWT is a
useful measurement of physical capacity; data are limited on its ability
to assess benefit following PCI. Conclusion(s): The 6MWT has been
studied inconsistently in IHD. The majority of data are on patients before
and after CR. Data are limited concerning the effect on 6MWTd of OHS or
PCI. The available data support the 6MWT as a measure of change in
performance status following coronary intervention. More work is required
to confirm this hypothesis. Copyright © 2023 The Authors

<49>
Accession Number
2027215370
Title
The changes of cardiac energy metabolism with sodium-glucose transporter 2
inhibitor therapy.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1291450. Date of Publication: 2023.
Author
Su S.; Ji X.; Li T.; Teng Y.; Wang B.; Han X.; Zhao M.
Institution
(Su, Ji, Li, Teng, Wang, Han, Zhao) Key Laboratory of Chinese Internal
Medicine of Ministry of Education and Beijing, Dongzhimen Hospital
Affiliated to Beijing University of Chinese Medicine, Beijing, China
(Han) Department of Cardiology, Dongzhimen Hospital Affiliated to Beijing
University of Chinese Medicine, Beijing, China
Publisher
Frontiers Media SA
Abstract
(Figure presented.) Graphical abstracts of this systematic review. SGLT2i,
sodium-glucose transporter 2 inhibitor; DM, diabetes mellitus; HF, heart
failure; ROS, reactive oxygen species; beta-OHB, beta-hydroxybutyric acid;
AcAc, acetoacetate.
Background/aims: To investigate the specific effects of sodium-glucose
transporter 2 inhibitor (SGLT2i) on cardiac energy metabolism.
 Method(s): A systematic literature search was conducted in eight
databases. The retrieved studies were screened according to the inclusion
and exclusion criteria, and relevant information was extracted according
to the purpose of the study. Two researchers independently screened the
studies, extracted information, and assessed article quality.
 Result(s): The results of the 34 included studies (including 10
clinical and 24 animal studies) showed that SGLT2i inhibited cardiac
glucose uptake and glycolysis, but promoted fatty acid (FA) metabolism in
most disease states. SGLT2i upregulated ketone metabolism, improved the
structure and functions of myocardial mitochondria, alleviated oxidative
stress of cardiomyocytes in all literatures. SGLT2i increased cardiac
glucose oxidation in diabetes mellitus (DM) and cardiac FA metabolism in
heart failure (HF). However, the regulatory effects of SGLT2i on cardiac
FA metabolism in DM and cardiac glucose oxidation in HF varied with
disease types, stages, and intervention duration of SGLT2i.
 Conclusion(s): SGLT2i improved the efficiency of cardiac energy
production by regulating FA, glucose and ketone metabolism, improving
mitochondria structure and functions, and decreasing oxidative stress of
cardiomyocytes under pathological conditions. Thus, SGLT2i is deemed to
exert a benign regulatory effect on cardiac metabolic disorders in various
diseases. Systematic review registration: https://www.crd.york.ac.uk/,
PROSPERO (CRD42023484295). Copyright 2023 Su, Ji, Li, Teng, Wang, Han
and Zhao.

<50>
Accession Number
2027181701
Title
The COBRA II (COmplex Bifurcation lesions: RAndomized comparison of a
fully bioresorbable modified-T stenting strategy versus bifurcation
reconstruction with a dedicated self-expanding stent in combination with
bioresorbable scaffolds) study: Final 5-year follow-up.
Source
Indian Heart Journal. 75(6) (pp 473-476), 2023. Date of Publication: 01
Nov 2023.
Author
Bennett J.; Desmet W.; Dubois C.
Institution
(Bennett, Desmet, Dubois) Department of Cardiovascular Medicine,
University Hospitals Leuven, Leuven, Belgium
(Bennett, Desmet, Dubois) Department of Cardiovascular Sciences,
Katholieke Universiteit Leuven, Leuven, Belgium
Publisher
Elsevier B.V.
Abstract
Background: In order to advocate further research in bioresorbable
scaffold (BVS) technology we report the final 5-year outcomes of the COBRA
II study, the only randomized controlled trial (RCT) performed to
investigate the safety, feasibility, and performance of Absorb BVS (Abbott
Vascular) in true coronary bifurcations. Method(s): COBRA II was a
prospective single-center RCT. Fifteen patients with true coronary
bifurcation lesions were randomized to bifurcation treatment with
self-expanding biolimus-eluting Axxess bifurcation device (Biosensors
International) combined with additional bioresorbable everolimus-eluting
Absorb BVS in the bifurcation branches on (Axxess group) or to 2-stent
mod-T stenting technique with Absorb BVS (mod-T group). Optical coherence
tomography was performed post-procedure and at 30-months. The primary
endpoint was change in minimal luminal area (MLA) on OCT from baseline to
30-months. Result(s): Fifteen patients with coronary bifurcation
lesions were randomized to the Axxess group (n = 8) or Modified-T group (n
= 7). At 30 months, MLAs were significantly smaller than post-procedure in
the majority of bifurcation segments treated with BVS due to neointima
formation, while MLAs in the proximal Axxess segment remained stable
(primary endpoint). Five-year clinical follow-up was available for all
patients. Only 1 major adverse cardiac event occurred; a patient underwent
target lesion revascularization at 30 months in the Axxess group. There
were no cases of cardiac death, spontaneous MI, or stent/scaffold
thrombosis. Conclusion(s): In this small RCT bifurcation study, BVS
luminal dimensions were significantly smaller at 30 months, with acute
strut discontinuities and late Intraluminal dismantling frequently
observed, although acceptable clinical outcomes were noted at 5
years. Copyright © 2023 Cardiological Society of India

<51>
Accession Number
2027049376
Title
Evaluation of the efficacy and safety of amustaline/glutathione
pathogen-reduced RBCs in complex cardiac surgery: the Red Cell Pathogen
Inactivation (ReCePI) study-protocol for a phase 3, randomized, controlled
trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 799. Date of
Publication: December 2023.
Author
Snyder E.L.; Sekela M.E.; Welsby I.J.; Toyoda Y.; Alsammak M.; Sodha N.R.;
Beaver T.M.; Pelletier J.P.R.; Gorham J.D.; McNeil J.S.; Sniecinski R.M.;
Pearl R.G.; Nuttall G.A.; Sarode R.; Reece T.B.; Kaplan A.; Davenport
R.D.; Ipe T.S.; Benharash P.; Lopez-Plaza I.; Gammon R.R.; Sadler P.;
Pitman J.P.; Liu K.; Bentow S.; Corash L.; Mufti N.; Varrone J.; Benjamin
R.J.
Institution
(Snyder) Yale University School of Medicine, New Haven, CT, United States
(Sekela) Gill Heart Institute University of Kentucky, Lexington, KY,
United States
(Welsby) Duke University Medical Center, Durham, NC, United States
(Toyoda) Temple University Hospital, Philadelphia, PA, United States
(Alsammak) Temple University Health System, Philadelphia, PA, United
States
(Sodha) Rhode Island Hospital, Providence, RI, United States
(Beaver, Pelletier) University of Florida, Gainesville, FL, United States
(Kaplan) University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Sniecinski) Emory University, Atlanta, GA, United States
(Reece) University of Colorado Hospital, Denver, CO, United States
(Pearl) Stanford University, Stanford, CA, United States
(Davenport) University of Michigan, Ann Arbor, MI, United States
(Gorham, McNeil) University of Virginia Health System, Charlottesville,
VA, United States
(Sarode) University of Texas, Southwestern, Dallas, TX, United States
(Ipe) Our Blood Institute, Oklahoma City, OK, United States
(Ipe) University of Arkansas for Medical Sciences, Little Rock, AR, United
States
(Nuttall) Mayo Clinic, Rochester, MN, United States
(Benharash) UCLA, Los Angeles, CA, United States
(Lopez-Plaza) Henry Ford Hospital, Detroit, MI, United States
(Gammon) Scientific, Medical and Technical and Research Department,
OneBlood, Orlando, FL, United States
(Sadler) Central California Blood Center, Fresno, CA, United States
(Pitman, Liu, Bentow, Corash, Mufti, Varrone, Benjamin) Cerus Corporation,
1220 Concord Ave, Concord, CA 94520, United States
(Kaplan) Vitalant, Pittsburgh, PA, United States
Publisher
BioMed Central Ltd
Abstract
Background: Red blood cell (RBC) transfusion is a critical supportive
therapy in cardiovascular surgery (CVS). Donor selection and testing have
reduced the risk of transfusion-transmitted infections; however, risks
remain from bacteria, emerging viruses, pathogens for which testing is not
performed and from residual donor leukocytes. Amustaline
(S-303)/glutathione (GSH) treatment pathogen reduction technology is
designed to inactivate a broad spectrum of infectious agents and
leukocytes in RBC concentrates. The ReCePI study is a Phase 3 clinical
trial designed to evaluate the efficacy and safety of pathogen-reduced
RBCs transfused for acute anemia in CVS compared to conventional RBCs, and
to assess the clinical significance of treatment-emergent RBC antibodies.
 Method(s): ReCePI is a prospective, multicenter, randomized,
double-blinded, active-controlled, parallel-design, non-inferiority study.
Eligible subjects will be randomized up to 7 days before surgery to
receive either leukoreduced Test (pathogen reduced) or Control
(conventional) RBCs from surgery up to day 7 post-surgery. The primary
efficacy endpoint is the proportion of patients transfused with at least
one study transfusion with an acute kidney injury (AKI) diagnosis defined
as any increased serum creatinine (sCr) level >= 0.3 mg/dL (or 26.5
micromol/L) from pre-surgery baseline within 48 +/- 4 h of the end of
surgery. The primary safety endpoints are the proportion of patients with
any treatment-emergent adverse events (TEAEs) related to study RBC
transfusion through 28 days, and the proportion of patients with
treatment-emergent antibodies with confirmed specificity to
pathogen-reduced RBCs through 75 days after the last study transfusion.
With >= 292 evaluable, transfused patients (> 146 per arm), the study has
80% power to demonstrate non-inferiority, defined as a Test group AKI
incidence increase of no more than 50% of the Control group rate, assuming
a Control incidence of 30%. Discussion(s): RBCs are transfused to
prevent tissue hypoxia caused by surgery-induced bleeding and anemia. AKI
is a sensitive indicator of renal hypoxia and a novel endpoint for
assessing RBC efficacy. The ReCePI study is intended to demonstrate the
non-inferiority of pathogen-reduced RBCs to conventional RBCs in the
support of renal tissue oxygenation due to acute anemia and to
characterize the incidence of treatment-related antibodies to
RBCs. Copyright © 2023, The Author(s).

<52>
Accession Number
2026976015
Title
Effects of intravenous glucocorticoids on postoperative delirium in adult
patients undergoing major surgery: a systematic review and meta-analysis
with trial sequential analysis.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 399. Date
of Publication: December 2023.
Author
Li C.; Zhang Z.; Xu L.; Lin X.; Sun X.; Li J.; Wei P.
Institution
(Li, Zhang, Xu, Lin, Sun, Li, Wei) Department of Anesthesiology, Qilu
Hospital (Qingdao), Cheeloo College of Medicine, Shandong University,
Qingdao 266035, China
(Li, Zhang, Lin, Sun, Li) Department of Anesthesiology, Qilu Hospital of
Shandong University, Jinan 250000, China
Publisher
BioMed Central Ltd
Abstract
Background: The effects of intravenous glucocorticoids on postoperative
delirium (POD) in adult patients undergoing major surgery remain
controversial. Therefore, we conducted this meta-analysis to assess
whether intravenous glucocorticoids can decrease POD incidence in the
entire adult population undergoing major surgery and its association with
patients age, type of surgery, and type of glucocorticoid. Method(s):
We searched the relevant literature published before November 3, 2023,
through Cochrane Library, PubMed, Embase, and Web of Science. The primary
outcome was POD incidence. The risk ratio for the primary outcome was
calculated using the Mantel-Haenszel method. The secondary outcomes
included 30-day mortality, length of hospital stay, ICU duration,
mechanical ventilation duration, and occurrence of glucocorticoid-related
adverse effects (e.g., infection and hyperglycemia). This meta-analysis
was registered in PROSPERO: CRD42022345997. Result(s): We included
eight randomized controlled studies involving 8972 patients. For the
entire adult population undergoing major surgery, intravenous
glucocorticoids reduced the POD incidence (risk ratio = 0.704, 95%
confidence interval, 0.519-0.955; P = 0.024). However, subgroups defined
by type of surgery showed differential effects of glucocorticoids on POD.
Intravenous glucocorticoids can not reduce POD incidence in adult patients
undergoing cardiac surgery (risk ratio = 0.961, 95% confidence interval,
0.769-1.202; P = 0.728), with firm evidence from trial sequential
analysis. However, in major non-cardiac surgery, perioperative intravenous
glucocorticoid reduced the incidence of POD (risk ratio = 0.491, 95%
confidence interval, 0.338-0.714; P < 0.001), which warrants further
studies due to inconclusive evidence by trial sequence analysis. In
addition, the use of glucocorticoids may reduce the mechanical ventilation
time (weighted mean difference, -1.350; 95% confidence interval, -1.846 to
-0.854; P < 0.001) and ICU duration (weighted mean difference = -7.866;
95% confidence interval, -15.620 to -0.112; P = 0.047).
 Conclusion(s): For the entire adult population undergoing major
surgery, glucocorticoids reduced the POD incidence. However, the effects
of glucocorticoids on POD appear to vary according to the type of surgery.
In patients receiving major non-cardiac surgery, glucocorticoid may be an
attractive drug in the prevention of POD, and further studies are needed
to draw a definitive conclusion. In cardiac surgery, intravenous
glucocorticoids have no such effect. Copyright © 2023, The
Author(s).

<53>
Accession Number
2019495186
Title
Randomized Trial of Surgical Left Atrial Appendage Closure: Protection
Against Cerebrovascular Events.
Source
Seminars in Thoracic and Cardiovascular Surgery. 35(4) (pp 664-672), 2023.
Date of Publication: Winter 2023.
Author
Madsen C.V.; Park-Hansen J.; Holme S.J.V.; Irmukhamedov A.; Carranza C.L.;
Greve A.M.; Al-Farra G.; Riis R.G.C.; Nilsson B.; Clausen J.S.R.; Norskov
A.S.; Kruuse C.; Truelsen T.C.; Dominguez H.
Institution
(Madsen, Park-Hansen, Clausen, Norskov, Dominguez) Department of
Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg,
Copenhagen, Denmark
(Madsen, Clausen, Norskov, Dominguez) Department of Biomedical Science,
University of Copenhagen, Copenhagen, Denmark
(Holme, Carranza) Department of Cardio-Thoracic Surgery, Copenhagen
University Hospital - Rigshospitalet-Glostrup, Copenhagen, Denmark
(Irmukhamedov) Department of Heart, Lung, and Vascular Surgery, Odense
University Hospital, Odense, Denmark
(Greve) Department of Clinical Biochemistry, Copenhagen University
Hospital - Herlev and Gentofte, Herlev, Denmark
(Al-Farra) Department of Radiology, Copenhagen University Hospital -
Herlev and Gentofte, Herlev, Denmark
(Riis) Department of Radiology, Copenhagen University Hospital -
Rigshospitalet-Glostrup Hospital, Copenhagen, Denmark
(Nilsson) Department of Cardiology, Copenhagen University Hospital -
Amager and Hvidovre, Hvidovre, Denmark
(Kruuse) Department of Neurology, Neurovascular Research Unit, Copenhagen
University Hospital - Herlev and Gentofte, Herlev, Denmark
(Truelsen) Department of Neurology, Copenhagen University Hospital -
Rigshospitalet-Glostrup, Copenhagen, Denmark
Publisher
W.B. Saunders
Abstract
Following open-heart surgery, atrial fibrillation and stroke occur
frequently. Left atrial appendage closure added to elective open-heart
surgery could reduce the risk of ischemic stroke. We aim to examine if
routine closure of the left atrial appendage in patients undergoing
open-heart surgery provides long-term protection against cerebrovascular
events independently of atrial fibrillation history, stroke risk, and oral
anticoagulation use. Long-term follow-up of patients enrolled in the
prospective, randomized, open-label, blinded evaluation trial entitled
left atrial appendage closure by surgery (NCT02378116). Patients were
stratified by oral anticoagulation status and randomized (1:1) to left
atrial appendage closure in addition to elective open-heart surgery vs
standard care. The primary composite endpoint was ischemic stroke events,
transient ischemic attacks, and imaging findings of silent cerebral
ischemic lesions. Two neurologists blinded for treatment assignment
adjudicated cerebrovascular events. In total, 186 patients (82% males)
were reviewed. At baseline, mean (standard deviation (SD)) age was68 (9)
years and 13.4% (n = 25/186) had been diagnosed with atrial fibrillation.
Median [interquartile range (IQR)] CHA<inf>2</inf>DS<inf>2</inf>-VASc was
3 [2,4] and 25.9% (n = 48/186) were receiving oral anticoagulants. Mean
follow-up was 6.2 (2.5) years. The left atrial appendage closure group
experienced fewer cerebrovascular events; intention-to-treat 11 vs 19 (P =
0.033, n = 186) and per-protocol 9 vs 17 (P = 0.186, n = 141). Left atrial
appendage closure as an add-on open-heart surgery, regardless of
pre-surgery atrial fibrillation and oral anticoagulation status, seems
safe and may reduce cerebrovascular events in long-term follow-up. More
extensive randomized clinical trials investigating left atrial appendage
closure in patients without atrial fibrillation and high stroke risk are
warranted. Copyright © 2022 The Author(s)

<54>
Accession Number
2028023449
Title
Albumin and Cardioprotection in On-Pump Cardiac Surgery-A Post Hoc
Analysis of a Randomized Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(1) (pp 86-92), 2024.
Date of Publication: January 2024.
Author
Vlasov H.; Talvasto A.; Hiippala S.; Suojaranta R.; Wilkman E.; Rautamo
M.; Helve O.; Petaja L.; Raivio P.; Juvonen T.; Pesonen E.
Institution
(Vlasov, Talvasto, Hiippala, Suojaranta, Wilkman, Petaja, Pesonen)
Department of Anesthesiology and Intensive Care Medicine, University of
Helsinki and Helsinki University Hospital, Helsinki, Finland
(Rautamo) HUS Pharmacy, University of Helsinki and Helsinki University
Hospital, Helsinki, Finland
(Helve) Children's Hospital, Pediatric Research Center, University of
Helsinki and Helsinki University Hospital, Helsinki, Finland
(Helve) Department of Health Security, Finnish Institute for Health and
Welfare, Helsinki, Finland
(Raivio, Juvonen) Department of Cardiac Surgery, Heart, and Lung Center,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Publisher
W.B. Saunders
Abstract
Objectives: To study the quantitative potency of plasma albumin on
cardioprotection in terms of creatinine kinase-myocardial band mass
(CK-MBm) in on-pump cardiac surgery. Design(s): Post hoc analysis of
a double-blinded randomized clinical trial. Setting(s): Single-center
study in the Helsinki University Hospital. Participant(s): A total of
1,386 adult on-pump cardiac surgical patients. Intervention(s):
Administration of 4% albumin (n = 693) or Ringers acetate (n = 693) for
cardiopulmonary bypass priming and volume replacement intraoperatively and
postoperatively during the first 24 hours. Measurements and Main
Results: Albumin concentration was measured preoperatively and
intraoperatively (after protamine administration), and CK-MBm on the first
postoperative morning. Multivariate linear regression analyses were
measured in the whole cohort and the Ringer group. Plasma albumin
concentration did not differ between the groups preoperatively (Ringer v
albumin: 38.3 +/- 5.0 g/L v 38.6 +/- 4.5 g/L; p = 0.171) but differed
intraoperatively (29.5 +/- 5.2 g/L v 41.5 +/- 6.0 g/L; p < 0.001).
Creatinine kinase-myocardial band mass was higher in the Ringer (32.0 +/-
34.8 mug/L) than in the albumin group (24.3 +/- 33.0 mug/L) (p < 0.001).
Aortic cross-clamping time associated with CK-MBm in the whole cohort
(standardized beta = 0.376 [95% CI 0.315-0.437], p < 0.001) and the Ringer
group (beta = 0.363 [0.273-0.452]; p < 0.001). Albumin administration in
the whole cohort (beta = -0.156 [-0.201 to -0.111]; p < 0.001) and high
intraoperative albumin concentration in the Ringer group (beta = -0.07
[-0.140 to -0.003]; p = 0.04) associated with reduced CK-MBm. Compared
with ischemia-induced increase in CK-MBm, albumin's potency to reduce
CK-MBm was 41% in the whole cohort (beta-value ratio of -0.156/0.376) and
19% in the Ringer group (beta-value ratio of -0.07/0.363).
 Conclusion(s): Both endogenous and exogenous albumin appear to be
cardioprotective regarding CK-MBm release in on-pump cardiac
surgery. Copyright © 2023 The Authors

<55>
Accession Number
2027953743
Title
Delirium in older patients given propofol or sevoflurane anaesthesia for
major cancer surgery: a multicentre randomised trial. Comment on Br J
Anaesth 2023; 131: 253-65.
Source
British Journal of Anaesthesia. 132(1) (pp 164-165), 2024. Date of
Publication: January 2024.
Author
O'Reilly D.; Naughton R.; Lavelle A.
Institution
(O'Reilly, Naughton, Lavelle) Department of Anaesthesiology, St. James's
Hospital, Dublin, Ireland
Publisher
Elsevier Ltd

<56>
Accession Number
2025644607
Title
Comment on "Effect of high-energy and/or high-protein feeding in children
with congenital heart disease after cardiac surgery: a systematic review
and meta-analysis".
Source
European Journal of Pediatrics. 182(12) (pp 5719-5720), 2023. Date of
Publication: December 2023.
Author
Xiang G.
Institution
(Xiang) Department of Neonatology, The Central Hospital of Enshi Tujia and
Miao Autonomous Prefecture, Hubei, Enshi 445000, China
Publisher
Springer Science and Business Media Deutschland GmbH

<57>
Accession Number
642989290
Title
Health-related quality of life following TAVI or cardiac surgery in
patients at intermediate and low risk: a systematic review and
meta-analysis.
Source
Clinical medicine (London, England). 23(6) (pp 594-605), 2023. Date of
Publication: 01 Nov 2023.
Author
Gonnah A.R.; Abdelwahab M.; Taylor R.; Labib A.; Masoud O.; Debski M.;
Abdelaziz H.K.; Roberts D.H.
Institution
(Gonnah) Imperial College Healthcare NHS Trust, London, United Kingdom
(Abdelwahab) Boston University, Boston, MA, United States
(Taylor) Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool,
United Kingdom
(Labib) Southport and Ormskirk NHS Foundation Trust, Southport, United
Kingdom
(Masoud) University College London Hospitals NHS Foundation Trust, London,
United Kingdom
(Debski) University of East Anglia, UK and research fellow, Norfolk and
Norwich University Hospital, Norwich, United Kingdom
(Abdelaziz) Lancashire Cardiac Centre, Blackpool, United Kingdom
(Roberts) Lancashire Cardiac Centre, honorary senior lecturer, University
of Liverpool, Blackpool, United Kingdom
Abstract
Recent randomised trials have shown that clinical outcomes with
transcatheter aortic valve implantation (TAVI) are non-inferior to
surgical aortic valve replacement (SAVR) in patients with symptomatic
aortic stenosis at intermediate to low risk. Health-related quality of
life (HrQoL) outcomes in these patient groups remain uncertain. A
systematic search of the literature was conducted that included nine
trials and 11,295 patients. Kansas City Cardiomyopathy Questionnaire
(KCCQ), a heart-failure-specific measure and EuroQol-5D (EQ-5D) (a generic
health status tool) changes were the primary outcomes. New York Heart
Association (NYHA) classification was the secondary outcome. Improvement
in KCCQ scores was greater with TAVI (mean difference (MD)=13.56, 95%
confidence interval (CI) 11.67-15.46, p<0.001) at 1 month, as was the
improvement in EQ-5D (MD=0.07, 95% CI 0.05-0.08, p<0.001). There was no
difference in KCCQ (MD=1.05, 95% CI -0.11 to 2.21, p=0.08) or EQ-5D
(MD=-0.01, 95% CI -0.03 to 0.01), p=0.37) at 12 months. NYHA functional
class 3/4 was lower in patients undergoing TAVI at 1 month (MD=0.51, 95%
CI 0.34-0.78, p=0.002), but there was no difference at 12 months (MD=1.10;
95% CI 0.87-1.38, p=0.43). Overall, TAVI offers early benefit in HRQoL
outcomes compared with SAVR, but they are equivalent at 12
months. Copyright © Royal College of Physicians 2023. All rights
reserved.

<58>
Accession Number
642688793
Title
Prevalence and clinical characteristics of oral lesions in heart
transplant patients induced by sirolimus and everolimus: a systematic
review and meta-analysis on a global scale.
Source
Oral surgery, oral medicine, oral pathology and oral radiology. 137(1) (pp
37-52), 2024. Date of Publication: 01 Jan 2024.
Author
Moura A.E.O.; Besseler M.O.; Perez-de-Oliveira M.E.; Normando A.G.C.;
Neves I.L.I.; Neves R.S.; Vargas P.A.; Azeka E.; Santos-Silva A.R.;
Montano T.C.P.
Institution
(Moura, Besseler, Perez-de-Oliveira, Normando, Vargas, Santos-Silva) Oral
Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba
Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo,
Brazil
(Neves, Neves) Dental Unit, Instituto do Coracao (InCor), Hospital das
Clinicas, Medical School, University of Sao Paulo (HCFMUSP), Sao Paulo,
Brazil
(Azeka) Pediatric Cardiology Unit, Instituto do Coracao (InCor), Hospital
das Clinicas, Medical School, University of Sao Paulo (HCFMUSP), Sao
Paulo, Brazil
(Montano) Oral Diagnosis Department, Semiology and Oral Pathology Areas,
Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba,
Sao Paulo, Brazil; Dental Unit, Instituto do Coracao (InCor), Hospital das
Clinicas, Medical School, University of Sao Paulo (HCFMUSP), Sao Paulo,
Brazil
Abstract
OBJECTIVE: Sirolimus (SRL) and everolimus (EVL) are increasingly included
in immunosuppressive protocols after heart transplantation. They present
some side effects, including the appearance of painful lesions in the oral
cavity. Therefore, this systematic review aimed to verify the global
prevalence and clinical characteristics of oral lesions induced by SRL and
EVL in heart transplant patients. STUDY DESIGN: A systematic review was
performed using 5 main electronic databases (Medline/PubMed, SCOPUS,
EMBASE, Web of Science, and LILACS), in addition to the gray literature.
Studies were independently assessed by 2 reviewers based on established
eligibility criteria. The risk of bias was assessed using the Joanna
Briggs Institute appraisal tools, and the certainty of evidence was
evaluated through GRADE assessment. RESULT(S): Seventeen studies (860
patients) were included in the qualitative analysis. Of these, 11 studies
were pooled in a meta-analysis of prevalence. The worldwide prevalence of
oral lesions induced by SRL and EVL in heart transplant patients was
10.0%, and most lesions were described as ulcers >1.0 cm, related to
significant pain. CONCLUSION(S): Oral lesions induced by SRL and/or
EVL, although not very prevalent, have a relevant impact on patient's
lives and the continuity of treatment. Copyright © 2023 Elsevier
Inc. All rights reserved.

<59>
[Use Link to view the full text]
Accession Number
643050184
Title
Biological equivalence of genetically engineered porcine pericardium for
biological heart valve manufacture: A randomized 150 day blind study in
sheep.
Source
Transplantation. Conference: IPITA-IXA-CTRMS Congress. San Diego, CA
United States. 107(10 Supplement 2) (pp 24), 2023. Date of Publication:
October 2023.
Author
McGregor C.G.; Salmonsmith J.; Burriesci G.; Byrne G.
Institution
(McGregor, Byrne) Department of Surgery, University of Minnesota,
Minneapolis, MN, United States
(McGregor, Salmonsmith, Burriesci, Byrne) Institute of Cardiovascular
Science, University College London, London, United Kingdom
(Burriesci) Bioengineering Group, Ri.MED Foundation, Palermo, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Current biological heart valves (BHVs) contain the porcine
antigen alpha-Gal (Gal). The presence of this antigen creates a clinical
immune disparity in heart valve recipients since humans universally
produce anti-Gal antibody. We have shown that human anti-Gal antibody
causes an immune infammation in fxed bioprosthetic tissue resulting in
accelerated tissue calcifcation (Cal) of Gal+ wild type tissue
but not Gal-free tissue (GalKO). Sourcing BHV tissue from GalKO animals
eliminates this immune disparity, potentially mitigating BHV Cal and
extending device durability. This study tests ISO standard biological
equivalence (BE) of valves made from GalKO pig pericardium (PP) to current
BHV materials. Method(s): This randomized blind study of mitral valve
implantation in adolescent sheep with a 150-day follow-up tested BE in 2
groups: A) (n=6) BHVs made from GalKO PP and B) BHVs made from current
materials: commercial bovine pericardial BHVs (n=2, Carpentier-Edwards
Perimount Magna Mitral Ease), commercial porcine BHVs (n=2, Abbott Epic
porcine tissue valves) or standard PP (n=2) (n=6 in total) (Figure 1).
Porcine pericardial BHVs (PP-BHVs) from WT or GalKO tissue were fxed in
0.6% glutaraldehyde and post treated with 4% formaldehyde, 22% ethanol and
1.2% Tween (FET). Hemodynamic performance was measured every 30-days and
at explant. Explant histology was blindly scored for pannus formation,
fbrin deposition and infammation. Tissue Cal was measured by atomic
spectroscopy.

<60>
Accession Number
2029239676
Title
Which should you choose for post operative atrial fibrillation, carvedilol
or metoprolol? A systemic review and meta-analysis.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102220. Date of Publication: February 2024.
Author
Abouzid M.R.; Vyas A.; Eldahtoury S.; Anwar J.; Naccour S.; Elshafei S.;
Memon A.; Subramaniam V.; Bennett W.; Morin D.P.; Lavie C.J.; Nwaukwa C.
Institution
(Abouzid, Eldahtoury, Anwar, Naccour, Elshafei, Memon, Nwaukwa) Department
of Internal Medicine, Baptist Hospitals of Southeast Texas, Beaumont, TX,
United States
(Vyas, Subramaniam, Bennett, Morin, Lavie) Department of Cardiology,
Ochsner Medical Center, New Orleans, LA, United States
Publisher
Elsevier Inc.
Abstract
Background: Postoperative atrial fibrillation (POAF) is the most common
arrhythmic complication following cardiac surgery. Current guidelines
suggest beta-blockers for the prevention of POAF. In comparing metoprolol
succinate with carvedilol, the later has sparked interest in its usage as
an important medication for POAF prevention. Method(s): We considered
randomized controlled studies (RCTs) and retrospective studies that
evaluated the efficacy of carvedilol versus metoprolol for the prevention
of POAF. After literature search, data extraction, and quality evaluation,
pooled data were analyzed using either the fixed-effect or random-effect
model using Review Manager 5.3. The Cochrane risk of bias tool was used to
assess the bias of included studies. The incidence of POAF was the primary
endpoint, while mortality rate and bradycardia were secondary outcomes.
 Result(s): In meta-analysis 5 RCTs and 2 retrospective studies with a
total of 1000 patients were included. The overall effect did not favor the
carvedilol over metoprolol groups in terms of mortality rate [risk ratio
0.45, 95 % CI (0.1-1.97), P=0.29] or incidence of bradycardia [risk ratio
0.63, 95 % CI (0.32-1.23), P=0.17]. However, the incidence of POAF was
lower in patients who received carvedilol compared to metoprolol [risk
ratio 0.54, 95 % CI (0.42-0.71), P < 0.00001]. Conclusion(s): In
patients undergoing cardiac surgery, carvedilol may minimize the
occurrence of POAF more effectively than metoprolol. To definitively
establish the efficacy of carvedilol compared to metoprolol and other
beta-blockers in the prevention of POAF, a large-scale, well-designed
randomized controlled trials are required. Copyright © 2023

<61>
Accession Number
2029192955
Title
Efficacy and outcomes of Bempedoic acid versus placebo in patients with
statin-intolerance: A pilot systematic review and meta-analysis of
randomized controlled trials.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102236. Date of Publication: February 2024.
Author
Goyal A.; Changez M.I.K.; Tariq M.D.; Mushtaq F.; Shamim U.; Sohail A.H.;
Mahalwar G.
Institution
(Goyal) Department of Internal Medicine, Seth GS Medical College and KEM
Hospital, Mumbai, India
(Changez) Department of Surgery, Quetta Institute of Medical Sciences,
Quetta, Pakistan
(Tariq) Department of Internal Medicine, Foundation University Medical
College, Islamabad, Pakistan
(Mushtaq) Department of Internal Medicine, Allama Iqbal Medical College,
Lahore, Pakistan
(Shamim) Department of Internal Medicine Aga Khan University Hospital,
Karachi, Pakistan
(Sohail) Department of Surgery, University of New Mexico Health Sciences,
Albuquerque, NM, United States
(Mahalwar) Department of Internal Medicine, Cleveland Clinic Foundation,
Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Introduction: Bempedoic acid (BA) has shown significant progress in
reducing cholesterol levels and is relatively free from the many side
effects encountered with the use of other hyperlipidemic drugs such as
statins. However, its efficacy in patients with statin intolerance is
controversial with inconsistent results among studies. Material(s)
and Method(s): An electronic literature search was performed using various
databases such as Medline, Google Scholar, and the International Registry
of Clinical Trials. The primary endpoint was the change in LDL-C levels.
The secondary endpoints included changes in HDL-C, non-HDL-C,
triglycerides (TG), clinical outcomes such as MACE, all-cause mortality
(ACM), cardiovascular mortality, myocardial infarction (MI), and
additional safety outcomes. The least-square mean (LSM) percent change for
assessing changes in lipid parameter levels from the baseline and the risk
ratio (RR) were used for the evaluation of binary endpoints, with
statistical significance set at p<0.05. Random-effects meta-analyses were
performed for all the outcomes. Result(s): Our analysis included 5
randomized controlled trials (RCTs) with a total of 18,848 participants.
BA showed a significant reduction in LDL-C [LSM difference in %: -25.24;
95 % CI: -30.79 to -19.69; p < 0.00001], total cholesterol [LSM difference
in %:-21.28; 95 % CI:-30.58 to-11.98; p < 0.00001], non-HDL-C [LSM
difference in %: -23.27; 95 % Cl: -29.80 to -16.73 p < 0.00001], and HDL-C
[LSM difference in %:-3.37, 95 % CI:-3.73 to-3.01, p < 0.00001] compared
to placebo. In terms of clinical efficacy, BA was associated with a lower
risk of coronary revascularization [RR:0.81; 95 % CI:0.66 to 0.99; p =
0.04], hospitalization for unstable angina [RR:0.67; 95 % CI:0.50 to 0.88;
p = 0.005], and myocardial infarction [RR:0.76; 95 % CI:0.66 to 0.88;p =
0.0004]. No significant difference was observed in MACE [RR:0.81; p =
0.15], ACM [RR:0.86; p = 0.46], cardiovascular-related mortality [RR:0.79;
p = 0.44], and stroke [RR:0.83; p = 0.08] between the two groups. In terms
of safety efficacy, the risk for myalgia was significantly lower in
BA-treated patients than in placebo [RR:0.80; p = 0.0002], while the risk
for gout [RR:1.46; p < 0.0001] and hyperuricemia [RR:1.93; p < 0.00001]
was higher for BA than for placebo. The risks for other adverse effects,
such as neurocognitive disorder, nasopharyngitis urinary tract infection,
upper respiratory infection, muscular disorder, and worsening
hyperglycemia/DM were comparable between the two groups.
 Conclusion(s): Our analysis demonstrated that BA significantly
reduced the levels of LDL-C, total cholesterol, non-HDL-C, HDL-C, ApoB,
and hs-CRP compared with the placebo group. Additionally, patients who
received BA had a lower likelihood of coronary revascularization and
hospitalization due to unstable angina, MI, and myalgia. Further
large-scale RCTs are required to generate more robust
evidence. Copyright © 2023

<62>
Accession Number
2028715953
Title
Intracranial Atherosclerosis Increases the Risk of Postoperative Stroke
After Cardiac Surgery: A Review and Meta-Analysis.
Source
Heart Lung and Circulation. 32(12) (pp 1417-1425), 2023. Date of
Publication: December 2023.
Author
Yang A.; Nguyenhuy M.; Seevanayagam S.
Institution
(Yang, Seevanayagam) Brian F. Buxton Department of Cardiac and Thoracic
Aortic Surgery, Austin Health, Melbourne, VIC, Australia
(Nguyenhuy) Department of Radiology, Western Health, Melbourne, VIC,
Australia
Publisher
Elsevier Ltd
Abstract
Background: Postoperative stroke is a devastating complication of cardiac
surgery with high morbidity, mortality, and health care cost. Extracranial
carotid atherosclerosis (ECAS) is a known risk factor for stroke; however,
the impact of intracranial atherosclerosis (ICAS) remains unclear. To our
knowledge, this is the first literature review of ICAS in cardiac surgery.
We aimed to assess the prevalence, association with postoperative stroke,
and perioperative management of ICAS in cardiac surgery. Method(s): A
search was performed to identify studies reporting rates of ICAS and
stroke after cardiac surgery. Data extraction and primary outcomes for
meta-analysis included the prevalence of preoperative ICAS and the
association between ICAS and stroke. Risk ratios (RRs) and 95% confidence
intervals (CIs) were pooled by random-effects modelling. Result(s):
Seventeen studies were reviewed and seven were included in the
meta-analysis, comprising 4,936 patients. Prevalence of intracranial
atherosclerosis (ICAS) among cardiac surgery patients was 21% (95% CI
13%-32%). Patients with ICAS were more likely to develop postoperative
stroke (RR 3.61; 95% CI 2.30-5.67; p<0.001). ICAS was more closely
associated with stroke than ECAS. Preoperative brain perfusion
single-photon emission computed tomography with acetazolamide challenge,
staged intracerebral revascularisation, or conversion to off-pump coronary
artery bypass grafting are described management options for ICAS.
 Conclusion(s): Patients with ICAS are 3.61 times more likely to
develop stroke after cardiac surgery. Known predictors for ICAS can be
used to develop risk stratification screening tools. Further research with
diverse cohorts is required to develop evidence-based guidelines for
screening and management of ICAS in cardiac surgery. Copyright ©
2023

<63>
Accession Number
2026418560
Title
Barriers to Accessing Congenital Heart Surgery in Low- and Middle-Income
Countries: A Systematic Review.
Source
World Journal for Pediatric and Congenital Heart Surgery. 15(1) (pp
94-103), 2024. Date of Publication: January 2024.
Author
Cheng S.P.S.; Heo K.; Joos E.; Vervoort D.; Joharifard S.
Institution
(Cheng, Heo) Faculty of Medicine, University of British Columbia,
Vancouver, BC, Canada
(Joos) Division of General Surgery, Department of Surgery, Vancouver
General Hospital, University of British Columbia, Vancouver, BC, Canada
(Vervoort) Division of Cardiac Surgery, University of Toronto, Toronto,
ON, Canada
(Vervoort) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, Canada
(Joharifard) Division of Pediatric Surgery, Department of Surgery, British
Columbia Children's Hospital, University of British Columbia, Vancouver,
BC, Canada
Publisher
SAGE Publications Inc.
Abstract
Background: Congenital heart disease (CHD) is the most common major
congenital anomaly. Ninety percent of children with CHD are born in low-
and middle-income countries (LMICs), where over 90% of patients lack
access to necessary treatments. Reports on barriers to accessing CHD care
are limited. Accordingly, it is difficult to design evidence-based
interventions to increase access to congenital cardiac surgical care in
LMICs. Objective(s): We performed a qualitative systematic review to
understand barriers to accessing congenital cardiac surgical care in
LMICs. Method(s): We conducted a search of Ovid MEDLINE and CINAHL
databases to identify relevant articles from January 2000 to May 2021. We
then used a thematic analysis to summarize qualitative data into a
framework of preoperative, perioperative, and postoperative barriers.
 Result(s): Our search yielded 1,585 articles, of which 67 satisfied
the inclusion criteria. Notable preoperative barriers included delayed
diagnosis, insufficient caregiver education, financial constraints,
difficulty reaching treatment centers, sociocultural stigma of CHD,
sex-based discrimination of patients with CHD, and Indigeneity.
Perioperative barriers included lack of hospital resources and workforce,
need for prolonged hospitalization, and strained physician-patient
relationships. Many patients faced barriers postoperatively and into
adulthood due to a shortage of critical care resources, inadequate
caregiver counseling and patient education, lack of follow-up, and debt
from hospital bills and missed work. Conclusion(s): Reducing neonatal
and childhood mortality begins with recognizing barriers to accessing
health care. Our systematic review identifies and classifies challenges in
accessing CHD in LMICs and suggests solutions to major
barriers. Copyright © The Author(s) 2023.

<64>
Accession Number
2020352702
Title
Influences of Antithrombotic Elastic Socks Combined with Air Pressure in
Reducing Lower Extremity Deep Venous Thrombosis for Patients Undergoing
Cardiothoracic Surgery.
Source
Computational and Mathematical Methods in Medicine. 2022 (no pagination),
2022. Article Number: 1338214. Date of Publication: 2022.
Author
Fu W.; Zhang Q.; Sun X.; Gu Y.
Institution
(Fu, Sun) Department of Thoracic Surgery, Affiliated Hospital of Nantong
University, Jiangsu, Nantong 226001, China
(Zhang) Department of Cardiovascular Surgery, Affiliated Hospital of
Nantong University, Jiangsu, Nantong 226001, China
(Gu) Department of Surgery, Affiliated Hospital of Nantong University,
Jiangsu, Nantong 226001, China
Publisher
Hindawi Limited
Abstract
This study was designed to investigate the application and therapeutic
effect of antithrombotic elastic socks combined with air pressure in the
prevention of lower extremity deep venous thrombosis in patients
undergoing cardiothoracic surgery. Sixty patients in cardiothoracic
surgery of our hospital from January 2019 to December 2020 were randomly
divided into a study group and control group. The control group was
treated with routine treatment intervention. Based on routine treatment
intervention, the study group was treated with antithrombotic elastic
socks combined with pneumatic treatment intervention. The activated
partial thromboplastin time (APTT), thrombin time (TT), femoral venous
blood flow velocity of both lower limbs, and the incidence of lower
extremity deep venous thrombosis (LEDVT), postoperative lower extremity
swelling, inflammatory factors, and satisfaction were measured. After
intervention, APTT (31.74+/-1.15 s) and TT (14.58+/-0.24 s) in the study
group were higher than those in the control group APTT (25.13+/-1.14 s)
and TT (12.14+/-0.23 s) (P<0.05). The left lower limb femoral vein blood
flow velocity and the right lower limb femoral vein blood flow velocity in
the study group were better than those in the control group (P<0.05). The
incidence of postoperative lower limb swelling and deep vein in the study
group was lower than that in the control group (P<0.05). Serum tumor
necrosis factor alpha and interleukin-6 concentrations in the study group
were lower than those in the control group (P<0.05). The satisfaction rate
of patients in the study group (93.33%) was significantly higher than that
in the control group (70.00%) (P<0.05). In conclusion, after
cardiothoracic surgery, antithrombotic elastic socks combined with air
pressure can significantly reduce the incidence of LEDVT by improving
patients' coagulation function, reducing inflammatory reaction. It is
worthy of popularization and application in relevant surgery.
 Copyright © 2022 Weihong Fu et al.

<65>
Accession Number
2029145270
Title
Long-term outcomes of bioprosthetic valves in the mitral position a
systematic review of studies published over the last 20 years.
Source
European Journal of Cardio-thoracic Surgery. 64(5) (no pagination), 2023.
Article Number: ezad384. Date of Publication: 01 Nov 2023.
Author
Koulouroudias M.; Di Mauro M.; Lorusso R.
Institution
(Koulouroudias, Di Mauro, Lorusso) Cardiovascular Research Institute,
Carim, University of Maastricht, Netherlands
(Koulouroudias) Trent Cardiac Centre, Nottingham University Hospitals,
Nottingham, United Kingdom
(Lorusso) Heart & Vascular Centre, Maastricht University Medical Centre,
Netherlands
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Although the use of bioprostheses for mitral valve replacement
(bMVR) is on the rise, their long-term durability is not well described.
Defining bMVR durability will be instrumental in setting the standard
against which the performance of transcatheter mitral replacement is to be
judged against. The authors of this systematic review aimed to identify,
assess the quality and review the outcomes in studies reporting on
long-term outcomes after bMVR published over the last 20 years.
 METHOD(S): Medline, Embase and Cochrane CENTRAL were searched for
studies that have reported outcomes beyond a minimum of 5 years of
follow-up after bMVR. Cohort characteristics, definitions of structural
valve deterioration (SVD) and outcomes were summarized. The risk of bias
in included studies was assessed using the Cochrane QUIPS tool.
 RESULT(S): Twenty-one studies, including 15 833 patients, were
identified. Sixty-four percent of all implants were porcine and the
remaining bovine pericardial. Freedom from SVD at 10 years ranged from
58.9% to 100% and at 15 years from 58.3% to 93%. Freedom from reoperation
ranged from 65% to 98.7% at 10 years and 78.5% to 91% at 15 years.
Information on native valve pathology or dominant haemodynamic lesion was
missing in 25% and 66% of studies, respectively. Reports of postoperative
echocardiography were lacking, despite the heavy reliance on
echocardiography for SVD diagnosis. CONCLUSION(S): There is
considerable variability in reporting bMVR long-term outcomes. As such, it
is difficult to generate an unbiased, generalizable understanding of long-
term outcomes after bMVR across the spectrum of mitral disease
phenotypes. Copyright © 2023 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<66>
[Use Link to view the full text]
Accession Number
2029139859
Title
Clinical Decision Support Systems Used in Transplantation: Are They Tools
for Success or an Unnecessary Gadget? A Systematic Review.
Source
Transplantation. 108(1) (pp 72-99), 2024. Date of Publication: 01 Jan
2024.
Author
Wingfield L.R.; Salaun A.; Khan A.; Webb H.; Zhu T.; Knight S.
Institution
(Wingfield, Knight) Nuffield Department of Surgical Sciences, University
of Oxford, Oxford, United Kingdom
(Salaun, Zhu) Department of Engineering Science, University of Oxford,
Oxford, United Kingdom
(Khan) Department of Neurosurgery, Stanford University, Stanford, CA,
United States
(Webb) School of Computer Science, University of Nottingham, Nottingham,
United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Although clinical decision support systems (CDSSs) have been used since
the 1970s for a wide variety of clinical tasks including optimization of
medication orders, improved documentation, and improved patient adherence,
to date, no systematic reviews have been carried out to assess their
utilization and efficacy in transplant medicine. The aim of this study is
to systematically review studies that utilized a CDSS and assess impact on
patient outcomes. A total of 48 articles were identified as meeting the
author-derived inclusion criteria, including tools for posttransplant
monitoring, pretransplant risk assessment, waiting list management,
immunosuppressant management, and interpretation of histopathology.
Studies included 15 984 transplant recipients. Tools aimed at helping with
transplant patient immunosuppressant management were the most common (19
studies). Thirty-four studies (85%) found an overall clinical benefit
following the implementation of a CDSS in clinical practice. Although
there are limitations to the existing literature, current evidence
suggests that implementing CDSS in transplant clinical settings may
improve outcomes for patients. Limited evidence was found using more
advanced technologies such as artificial intelligence in transplantation,
and future studies should investigate the role of these emerging
technologies. Copyright © 2024 Lippincott Williams and Wilkins.
All rights reserved.

<67>
Accession Number
2029102205
Title
Ultrasound-guided serratus anterior plane block to prevent neurocognitive
impairment in elderly patients after thoracoscopic lobectomy: Protocol for
a single-centre, double-blind, randomised controlled trial.
Source
BMJ Open. 13(12) (no pagination), 2023. Article Number: e069652. Date of
Publication: 11 Dec 2023.
Author
Wang D.-Y.; Feng D.; Liu M.-Y.; Wu W.; Xu H.; Shi H.
Institution
(Wang, Feng, Liu, Wu, Xu, Shi) Department of Anesthesiology, Shanghai
Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative neurocognitive dysfunction (PND), including
postoperative delirium (POD), is a common complication in elderly patients
after major surgeries, often leading to poor postoperative recovery.
Although the pathological mechanism underlying PND is still unclear,
postoperative pain is strongly associated with the development of PND. The
ultrasound-guided serratus anterior plane block (SAPB) has been reported
to relieve postoperative pain in thoracic surgery. Therefore, this
prospective trial hypothesises that SAPB may reduce the incidence of PND
in the elderly undergoing thoracoscopic lobectomy. Methods and analysis
This study is designed as a single-centre, double-blind, randomised
controlled clinical trial. A total of 256 elderly patients scheduled to
undergo thoracoscopic lobectomy at Shanghai Pulmonary Hospital will be
randomly assigned to general anaesthesia group or SAPB group. The primary
outcome is the incidence of PND 7 days postoperatively or before discharge
from hospital. The secondary outcomes include the occurrence of POD, the
postoperative pain scores, Quality of Recovery at 1-2 days postoperatively
and incidence of PND at 3 months postoperatively. The levels of fasting
blood glucose in peripheral blood will be examined before and 1-2 days
postoperatively. Ethics and dissemination The trial has been approved by
the Clinical Research Ethics Committee of Shanghai Pulmonary Hospital
(identifier: K20-290). All participants will be required to provide
written informed consent before any protocol-specific procedures. Findings
will be disseminated in a peer-reviewed journal and in national and/or
international meetings to guide future practice. Trial registration number
ChiCTR2100052633. Copyright © 2023 BMJ Publishing Group. All
rights reserved.

<68>
Accession Number
2028997772
Title
Regional and temporal variations of spontaneous coronary artery dissection
care according to consensus recommendations: a systematic review and
meta-analysis.
Source
Open Heart. 10(2) (no pagination), 2023. Article Number: e002379. Date of
Publication: 06 Dec 2023.
Author
Dang Q.; Othman F.; Sheahen B.; Marschner S.; Psaltis P.; Al-Lamee R.K.;
Szirt R.; Chong J.; Zaman S.
Institution
(Dang, Sheahen, Marschner, Zaman) Westmead Applied Research Centre,
Faculty of Medicine and Health, University of Sydney, Westmead, NSW,
Australia
(Othman) The University of Western Australia, Perth, WA, Australia
(Othman) Department of Cardiology, Fiona Stanley Hospital, Perth, WA,
Australia
(Psaltis) Vascular Research Centre, Lifelong Health Theme, South
Australian Medical and Health Research Institute, Adelaide, SA, Australia
(Psaltis) Adelaide Medical School, Faculty of Health and Medical Sciences,
The University of Adelaide, Adelaide, SA, Australia
(Psaltis) Department of Cardiology, Central Adelaide Local Health Network,
Adelaide, SA, Australia
(Al-Lamee) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Szirt) St George Hospital, Kogarah, NSW, Australia
(Chong, Zaman) Department of Cardiology, Westmead Hospital, Westmead, NSW,
Australia
Publisher
BMJ Publishing Group
Abstract
Aim The first expert consensus documents on management of patients with
spontaneous coronary artery dissection (SCAD) were published in 2018.
Worldwide quality of care, as measured by adherence to these
recommendations, has not been systematically reviewed. We aim to review
the proportion of patients with SCAD receiving consensus recommendations
globally, regionally and, determine differences in practice before and
after 2018. Methods and results A systematic review was performed by
searching four main databases (Medline, Embase, SCOPUS, CINAHL) from their
inception to 16 June 2022. Studies were selected if they included patients
with SCAD and reported at least one of the consensus document
recommendations. 53 studies, n=8456 patients (mean 50.1 years, 90.6%
female) were included. On random effects meta-analysis, 92.1% (95% CI 89.3
to 94.8) received at least one antiplatelet, 78.0% (CI 73.5 to 82.4)
received beta-blockers, 58.7% (CI 52.3 to 65.1) received ACE inhibitors or
aldosterone receptor blockers (ACEIs/ARBs), 54.4% (CI 45.4 to 63.5) were
screened for fibromuscular dysplasia (FMD), and 70.2% (CI 60.8 to 79.5)
were referred to cardiac rehabilitation. Except for cardiac rehabilitation
referral and use of ACEIs/ARBs, there was significant heterogeneity in all
other quality-of-care parameters, across geographical regions. No
significant difference was observed in adherence to recommendations in
studies published before and after 2018, except for lower cardiac
rehabilitation referrals after 2018 (test of heterogeneity, p=0.012).
Conclusion There are significant variations globally in the management of
patients with SCAD, particularly in FMD screening. Raising awareness about
consensus recommendations and further prospective evidence about their
effect on outcomes may help improve the quality of care for these
patients. Copyright © Author(s) (or their employer(s)) 2023.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<69>
Accession Number
2028997680
Title
Pharmacological and non-pharmacological interventions to prevent delirium
after cardiac surgery: a protocol for a systematic review and
meta-analysis.
Source
BMJ Open. 13(12) (no pagination), 2023. Article Number: e076919. Date of
Publication: 10 Dec 2023.
Author
Cottuli De Cothi E.; Perry R.; Kota R.; Walker-Smith T.; Barnes J.D.;
Pufulete M.; Gibbison B.
Institution
(Cottuli De Cothi, Perry, Kota, Pufulete, Gibbison) University of Bristol,
Bristol, United Kingdom
(Walker-Smith) Bristol Heart Institute, University of Bristol, Bristol,
United Kingdom
(Barnes) North Bristol Nhs Trust, Bristol, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Delirium is a syndrome characterised by a disturbance in
attention, awareness and cognition as a result of another physical
condition. It occurs in up to 50% of patients after cardiac surgery and is
associated with increased mortality, prolonged intensive care and hospital
stay and long-term cognitive dysfunction. Identifying effective preventive
interventions is important. We will therefore conduct a systematic review
to identify all randomised controlled studies that have tested a
pharmacological or non-pharmacological intervention to prevent delirium.
Methods and analysis We will search electronic databases (CDSR (Reviews),
CENTRAL (Trials), MEDLINE Ovid, Embase Ovid, PsycINFO Ovid) as well as
trial registers (clinicaltrials.gov and ISCRTN) for randomised controlled
trials of both pharmacological and non-pharmacological interventions
designed to prevent delirium after cardiac surgery in adults. Screening of
search results and data extraction from included articles will be
performed by two independent reviewers using Rayyan. The primary outcome
will be the incidence of delirium. Secondary outcomes include: duration of
postoperative delirium, all-cause mortality, length of postoperative
hospital and intensive care stay, postoperative neurological complications
other than delirium, health-related quality of life and
intervention-specific adverse events. Studies will be assessed for risk of
bias using the Cochrane RoB2 tool. A narrative synthesis of all included
studies will be presented and meta-analysis (if appropriate network
meta-analysis) will be undertaken where there are sufficient studies
(three or more) for pooling results. Results will be reported according to
the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
statement. Ethics and dissemination No ethical approval is required. This
review will be disseminated via peer-reviewed manuscript and conferences.
PROSPERO registration number CRD42022369068. Copyright © 2023
BMJ. All rights reserved.

<70>
Accession Number
2028997633
Title
Effect of preinitiated glucose-insulin-potassium strategy for patients
with undergoing planned percutaneous coronary intervention: a systematic
review and meta-analysis.
Source
BMJ Open. 13(12) (no pagination), 2023. Article Number: e073557. Date of
Publication: 07 Dec 2023.
Author
Liu H.; Liu R.; Yang Z.; Xu F.; Li C.
Institution
(Liu, Liu, Yang, Xu, Li) Department of Emergency Medicine and Chest Pain
Centre, Qilu Hospital of Shandong University, Shandong, Jinan, China
(Liu, Liu, Yang, Xu, Li) Key Laboratory of Emergency and Critical Care
Medicine of Shandong Province, Qilu Hospital of Shandong University,
Shandong, Jinan, China
Publisher
BMJ Publishing Group
Abstract
Objectives Whether the glucose-insulin-potassium (GIK) should be used as
an adjuvant therapy for ischaemic myocardial disease remains controversial
nowadays reperfusion era. This meta-analysis aimed to assess the effects
of preinitiated GIK for patients undergoing planned percutaneous coronary
intervention (PCI). Design Systematic review and meta-analysis. Data
sources PubMed, Web of science, MEDLINE, Embase, Cochrane Library and
ClinicalTrials.gov were searched through 27 November 2022. Eligibility
criteria Only randomised controlled trials involving participants
preinitiated with GIK or placebo before planned PCI were included. Data
extraction and synthesis Two independent reviewers used standardised
methods to search, screen and code included trials. Risk of bias was
assessed with the Cochrane tool. Pooled analysis was conducted using
random or effects models according to the heterogeneity. Subgroup analyses
were carried out for dosage of GIK and if with ongoing myocardial
ischaemia. Results 13 randomised controlled trials (RCTs) including 3754
participants were evaluated. We found patients preconditioned with GIK
before PCI showed a significant increase in Thrombolysis in Myocardial
Infarction 3 flow events after angioplasty (OR 1.59, 95% CI 1.03 to 2.46,
p=0.04), also revealed improved in-hospital left ventricular ejection
fraction (weighed mean difference, WMD 1.62, 95% CI 0.21 to 3.03, p=0.02)
and myocardial salvage index (WMD 0.09, 95% CI 0.01 to 0.16, p=0.03).
Nevertheless, no benefit was observed in all-cause mortality neither on
30-day (OR 0.81, 95% CI 0.59 to 1.11, p=0.18) nor 6 months (OR 1.02, 95%
CI 0.42 to 2.46, p=0.97). Furthermore, GIK intervention was associated
with higher occurrences of complications such as phlebitis (OR 10.13, 95%
CI 1.74 to 59.00, p=0.01) and hypoglycaemia (OR 10.43, 95% CI 1.32 to
82.29, p=0.03), but not hyperkalaemia (OR 9.36, 95% CI 0.50 to 175.27,
p=0.13), liquid overload (OR 1.02, 95% CI 0.25 to 4.13, p=0.98) or
in-hospital heart failure (OR 0.42, 95% CI 0.06 to 2.96, p=0.39).
Conclusions Our study shows preconditioning GIK exhibits myocardial
reperfusion and cardiac function benefits for patients planning to receive
PCI intervention, while also some complications such as phlebitis and
hypoglycaemia accompany. PROSPERO registration number
CRD42022326334. Copyright © 2023 BMJ Publishing Group. All rights
reserved.

<71>
Accession Number
2027949063
Title
ATE Score Diagnostic Accuracy for Predicting the Absence of Intra-Atrial
Thrombi Before AF Ablation.
Source
JACC: Clinical Electrophysiology. 9(12) (pp 2550-2557), 2023. Date of
Publication: December 2023.
Author
Milhem A.; Anselme F.; Da Costa A.; Abbey S.; Mansourati J.; Bader H.;
Winum P.-F.; Badenco N.; Maury P.; Dompnier A.; Shah D.; Johner N.; Taieb
J.; Bertrand J.; Treguer F.; Amelot M.; Ingrand P.; Allix-Beguec C.
Institution
(Milhem) Department of Cardiology, CH la Rochelle, La Rochelle, France
(Anselme) Department of Cardiology, CHU Rouen, Rouen, France
(Da Costa) Department of Cardiology, CHU Saint-Etienne, Saint-Etienne,
France
(Abbey) Department of Cardiology, Nouvelles Cliniques Nantaises, Groupe
Confluent, Nantes, France
(Mansourati) Department of Cardiology, CHU Brest, Brest, France
(Bader) Department of Cardiology, CH Pau, Pau, France
(Winum) Department of Cardiology, CHU Nimes, Nimes, France
(Badenco) Department of Cardiology, APHP, Hopital Pitie Salpetriere,
Paris, France
(Badenco) Sorbonne Universite, INSERM, UMRS 1166-ICAN, Institute of
Cardiometabolism and Nutrition, Paris, France
(Maury) Department of Cardiology, CHU Toulouse, Toulouse, France
(Dompnier) Department of Cardiology, CH Annecy, Pringy, France
(Shah, Johner) Department of Cardiology, University Hospital Geneva,
Geneva, Switzerland
(Taieb) Department of Cardiology, CH Pays d'Aix, Aix-en-Provence, France
(Bertrand) Department of Cardiology, CHR Metz-Thionville, Ars-Laquenexy,
France
(Treguer) Department of Cardiology, Clinique St-Joseph, Trelaze, France
(Amelot) Department of Cardiology, CH le Mans, le Mans, France
(Ingrand) Epidemiology and Biostatistics, INSERM CIC 1402, Universite de
Poitiers, CHU Poitiers, Poitiers, France
(Allix-Beguec) Clinical Research Unit, CH la Rochelle, la Rochelle, France
Publisher
Elsevier Inc.
Abstract
Background: In a preliminary study in patients hospitalized for catheter
ablation of atrial fibrillation (AF), the atrial thrombus exclusion (ATE)
score (stroke, hypertension, heart failure, and D-dimers >270 ng/mL) was
developed to rule out the diagnosis of intra-atrial thrombus, with a
negative predictive value (NPV) of 100%, and to avoid performing
transesophageal echocardiography (TEE). Objective(s): The present
study was designed to prospectively confirm the NPV of the ATE score in an
independent population. Method(s): Consecutive patients hospitalized
for catheter ablation of AF or left atrial tachycardia (LAT) were
prospectively enrolled in a multicenter study. D-dimer levels were
measured within 48 hours before ablation. An ATE score of 0 was considered
predictive of no thrombus. TEE was routinely performed at the beginning or
just before the ablation procedure. The primary endpoint was the presence
of atrial thrombus diagnosed by TEE. Result(s): The analysis included
3,072 patients (53.3% paroxysmal AF, 36.7% persistent AF, and 10% LAT). A
thrombus was detected in 29 patients (0.94%; 95% CI: 0.63%-1.35%), all on
appropriate anticoagulant therapy. An ATE score of 0 was observed in 818
patients (26.6%), and the sensitivity, specificity, positive predictive
value, and NPV were 93.1%, 26.8%, 1.2%, and 99.8%, respectively. Follow-up
of the 2 false negative patients revealed the persistence of chronic
organized thrombi. Conclusion(s): In patients hospitalized for
catheter ablation of AF or LAT, the ATE score identifies a population at
very low risk for atrial thrombus. In consultation with the patient, the
cardiologist may consider not performing a preoperative TEE in case of an
ATE score of 0. Copyright © 2023 American College of Cardiology
Foundation

<72>
Accession Number
2027196806
Title
A systematic review and meta-analysis of sex differences in clinical
outcomes of hypertrophic cardiomyopathy.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1252266. Date of Publication: 2023.
Author
Liu G.; Su L.; Lang M.
Institution
(Liu, Su, Lang) Department of Cardiology, Chengdu Fifth People's Hospital,
Chengdu, China
Publisher
Frontiers Media SA
Abstract
Background: Hypertrophic cardiomyopathy (HCM) is recognized as the most
prevalent form of genetic cardiomyopathy, and recent investigations have
shed light on the existence of sex disparities in terms of clinical
presentation, disease progression, and outcomes. Objective(s): This
study aimed to systematically review the literature and perform a
meta-analysis to comprehensively compare the clinical outcomes between
female and male patients with HCM. Method(s): A thorough search was
conducted in databases including PubMed, Embase, Cochrane Library, and Web
of Science, encompassing literature from inception until June 2023. The
primary endpoints examined were: (1) all-cause mortality; (2) an
arrhythmic endpoint comprising sudden cardiac death (SCD), sustained
ventricular tachycardia, ventricular fibrillation, or aborted SCD; and (3)
a composite endpoint incorporating either (1) or (2), in addition to
hospitalization for heart failure or cardiac transplantation. Pooled
estimates were derived using a random-effects meta-analysis model.
 Result(s): The analysis encompassed a total of 29 observational
studies, involving 44,677 patients diagnosed with HCM, of which 16,807
were female. Baseline characteristics revealed that the female group
exhibited an advanced age [55.66 +/- 0.04 years vs. 50.38 +/- 0.03 years,
pooled mean difference (MD) = 0.31, 95% CI: 0.22-0.40, p = 0.000,
I2 = 88.89%], a higher proportion of New York Heart Association
class III/IV patients [pooled odds ratio (OR) = 1.94, 95% CI: 1.55-2.43, p
= 0.000, I2 = 85.92%], and a greater prevalence of left
ventricular outflow tract gradient greater than or equal to 30 mmHg
(pooled OR = 1.48, 95% CI: 1.27-1.73, p = 0.000, I2 = 68.88%)
compared to the male group. The female group were more likely to have a
positive genetic test (pooled OR = 1.27, 95% CI: 1.08-1.48, p = 0.000,
I2 = 42.74%) and to carry the myosin heavy chain beta 7
mutation (pooled OR = 1.26, 95% CI: 1.04-1.54, p = 0.020, I2 =
0.00%) compared to the male group. Female sex exhibited a significant
association with increased risks of all-cause mortality (pooled OR = 1.62,
95% CI: 1.38-1.89, p = 0.000, I2 = 72.78%) and the composite
endpoint (pooled OR = 1.47, 95% CI: 1.20-1.79, p = 0.000, I2 =
84.96%), while no substantial difference was observed in the arrhythmic
endpoint (pooled OR = 1.08, 95% CI: 0.87-1.34, p = 0.490, I2 =
55.48%). Conclusion(s): The present findings suggest that female
patients with HCM tend to experience poorer clinical outcomes. It is
imperative to critically reevaluate disease definitions and enhance
awareness to mitigate delays in the diagnosis and treatment of HCM in
women, thereby fostering equitable healthcare practices. Systematic Review
Registration: https://www.crd.york.ac.uk/, PROSPERO
(CRD42023431881). Copyright 2023 Liu, Su and Lang.

<73>
Accession Number
2026353011
Title
Left Atrial Appendage Occlusion versus Novel Oral Anticoagulation for
Stroke Prevention in Atrial Fibrillation-One-Year Survival.
Source
Journal of Clinical Medicine. 12(20) (no pagination), 2023. Article
Number: 6693. Date of Publication: October 2023.
Author
Tiosano S.; Banai A.; Mulla W.; Goldenberg I.; Bayshtok G.; Amit U.;
Shlomo N.; Nof E.; Rosso R.; Glikson M.; Guetta V.; Barbash I.; Beinart R.
Institution
(Tiosano, Mulla, Goldenberg, Bayshtok, Amit, Shlomo, Nof, Guetta, Barbash,
Beinart) Leviev Heart Center, Sheba Medical Center, Ramat Gan 52621,
Israel
(Tiosano, Banai, Goldenberg, Bayshtok, Amit, Shlomo, Nof, Rosso, Guetta,
Barbash, Beinart) Faculty of Medicine, Tel Aviv University, Ramat Aviv,
Tel Aviv 6997801, Israel
(Banai, Rosso) Department of Cardiology, Tel Aviv Sourasky Medical Center,
Tel Aviv 64239, Israel
(Mulla) Surgeon General Headquarters, Israel Defense Forces, Ramat Gan
5262000, Israel
(Bayshtok) Arrow Program, Sheba Medical Center, Ramat Gan 5266202, Israel
(Glikson) Jesselson Integrated Heart Center, Shaare Zedek Medical Center,
Jerusalem 9103102, Israel
(Glikson) Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem
9574425, Israel
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Aim To compare the 1-year survival rate of patients with atrial
fibrillation (AF) following left atrial appendage occluder (LAAO)
implantation vs. treatment with novel oral anticoagulants (NOACs).
 Method(s): We have conducted an indirect, retrospective comparison
between LAAO and NOAC registries. The LAAO registry is a national
prospective cohort of 419 AF patients who underwent percutaneous LAAO
between January 2008 and October 2015. The NOACs registry is a multicenter
prospective cohort of 3138 AF patients treated with NOACs between November
2015 and August 2018. Baseline patient characteristics were
retrospectively collected from coded diagnoses of hospitalization and
outpatient clinic notes. Follow-up data was sorted from coded diagnoses
and the national civil registry. Subjects were matched according to
propensity score. Baseline characteristics were compared using Chi-Square
and student's t-test. Survival analysis was performed using Kaplan-Meier
survival curves, log-rank test, and multivariable Cox regression,
adjusting for possible confounding variables. Result(s): This study
included 114 subjects who underwent LAAO implantation and 342 subjects
treated with NOACs. The mean age of participants was 77.9 +/- 7.44 and
77.1 +/- 11.2 years in the LAAO and NOAC groups, respectively (p = 0.4).
The LAAO group had 70 (61%) men compared to 202 (59%) men in the NOAC
group (p = 0.74). No significant differences were found in baseline
comorbidities, renal function, or CHA<inf>2</inf>DS<inf>2</inf>-VASc
score. One-year mortality was observed in 5 (4%) patients and 32 (9%)
patients of the LAAO and NOAC groups, respectively. After adjusting for
confounders, LAAO was significantly associated with a lower risk for
1-year mortality (HR 0.38, 95%CI 0.14-0.99). In patients with impaired
renal function, this difference was even more prominent (HR 0.21 for
creatinine clearance (CrCl) < 60 mL/min). Conclusion(s): In a pooled
analysis of two registries, we found a significantly lower risk for 1-year
mortality in patients with AF who were implanted with LAAO than those
treated with NOACs. This finding was more prominent in patients with
impaired renal function. Future prospective direct studies should further
investigate the efficacy and adverse effects of both treatment
strategies. Copyright © 2023 by the authors.

<74>
Accession Number
2025901519
Title
Watchful waiting for venting in venoarterial extracorporeal membrane
oxygenation.
Source
European Journal of Heart Failure. 25(11) (pp 2047-2049), 2023. Date of
Publication: November 2023.
Author
Vishram-Nielsen J.K.K.; Gustafsson F.
Institution
(Vishram-Nielsen) Department of Cardiology, Zealand University Hospital,
Roskilde, Denmark
(Gustafsson) Department of Cardiology, Rigshospitalet, University Hospital
of Copenhagen, Copenhagen, Denmark
(Gustafsson) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
Publisher
John Wiley and Sons Ltd

<75>
[Use Link to view the full text]
Accession Number
2029217111
Title
Innovative designs for trials informing the care of cardiac surgical
patients: Part i.
Source
Current Opinion in Anaesthesiology. 37(1) (pp 42-48), 2024. Date of
Publication: 01 Feb 2024.
Author
Anusic N.; Sessler D.I.
Institution
(Anusic, Sessler) Department of Outcomes Research, Cleveland Clinic,
Cleveland, OH, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewRandomized clinical trials, now commonplace and regarded
as top-tier evidence, are actually a recent development. The first
randomized trial took place in 1948, just six decades ago. As anticipated
from a relatively young field, rapid progress continues in response to an
ever-increasing number of medical questions that demand answers. We
examine evolving methodologies in cardiac anesthesia clinical trials,
focusing on the transition towards larger sample sizes, increasing use of
pragmatic trial designs, and the innovative adoption of real-time
automated enrollment and randomization. We highlight how these changes
enhance the reliability and feasibility of clinical trials.Recent
findingsRecent understanding in clinical trial methodology acknowledges
the importance of large sample sizes, which increase the reliability of
findings. As illustrated by P value fragility, small trials can mislead
despite statistical significance. Pragmatic trials have gained prominence,
offering real-world insights into the effectiveness of various treatments.
Additionally, the use of real-time automated enrollment and randomization,
particularly in situations where obtaining prior consent is impractical,
is an important methodological advance.SummaryThe landscape of cardiac
anesthesia clinical trials is rapidly evolving, with a clear trend towards
large sample sizes and innovative approaches to enrollment. Recent
developments enhance the quality and applicability of research findings,
thus providing robust guidance to clinicians. Copyright © 2024
Lippincott Williams and Wilkins. All rights reserved.

<76>
Accession Number
2029145122
Title
Creating a social media strategy for an international cardiothoracic
research network: a scoping review.
Source
European Journal of Cardiovascular Nursing. 22(8) (pp 751-757), 2023. Date
of Publication: 01 Nov 2023.
Author
Fredericks S.; Bae T.; Sochaniwskyj M.; Sanders J.; Martorella G.; Wynne
R.
Institution
(Fredericks, Bae, Sochaniwskyj) Daphne Cockwell School of Nursing, Toronto
Metropolitan University, M5B 2K3, 350 Victoria St., Toronto, ON, Canada
(Sanders) St. Bartholomew Hospital - W Smithfield, Barts Health NHS Trust
and Clinical Professor of Cardiovascular Nursing, London EC1A 7BE, United
Kingdom
(Sanders) William Harvey Research Institute, Queen Mary University of
London, Queen Mary University, Mile End Rd, Bethnal Green, London E1 4NS,
United Kingdom
(Martorella) College of Nursing, Florida State University, United States
(Martorella) Office 104F-Vivian M Duxbury Hall, United Kingdom
(Martorella) TMH Center for Research and Evidence-Based Practice, 98
Varsity Way, Tallahassee, FL 32306, United States
(Wynne) Cardiothoracic Surgery, The Royal Melbourne Hospital, 300 Grattan
Street (corner of Royal Parade), Parkville, VIC 3050, Australia
Publisher
Oxford University Press
Abstract
Aims A cardiac surgery international nursing and allied professional
research network titled CONNECT was created to strengthen collaborative
cardiac surgery research through shared initiatives including supervision,
mentorship, workplace exchange programs, and multi-site clinical research.
As with any new initiative, there is a need to build brand awareness to
enhance user familiarity, grow membership, and promote various
opportunities offered. Social media has been used across various surgical
disciplines; however, their effectiveness in promoting scholarly and
academic-based initiatives has not been examined. The aim of this scoping
review was to examine the different types of social media platforms and
strategies used to promote cardiac research initiatives for CONNECT.
Methods A scoping review was undertaken in which a comprehensive and
thorough review of the literature was performed. Fifteen and results
articles were included in the review. Twitter appeared to be the most
common form of social media used to promote cardiac initiatives, with
daily posts being the most frequent type of engagement. Frequency of
views, number of impressions and engagement, link clicks, and content
analysis were the most common types of evaluation metrics that were
identified. Conclusion Findings from this review will inform the design
and evaluation of a targeted Twitter campaign aimed at increasing brand
awareness of CONNECT, which will include the use of @CONNECTcardiac
Twitter handle, hashtags, and CONNECT-driven journal clubs. In addition,
the use of Twitter to disseminate information and brand initiatives
related to CONNECT will be evaluated using the Twitter Analytics
function. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved.

<77>
[Use Link to view the full text]
Accession Number
2029217115
Title
Get your 7-point golden medal for pain management in video-assisted
thoracoscopic surgery.
Source
Current Opinion in Anaesthesiology. 37(1) (pp 64-68), 2024. Date of
Publication: 01 Feb 2024.
Author
Hoogma D.F.; Brullot L.; Coppens S.
Institution
(Hoogma, Brullot, Coppens) Department of Anesthesiology, University
Hospitals of Leuven, Belgium
(Hoogma, Coppens) Department of Cardiovascular Sciences, Biomedical
Sciences Group, University of Leuven, Leuven, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewThoracic surgery is evolving, necessitating an adaptation
for perioperative anesthesia and analgesia. This review highlights the
recent advancements in perioperative (multimodal) analgesia for minimally
invasive thoracic surgery.Recent findingsContinuous advancements in
surgical techniques have led to a reduction in surgical trauma. However,
managing perioperative pain remains a major challenge, impeding
postoperative recovery. The traditional neuraxial technique is now deemed
outdated for minimally invasive thoracic surgery. Instead, newer regional
techniques have emerged, and traditional approaches have undergone
(re-)evaluation by experts and professional societies to establish
guidelines and practices. Assessing the quality of recovery, evenafter
discharge, has become a crucial factor in evaluating the effectiveness of
these strategies, aiding clinicians in making informed decisions to
improve perioperative care.SummaryIn the realm of minimally invasive
thoracic surgery, perioperative analgesia is typically administered
through systemic and regional techniques. Nevertheless, collaboration
between anesthesiologists and surgeons, utilizing surgically placed nerve
blocks and an active chest drain management, has the potential to
significantly improve overall patient care. Copyright © 2024
Lippincott Williams and Wilkins. All rights reserved.

<78>
[Use Link to view the full text]
Accession Number
2029217112
Title
Innovative designs for trials informing the care of cardiac surgical
patients: Part II.
Source
Current Opinion in Anaesthesiology. 37(1) (pp 49-54), 2024. Date of
Publication: 01 Feb 2024.
Author
Anusic N.; Sessler D.I.
Institution
(Anusic, Sessler) Department of Outcomes Research, Cleveland Clinic,
Cleveland, OH, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewThis review examines advances in clinical trial
methodologies relevant to cardiac anesthesia. It focuses on innovative
approaches, including factorial randomization, composite outcomes, and
cluster randomized trials, which enhance the efficiency, practical
relevance, and generalizability of trial outcomes.Recent findingsFactorial
randomization is becoming popular because the approach allows
investigators to simultaneously evaluate two or more interventions.
Furthermore, factorial designs can evaluate interactions among treatments
which is highly relevant information that cannot be obtained from separate
trials. Composite outcomes are also increasingly utilized, combining
multiple individual outcomes into a single measure, which increases
statistical power and can better represent relevant physiology. Designing
valid composites requires careful consideration of component outcome
severity and incidence. Cluster randomized trials, including stepped wedge
and multiple crossover designs, address the challenges of group-level
effects and shared environments.SummaryThe evolution of clinical trial
designs is marked by a shift towards methodologies that enhance efficiency
and provide more nuanced insights into treatment effects. These include
factorial designs for simultaneous intervention assessment, composite
outcomes for comprehensive physiological representation, and cluster
trials for group-level effect analysis. Such advancements are shaping the
future of clinical research, making it more relevant, efficient, and
broadly applicable. Copyright © 2024 Lippincott Williams and
Wilkins. All rights reserved.

<79>
Accession Number
2029033897
Title
Periprocedural continuation versus interruption of oral anticoagulant
drugs during transcatheter aortic valve implantation: rationale and design
of the POPular PAUSE TAVI trial.
Source
EuroIntervention. 19(9) (pp 766-771), 2023. Date of Publication: November
2023.
Author
van Ginkel D.J.; Bor W.L.; Dubois C.L.F.; Aarts H.M.; Rooijakkers M.J.P.;
van Bergeijk K.H.; Rosseel L.; Veenstra L.; De Backer O.; Van Mieghem
N.M.; van der Kley F.; Wilgenhof A.; Leonora R.; Halim J.; Schotborgh C.;
Barbato E.; Van Der Heyden J.A.S.; Frambach P.; Ferdinande B.; Mylotte D.;
Fabris E.; Rensing B.J.W.M.; Timmers L.; Swaans M.J.; Brouwer J.;
Nijenhuis V.J.; Peper J.; Vriesendorp P.A.; de Laat B.; Ninivaggi M.;
Stragier H.; Voskuil M.; IJsselmuiden A.J.J.; Hermanides R.S.; Agostoni
P.; van 't Hof A.W.J.; Wykrzykowska J.J.; van Royen N.; Delewi R.; ten
Berg J.M.
Institution
(ten Berg) Department of Cardiology, St Antonius Hospital, Koekoekslaan 1,
Nieuwegein 3435 CM, Netherlands
(van Ginkel, Bor, Rensing, Timmers, Swaans, Brouwer, Nijenhuis, Peper, ten
Berg) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(Dubois) Department of Cardiovascular Medicine, University Hospital
Leuven, Leuven, Belgium
(Aarts, Wilgenhof, Delewi) Department of Cardiology, Amsterdam UMC,
Amsterdam, Netherlands
(Aarts, Voskuil) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
(Rooijakkers, van Royen) Department of Cardiology, Radboud University
Medical Center, Nijmegen, Netherlands
(van Bergeijk, Wykrzykowska) Department of Cardiology, University Medical
Center Groningen, Groningen, Netherlands
(Rosseel) Department of Cardiology, Algemeen Stedelijk Hospital Aalst,
Aalst, Belgium
(Veenstra, Vriesendorp, van 't Hof) Department of Cardiology, Maastricht
University Medical Center, Maastricht, Netherlands
(De Backer) The Heart Center, Rigshospitalet, Copenhagen University
Hospital, Copenhagen, Denmark
(Van Mieghem, Voskuil) Department of Cardiology, Erasmus University
Medical Center, Rotterdam, Netherlands
(van der Kley, Agostoni) Department of Cardiology, Leiden University
Medical Center, Leiden, Netherlands
(Wilgenhof) Department of Cardiology, Hospital Network Antwerp (ZNA)
Middelheim, Antwerp, Belgium
(Leonora, Hermanides) Department of Cardiology, Isala Hospital, Zwolle,
Netherlands
(Halim, IJsselmuiden) Department of Cardiology, Amphia Hospital, Breda,
Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Barbato) Cardiovascular Center Aalst, Onze Lieve Vrouwe Hospital, Aalst,
Netherlands
(Van Der Heyden) Department of Cardiology, Sint-Jan Hospital, Brugge,
Belgium
(Frambach) Department of Cardiology, Institut National de Chirurgie
Cardiaque et de Cardiologie Interventionnelle, Luxembourg City, Luxembourg
(Ferdinande) Department of Cardiology, Hospital Oost-Limburg, Genk,
Belgium
(Mylotte) Department of Cardiology, University Hospital Galway, Galway,
Ireland
(Fabris) Cardiothoracovascular Department, University of Trieste, Trieste,
Italy
(de Laat, Ninivaggi) Department of Functional Coagulation, Synapse
Research Institute, Maastricht, Netherlands
(Stragier) Department of Anesthesiology, Intensive Care Medicine,
Emergency Medicine and Pain Therapy, Hospital Oost-Limburg, Genk, Belgium
(Stragier, van 't Hof, ten Berg) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht, Netherlands
Publisher
Europa Group
Abstract
About one-third of patients undergoing transcatheter aortic valve
implantation (TAVI) use oral anticoagulants (OAC), mainly due to atrial
fibrillation. General guidelines advise interrupting OAC in patients with
a high risk of bleeding undergoing interventions. However, preliminary
observational data suggest that the continuation of OAC during TAVI is
safe and may reduce the risk of periprocedural thromboembolic events. The
Periprocedural Continuation Versus Interruption of Oral Anticoagulant
Drugs During Transcatheter Aortic Valve Implantation (POPular PAUSE TAVI)
is a multicentre, randomised clinical trial with open-label treatment and
blinded endpoint assessment. Patients are randomised 1:1 to periprocedural
continuation versus interruption of OAC and are stratified for vitamin K
antagonist or direct oral anticoagulant use. The primary endpoint is a
composite of cardiovascular mortality, all stroke, myocardial infarction,
major vascular complications and type 2-4 bleeding within 30 days after
TAVI, according to the Valve Academic Research Consortium-3 criteria.
Secondary endpoints include separate individual and composite outcomes,
quality of life and cost-effectiveness. Since continuation of OAC is
associated with the ancillary benefit that it simplifies periprocedural
management, the primary outcome is first analysed for non-inferiority; if
non-inferiority is proven, superiority will be tested. Recruitment started
in November 2020, and the trial will continue until a total of 858
patients have been included and followed for 90 days. In summary, POPular
PAUSE TAVI is the first randomised clinical trial to assess the safety and
efficacy of periprocedural continuation versus interruption of OAC in
patients undergoing TAVI. Copyright © Europa Digital & Publishing
2023. All rights reserved.

<80>
Accession Number
2029013092
Title
Antithrombotic Therapy after Percutaneous Left Atrial Appendage Closure:
Evidence, Challenges and Future Directions.
Source
Reviews in Cardiovascular Medicine. 24(12) (no pagination), 2023. Article
Number: 343. Date of Publication: 2023.
Author
Galea R.; Raber L.
Institution
(Galea, Raber) Department of Cardiology, Inselspital, Bern University
Hospital, University of Bern, Bern 3010, Switzerland
Publisher
IMR Press Limited
Abstract
Percutaneous left atrial appendage closure (LAAC) has been established in
clinical practice as an attractive alternative to oral anticoagulation for
preventing stroke in patients with atrial fibrillation and high bleeding
risk. The devices approved in Europe and United States (US) for
percutaneous LAAC contain metal and antithrombotic therapy is strongly
recommended after their implantation to prevent apposition of thrombus on
the atrial surface of the device during endothelialization. However, there
is still uncertainty regarding the optimal antithrombotic drug regimen
following device implantation in view of the incomplete understanding of
the LAAC device healing process, the lack of randomized clinical trials
comparing different antithrombotic agents after LAAC and the heterogeneous
bleeding risk of patients undergoing LAAC. Thus, this review aims to
evaluate the available evidence and the remaining challenges related to
the post-LAAC antithrombotic regimens. Furthermore, common clinical
scenarios associated with challenging management of antithrombotic therapy
after LAAC and potential future directions, will be
discussed. Copyright © 2023 The Author(s). Published by IMR
Press.

<81>
Accession Number
2029145406
Title
Angioplasty Guidewire-Assisted vs. Conventional Transseptal Puncture for
Left Atrial Appendage Occlusion: a multicentre randomized controlled
trial.
Source
Europace. 25(12) (no pagination), 2023. Article Number: euad349. Date of
Publication: 01 Dec 2023.
Author
Hu F.; Xu B.; Qiao Z.; Cheng F.; Zhou Z.; Zou Z.; Zang M.; Ding S.; Hong
J.; Xie Y.; Zhou Y.; Huang J.; Pu J.
Institution
(Hu, Xu, Qiao, Cheng, Zhou, Zou, Zang, Ding, Xie, Zhou, Huang, Pu)
Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai
Jiao Tong University, 160# PuJian Road, Shanghai 200127, China
(Hong, Xie) Department of Cardiology, Ningbo Hangzhou Bay Hospital,
Zhejiang, Ningbo, China
(Zhou) Department of Cardiology, Punan Hospital, Pudong New District,
Shanghai, China
(Huang) Department of Cardiology, Dachang Hospital, Baoshan District,
Shanghai, China
Publisher
Oxford University Press
Abstract
Aims This study was performed to compare the usability, efficiency, and
safety of a modified angioplasty guidewire-assisted transseptal puncture
(TSP) technique vs. the conventional approach in facilitating access into
the left atrium during left atrial appendage occlusion (LAAO) procedures
for the treatment of atrial fibrillation. Methods The ADVANCE-LAAO trial
(Angioplasty Guidewire-Assisted vs. Conventional Transseptal Puncture for
Left Atrial and results Appendage Occlusion) was an
investigator-initiated, prospective, multicentre, randomized controlled
trial (NCT05125159). Patients with atrial fibrillation who underwent LAAO
were prospectively enrolled from four centres and randomly assigned to an
angioplasty guidewire-assisted TSP group (n = 131) or to a conventional
Brockenbrough needle TSP group (n = 132). The primary endpoint was the
one-time success rate of TSP. We also analysed the TSP procedure time,
failure rate of the assigned TSP type, radiation dose, contrast dose, and
procedural complications in both groups. All patients in the
guidewire-assisted group underwent successful TSP, whereas five in the
standard conventional group switched to the guidewire-assisted approach.
The guidewire-assisted puncture improved the one-time success rate (92.4
vs. 77.3%, P = 0.001), shortened the TSP procedure time (109.2 +/- 48.2
vs. 120.5 +/- 57.6 s, P = 0.023), and tended to have a higher rate of good
coaxial orientation of the sheath with the left atrial appendage during
the LAAO procedure (66.4 vs. 54.5%, P = 0.059). No TSP-related
complications occurred in the guidewire-assisted TSP group, whereas two
complications occurred in the conventional TSP group. There was no
significant difference in the failure rate of the assigned TSP type, the
total procedure time, the total radiation dose, the rate of successful
LAAO implantation, or the procedural complication rate between the two
groups (all P > 0.05). Conclusion This study confirmed that
angioplasty guidewire-assisted puncture can effectively improve the
success rate of TSP during LAAO procedures. This novel technique has high
potential for application in interventional therapies requiring
TSP. Copyright © The Author(s) 2023.

<82>
Accession Number
2027271357
Title
Effect of intranasal insulin administration on postoperative delirium
prevention in elderly cardiac surgery patients: study protocol for a
multicenter, double-blind, randomized, controlled trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 822. Date of
Publication: December 2023.
Author
Nakadate Y.; Yamada M.; Kusuyama N.; Ishii R.; Sato H.; Schricker T.;
Tanaka M.
Institution
(Nakadate, Yamada) Department of Anesthesiology, University of Tsukuba
Hospital, 2-1-1, Amakubo, Tsukuba, Ibaraki 305-8576, Japan
(Kusuyama) Department of Anesthesia, Tsukuba Medical Center Hospital,
Ibaraki, Japan
(Ishii) Department of Biostatistics, Faculty of Medicine, University of
Tsukuba, Ibaraki, Japan
(Sato, Schricker) Department of Anesthesia, McGill University Health
Centre Glen Site, Royal Victoria Hospital, Montreal, Canada
(Tanaka) Department of Anesthesiology, Faculty of Medicine, University of
Tsukuba, Ibaraki, Japan
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative delirium (POD) is a complication after surgery
which leads to worse outcomes. The frequency of this syndrome is
increasing as more elderly patients undergo major surgery. The frequency
is around 10-25% but reaches as high as 50% for cardiac surgery. Although
intranasal insulin (INI) administration of up to 160 units in patients
with cognitive dysfunction and delirium has been shown to improve memory
function and brain metabolism without complications such as hypoglycemia,
it remains unknown whether INI prevents POD after cardiac surgery Methods:
A multicenter, double-blind, randomized, controlled trial will be
conducted at University of Tsukuba Hospital and Tsukuba Medical Center
Hospital, Japan, from July 1, 2023, to December 31, 2025. A total of 110
elderly patients (65 years old or older) undergoing cardiac surgery
requiring cardiopulmonary bypass will be enrolled and randomly allocated
to intranasal insulin or intranasal saline groups. The primary outcome is
the incidence of POD within 7 days after surgery. Secondary outcomes
include days and times of delirium, screening tests of cognitive function,
pain scores, duration of postoperative tracheal intubation, and length of
ICU stay. Discussion(s): The present objective is to assess whether
80 IU INI administration during surgery prevents POD after cardiac
surgery. The results may provide strategic choices to prevent POD in
patients with cardiac surgery requiring cardiopulmonary bypass. Trial
registration: The trial was registered with the Japan Registry for
Clinical Trials with identifier jRCTs031230047 on April 21,
2023. Copyright © 2023, The Author(s).

<83>
Accession Number
2027253959
Title
Goal-Directed Therapy in Cardiogenic Shock: No Magical Recipe.
Source
Current Anesthesiology Reports. (no pagination), 2023. Date of
Publication: 2023.
Author
Lescroart M.; Piccoli J.; Hebert J.-L.; Kimmoun A.
Institution
(Lescroart, Kimmoun) CHRU de Nancy, Medecine Intensive et Reanimation
Brabois, Universite de Lorraine, FCRIN INI-CRCT, Nancy, France
(Lescroart, Kimmoun) Universite de Lorraine, INSERM U1116, Nancy, France
(Piccoli) Departement de chirurgie cardiaque et transplantation, CHRU de
Nancy, Universite de Lorraine, Nancy, France
(Hebert) Institut de Cardiologie, AP-HP, CHU Pitie-Salpetriere, Sorbonne
Universite, Paris, France
Publisher
Springer
Abstract
Purpose of Review: Cardiogenic shock (CS) remains a critical condition
associated with a high mortality rate. Early and appropriate management
may prevent or reverse multiple organ failure. Various strategies have
been proposed to appropriately manage CS, but no goal-directed therapy has
yet been validated. Recent Findings: In this narrative review, we propose
a physiological-based goal-directed therapy that relies on both flow and
pressure monitoring to adapt the titration of inotropic and vasopressor
drugs. Along with addressing the initial trigger, these physiological
endpoints should serve as the benchmark for accurately adjusting
therapeutics up to veno-arterial extracorporeal membrane oxygenation
implementation if necessary. Summary: The ultimate challenge is to
define early in the trajectory of patients with cardiogenic shock, whether
it is a bridge to recovery or, if eligible, a bridge to heart
transplantation or a long-term assistance device. Graphical Abstract:
[Figure not available: see fulltext.] MAP, mean arterial pressure; RAP,
right atrial pressure; RV, right ventricle; mPAP, mean pulmonary artery
pressures; PCWP, pulmonary capillary wedge pressures; HTx, heart
transplantation; TTE, transthoracic echocardiography; LVOT VTI, left
ventricular outflow tract velocity time integral; IVC, inferior vena cava;
LVFP, left ventricular filling pressures; CS, cardiogenic shock; CO,
cardiac output; PAC, pulmonary artery catheter; PICCO, pulse index
continuous cardiac output; CRT, capillary refill time. Copyright
© 2023, The Author(s), under exclusive licence to Springer
Science+Business Media, LLC, part of Springer Nature.

<84>
Accession Number
2027253652
Title
Medical graphics to improve patient understanding and anxiety in elderly
and cognitively impaired patients scheduled for transcatheter aortic valve
implantation (TAVI).
Source
Clinical Research in Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Brand A.; Hornig C.; Crayen C.; Hamann A.; Martineck S.; Leistner D.M.;
Dreger H.; Sundermann S.; Unbehaun A.; Sherif M.; Haghikia A.; Bischoff
S.; Lueg J.; Kuhnle Y.; Paul O.; Squier S.; Stangl K.; Falk V.; Landmesser
U.; Stangl V.
Institution
(Brand, Hornig, Dreger, Bischoff, Lueg, Stangl, Stangl) Department of
Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum
der Charite, Campus Charite Mitte, Berlin, Germany
(Brand, Leistner, Haghikia, Landmesser) Department of Cardiology,
Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite,
Campus Benjamin Franklin, Berlin, Germany
(Brand, Leistner, Dreger, Sundermann, Haghikia, Falk, Landmesser, Stangl)
DZHK (German Centre for Cardiovascular Research), partner Site Berlin,
Berlin, Germany
(Crayen) Department of Education and Psychology, Freie Universitat Berlin,
Habelschwerdter Allee 45, Berlin 14195, Germany
(Hamann) Mintwissen-Science Communication Agency and Publishing House,
Paulusstr. 11, Dusseldorf 40237, Germany
(Martineck) Kollwitzstrase 52, Berlin 10405, Germany
(Sundermann, Unbehaun, Falk) Department of Cardiothoracic and Vascular
Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany
(Sherif, Kuhnle, Paul) Department of Cardiology, Angiology and Intensive
Care Medicine, Deutsches Herzzentrum der Charite, Campus Virchow Klinikum,
Berlin, Germany
(Squier) Brill Professor Emeritus of English and Women's, Gender and
Sexuality Studies, The Pennsylvania State University, University Park, PA
16802, United States
(Leistner) Department of Cardiology, Angiology and Intensive Care
Medicine, Goethe University Hospital, Universitares Herz- und
Gefasszentrum Frankfurt, Frankfurt am Main, Frankfurt 60590, Germany
(Leistner) DZHK (German Centre for Cardiovascular Research), partner site
Rhein-Main, Munich, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Anxiety and limited patient comprehension may pose significant
barriers when informing elderly patients about complex procedures such as
transcatheter aortic valve implantation (TAVI). Objective(s): We
aimed to evaluate the utility of medical graphics to improve the patient
informed consent (IC) before TAVI. Method(s): In this prospective,
randomized dual center study, 301 patients were assigned to a patient
brochure containing medical graphics (Comic group, n = 153) or sham
information (Control group, n = 148) on top of usual IC. Primary outcomes
were patient understanding of central IC-related aspects and
periprocedural anxiety assessed by the validated Spielberger State Trait
Anxiety Inventory (STAI), both analyzed by cognitive status according to
the Montreal Cognitive Assessment (MoCA). Result(s): Patient
understanding was significantly higher in the Comic group [mean number of
correct answers 12.8 (SD 1.2) vs. 11.3 (1.8); mean difference 1.5 (95% CI
1.2-1.8); p < 0.001]. This effect was more pronounced in the presence of
cognitive dysfunction (MoCA < 26) [12.6 (1.2) in the Comic vs. 10.9 (1.6)
in the Control group; mean difference 1.8 (1.4-2.2), p < 0.001]. Mean STAI
score declined by 5.7 (95% CI 5.1-6.3; p < 0.001) in the Comic and 0.8
points (0.2-1.4; p = 0.015) in the Control group. Finally, mean STAI score
decreased in the Comic group by 4.7 (3.8-5.6) in cognitively impaired
patients and by 6.6 (95% CI 5.8 to 7.5) in patients with normal cognitive
function (p < 0.001 each). Conclusion(s): Our results prove
beneficial effects for using medical graphics to inform elderly patients
about TAVI by improving patient understanding and reducing periprocedural
anxiety (DRKS00021661; 23/Oct/2020). Graphical Abstract: Medical graphics
entailed significant beneficial effects on the primary endpoints, patient
understanding and periprocedural anxiety, compared to the usual patient
informed consent (IC) procedure. Patient understanding of IC-related
aspects was significantly higher in the Comic group, with a more
pronounced benefit in patients with cognitive impairment (p for IC method
and cognitive status < 0.001, respectively; p for IC method x MoCA
category interaction = 0.017). There further was a significant decline of
periprocedural anxiety in patients with and without cognitive impairment
(p for IC method x measuring time point < 0.001; p for IC method x MoCA
category x measuring time point interaction = 0.018) [Figure not
available: see fulltext.]. Copyright © 2023, The Author(s).

<85>
Accession Number
2027244814
Title
Rescue designs in analgesic trials from 0 to 2 years of age: scoping
review.
Source
Pediatric Research. (no pagination), 2023. Date of Publication: 2023.
Author
Haskes K.; Donado C.; Carbajal R.; Berde C.B.; Kossowsky J.
Institution
(Haskes, Donado, Berde, Kossowsky) Department of Anesthesiology, Critical
Care & Pain Medicine, Boston Children's Hospital, Boston, MA, United
States
(Donado, Berde, Kossowsky) Department of Anaesthesia, Harvard Medical
School, Boston, MA, United States
(Carbajal) Pediatric Emergency Department, Assistance Publique-Hopitaux de
Paris, Hopital Armand Trousseau-Sorbonne Universite, Paris, France
(Carbajal) Institut National de La Sante et de La Recherche Medicale,
Paris UMR1153, France
Publisher
Springer Nature
Abstract
Abstract: Pediatric analgesic trials are challenging, especially in
newborns and infants. Following an FDA-academic consensus meeting, we
analyzed pragmatic rescue designs in postoperative trials of local
anesthetics, acetaminophen, opioids, and NSAIDs involving children ages
0-2 years and assessed surgical volumes to provide trial design
recommendations. Searches of PubMed, Embase, CINAHL, The Cochrane Library,
and Web of Science were conducted. A scoping approach identified trends in
analgesic trials with an emphasis on randomized controlled trials (RCTs)
utilizing immediate rescue designs. Age-specific surgical volumes were
estimated from French national databases. Of 3563 studies identified, 23
RCTs used study medication(s) of interest and immediate rescue paradigms
in children ages 0-2 years. A total of 270 studies met at least one of
these criteria. Add-on and head-to-head designs were common and often used
sparing of non-opioid or opioid rescue medication as a primary outcome
measure. According to French national data, inguinal and penile surgeries
were most frequent in ages 1 month to 2 years; abdominal and thoracic
surgeries comprise approximately 75% of newborn surgeries. Analgesic
trials with rescue sparing paradigm are currently sparse among children
ages 0-2 years. Future trials could consider age-specific surgical
procedures and use of add-on or head-to-head designs. Impact: Clinical
trials of analgesic medications have been challenging in pediatrics,
especially in the group from newborns to 2 years of age. Following an
FDA-academic workshop, we analyzed features of completed analgesic trials
in this age group. Studies using immediate rescue in placebo control,
add-on, and head-to-head trial designs are pragmatic approaches that can
provide important information regarding clinical effectiveness, side
effects, and safety. Using a French national dataset with a granular
profile of inpatient, outpatient, and short-stay surgeries, we provide
information to future investigators on relative frequencies of different
operations in neonates and through the first 2 years of
life. Copyright © 2023, The Author(s), under exclusive licence to
the International Pediatric Research Foundation, Inc.

<86>
Accession Number
2027212261
Title
Transcatheter left atrial appendage occlusion in patients with chronic
kidney disease: a systematic review and meta-analysis.
Source
Clinical Research in Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Flores-Umanzor E.; Asghar A.; Cepas-Guillen P.L.; Farrell A.; Keshvara R.;
Alvarez-Rodriguez L.; Osten M.; Freixa X.; Horlick E.; Abrahamyan L.
Institution
(Flores-Umanzor, Keshvara, Alvarez-Rodriguez, Osten, Horlick) Toronto
Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre,
University Health Network, Toronto, ON, Canada
(Asghar, Abrahamyan) Toronto General Hospital Research Institute,
University Health Network, 10th Floor Eaton North, Room 237, 200 Elizabeth
Street, Toronto, ON M5G 2C4, Canada
(Asghar, Abrahamyan) Institute for Health Policy, Management, and
Evaluation, University of Toronto, Toronto, ON, Canada
(Cepas-Guillen, Freixa) Cardiology Department, Cardiovascular Institute,
Hospital Clinic, University of Barcelona, Barcelona, Spain
(Farrell) Library and Information Services, University Health Network,
Toronto, ON, Canada
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Chronic kidney disease (CKD) is a risk factor for embolic
stroke, and many nonvalvular atrial fibrillation (NVAF) patients have
concomitant CKD. Anticoagulation therapy can be challenging in CKD due to
increased bleeding risk, and left atrial appendage occlusion (LAAO) may be
a promising alternative. Objective(s): This systematic review aimed
to consolidate current evidence on the safety and effectiveness of
transcatheter LAAO in patients with CKD and end-stage renal disease
(ESRD). Method(s): Medline, Cochrane, and Embase databases were
searched from inception to September 2, 2022. We conducted a meta-analysis
if an outcome was evaluated in at least two similar studies.
 Result(s): We included 15 studies with 77,780 total patients. Of the
15 studies, 11 had a cohort design (five prospective and six
retrospective), and four were case series. Patients with CKD were older
and had a higher prevalence of comorbidities than non-CKD patients. The
two groups did not differ in procedural failure rate, vascular
complications, or pericardial tamponade. CKD patients exhibited higher
odds of in-hospital acute kidney injury (AKI) and bleeding, longer-term
bleeding, and mortality than those without CKD. The risk of in-hospital
and longer-term cardioembolic events was similar between CKD and non-CKD
populations (odds ratio = 1.01 [95% CI 0.70-1.15] and 1.05 [95% CI
0.55-2.00], respectively). Patients with ESRD had higher odds of
in-hospital mortality and cardioembolic events than non-ESRD patients,
with no differences in risk of pericardial tamponade. Conclusion(s):
Based on observational studies, LAAO may be an effective option to prevent
cardioembolic events in CKD. However, CKD patients may have higher odds of
AKI and in-hospital and long-term bleeding and mortality. The adverse
clinical outcomes observed in CKD patients may be attributed to this
population's high burden of comorbidities, especially among those with
ERSD, rather than the LAAO procedure itself. To ensure maximum clinical
benefit, careful patient selection, management, and surveillance involving
multidisciplinary teams are essential for CKD patients undergoing LAAO.
Graphical abstract: Transcatheter Left Atrial Appendage Occlusion (laao)
Can Prevent Cardioembolic Events In Chronic Kidney Disease (ckd) Patients.
However, Ckd Patients, Particularly Those With End-stage Renal
Disease/dialysis (esrd), May Face Increased Odds Of Acute Kidney Injury,
In-hospital And Long-term Bleeding, And Mortality. Notably, These Adverse
Outcomes In Ckd Patients May Be Linked To Their High Comorbidity Burden,
Particularly In Those With Esrd, Rather Than The Laao Procedure Itself.
Careful Patient Selection, Management, And Surveillance Involving
Multidisciplinary Teams Are Essential For Ckd Patients Undergoing Laao To
Ensure Maximum Clinical Benefit Transcatheter left atrial appendage
occlusion (LAAO) can prevent cardioembolic events in chronic kidney
disease (CKD) patients. However, CKD patients, particularly those with
end-stage renal disease/dialysis (ESRD), may face increased odds of acute
kidney injury, in-hospital and long-term bleeding, and mortality. Notably,
these adverse outcomes in CKD patients may be linked to their high
comorbidity burden, particularly in those with ESRD, rather than the LAAO
procedure itself. Careful patient selection, management, and surveillance
involving multidisciplinary teams are essential for CKD patients
undergoing LAAO to ensure maximum clinical benefit.[Figure not available:
see fulltext.]. Copyright © 2023, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany.

<87>
Accession Number
2027198512
Title
Cost-Effectiveness and Budget Impact Analyses of Patient Blood Management
in a Cardiovascular Surgery Department at Ankara Bilkent City Hospital in
Turkey.
Source
Advances in Therapy. (no pagination), 2023. Date of Publication: 2023.
Author
Sanal L.; Gunaydin S.; Tatar M.
Institution
(Sanal) Transfusion Center, Ministry of Health, Ankara Bilkent City
Hospital Campus, Ankara, Turkey
(Gunaydin) Department of Cardiovascular Surgery, University of Health
Sciences, Ankara Bilkent City Hospital Campus, Ankara, Turkey
(Tatar) Vitale Health Economics, Policy and Consultancy, London, United
Kingdom
Publisher
Adis
Abstract
Introduction: Anemia and transfusion of blood products are risk factors
associated with poor patient outcomes across all elective surgeries.
Patient blood management (PBM) is a patient-centered approach to optimize
patient's endogenous red cell mass, to minimize blood loss in patients
undergoing surgery, and to harness and optimize patient-specific
physiological tolerance to anemia. This study aimed to assess (1) the
impact of PBM on blood product usage in cardiovascular surgeries in a
state hospital setting, (2) cost-effectiveness of PBM with a model based
on transfusion of red blood cells (RBCs) in cardiovascular surgeries, and
(3) the budget impact of PBM implementation based on transfusion of RBCs.
 Method(s): Cost-effectiveness and budget impact models, based on the
numbers of avoided transfusions and avoided complications after
implementation of the PBM program, were compared between pre- and post-PBM
periods at the cardiovascular surgery department of Ankara Bilkent City
Hospital between February 11, 2019 and July 24, 2022. The probabilities of
transfusions and complications with and without PBM were taken from recent
meta-analyses. Data from the Ankara Bilkent City Hospital transfusion
center informed the pre- and post-PBM calculations. Costs were calculated
from the Social Security Institution's perspective. Result(s): There
was a 21% decrease in the use of RBCs and a 23.7% decrease in use of all
blood products after the implementation of PBM. The number of RBC packs
per patient reduced by 0.88 packs (21%). The cost saving from reduction of
RBC transfusions per patient was 518.68 Turkish lira (TRY) and for the
hospital it was 1,635,948 TRY. Fewer complications and lower costs in
favor of the post-PBM arm were demonstrated in the cost-effectiveness
analysis. On the basis of the budget impact model, in 20 months, the
hospital's cardiovascular surgery department saved 6,596,934 TRY
(342,302). Conclusion(s): This hospital-based study demonstrated that
PBM is a budget-saving and cost-effective option in Turkey. Copyright
© 2023, The Author(s).

<88>
[Use Link to view the full text]
Accession Number
2028943241
Title
Influence of Regional Nerve Block in Addition to General Anesthesia on
Postoperative Delirium, Pain, and In-hospital Stay in Patients Undergoing
Cardiothoracic Surgery: A Meta-analysis.
Source
Journal of Cardiovascular Pharmacology. 82(6) (pp 496-503), 2023. Date of
Publication: 06 Dec 2023.
Author
Li L.; Liu M.; Li S.; Xu J.; Zheng J.; Lv C.; Wu L.; Heng L.
Institution
(Li, Lv) Department of Critical Care Medicine, First People's Hospital of
Xuzhou, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University,
Affiliated Hospital of Mining and Technology of China University, Jiangsu,
Xuzhou, China
(Liu) Department of Thoracic Surgery, Xuzhou Central Hospital, Jiangsu,
Xuzhou, China
(Li, Zheng) Department of Orthopedics, First People's Hospital of Xuzhou,
Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University,
Affiliated Hospital of Mining and Technology of China University, Jiangsu,
Xuzhou, China
(Xu) Department of Ophthalmology, First People's Hospital of Xuzhou,
Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University,
Affiliated Hospital of Mining and Technology of China University, Jiangsu,
Xuzhou, China
(Wu) Department of Hemodialysis, First People's Hospital of Xuzhou, Xuzhou
Municipal Hospital Affiliated to Xuzhou Medical University, Affiliated
Hospital of Mining and Technology of China University, Jiangsu, Xuzhou,
China
(Heng) Department of Anesthesiology, Xuzhou Cancer Hospital, Jiangsu
Province, Xuzhou City, China
(Heng) Department of Anesthesiology, Xuzhou New Healthy Geriatric
Hospital, Jiangsu Province, Xuzhou City, China
(Heng) Department of Anesthesiology, The Affiliated Xuzhou Hospital of
JiangSu University, Jiangsu Province, Xuzhou City, China
Publisher
Lippincott Williams and Wilkins
Abstract
This study aims to investigate whether venous injection of sedative agent
or regional nerve block in alliance with major anesthesia could decrease
the risk of postoperative delirium occurrence in patients receiving
cardiothoracic surgery. Electronic academic databases were retrieved for
related publications, and statistical software was used for data pooling
and analysis. Forest plot was used to show the pooled sensitivity,
specificity, and diagnostic odds ratio. Combined receiver operating
characteristic curve was used to show the area under the curve of complex
data. Seven studies were included for analysis. The risk of occurrence of
delirium still showed no difference (risk rate = 0.93, 95% CI, 0.85-1.03)
between the intervention group and placebo group. Postoperative pain
feeling was more alleviated in patients with prophylactic application of
regional nerve block. In addition, prophylactic application of regional
nerve block could decrease the risk of postoperative in-hospital stay
(risk rate = 0.28, 95% CI, 0.02-0.54). Our study demonstrated that, in
elderly patients or pediatric patients undergoing cardiac surgery,
prophylactic application of regional nerve block failed to decrease the
incidence of postoperative delirium. However, the option of regional nerve
block could decrease the duration of in-hospitalization stay and alleviate
the acute pain during the postoperative period after open-heart
surgery. Copyright © 2023 Lippincott Williams and Wilkins. All
rights reserved.

<89>
Accession Number
2028788327
Title
Mental health and transcatheter aortic valve replacement: A scoping
systematic review.
Source
General Hospital Psychiatry. 86 (pp 10-23), 2024. Date of Publication: 01
Jan 2024.
Author
Suen W.-L.; Bhasin S.; Betti V.; Bruckel J.T.; Oldham M.A.
Institution
(Suen, Oldham) Department of Psychiatry, University of Rochester Medical
Center, United States
(Bhasin, Betti) School of Medicine & Dentistry, University of Rochester
Medical Center, United States
(Bruckel) Department of Medicine, University of Rochester Medical Center,
United States
Publisher
Elsevier Inc.
Abstract
Objective: To systematically review the literature on mental health
symptoms before and after transcatheter aortic valve replacement (TAVR)
and describe reported clinical associations with these symptoms.
 Method(s): Using the Preferred Reporting Items for Systematic reviews
and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines,
we reviewed studies involving pre- or post-TAVR mental health assessments
or psychiatric diagnoses. Result(s): Eighteen studies were included.
Before TAVR, clinically significant depression and anxiety prevalence is
15-30% and 25-30%, respectively, with only a third of these meeting
diagnostic thresholds. These symptoms generally improve over the year
post-TAVR. Depression is associated with functional impairment,
multimorbidity, and lower physical activity; few associations have been
described in relation to anxiety. Inconsistent evidence finds depression
associated with post-TAVR mortality. One notable study found persistent
depression independently predictive of 12-month mortality, and another
found depression and cognition to have additive value in predicting
mortality risk. Conclusion(s): Mental health symptoms occur in a
significant proportion of the TAVR population. Although symptoms tend to
improve, the associations with depression, particularly persistent
depression, call for further investigation to examine their associated
outcomes. Research is also needed to understand the relationships between
mental health conditions and cognition in TAVR-related
outcomes. Copyright © 2023 Elsevier Inc.

<90>
Accession Number
2027356625
Title
Effect of Exercise Training on Peak Aerobic Power After Heart
Transplantation: A Brief Review.
Source
Canadian Journal of Cardiology. 39(11 Supplement) (pp S368-S374), 2023.
Date of Publication: November 2023.
Author
Foulkes S.J.; Hewitt D.; Peters A.; Schmidt T.; Reiss N.; Riess K.;
Paterson S.; La Gerche A.; Haykowsky M.J.
Institution
(Foulkes, Hewitt, Riess, Paterson, Haykowsky) College of Health Sciences,
University of Alberta, Edmonton, AB, Canada
(Foulkes, La Gerche) Baker Heart and Diabetes Institute, Melbourne, VIC,
Australia
(Foulkes, La Gerche) University of Melbourne, Parkville, VIC, Australia
(Peters) Duke University, Durham, NC, United States
(Schmidt, Reiss) Schuchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde,
Germany
(Schmidt) Institute for Cardiology and Sports Medicine, German Sports
University Cologne, Cologne, Germany
(Riess) Northern Alberta Institute of Technology, Edmonton, AB, Canada
(La Gerche) Department of Cardiology, St Vincent's Hospital Melbourne,
Victoria, Australia
Publisher
Elsevier Inc.
Abstract
Heart transplantation (HTP) is a life-saving therapy for selected
individuals with end-stage refractory heart failure. Despite improvements
in quality of life and survival, HTP recipients' peak aerobic power (peak
VO<inf>2</inf>) remains up to 50% lower than age-matched healthy control
subjects owing to abnormal cardiovascular and skeletal muscle function.
Currently, little is known regarding the effect of exercise training (ET)
to improve peak VO<inf>2</inf> after HTP. This brief review aims to
summarise existing evidence regarding the role of ET on peak
VO<inf>2</inf> and its determinants, highlights the upper limits of
endurance performance in highly trained HTP athletes, and identifies areas
for future HTP exercise rehabilitation research. Copyright © 2023
The Authors

<91>
Accession Number
2026898569
Title
Meta-analysis of clinical adverse events after CABG vs. PCI in patients
with chronic kidney disease and coronary artery disease.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
590. Date of Publication: December 2023.
Author
Luo C.; wang Q.; Nong S.; Chen Y.; Li L.; Gui C.
Institution
(Luo, wang, Nong, Chen, Li, Gui) Department of Cardiology, The First
Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang
Autonomous Region, Nanning 530021, China
(Luo) Department of Cardiology, The Fourth Affiliated Hospital of Guangxi
Medical University, Liuzhou, China
(Gui) Guangxi Key Laboratory Base of Precision Medicine in
Cardiocerebrovascular Diseases Control and Prevention, Guangxi Clinical
Research Center for Cardiocerebrovascular Diseases, Guangxi Zhuang
Autonomous Region, Nanning 530021, China
Publisher
BioMed Central Ltd
Abstract
Aim: To investigate the efficacy and postoperative clinical adverse events
of coronary artery bypass grafting (CABG) or percutaneous coronary
intervention (PCI) for chronic kidney disease (CKD) study participants
combined with coronary artery disease (CAD). Method(s): All
randomized controlled trials (RCTs) that focus on the therapeutic effect
evaluation of CABG and PCI and their effect on postoperative clinical
adverse events as well as main adverse cardiovascular and cerebrovascular
events (MACCEs) in CKD study participants with CAD were screened from the
following databases, including CNKI, CBM, Wan Fang, VIP, Embase, PubMed,
as well as Cochrane library clinical controlled trials. The study was
conducted under the PRISMA 2020 criteria. Data were extracted, and quality
control was evaluated from the modified Jadad rating scale. Meta-analysis
was then undertaken through STATA 16.0 software. Result(s): A total
of 5 RCTs were obtained, including 1198 patients. Study participants were
subdivided into two groups, including the PCI group (n = 604) and the CABG
group (n = 594). Meta-analysis of clinical adverse events results showed
that the long-term survival results of CAD patients with CKD who underwent
PCI were worsened compared to CABG, such as long-term MACCEs (RR = 1.59,
95%CI: 1.04-2.43) and the long-term repeated revascularization (RR = 2.48,
95%CI: 1.76-3.49). Also, cardiac death (RR = 1.68, 95%CI:1.04-2.71), as
well as cerebrovascular accident (RR = 1.74, 95%CI:1.04-2.90) in CABG
group was significantly lower than that in PCI group. Conclusion(s):
This meta-analysis showed that CABG provided a better therapeutic effect
than PCI in CKD patients with CAD when considering long-term prognosis.
However, more prospective RCTs are needed to define the proper
revascularization strategy for CAD patients with CKD. Copyright ©
2023, The Author(s).

<92>
Accession Number
2026236385
Title
Transcatheter aortic valve implantation in patients with anomalous origin
of a coronary artery.
Source
Catheterization and Cardiovascular Interventions. 102(7) (pp 1393-1400),
2023. Date of Publication: 01 Dec 2023.
Author
Loria J.R.D.; Abdelhafez A.; Desch S.; Thiele H.; Abdel-Wahab M.
Institution
(Loria, Abdelhafez, Desch, Thiele, Abdel-Wahab) Department of Cardiology,
Heart Center Leipzig at University of Leipzig, Leipzig, Germany
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter aortic valve implantation (TAVI) has become a
well-established treatment option for elderly patients with symptomatic
severe aortic stenosis. Coronary artery anomalies are an infrequent
finding and there have only been few anecdotal reports of patients with
coronary anomalies treated with TAVI. We here present a comprehensive
overview of existing reports in addition to an own case series to
facilitate better understanding of this potentially challenging clinical
scenario. Copyright © 2023 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<93>
[Use Link to view the full text]
Accession Number
2029140026
Title
Poor Agreement Between Preoperative Transthoracic Echocardiography and
Intraoperative Transesophageal Echocardiography for Grading Diastolic
Dysfunction.
Source
Anesthesia and Analgesia. 138(1) (pp 123-133), 2024. Date of Publication:
01 Jan 2024.
Author
Mcilroy D.R.; Wettig P.; Burton J.; Neylan A.; French B.; Lin E.; Hastings
S.; Waldron B.J.F.; Buckland M.R.; Myles P.S.
Institution
(Mcilroy) The Department of Anesthesiology, Vanderbilt University,
Nashville, TN, United States
(Mcilroy, Lin, Hastings, Myles) Department of Anaesthesia & Perioperative
Medicine, Monash University, Melbourne, VIC, Australia
(Wettig, Burton) Department of Cardiology, Alfred Hospital, Melbourne,
VIC, Australia
(Neylan, Lin, Hastings, Waldron, Buckland, Myles) Department of Anesthesia
& Perioperative Medicine, Alfred Hospital, Melbourne, VIC, Australia
(French) Department of Biostatistics, Vanderbilt University Medical
Center, Nashville, TN, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Guidelines for the evaluation and grading of diastolic
dysfunction are available for transthoracic echocardiography (TTE).
Transesophageal echocardiography (TEE) is used for this purpose
intraoperatively but the level of agreement between these 2 imaging
modalities for grading diastolic dysfunction is unknown. We assessed
agreement between awake preoperative TTE and intraoperative TEE for
grading diastolic dysfunction. Method(s): In 98 patients undergoing
cardiac surgery, key Doppler measurements were obtained using TTE and TEE
at the following time points: TTE before anesthesia induction
(TTE<inf>awake</inf>), TTE following anesthesia induction
(TTE<inf>anesth</inf>), and TEE following anesthesia induction
(TEE<inf>anesth</inf>). The primary endpoint was grade of diastolic
dysfunction categorized by a simplified algorithm, and measured by
TTE<inf>awake</inf> and TEE<inf>anesth</inf>, for which the weighted kappa
statistic assessed observed agreement beyond chance. Secondary endpoints
were peak early diastolic lateral mitral annular tissue velocity
(e'<inf>lat</inf>) and the ratio of peak early diastolic mitral inflow
velocity (E) to e'<inf>lat</inf> (E/e'<inf>lat</inf>), measured by
TTE<inf>awake</inf> and TEE<inf>anesth</inf>, were compared using
Bland-Altman limits of agreement. Result(s): Disagreement in grading
diastolic dysfunction by >=1 grade occurred in 43 (54%) of 79 patients and
by >=2 grades in 8 (10%) patients with paired measurements for analysis,
yielding a weighted kappa of 0.35 (95% confidence interval [CI],
0.19-0.51) for the observed level of agreement beyond chance. Bland-Altman
analysis of paired data for e'<inf>lat</inf> and E/e'<inf>lat</inf>
demonstrated a mean difference (95% CI) of 0.51 (-0.06 to 1.09) and 0.70
(0.07-1.34), respectively, for measurements made by TTE<inf>awake</inf>
compared to TEE<inf>anesth</inf>. The percentage (95% CI) of paired
measurements for e'<inf>lat</inf> and E/e'<inf>lat</inf> that lay outside
the [-2, +2] study-specified boundary of acceptable agreement was 36%
(27%-48%) and 39% (29%-51%), respectively. Results were generally robust
to sensitivity analyses, including comparing measurements between
TTE<inf>awake</inf> and TTE<inf>anesth</inf>, between TTE<inf>anesth</inf>
and TEE<inf>anesth</inf>, and after regrading diastolic dysfunction by the
American Society of Echocardiography (ASE)/European Association of
CardioVascular Imaging (EACVI) algorithm. Conclusion(s): There was
poor agreement between TTE<inf>awake</inf> and TEE<inf>anesth</inf> for
grading diastolic dysfunction by a simplified algorithm, with disagreement
by >=1 grade in 54% and by >=2 grades in 10% of the evaluable cohort.
Future studies, including comparing the prognostic utility of
TTE<inf>awake</inf> and TEE<inf>anesth</inf> for clinically important
adverse outcomes that may be a consequence of diastolic dysfunction, are
needed to understand whether this disagreement reflects random variability
in Doppler variables, misclassification by the changed technique and
physiological conditions of intraoperative TEE, or the accurate detection
of a clinically relevant change in diastolic dysfunction. Copyright
© 2022 International Anesthesia Research Society.

<94>
Accession Number
2028135682
Title
Coronary Artery Bypass Surgery to Treat Anomalous Origin of Coronary
Arteries in Adults: A Systematic Review.
Source
Heart Lung and Circulation. 32(12) (pp 1500-1511), 2023. Date of
Publication: December 2023.
Author
Alzghari T.; Sandner S.; Di Franco A.; Harik L.; Perezgorvas-Olaria R.;
Soletti G.; Dimagli A.; Cancelli G.; Demetres M.; Lau C.; Girardi L.N.;
Gaudino M.
Institution
(Alzghari, Di Franco, Harik, Perezgorvas-Olaria, Soletti, Dimagli,
Cancelli, Lau, Girardi, Gaudino) Department of Cardiothoracic Surgery,
Weill Cornell Medicine, New York, NY, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell Medicine, New York, NY, United States
Publisher
Elsevier Ltd
Abstract
Objective: To review the available literature on the use of coronary
artery bypass grafting (CABG) as a treatment option for anomalous origin
of coronary artery in adults. Method(s): A systematic literature
search was performed in March 2023 (including Ovid MEDLINE, Ovid Embase,
and the Cochrane Library databases) to identify studies reporting the use
of CABG in adult patients with anomalous origin of coronary artery.
 Result(s): A total of 31 studies and 62 patients were included, 32
patients (52%) were women, and the mean age was 45.1+/-16.1 years. The
most common coronary anomaly was the right coronary artery arising from
the left coronary sinus in 26 patients (42%), followed by an anomalous
left coronary artery from the pulmonary artery in 23 patients (37%). A
total of 65 conduits were used in 61 patients, and 1 case report did not
report conduit type. Reported grafts included saphenous vein (23 of 65
[35.4%]), left internal thoracic artery (15 of 65 [23.1%]), right internal
thoracic artery (23 of 65 [35.4%]), and radial artery (2 of 65 [3.1%]);
right gastroepiploic artery and basilic vein were used once (1.5%) each.
Ligation of the native coronary artery was performed in 42 (67.7%)
patients. Patient follow-up was available in 19 studies with a mean of
31.2 months. Only 1 operative mortality was reported. Conclusion(s):
Based on the limited available data, CABG can be performed with good early
results. Use of arterial conduits and ligation of the native coronary
artery may improve long-term graft patency. Copyright © 2023
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<95>
Accession Number
2027173493
Title
Risk factors associated with surgical site infections in patients
undergoing cardiothoracic surgery: A systematic review and meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Zhang Y.; Tan S.; Chen S.; Fan X.
Institution
(Zhang, Tan, Fan) Department of Cardiovascular Surgery, Guangdong
Provincial Hospital of Chinese Medicine, Guangdong Province, Guangzhou,
China
(Chen) Department of Cardiology, Shengjing Hospital of China Medical
University, Liaoning Province, Shenyang, China
Publisher
John Wiley and Sons Inc
Abstract
Surgical site infections (SSIs) following cardiothoracic surgery can pose
significant challenges to patient recovery and outcome. This systematic
review and meta-analysis aim to identify and quantify the risk factors
associated with SSIs in patients undergoing cardiothoracic surgery. A
comprehensive literature search adhering to Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) guidelines and based on the
PICO paradigm was conducted across four databases: PubMed, Embase, Web of
Science and the Cochrane Library, without any temporal restrictions. The
meta-analysis incorporated studies detailing the risk factors for
post-operative sternal infections, especially those reporting odds ratios
(OR) or relative risks with 95% confidence intervals (CI). Quality
assessment of the studies was done using the Newcastle-Ottawa Scale.
Statistical analysis was executed using the chi-square tests for
inter-study heterogeneity, with further analyses depending on
I2 values. Sensitivity analyses were performed, and potential
publication bias was also assessed. An initial dataset of 2442 articles
was refined to 21 articles after thorough evaluations based on inclusion
and exclusion criteria. Patients with diabetes mellitus have an OR of 1.80
(95% CI: 1.40-2.20) for the incidence of SSIs, while obese patients
demonstrate an OR of 1.63 (95% CI: 1.40-1.87). Individuals who undergo
intraoperative blood transfusion present an OR of 1.13 (95% CI:
1.07-1.18), and smokers manifest an OR of 1.32 (95% CI: 1.03-1.60). These
findings unequivocally indicate a pronounced association between these
factors and an elevated risk of SSIs post-operatively. This meta-analysis
confirms that diabetes, obesity, intraoperative transfusion and smoking
heighten the risk of SSIs post-cardiac surgery. Clinicians should be alert
to these factors to optimise patient outcomes. Copyright © 2023
The Authors. International Wound Journal published by Medicalhelplines.com
Inc and John Wiley & Sons Ltd.

<96>
[Use Link to view the full text]
Accession Number
2029139685
Title
Outcomes Following Transcatheter Aortic Valve Replacement for Aortic
Stenosis in Patients with Type 0 Bicuspid, Type 1 Bicuspid, and Tricuspid
Aortic Valves.
Source
Circulation: Cardiovascular Interventions. 16(12) (pp E013083), 2023. Date
of Publication: 01 Dec 2023.
Author
He J.; Xiong T.-Y.; Yao Y.-J.; Peng Y.; Wei J.-F.; Zhao Z.-G.; Chen G.; Ou
Y.-W.; Liu Q.; Wang X.; Zhu Z.; Yang H.-R.; Jia K.; Mylotte D.; Piazza N.;
Prendergast B.; Feng Y.; Chen M.
Institution
(He, Xiong, Yao, Peng, Wei, Zhao, Ou, Liu, Wang, Zhu, Yang, Jia, Feng,
Chen) Department of Cardiology, West China Hospital, Sichuan University,
China
(Xiong, Zhao, Yang, Chen) Laboratory of Heart Valve Disease, West China
Hospital, Sichuan Univ., China
(Chen) Department of Anesthesiology, West China Hospital, Sichuan
University, China
(He) Cardiology Department, Hospital of Sun Yat-sen University, Guangzhou,
China
(Mylotte) Department of Cardiology, University Hospital Galway, Natl.
Univ. of Ireland, Ireland
(Piazza) Division of Cardiology, Department of Medicine, McGill University
Health Center, Montreal, QC, Canada
(Prendergast) Department of Cardiology, St. Thomas' Hospital, London,
United Kingdom
(Prendergast) Cleveland Clinic London, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Data concerning the outcomes of transcatheter aortic valve
replacement in type 0 bicuspid aortic stenosis (AS) are scarce. The study
aims to compare the outcomes of transcatheter aortic valve replacement for
AS in patients with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic
valve anatomy. METHOD(S): We enrolled consecutive patients undergoing
transcatheter aortic valve replacement for severe AS between 2012 and 2022
in this single-center retrospective cohort study. The primary outcome was
mortality, while secondary outcomes included in-hospital complications
such as stroke and pacemaker implantation and transcatheter heart valve
hemodynamic performance. RESULT(S): The number of patients with AS
with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic valve anatomy
was 328, 302, and 642, respectively. Self-expanding transcatheter heart
valves were used in the majority of patients (n=1160; 91.4%). In the
matched population, differences in mortality (30 days: 4.2% versus 1.7%
versus 1.7%, P<inf>overall</inf>=0.522; 1 year: 10% versus 2.3% versus
6.2%, P<inf>overall</inf>=0.099) and all stroke (30 days: 1.0% versus 0.9%
versus 0.0%, P<inf>overall</inf>=0.765; 1 year: 1.4% versus 1.6% versus
1.3%, P<inf>overall</inf>=NS) were nonsignificant, and the incidence of
overall in-hospital complications was comparable among groups. Ascending
aortic diameter was the single predictor of 1-year mortality in type 0
bicuspid patients (hazard ratio, 1.59 [95% CI, 1.03-2.44]; P=0.035). The
proportion of patients with a mean residual gradient >=20 mm Hg was the
highest in those with type 0 bicuspid anatomy, although the need for
permanent pacemaker implantation was the lowest in this group.
 CONCLUSION(S): Major clinical outcomes of transcatheter aortic valve
replacement for AS in patients with type 0 bicuspid, type 1 bicuspid, and
tricuspid aortic valve anatomy are equivalent at short-and mid-term
follow-up. These observations merit further exploration in prospective
international registries and randomized controlled trials. Copyright
© 2023 Lippincott Williams and Wilkins. All rights reserved.

<97>
Accession Number
2027192664
Title
Intraoperative circulatory arrest secondary to high-risk pulmonary
embolism. Case series and updated literature review.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 415. Date
of Publication: December 2023.
Author
Cruz G.; Pedroza S.; Giraldo M.; Pena A.D.; Calderon C.A.; Quintero I.F.
Institution
(Cruz, Quintero) Departamento de anestesiologia, Fundacion Valle del Lili,
Cra 98 No. 18-49, Cali 760032, Colombia
(Pedroza) Centro de investigaciones clinicas, Fundacion Valle del Lili,
Cra 98 No. 18-49, Cali 760032, Colombia
(Giraldo) Departamento de cardiologia y hemodinamia, Fundacion Valle del
Lili, Cra 98 No. 18-49, Cali 760032, Colombia
(Pena) Departamento de cirugia cardiovascular, Fundacion Valle del Lili,
Cra 98 No. 18-49, Cali 760032, Colombia
(Calderon) Departamento de cardiologia, Fundacion Valle del Lili, Cra 98
No. 18-49, Cali 760032, Colombia
Publisher
BioMed Central Ltd
Abstract
Background: Intraoperative pulmonary embolism (PE) with cardiac arrest
(CA) represents a critical and potentially fatal condition. Available
treatments include systemic thrombolysis, catheter-based thrombus
fragmentation or aspiration, and surgical embolectomy. However, limited
studies are focused on the optimal treatment choice for this critical
condition. We present a case series and an updated review of the
management of intraoperative CA secondary to PE. Method(s): A
retrospective review of patients who developed high-risk intraoperative PE
was performed between June 2012 and June 2022. For the updated review, a
literature search on PubMed and Scopus was conducted which resulted in the
inclusion of a total of 46 articles. Result(s): A total of 196 174
major non-cardiac surgeries were performed between 2012 and 2022. Eight
cases of intraoperative CA secondary to high-risk PE were identified. We
found a mortality rate of 75%. Anticoagulation therapy was administered to
one patient (12.5%), while two patients (25%) underwent thrombolysis, and
one case (12.5%) underwent mechanical thrombectomy combined with thrombus
aspiration. Based on the literature review and our 10-year experience, we
propose an algorithm for the management of intraoperative CA caused by PE.
 Conclusion(s): The essential components for adequate management of
intraoperative PE with CA include hemodynamic support, cardiopulmonary
resuscitation, and the implementation of a primary perfusion intervention.
The prompt identification of the criteria for each specific treatment
modality, guided by the individual patient's characteristics, is necessary
for an optimal approach. Copyright © 2023, The Author(s).

<98>
Accession Number
2029002446
Title
A COMPARATIVE STUDY OF HAEMODYNAMIC EFFECTS OF PROPOFOL AND ETOMIDATE AS
INDUCTION AGENTS IN CARDIAC PATIENTS FOR NON CARDIAC SURGERIES. A
PROSPECTIVE RANDOMIZED CONTROLLED STUDY.
Source
International Journal of Academic Medicine and Pharmacy. 5(5) (pp
1248-1252), 2023. Date of Publication: 2023.
Author
Vasanthi B.; Periyasamy T.; Kumar D.S.
Institution
(Vasanthi, Kumar) Department of Anaesthesiology, Government Medical
College and ESI Hospital, Tamil Nadu, Coimbatore, India
(Periyasamy) Department of Anaesthesiology, Government Theni Medical
College, Tamil Nadu, Theni, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: The aim of the study was to compare the safety of propofol and
etomidate as induction agents of anaesthesia in cardiac patients for
non-cardiac surgeries in terms of haemodynamic parameters and side
effects. Material(s) and Method(s): The study was conducted in 40
adult Cardiac patients between 20 - 60 years of age group for elective
surgeries under general anaesthesia ASA III/IV by prospective randomized
study. We compared the outcome of the two groups in terms of haemodynamic
parameters and side effects. Result(s): There was no statistical
significance between the two groups in terms of age, sex, body weight,
oxygen saturation and heart rate changes post intubation. The systolic,
diastolic and mean arterial blood pressure were comparable between the two
groups. The decrease in systolic, diastolic and mean arterial pressure at
1,3,5.10 minutes was higher in propofol group I when compared to the
etomidate group II where the reduction was lower or almost nil and was
statistically significant with p<0.05 for decrease in systolic BP, p <
0.001 for decrease in diastolic BP for 1 min and 10 minutes and p<0.016,
p<0.004 for 3min and 5 minutes respectively. The p value was p< 0.001 for
decrease in MAP at 1,3,5. The incidence of pain on injection was higher
with propofol when compared to etomidate (p<0.05). Conclusion(s):
Etomidate was found to be an ideal induction agent for cardiac patients
undergoing non cardiac elective surgeries under general anaesthesia when
compared to protocol in terms of maintaining good haemodynamic stability
with lesser side effects. Copyright © 2023 Society for Healthcare
and Research Development.

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