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<1>
Accession Number
2020808294
Title
Long-Term Consequences of Acute Kidney Injury After Pediatric Cardiac
Surgery: A Systematic Review.
Source
Journal of Pediatrics. 252 (pp 83-92.e5), 2023. Date of Publication:
January 2023.
Author
Van den Eynde J.; Rotbi H.; Schuermans A.; Hassanabad A.F.; Gewillig M.;
Budts W.; Kutty S.; Mekahli D.
Institution
(Van den Eynde, Kutty) Helen B. Taussig Heart Center, The Johns Hopkins
Hospital and School of Medicine, Baltimore, MA, United States
(Van den Eynde, Schuermans, Gewillig, Budts) Department of Cardiovascular
Sciences, KU Leuven, Leuven, Belgium
(Rotbi) Faculty of Medicine, Radboud University, Nijmegen, Netherlands
(Rotbi) Radboud Institute for Health Sciences, Department of Physiology,
Radboud University Medical Center, Nijmegen, Netherlands
(Hassanabad) Section of Cardiac Surgery, Department of Cardiac Sciences,
Libin Cardiovascular Institute, Cumming School of Medicine, Calgary, AB,
Canada
(Gewillig) Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Budts) Congenital and Structural Cardiology, UZ Leuven, Leuven, Belgium
(Mekahli) Department of Pediatric Nephrology, University Hospitals of
Leuven, Leuven, Belgium
(Mekahli) PKD Research Group, GPURE, Department of Development and
Regeneration, KU Leuven, Leuven, Belgium
Publisher
Elsevier Inc.
Abstract
Objective: The objective of this study was to evaluate the available data
on long-term kidney dysfunction, hypertension, and mortality after cardiac
surgery-associated acute kidney injury (AKI) in the pediatric population.
Study design: PubMed/MEDLINE, Embase, Scopus, and reference lists of
relevant articles were searched for eligible studies published from
inception through March 2022. Long-term outcomes after pediatric cardiac
surgery complicated by AKI and those without were investigated.
 Result(s): We identified 14 studies published between 2013 and 2022
that included a total of 6701 patients (AKI: 1376 patients; no AKI: 5325
patients). These studies used different well-established classifications
to define AKI. All the studies suggested that AKI after heart surgery is
common in the pediatric patient population and reported a potential link
between cardiac surgery-associated AKI and important clinical outcomes.
However, only 4 out of 11 studies found a strong association between
(absence of recovery from) cardiac surgery-associated AKI and risk of
developing chronic kidney disease, and 3 out of 5 studies found a
significant increase in mortality rates for pediatric patients who
developed AKI after cardiac surgery. Only 1 out of 4 studies found an
association between AKI and hypertension at 12 months postoperatively, but
found no association at later follow-up times. Conclusion(s):
Although there is a trend, evidence on the long-term consequences of
cardiac surgery-associated AKI in the pediatric population is mixed.
Genetic syndromes, preexisting kidney disease, univentricular or cyanotic
heart conditions, and/or high-complexity surgery may be more important for
the development of kidney dysfunction by adolescence and early adulthood.
Regardless, these children may benefit from a long-term kidney
follow-up. Copyright © 2022 Elsevier Inc.

<2>
Accession Number
2021659887
Title
Rationale and design of the TUXEDO-2 India study: Ultra-Thin strUt
Supraflex Cruz versus XiencE in a Diabetic pOpulation with multi-vessel
disease-2.
Source
American Heart Journal. 256 (pp 128-138), 2023. Date of Publication:
February 2023.
Author
Kaul U.; Arambam P.; Sinha S.K.; Abhaichand R.; Parida A.K.; Banker D.;
Mody R.; Khan A.; Sharma R.; Moorthy N.; Chandra S.; Koduganti S.C.; Garg
R.; Sarma P.R.; Agrawal D.K.; Reddy K.M.K.; Bangalore S.
Institution
(Kaul, Arambam) Batra Hospital & Medical Research Centre, New Delhi,
Delhi, India
(Sinha) LPS Institute of cardiology and Cardiac surgery, Uttar Pradesh,
Kanpur, India
(Abhaichand) G.Kuppuswamy Naidu Memorial Hospital, Tamil Nadu, Coimbatore,
India
(Parida) Health World Hospitals, West Bengal, Durgapur, India
(Banker) Bankers Heart Institute, Gujarat, Vadodara, India
(Mody) Max Super Specialty Hospital, Punjab, Bhatinda, India
(Khan) Crescent Hospital and Heart Centre, Maharashtra, Nagpur, India
(Sharma) Indira Gandhi Medical College & Hospital, Himachal Pradesh,
Shimla, India
(Moorthy) Sri Jayadeva Institute of Cardiovascular Sciences and Research,
Karnataka, Bengaluru, India
(Chandra) King George's Medical University, Uttar Pradesh, Lucknow, India
(Koduganti) Virinchi Hospitals, Telangana, Hyderabad, India
(Garg) Aware Gleneagles Global Hospital, Telangana, Hyderabad, India
(Sarma) Lalitha Super Speciality Hospitals, Andhra Pradesh, Guntur, India
(Agrawal) Mahatma Gandhi University of Medical Sciences & Technology,
Rajasthan, Jaipur, India
(Reddy) Osmania General Hospital, Telangana, Hyderabad, India
(Bangalore) NYU School of Medicine, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The role of percutaneous coronary interventions (PCI) in
patients with diabetes mellitus and multi-vessel disease has been
questioned by the results of the FREEDOM trial, which showed superiority
of coronary artery bypass graft(CABG) over first generation drug-eluting
stents (DES) including a reduction in mortality. In the light of safer and
more efficacious stents and significantly better medical management, those
results that date back to 2012 need to be revisited. TUXEDO-2 is a study
designed to compare two contemporary stents in Indian diabetic patients
with multi-vessel disease. Aim(s): The primary objective of the
TUXEDO-2 study is to compare the clinical outcomes of PCI with ultra-thin
Supraflex Cruz vs Xience when combined with contemporary optimal medical
therapy (OMT) in diabetic patients with multi-vessel disease. The
secondary objective is to compare clinical outcomes between a pooled
cohort from both arms of the study (Supraflex Cruz + Xience; PCI arm) vs
CABG based on a performance goal derived from the CABG arm of the FREEDOM
trial (historical cohort). The tertiary objective is a randomized
comparison of ticagrelor vs prasugrel in addition to aspirin for the
composite of ischemic and bleeding events. Method(s): In this
prospective, open-label, multi-centre, 2 x 2 factorial, randomized,
controlled study, 1,800 patients with diabetes mellitus and multi-vessel
disease (inclusion criteria similar to FREEDOM trial) with indication for
coronary revascularization will be randomly assigned to Supraflex Cruz or
Xience stents and also to ticagrelor- or prasugrel- based antiplatelet
strategies. All patients will receive guideline directed OMT and optimal
PCI including image- and physiology-guided complete revascularization
where feasible. The patients will be followed through five years to assess
their clinical status and major clinical events. The primary endpoint is a
non-inferiority comparison of target lesion failure at one-year for
Supraflex Cruz vs Xience (primary objective) with an expected event rate
of 11% and a non-inferiority margin of 4.5%. For PCI vs CABG (secondary
objective), the primary endpoint is major adverse cardiac events (MACE),
defined as a composite of all cause death, nonfatal myocardial infarction,
or stroke at one-year and yearly up to five years, with a performance goal
of 21.6%. For ticagrelor vs prasugrel (tertiary objective), the primary
endpoint is composite of death, myocardial infarction, stroke, and major
bleeding as per the Bleeding Academic Research Consortium (BARC) at
one-year with expected event rate of 15% and a non-inferiority margin of
5%. Conclusion(s): The TUXEDO-2 study is a contemporary study
involving state-of-the-art PCI combined with guideline directed OMT in a
complex subset of patients with diabetes mellitus and multi-vessel
disease. The trial will answer the question as to whether a biodegradable
polymer coated ultra-thin Supraflex Cruz stent is an attractive option for
PCI in diabetic patients with multi-vessel disease. It will also help
address the question whether the results of FREEDOM trial would have been
different in the current era of safer and more efficacious stents and
modern medical therapy. In addition, the comparative efficacy and safety
of ticagrelor vs prasugrel in addition to aspirin will be evaluated.
(CTRI/2019/11/022088) Copyright © 2022

<3>
Accession Number
2019842369
Title
Target phosphate and calcium levels in patients undergoing hemodialysis: a
post-hoc analysis of the LANDMARK study.
Source
Clinical and Experimental Nephrology. 27(2) (pp 179-187), 2023. Date of
Publication: February 2023.
Author
Yoshida K.; Mizukami T.; Fukagawa M.; Akizawa T.; Morohoshi H.; Sambe T.;
Ito H.; Ogata H.; Uchida N.
Institution
(Yoshida, Mizukami, Sambe, Uchida) Division of Clinical Pharmacology,
Department of Pharmacology, Showa University School of Medicine, Tokyo,
Japan
(Yoshida, Ito, Ogata) Division of Nephrology, Department of Internal
Medicine, Showa University Northern Yokohama Hospital, Chigasaki-Chuo
35-1, Tsuzuki, Kanagawa, Yokohama 224-8503, Japan
(Fukagawa) Division of Nephrology, Endocrinology and Metabolism,
Department of Internal Medicine, Tokai University School of Medicine,
Kanagawa, Japan
(Akizawa) Division of Nephrology, Department of Medicine, Showa University
School of Medicine, Tokyo, Japan
(Morohoshi) Department of Hygiene, Public Health and Preventive Medicine,
Showa University School of Medicine, Tokyo, Japan
Publisher
Springer
Abstract
Background: It is necessary to re-examine the optimal phosphate (P) and
calcium (Ca) target values in the contemporary management of chronic
kidney disease-mineral and bone disorder to reduce the risks of
cardiovascular events in patients receiving hemodialysis. Method(s):
We performed a post-hoc analysis of the LANDMARK study. The outcomes were
defined as cardiovascular events and all-cause death. Data from 2135
patients receiving hemodialysis at risk of vascular calcification were
analyzed using a time-dependent Cox proportional hazard model adjusted for
background factors. Result(s): On the hazard ratio (HR) curve, the
ranges where the lower 95% confidence interval (CI) were below the minimum
of HR (= 1.00) were as follows: P = 3.5-5.5 mg/dL; albumin-adjusted Ca <
9.1 mg/dL for cardiovascular events; and P = 3.6-5.3 mg/dL;
albumin-adjusted Ca < 9.1 mg/dL for all-cause mortality. In stratified
analysis, the HRs for cardiovascular events in P < 3.5 mg/dL and P >= 5.5
mg/dL were similar to that of P = 3.5-5.5 mg/dL (P >= 0.05), and
albumin-adjusted Ca >= 9.1 mg/dL had higher HR than values < 9.1 mg/dL
[1.30 (95% CI 1.00-1.68; P = 0.046)]. For all-cause mortality, the HR in P
< 3.6 mg/dL was higher than that in P = 3.6-5.3 mg/dL [1.76 (95% CI
1.25-2.48; P = 0.001)], while the HRs between P >= 5.3 mg/dL and P =
3.6-5.3 mg/dL as well as those between albumin-adjusted Ca >= 9.1 and <
9.1 mg/dL were not significantly different (P >= 0.05).
 Conclusion(s): Managing albumin-adjusted Ca < 9.1 mg/dL may reduce
the cardiovascular risk among patients undergoing hemodialysis.
Hypophosphatemia < 3.6 mg/dL may be associated with
mortality. Copyright © 2022, The Author(s), under exclusive
licence to The Japanese Society of Nephrology.

<4>
Accession Number
2020108086
Title
Sex differences in saphenous vein graft patency: A systematic review and
meta-analysis.
Source
Journal of Cardiac Surgery. 37(12) (pp 4573-4578), 2022. Date of
Publication: December 2022.
Author
Lehtinen M.L.; Harik L.; Soletti G.; Rahouma M.; Dimagli A.;
Perezgrovas-Olaria R.; Audisio K.; Demetres M.; Gaudino M.
Institution
(Lehtinen) Department of Cardiac Surgery, Heart and Lung Center, Helsinki
University Hospital and University of Helsinki, Helsinki, Finland
(Harik, Soletti, Rahouma, Dimagli, Perezgrovas-Olaria, Audisio, Gaudino)
Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York,
NY, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell, Medicine, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Saphenous vein grafts (SVG) are the most commonly used
conduits in coronary artery bypass grafting (CABG). Graft failure is
observed in up to 50% of SVG at 10 years after surgery. Whether a
difference in SVG patency rates exists between men and women remains
unclear. Method(s): We performed a study-level meta-analysis to
evaluate sex-related differences in follow-up patency rates of SVG after
CABG. A systematic literature search was conducted to identify studies on
CABG that reported follow-up SVG patency rates in men and women. The
primary outcome was SVG patency rates by sex at follow-up. Result(s):
Seventeen studies totaling 8235 patients and 14,781 SVG grafts were
included. There was no significant difference in follow-up SVG patency
rates between men and women (incidence rate ratio 0.96, 95% confidence
interval 0.90-1.03, p =.24), with mean angiographic follow-up of 33.5
months (standard deviation 29.2). Leave-one-out and cumulative analysis
were consistent with the main analysis. We concluded that follow-up SVG
patency rate is similar between men and women undergoing
CABG. Copyright © 2022 Wiley Periodicals LLC.

<5>
Accession Number
2019627586
Title
Should nasogastric tube be used routinely in patients undergoing cardiac
surgery? A narrative review.
Source
Journal of Cardiac Surgery. 37(12) (pp 5300-5306), 2022. Date of
Publication: December 2022.
Author
Paleczny S.; Fatima R.; Amador Y.; El Diasty M.
Institution
(Paleczny, Fatima, El Diasty) Department of Surgery, Division of Cardiac
Surgery, Kingston General Hospital, Queen's University, Kingston, ON,
Canada
(Amador) Department of Anesthesiology and Perioperative Medicine, Kingston
General Hospital, Queen's University, Kingston, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim: Nasogastric tube (NGT) use has been common in the
immediate postoperative period in surgical patients for decades. Potential
advantages include the decompression of gastric contents and the early
administration of time-sensitive medications. However, its routine use
after cardiac surgery has not been established as a gold standard yet. The
NGT use for prevention of postoperative nausea and vomiting has been a
matter of debate in literature. Also, NGT use has also been associated
with the incidence of some respiratory and gastrointestinal complications
and it may be a source of significant pain and discomfort to patients. In
this article, we review the current available literature regarding the use
of NGT during and immediately after cardiac surgery, with particular
emphasis on its potential role in enhanced postoperative recovery.
 Method(s): We performed a database search in October 2021 using
Embase, Cochrane Library, and Medline to identify studies that examined
the use of NGT in patients that underwent cardiac surgery. Data and
literature about NGT's impact on post-operative nausea and vomiting, early
administration of medications, interference with imaging, post-operative
complications, respiratory complications, gastrointestinal complications,
pain and discomfort, and enhanced recovery after surgery were examined.
 Result(s): Three reports investigating the use of NGT to reduce
post-operative nausea and vomiting were examined with sample sizes of 114,
104, and 202. The use of NGT did not significantly reduce the incidence of
post-operative nausea and vomiting in 2/3 of the studies: a 2% nausea
reduction with NGT (p < 0.05), a 7.7% nausea reduction with NGT (p = 0.6),
and a 14% vomiting reduction with NGT (p = 0.007). The prevalence of
pneumonia following NGT use has been shown to vary ranging from 4 to 95%
with associated mortality rates of 17 to 62%. Conclusion(s): Based on
our findings, there is currently not sufficient evidence to support the
routine use of NGT during cardiac surgery. Further research is needed to
establish the role of NGT in this patient population. Copyright ©
2022 Wiley Periodicals LLC.

<6>
Accession Number
2022205466
Title
The role of temporal changes of pro-inflammatory cytokines in the
development of adverse cardiac remodeling after ST-elevation myocardial
infarction.
Source
Postepy w Kardiologii Interwencyjnej. 18(3) (pp 217-227), 2022. Date of
Publication: 2022.
Author
Altintas M.S.; Eyerci N.; Sivri S.; Felekoglu M.A.; Karayigit O.; Demirtas
B.; Gok M.; Ates O.F.
Institution
(Altintas) Department of Cardiology, Istanbul Training and Research
Hospital, Istanbul, Turkey
(Eyerci) Department of Medical Biology, Kafkas University Faculty of
Medicine, Kars, Turkey
(Sivri) Department of Cardiology, Kirsehir State Hospital, Kirsehir,
Turkey
(Felekoglu) Department of Cardiology, Atakent Hospital, Yalova, Turkey
(Karayigit) Department of Cardiology, Yozgat City Hospital, Yozgat, Turkey
(Demirtas) Department of Cardiology, Cankiri State Hospital, Cankiri,
Turkey
(Gok) Department of Cardiology, Edirne Sultan Murat I State Hospital,
Edirne, Turkey
(Ates) Department of Radiology, Sakarya University Faculty of Medicine,
Sakarya, Turkey
Publisher
Termedia Publishing House Ltd.
Abstract
Introduction: Increasing evidence supports the view that pro-inflammatory
cytokines play a role in fibrosis after myocardial infarction (MI). It has
been suggested that interleukin (IL)-12p40, a pro-inflammatory cytokine,
can induce interferon g (IFN-g) and matrix metalloproteinase (MMP).
However, the role of IL-12p40 in adverse cardiac remodeling (AR) after
ST-elevation MI (STEMI) is unclear. Aim(s): To examine the role of
temporal changes of pro-inflammatory cytokines in the development of
post-STEMI AR. Material(s) and Method(s): A total of 43 patients with
STEMI for the first time ever were prospectively analyzed. In cardiac
magnetic resonance imaging at 6 months after STEMI, a decrease of left
ventricular end-diastolic volume by >= 12% was defined as reverse cardiac
remodeling (RR), and a 12% increase was defined as AR. Cytokine
concentrations were measured on the first day (baseline) and 2 weeks after
STEMI. Result(s): Mean IL-12p40 (59.1 +/-14.5 vs. 46.7 +/-9.1 pq/ml,
p = 0.001), median IFN-g (20.4 vs. 16.2 pq/ml, p = 0.048) and median MMP-2
(33866 vs. 20691 pq/ml, p = 0.011) baseline concentrations were higher in
AR than RR. In patients with AR, IL-12p40 level was lower at 2 weeks than
baseline (p < 0.001). There was a positive correlation between the
baseline concentrations of IL-12p40, IFN-g, MMP-2, C-reactive protein and
infarct size (p < 0.05). Increased IL-12p40 and MMP-2 baseline levels were
independently associated with AR (OR = 1.14, p = 0.010; OR = 1.08, p =
0.035). Conclusion(s): In the initial phase of MI, greater release of
pro-inflammatory cytokines was associated with increased MMP-2 levels.
Elevated expression of IL-12 and MMP-2 had an independent association with
AR. This may be related to the excessive inflammatory response in the
initial phase of MI. Copyright © 2022 Termedia Publishing House
Ltd.. All rights reserved.

<7>
Accession Number
2022280416
Title
Effects of Nalbuphine with Morphine on Mean Systolic and Mean Diastolic
Blood Pressures after Laryngoscopic Tracheal Intubation in Elective
Coronary Artery Bypass Grafting.
Source
Pakistan Journal of Medical and Health Sciences. 16(12) (pp 209-212),
2022. Date of Publication: December 2022.
Author
Khan M.; Kumar R.; Kumar U.; Kumar V.; Shujaat H.; Hiranand
Institution
(Khan) Memon Medical Institute Hospital, Karachi, Pakistan
(Kumar, Kumar, Kumar) Department of Anaesthesia, Sindh Institute of
Urology & Transplantation, Karachi, Pakistan
(Shujaat) OMI Hospital, Karachi, Pakistan
(Hiranand) Department of Anaesthesia, Shaheed Mohtarma Benizar Bhutto
Institute of Trauma, Karachi, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Background: The raise in mean blood pressure and heart rate associated
with intubation and laryngoscopy is harmful for patients of ischemic heart
disease, hypertension, raised intracranial and intraocular pressure. To
counter this problem nalbuphine began to be used. Nalbuphine is an
opioidagonist antagonist which acts on e receptor as agonist and on mu
receptors as antagonist. We chose to study its haemodynamic response to
orotracheal intubation. Aim(s): To compare the mean systolic and
diastolic blood pressure with nalbuphine with morphine after laryngoscopic
tracheal intubation in elective coronary artery bypass grafting.
 Method(s): The study was a randomized controlled trial. 100 patients
fulfilling selection criteria were included in the study from Operation
theatre of Department of Cardiac Surgery, National Institute of
Cardiovascular Diseases, Karachi. Patients were randomly divided in two
equal groups by using lottery method. In group A, morphine was
administered and in group B, Nalbuphine were administered during induction
of general anaesthesia. History was taken from patients. Demographic
information like age, gender and co-morbid. Patients were followed for
results of the study. All information of was noted and entered in the
Proforma. Result(s): One hundred patients fulfilling selection
criteria were included in the study. In group A, morphine was administered
and in group B, Nalbuphine were administered during induction of general
anaesthesia. Comparison of SBP and DBP has been done between both of the
study groups mean and SD of SBP in morphine group was 113.16 and
9.15(p-value=0.007), in nalbuphine group 120.90 and 11.46(p-value=0.03),
respectively. Conclusion(s): It had been considered that morphine
offers better analgesic conditions, but it also cause hemodynamic
instability. nalbuphine can help in preventing anaesthesia complications,
and cause less hemodynamic instability which results in less requirement
of maintenance drugs for attenuation. This study to confirmed that
nalbuphine can help in less fluctuation in hemodynamic conditions of the
patients as compared to morphine. Copyright © 2022 Authors. All
rights reserved.

<8>
Accession Number
2018448285
Title
Pharmacokinetic principles of dose adjustment of mTOR inhibitors in solid
organ transplanted patients.
Source
Journal of Clinical Pharmacy and Therapeutics. 47(9) (pp 1362-1367), 2022.
Date of Publication: September 2022.
Author
Hartinger J.M.; Rysanek P.; Slanar O.; Sima M.
Institution
(Hartinger, Rysanek, Slanar, Sima) Department of Pharmacology, First
Faculty of Medicine, Charles University and General University Hospital,
Prague 2, Czechia
Publisher
John Wiley and Sons Inc
Abstract
What Is Known and Objectives: mTOR inhibitors possess narrow therapeutic
range and substantial pharmacokinetic variability and the consequences
from suboptimal dosing are serious. The aim of this review is to summarize
the current knowledge about the factors influencing mTOR inhibitors
pharmacokinetics and the possibility of using these relationships in order
to improve its therapy individualization in solid organ transplanted
patients. Method(s): Literature search from Pubmed and Web of Science
databases were performed using Boolean search operators in order to
identify relevant studies. Results and Discussion: A total of 701 reports
were identified from the initial literature search. Out of which 40
studies dealt with relationships between various factors and
pharmacokinetics of mTOR inhibitors and with relevance of these
associations for dosage optimization. What Is New and Conclusion(s):
The overview of the current covariates for pharmacokinetic variability of
mTOR inhibitors has been provided on the level of absorption, distribution
and elimination, and consequences of these relationships for dosing
optimization has been summarized. Copyright © 2022 John Wiley &
Sons Ltd.

<9>
Accession Number
2018177077
Title
Titrated versus conventional anticoagulation management for thrombin
generation in cardiac surgery: a randomized controlled trial.
Source
Canadian Journal of Anesthesia. 69(9) (pp 1117-1128), 2022. Date of
Publication: September 2022.
Author
Li H.; Bartoszko J.; Serrick C.; Rao V.; Karkouti K.
Institution
(Li, Serrick) Perfusion Services, University Health Network, Toronto, ON,
Canada
(Bartoszko, Karkouti) Department of Anesthesia and Pain Management, Sinai
Health System, Women's College Hospital, University Health Network,
Toronto, ON, Canada
(Bartoszko, Karkouti) Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Rao) Cardiovascular Surgery, University Health Network and University of
Toronto, Toronto, ON, Canada
(Bartoszko, Rao, Karkouti) Peter Munk Cardiac Centre, University Health
Network, Toronto, ON, Canada
(Karkouti) Interdepartmental Division of Critical Care, Department of
Medicine, University of Toronto, Toronto, ON, Canada
(Karkouti) Institute for Health Policy, Management, and Evaluation,
University of Toronto, Toronto, ON, Canada
Publisher
Springer
Abstract
Purpose: Optimal heparin titration during cardiopulmonary bypass (CPB) may
reduce coagulation system activation and preserve hemostatic function
post-CPB. Our objective was to assess if the Heparin Management System
(HMS) Plus improves heparin titration, thereby leading to higher thrombin
generation post-CPB compared with activated clotting time (ACT)-guided
management. Method(s): We conducted a randomized controlled trial of
100 patients undergoing cardiac surgery with CPB at a single center. A
total of 50 patients were randomized to conventional ACT-guided
management, and 50 to the HMS Plus system. The primary outcome was change
in thrombin generation post-CPB compared with baseline, as assessed by
calibrated automated thrombography. Secondary outcomes included
intraoperative blood loss, chest drain output up to 72 hr, and
transfusions. In an exploratory analysis, we compared the quintile of
patients with the highest average heparin concentration on CPB (>= 4.0
mgkg-1) with the rest of the cohort. Result(s): A total of
100 patients were included in an intent-to-treat analysis. We observed no
difference in post-CPB thrombin generation or secondary outcomes. However,
patients in the HMS Plus group had higher average heparin concentrations
while on CPB than patients in the conventional management group did (mean
difference, -0.21; 95% confidence interval, -0.42 to -0.01). The quintile
of patients with the highest average heparin concentration (4.0
mgkg-1) had higher thrombin generation post-CPB than the rest
of the cohort did. Conclusion(s): The HMS Plus system did not show
significant benefits in thrombin generation, bleeding outcomes, or
transfusion in patients undergoing cardiac surgery with CPB. Higher
average heparin concentrations on CPB were associated with higher post-CPB
thrombin generation. Study registration: www.ClinicalTrials.gov
(NCT03347201); first submitted 12 October 2017. Copyright © 2022,
Canadian Anesthesiologists' Society.

<10>
Accession Number
2022325747
Title
Coaptation Length as Predictor of Recurrent Mitral Regurgitation After
Surgical Repair for Degenerative Mitral Valve Disease: Meta-Analysis of
Reconstructed Time-to-Event Data.
Source
Structural Heart. (no pagination), 2023. Article Number: 100152. Date of
Publication: 2023.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Erten O.; Caldonazo T.; Doenst
T.; Marin-Cuartas M.; Borger M.A.; Clavel M.-A.; Pibarot P.; Rodriguez R.;
Ramlawi B.; Goldman S.
Institution
(Sa, Rodriguez, Ramlawi, Goldman) Department of Cardiothoracic Surgery,
Lankenau Heart Institute, Lankenau Medical Center, Main Line Health,
Wynnewood, PA, United States
(Sa, Erten, Rodriguez, Ramlawi, Goldman) Department of Cardiothoracic
Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA,
United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Caldonazo, Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Jena, Germany
(Marin-Cuartas, Borger) University Department of Cardiac Surgery, Leipzig
Heart Center, Leipzig, Germany
(Clavel, Pibarot) University Institute of Cardiology and Pulmonology of
Quebec - Laval University, Quebec City, Quebec, Canada
Publisher
Cardiovascular Research Foundation

<11>
Accession Number
2022325539
Title
Clinical outcomes of MANTA vs suture-based vascular closure devices after
transcatheter aortic valve replacement: An updated meta-analysis.
Source
Indian Heart Journal. (no pagination), 2023. Date of Publication: 2023.
Author
Doshi R.; Vasudev R.; Guragai N.; Patel K.N.; Kumar A.; Majmundar M.;
Doshi P.; Patel P.; Shah K.; Santana M.; Roman S.; Vallabhajosyula S.;
Virk H.; Bikkina M.; Shamoon F.
Institution
(Doshi, Vasudev, Guragai, Patel, Shah, Santana, Roman, Virk, Bikkina,
Shamoon) Department of Cardiology, St Joseph University Medical Center,
Paterson, NJ, United States
(Patel) Department of Internal Medicine, Saint Peter's University
Hospital, New Brunswick, NJ, United States
(Kumar) Department of Internal Medicine Cleveland Clinic Akron General,
Akron, OH, United States
(Majmundar) Department of Cardiology, University of Kansas Medical Center,
Kansas City, KS, United States
(Doshi) Department of Medicine, MS Ramaiah Medical College, Bengaluru,
India
(Vallabhajosyula) Section of Cardiovascular Medicine, Department of
Medicine, Wake Forest University School of Medicine, Winston-Salem, NC,
United States
Publisher
Elsevier B.V.
Abstract
Objective: A recently published randomized control trial showed different
results with suture-based vascular closure device (VCD) than plug-based
VCD in patients undergoing transfemoral transcatheter aortic valve
replacement (TAVR). The learning curve for MANTA device is steep, while
the learning curve for suture based VCD is shallow as the devices are
quite different. In this meta-analysis, we have compared suture-based
(ProGlide and Prostar XL) vs plug-based VCDs (MANTA). Method(s): We
performed a meta-analysis of all published studies (using PubMed/Medline
and Cochrane databases) reporting the clinical outcome of plug-based vs
suture-based VCDs in transfemoral TAVR patients. Result(s): We
included nine studies with a total of 2865 patients (plug-based n = 1631,
suture-based n = 1234). There was no significant difference in primary
outcome of all bleeding when using plug-based as opposed to suture-based
VCDs (RR 1.14 [0.62-2.06] I2 = 72%). There was no significant
difference in the incidence of secondary outcomes between two groups
including major life threatening bleeding (RR 1.16 [0.38-3.58]
I2 = 65%), major vascular complications (RR 0.84 [0.35-2.00]
I2 = 55%), minor vascular complications (RR 1.05 [0.56-1.95]
I2 = 42%), pseudo aneurysm (RR 1.84 [0.11-29.98] I2
= 44%), stenosis-dissection (RR 0.98 [0.66-1.47] I2 = 0%), VCD
failure (RR 1.71 [0.96-3.04] I2 = 0%), and blood transfusion
(RR 1.01 [0.38-2.71], I2 = 61%). Conclusion(s): Large bore
arteriotomy closure with plug-based VCD was not superior to suture-based
VCDs in this transfemoral TAVR population. There was very frequent use of
secondary VCDs in suture-based VCD group which is not practical when using
MANTA. Additional high-powered studies are required to determine the
safety and efficacy of MANTA device. Copyright © 2023
Cardiological Society of India

<12>
Accession Number
369755173
Title
Drug-Eluting Stents for Acute Coronary Syndrome: A Meta-Analysis of
Randomized Controlled Trials.
Source
PLoS ONE. 8(9) (no pagination), 2013. Article Number: e72895. Date of
Publication: 05 Sep 2013.
Author
Wang L.; Zang W.; Xie D.; Ji W.; Pan Y.; Li Z.; Shen J.; Shi Y.
Institution
(Wang, Ji, Pan, Li, Shen, Shi) Bio-X Institutes, Key Lab. for the Genetics
of Developmental and Neuropsychiatric Disorders (Ministry of Education),
Shanghai Jiao Tong University, Shanghai, China
(Wang, Zang, Xie) FengHe (ShangHai) Information Technology Co., Ltd,
Shanghai, China
(Ji, Pan, Shi) Shanghai Changning Mental Health Center, Shanghai, China
(Ji, Pan, Shi) Institute of Neuropsychiatric Science and Systems
Biological Medicine, Shanghai Jiao Tong University, Shanghai, China
Publisher
Public Library of Science
Abstract
Background:Drug-eluting stents (DES) are increasingly used for treatment
of acute coronary syndrome (ACS). However, clinical efficacy and safety of
various types of DES is not well established in these subjects. We
therefore evaluated clinical utility of second-generation and
first-generation DES in patients with ACS by conducting a meta-analysis.
 Method(s):A search of Medline, Embase, the Cochrane databases, and
Web of Science was made. Randomized controlled trials (RCTs) which
compared second-generation DES (everolimus-eluting stents [EES] or
zotarolimus-eluting stents [ZES]) versus first-generation DES
(sirolimus-eluting stents [SES] or paclitaxe-eluting stents [PES]) in
patients with ACS and provided data on clinical efficacy or safety
endpoints were included. Pooled estimates were calculated using
random-effects model. Result(s):A total of 2,757 participants with
ACS in 6 RCTs were included. Compared with first-generation one,
second-generation DES trended to be associated with the decreased
incidence of definite or probable stent thrombosis in ACS patients (risk
ratio [RR] = 0.60, 95% confidence intervals [CI] 0.33 to 1.07, p = 0.09).
However, the rate of target lesion revascularization (TLR) significantly
increased in second-generation DES (RR = 2.08, 95%CI 1.25 to 3.47, p =
0.005). There were no significant differences in the incidence of major
adverse cardiac events (MACEs), all-cause death, cardiac death, and
recurrent myocardial infarction between the two arms (all p>0.10). The
second-generation EES showed a tendency towards lower risk of MACEs (p =
0.06) and a beneficial effect on reducing stent thrombosis episodes (p =
0.009), while the second-generation ZES presented an increased occurrence
of MACEs (p = 0.02) and TLR (p = 0.003).
 Conclusion(s):Second-generation DES, especially EES, appeared to
present a lower risk of stent thrombosis, whereas second-generation ZES
might increase the need for repeat revascularization in ACS patients.
During coronary interventional therapy, DES class should be adequately
considered in order to maximize clinical benefit of DES implantation in
these specific subjects. © 2013 Wang et al.

<13>
Accession Number
2013619325
Title
Venoarterial extracorporeal membrane oxygenation with intra-aortic balloon
pump for postcardiotomy cardiogenic shock: A systematic review and
meta-analysis.
Source
Perfusion (United Kingdom). 38(1) (pp 142-149), 2023. Date of Publication:
January 2023.
Author
Huang D.; Xu A.; Guan Q.; Qin J.; Zhang C.
Institution
(Huang, Xu, Guan, Qin, Zhang) Emergency Department, Taizhou Hospital of
Zhejiang Province, Wenzhou Medical University, ZheJiang, Taizhou, China
Publisher
SAGE Publications Ltd
Abstract
Objective: Intra-aortic balloon pump (IABP) is currently recommended as a
strategy to address the increased afterload in patients who received
venoarterial extracorporeal membrane oxygenation (VA-ECMO). The benefit of
VA-ECMO with IABP in postcardiotomy cardiogenic shock is inconclusive. A
systematic review and meta-analysis was conducted to assess the influence
of VA-ECMO with IABP for postcardiotomy cardiogenic shock (PCS).
 Method(s): The Cochrane Library, PubMed, and Embase were searched for
all articles published from 1 January, 1964 to July 11, 2020.
Retrospective cohort studies targeting the comparison of VA-ECMO with IABP
and isolated VA-ECMO were included in this study. Result(s): We
included 2251 patients in the present study (917 patients in the VA-ECMO
with IABP group and 1334 patients in the isolated VA-ECMO group). Deaths
occurred in 589 of 917 patients (64.2%) in the VA-ECMO with IABP group and
occurred in 885 of 1334 patients (66.3%) in isolated VA-ECMO group.
Pooling the results of all studies showed that VA-ECMO with IABP was not
related to a reduced in-hospital mortality in patients who received
VA-ECMO for PCS (RR, 0.95; 95% CI, 0.86-1.04; p = 0.231). In addition,
VA-ECMO with IABP was not related to an increased rate of VA-ECMO weaning
in patients who received VA-ECMO for PCS (RR, 1.28; 95% CI, 0.99-1.66; p =
0.058). Conclusion(s): This study indicates that VA-ECMO with IABP
did not improve either in-hospital survival or weaning for VA-ECMO in
postcardiotomy cardiogenic shock patients. Copyright © The
Author(s) 2021.

<14>
Accession Number
2013157768
Title
Del Nido cardioplegia for myocardial protection in adult cardiac surgery:
a systematic review and update meta-analysis.
Source
Perfusion (United Kingdom). 38(1) (pp 6-17), 2023. Date of Publication:
January 2023.
Author
Zhai K.; Cheng X.; Zhang P.; Wei S.; Huang J.; Wu X.; Gao B.; Li Y.
Institution
(Zhai, Cheng, Zhang, Wei, Huang, Wu, Gao, Li) Department of Cardiac
Surgery, Lanzhou University Second Hospital, Lanzhou University, Lanzhou,
China
(Zhai, Cheng, Zhang, Wei, Huang, Li) Laboratory of Extracorporeal Life
Support, Lanzhou University Second Hospital, Lanzhou University, Lanzhou,
China
Publisher
SAGE Publications Ltd
Abstract
Objective: Although the application of del Nido cardioplegia solution
(DNC) in adult cardiac surgery is accumulating, the feasibility and safety
of this myocardial protection strategy in adults remains controversial. We
aimed to update our previous meta-analysis to determine the myocardial
protective effect of DNC versus conventional cardioplegia (CC) in adult
cardiac surgery. Method(s): A comprehensive literature search was
performed using PubMed, EMBASE, the Cochrane Library, and International
Clinical Trials Registry Platform databases through November 2020.
 Result(s): Thirty-seven observational studies and four randomized
controlled trials (RCTs) including 21,779 patients were identified. The
DNC group was associated with decreased postoperative cardiac enzymes
[troponin T (cTnT) and creatine kinase-MB (CK-MB)] [standardized mean
differences (SMD): -0.59, 95% confidence interval (CI): -0.99 to -0.19, p
= 0.004], cardiopulmonary bypass (CPB) time (MD: -9.31, 95% CI: -13.10 to
-5.51, p < 0.00001), aortic cross-clamp (ACC) time (MD: -7.20, 95% CI:
-10.31 to -4.09, p < 0.00001), and cardioplegia volume (SMD: -1.95, 95%
CI: -2.46 to -1.44, p < 0.00001). Intraoperative defibrillation
requirement was less in the DNC group [relative risk (RR): 0.50, 95% CI:
0.33 to 0.75, p = 0.0007]. The pooled analysis revealed no significant
difference in operative mortality among the patients assigned to DNC and
those undergoing CC. Conclusion(s): In adult cardiac surgery,
compared to CC, myocardial protection used with DNC yield similar or
better short-term clinical outcomes. More high-quality trials and RCTs
reflecting long-term follow-up morbidity and mortality are required in the
future to confirm these findings. Copyright © The Author(s) 2021.

<15>
Accession Number
2022160813
Title
The racial disparity among post transcatheter aortic valve replacement
outcomes: A meta-analysis.
Source
IJC Heart and Vasculature. 44 (no pagination), 2023. Article Number:
101170. Date of Publication: February 2023.
Author
Jaiswal V.; Peng Ang S.; Hanif M.; Savaliya M.; Vadhera A.; Raj N.; Gera
A.; Aujla S.; Daneshvar F.; Ishak A.; Subhan Waleed M.; Hugo
Aguilera-Alvarez V.; Naz S.; Hameed M.; Wajid Z.
Institution
(Jaiswal) JCCR Cardiology, Varanasi, India
(Jaiswal, Savaliya, Raj, Gera, Ishak, Subhan Waleed, Hameed) Department of
Cardiovascular Research, Larkin Community Hospital, South Miami, FL,
United States
(Peng Ang) Division of Internal Medicine, Rutgers Health/Community Medical
Center, NJ, United States
(Hanif) Department of Internal Medicine, SUNY Upstate Medical University,
United States
(Vadhera) Department of Medicine, Maulana Azad Medical College, New Delhi,
India
(Aujla) Department of Medicine, Government Medical College Amritsar,
Punjab, India
(Daneshvar) Department of Cardiology, AdventHealth, FL, United States
(Hugo Aguilera-Alvarez) Universidad Autonoma de Baja, CA, United States
(Naz) The University of Texas, MD Anderson Cancer Center, TX, United
States
(Wajid) Department of Internal Medicine, Wayne State University School of
Medicine, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Racial disparities have been well described in cardiovascular
disease. However, the impact of race on the outcomes post - Transcatheter
aortic valve replacement (TAVR) remains unknown. Objective(s): We aim
to evaluate the disparity among the race (black and white) post - TAVR.
 Method(s): We systematically searched all electronic databases from
inception until September 26, 2022. The primary outcome was in-hospital
all-cause mortality, and secondary outcomes was myocardial infarction
(MI), acute kidney injury (AKI), permanent pacemaker implantation (PPI) or
ICD, stroke, vascular complications, and major bleeding. Result(s): A
total of three studies with 1,02,009 patients were included in the final
analysis. The mean age of patients with white and black patients was 82.65
and 80.45 years, respectively. The likelihood of in-hospital all-cause
mortality (OR, 1.01(95 %CI: 0.86-1.19), P = 0.93), stroke (OR, 0.83(95
%CI:0.61-1.13), P = 0.23, I2 = 46.57 %], major bleeding [OR, 1.05(95
%CI:0.92-1.20), P = 0.46), and vascular complications [OR, 0.92(95
%CI:0.81-1.06), P = 0.26), was comparable between white and black
patients. However, patients with white race have lower odds of MI (OR,
0.65(95 %CI:0.50-0.84), P < 0.001), and AKI (OR, 0.84(95 %CI:0.74-0.95), P
= 0.01) and higher odds of PPI or ICD (OR, 1.16(95 %CI: 1.06-1.27), P <
0.001, I2 = 0 %) compared with black race patients. Conclusion(s):
Our findings suggest disparity post - TAVR outcomes existed, and black
patients are at higher risk of MI and AKI than white patients. Key
Clinical Message: * What is already known on this topic: Disparity has
been witnessed among patients with cardiovascular disease. However, no
studies have drawn a significant association among post-TAVR patients'
outcomes * What this study adds: Among patients who underwent TAVR, there
is a difference in the adverse outcomes between black and white race
patients. White patients have a lower risk of post-procedure MI and AKI
compared with Black patients. * How this study might affect research,
practice, or policy: These disparities need to be addressed, and proper
guidelines need to be made along with engaging patients with better
medical infrastructure and treatment options. Copyright © 2023
The Author(s)

<16>
Accession Number
2022129846
Title
Conventional and two-dimensional strain echocardiography in predicting
postoperative atrial fibrillation after coronary artery bypass grafting
surgery.
Source
Caspian Journal of Internal Medicine. 14(1) (pp 60-68), 2023. Date of
Publication: December 2023.
Author
Somesarayi S.A.B.; Faridi L.; Mohammadi K.; Arbat B.K.; Rahimi M.; Parizad
R.; Tabrizi M.T.
Institution
(Somesarayi, Faridi, Mohammadi, Arbat, Rahimi, Parizad, Tabrizi)
Cardiovascular Research Center, Tabriz University of Medical Sciences,
Tabriz, Iran, Islamic Republic of
Publisher
Babol University of Medical Sciences
Abstract
Background: Atrial fibrillation (AF) is a common complication after heart
surgeries. Advances in imaging technologies and an understanding of the
pathophysiology of preoperative left atrial (LA) dysfunction can lead to
more definitive potential therapeutic approaches. This study aimed to
determine the role of conventional echocardiography and LA two-dimensional
(2D) strain echocardiography in assessing LA function and predicting POAF
after CABG surgery. Method(s): All patients with sinus rhythm who
underwent CABG surgery were enrolled. All the patients had undergone
conventional echocardiography and LA 2D-strain echocardiography 24 hours
before surgery. In addition to demographic, clinical, and perioperative
features, electrocardiogram (ECG) and Holter monitoring were recorded.
 Result(s): Of the 105 patients included, 85 patients (81%) were men
with a mean age of 60.26+/-10.61 years. POAF was seen in 22.9% of patients
during hospitalization, and AF duration was 10 hours (median; IQR:
2.0-19.5). AF patients had a higher LA volume index (LAVI) than patients
with sinus rhythm (p=0.018). Patients with sinus rhythm had higher rates
of LA reservoir (26.97+/-6.87 VS. 20.46+/-4.27, p<0.001), LA contractile
(14.98+/-3.68 VS. 12.76+/-3.72, p =0.012) and LA global strain
(24.28+/-6.57 VS. 17.71+/-4.11, p<0.001) than AF patients. The results of
the multivariate logistic regression showed that LAVI (p=0.014) and LA
global strain (p=0.027) were independent predictors of AF detection.
 Conclusion(s): Compared to conventional echocardiography, 2D-strain
echocardiography is a more effective diagnostic method to predict the
possibility of post-CABG AF. Copyright © 2023 Babol University of
Medical Sciences. All rights reserved.

<17>
Accession Number
2015663467
Title
Regional Analgesia in Video-Assisted Thoracic Surgery: A Bayesian Network
Meta-Analysis.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 842332.
Date of Publication: 06 Apr 2022.
Author
Lin J.; Liao Y.; Gong C.; Yu L.; Gao F.; Yu J.; Chen J.; Chen X.; Zheng
T.; Zheng X.
Institution
(Lin, Liao, Gong, Yu, Gao, Yu, Chen, Chen, Zheng, Zheng) Department of
Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical
College of Fujian Medical University, Fuzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: A variety of regional analgesia methods are used during
video-assisted thoracic surgery (VATS). Our network meta-analysis (NMA)
sought to evaluate the advantages of various methods of localized
postoperative pain management in VATS patients. Method(s): PubMed,
the Cochrane Library, and EMBASE were searched from their date of
inception to May 2021 for randomized controlled trials (RCTs) comparing
two or more types of locoregional analgesia in adults using any
standardized clinical criteria. This was done using Bayesian NMA.
 Result(s): A total of 3,563 studies were initially identified, and 16
RCTs with a total of 1,144 participants were ultimately included. These
studies, which spanned the years 2014 to 2021 and included data from eight
different countries, presented new information. There were a variety of
regional analgesia techniques used, and in terms of analgesic effect,
thoracic epidural anesthesia (TEA) [SMD (standard mean difference) = 1.12,
CrI (Credible interval): (-0.08 to -2.33)], thoracic paravertebral block
(TPVB) (SMD = 0.67, CrI: (-0.25 to 1.60) and erector spinae plane block
(ESPB) (SMD = 0.34, CrI: (-0.5 to 1.17) were better than other regional
analgesia methods. Conclusion(s): Overall, these findings show that
TEA, TPVB and ESPB may be effective forms of regional analgesia in VATS.
This research could be a valuable resource for future efforts regarding
the use of thoracic regional analgesia and enhanced recovery after
surgery. Systematic Review Registration: Identifier [PROSPERO
CRD42021253218]. Copyright © 2022 Lin, Liao, Gong, Yu, Gao, Yu,
Chen, Chen, Zheng and Zheng.

<18>
Accession Number
2020285442
Title
Donation of Hearts After Circulatory Death: A Life Saver.
Source
Journal of the American College of Cardiology. 80(14) (pp 1327-1329),
2022. Date of Publication: 04 Oct 2022.
Author
Jorde U.P.
Institution
(Jorde) Montefiore Einstein Heart and Vascular Center, Albert Einstein
College of Medicine, Bronx, NY, United States
Publisher
Elsevier Inc.

<19>
Accession Number
638995149
Title
Interventions for increasing immunosuppressant medication adherence in
solid organ transplant recipients.
Source
Cochrane Database of Systematic Reviews. 2022(9) (no pagination), 2022.
Article Number: CD012854. Date of Publication: 12 Sep 2022.
Author
Mellon L.; Doyle F.; Hickey A.; Ward K.D.; de Freitas D.G.; McCormick
P.A.; O'Connell O.; Conlon P.
Institution
(Mellon, Doyle, Hickey) Department of Health Psychology, RCSI University
of Medicine and Health Sciences, Dublin, Ireland
(Ward) School of Public Health, University of Memphis, Memphis, TN, United
States
(de Freitas, Conlon) Department of Nephrology and Kidney Transplantation,
Beaumont Hospital, Dublin, Ireland
(McCormick) Irish Liver Transplant Unit, St Vincent's University Hospital,
Dublin, Ireland
(O'Connell) Irish National Lung and Heart Transplant Program, Mater
Misericordiae University, Dublin, Ireland
Publisher
John Wiley and Sons Ltd
Abstract
Background: Non-adherence to immunosuppressant therapy is a significant
concern following a solid organ transplant, given its association with
graft failure. Adherence to immunosuppressant therapy is a modifiable
patient behaviour, and different approaches to increasing adherence have
emerged, including multi-component interventions. There has been limited
exploration of the effectiveness of interventions to increase adherence to
immunosuppressant therapy. Objective(s): This review aimed to look at
the benefits and harms of using interventions for increasing adherence to
immunosuppressant therapies in solid organ transplant recipients,
including adults and children with a heart, lung, kidney, liver and
pancreas transplant. Search Method(s): We searched the Cochrane
Kidney and Transplant Register of Studies up to 14 October 2021 through
contact with the Information Specialist using search terms relevant to
this review. Studies in the Register were identified through searches of
CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International
Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov.
 Selection Criteria: All randomised controlled trials (RCTs),
quasi-RCTs, and cluster RCTs examining interventions to increase
immunosuppressant adherence following a solid organ transplant (heart,
lung, kidney, liver, pancreas) were included. There were no restrictions
on language or publication type. Data Collection and Analysis: Two
authors independently screened titles and abstracts of identified records,
evaluated study quality and assessed the quality of the evidence using the
GRADE approach. The risk of bias was assessed using the Cochrane tool. The
ABC taxonomy for measuring medication adherence provided the analysis
framework, and the primary outcomes were immunosuppressant medication
initiation, implementation (taking adherence, dosing adherence, timing
adherence, drug holidays) and persistence. Secondary outcomes were
surrogate markers of adherence, including self-reported adherence, trough
concentration levels of immunosuppressant medication, acute graft
rejection, graft loss, death, hospital readmission and health-related
quality of life (HRQoL). Meta-analysis was conducted where possible, and
narrative synthesis was carried out for the remainder of the results.
 Main Result(s): Forty studies involving 3896 randomised participants
(3718 adults and 178 adolescents) were included. Studies were
heterogeneous in terms of the type of intervention and outcomes assessed.
The majority of studies (80%) were conducted in kidney transplant
recipients. Two studies examined paediatric solid organ transplant
recipients. The risk of bias was generally high or unclear, leading to
lower certainty in the results. Initiation of immunosuppression was not
measured by the included studies. There is uncertain evidence of an
association between immunosuppressant medication adherence interventions
and the proportion of participants classified as adherent to taking
immunosuppressant medication (4 studies, 445 participants: RR 1.09, 95% CI
0.95 to 1.20; I2 = 78%). There was very marked heterogeneity in treatment
effects between the four studies evaluating taking adherence, which may
have been due to the different types of interventions used. There was
evidence of increasing dosing adherence in the intervention group (8
studies, 713 participants: RR 1.14, 95% CI 1.03 to 1.26, I2 = 61%). There
was very marked heterogeneity in treatment effects between the eight
studies evaluating dosing adherence, which may have been due to the
different types of interventions used. It was uncertain if an intervention
to increase immunosuppressant adherence had an effect on timing adherence
or drug holidays. There was limited evidence that an intervention to
increase immunosuppressant adherence had an effect on persistence. There
was limited evidence that an intervention to increase immunosuppressant
adherence had an effect on secondary outcomes. For self-reported
adherence, it is uncertain whether an intervention to increase adherence
to immunosuppressant medication increases the proportion of participants
classified as medically adherent to immunosuppressant therapy (9 studies,
755 participants: RR 1.21, 95% CI 0.99 to 1.49; I2 = 74%; very low
certainty evidence). Similarly, it is uncertain whether an intervention to
increase adherence to immunosuppressant medication increases the mean
adherence score on self-reported adherence measures (5 studies, 471
participants: SMD 0.65, 95% CI -0.31 to 1.60; I2 = 96%; very low certainty
evidence). For immunosuppressant trough concentration levels, it is
uncertain whether an intervention to increase adherence to
immunosuppressant medication increases the proportion of participants who
reach target immunosuppressant trough concentration levels (4 studies, 348
participants: RR 0.98, 95% CI 0.68 to 1.40; I2 = 40%; very low certainty
evidence). It is uncertain whether an intervention to increase adherence
to immunosuppressant medication may reduce hospitalisations (5 studies,
460 participants: RR 0.67, 95% CI 0.44 to 1.02; I2 = 64%; low certainty
evidence). There were limited, low certainty effects on patient-reported
health outcomes such as HRQoL. There was no clear evidence to determine
the effect of interventions on secondary outcomes, including acute graft
rejection, graft loss and death. No harms from intervention participation
were reported. Authors' conclusions: Interventions to increase taking and
dosing adherence to immunosuppressant therapy may be effective; however,
our findings suggest that current evidence in support of interventions to
increase adherence to immunosuppressant therapy is overall of low
methodological quality, attributable to small sample sizes, and
heterogeneity identified for the types of interventions. Twenty-four
studies are currently ongoing or awaiting assessment (3248 proposed
participants); therefore, it is possible that findings may change with the
inclusion of these large ongoing studies in future updates. Copyright
© 2022 The Cochrane Collaboration. Published by John Wiley & Sons,
Ltd.

<20>
Accession Number
640071276
Title
A case report of gonadal Y-chromosome mosaicism 45, X Turner syndrome
complicated by HCG-secreting gonadoblastoma.
Source
Hormone Research in Paediatrics. Conference: 60th Annual Meeting of the
European Society for Paediatric Endocrinology, ESPE 2022. Rome Italy.
95(Supplement 2) (pp 529), 2022. Date of Publication: September 2022.
Author
Zheng R.; Ma H.; Liu J.; Liang J.; Chen H.; Li Y.; Chen Q.; Zhang J.; Guo
S.; Wang B.; Du M.
Institution
(Zheng, Ma, Chen, Li, Chen, Zhang, Guo, Wang, Du) Department of
Pediatrics, First Affiliated Hospital, Sun Yat-sen University, Guangzhou,
China
(Liu, Chen) Department of Pediatric Surgery, First Affiliated Hospital,
Sun Yat-sen University, Guangzhou, China
(Liang) Department of Medical Laboratory, First Affiliated Hospital, Sun
Yat-sen University, Guangzhou, China
Publisher
S. Karger AG
Abstract
Objective: We report a case of a 5y3m patient who complained of breast
development with '45, X Turner syndrome (TS) and HCG-secreting
gonadoblastoma (Gb)' with Y chromosome mosaicism. Aim to understand the
diagnosis of TS and improve the diagnosis and treatment of HCG-secreting
tumors. Method(s): The data of clinical diagnosis and treatment of
this patient were summarized, and the literatures were reviewed.
 Result(s): The 3y2m patient was diagnosed with 'pulmonary venous
malformation + atrial septal defect' when she attended a local hospital
due to breast development for 2 months. She underwent cardiac surgery. Her
breast development was progressive, with accelerated growth and marked
progression in bone age. At the age of 3y7m, the local whole-exome
sequencing results were suspected to be 45, X karyotype, which was
confirmed by the latter two hospitals. At the age of 4y6m, serum beta-HCG
was found to be elevated (24.94mIU/mL), and the lesion was unknown.
Physical examination: slightly wide eye distance, high palatal arch, mild
cubitus valgus. The height was 113.7cm (+0.1SD), the muscles were strong.
Tanner stages: B4, PH3, female vulva and the clitoris was hypertrophic.
Blood test: FSH 0.12 IU/L, LH 0.02 IU/L, E2 28 pg/ml, T 1.96 ng/ml,
beta-HCG 32.33 mIU/mL, AFP 0.94 mug/L. Bone age was 10.5 years. Blood SRY
gene (PCR) (-), FISH (CEPY/CEPX probe) found only one X centromere.
Thoracic and abdominal CT, head and pelvic MRI were normal. Laparoscopic
gonad exploration (tumor appearance on the left, cord on the right),
bilateral gonadal venous blood collection (beta-HCG, E2 and T higher than
left > right > peripheral venous blood), gonadal resection (bilateral
gonads blastoma), bilateral gonadal SRY gene was positive. After surgery,
E2, T, beta-HCG decreased to normal. The patient received chemotherapy.
After 9 months of follow-up, her growth slowed down, breasts became softer
and smaller, clitoris was reduced and pubic hair was reduced. The level of
E2, T, beta-HCG were normal. Conclusion(s): The risk of Gb in TS
containing Y component is high. Gb with breast development as the main
clinical manifestation is rare, Gb secreting HCG is even rarer. Therefore,
TS with atypical clinical manifestations should pay attention to
mosaicism. For TS with virilizing characteristics, the presence or absence
of Y chromosome (component) should be identified, including tissue
mosaicism. This case is the fifth report of Gb secreting HCG in the world.
Precocious puberty regardless of gender, the testing of HCG, AFP are
required.

<21>
Accession Number
640068416
Title
Cost Utility Of Transcatheter Aortic Valve Implantation For Patients With
Inoperable Severe Aortic Stenosis In Brazil.
Source
International Journal of Technology Assessment in Health Care. Conference:
Annual Meeting of the Health Technology Assessment International, HTAi
2021. Virtual. 37(Supplement 1) (pp 25-26), 2021. Date of Publication:
December 2021.
Author
Magliano C.; Padilla M.P.; Franca A.; Meirelles I.; Fernandes R.; Santos
M.
Publisher
Cambridge University Press
Abstract
Introduction. Transcatheter aortic valve implantation (TAVI) represents a
new treatment option for aortic stenosis. This study aimed to evaluate the
cost utility of TAVI, compared with clinical treatment, in patients with
inoperable severe aortic stenosis from the perspective of the Brazilian
public health system. Methods. A Markov model with monthly cycles and a
five percent annual discount rate was constructed. A five-year time
horizon was chosen, to minimize the uncertainties inherent with data
extrapolations, based on the only randomized head-to-head trial, Placement
of AoRTic TraNscathetER Valve Trial (PARTNER B). All costs were obtained
from Brazil's official healthcare data. Utilities for clinical treatment
0.6 (range 0.56-0.63) and TAVI 0.71 (range 0.69-0.72) were based on
studies that used the EuroQol-5D instrument. TAVI's utility measures were
penalized by 25 percent in the first month, based on the estimate of the
procedure's impact on quality of life provided by the National Institute
of Health and Care Excellence in the United Kingdom. Lastly, deterministic
and probabilistic sensitivity analyses were used to evaluate the
robustness of the results. Results. The incremental cost-effectiveness
ratio was USD35,880 per quality-adjusted life-year (QALY), a result that
was mainly sensitive to TAVI's cost in the univariate analysis. In the
probabilistic analysis, all values were above the reference
willingness-to-pay threshold of three times the Brazilian per capita gross
domestic product (USD18,042 per QALY). Conclusions. In conclusion, even
though there is no established willingness-to-pay threshold in Brazil, the
cost of TAVI may represent an obstacle for its incorporation into the
Brazilian public health system.

<22>
Accession Number
640068402
Title
Extracorporeal Cytokine Adsorption Therapy: An Update Systematic Review Of
Clinical Efficacy And Safety For Two Indications.
Source
International Journal of Technology Assessment in Health Care. Conference:
Annual Meeting of the Health Technology Assessment International, HTAi
2021. Virtual. 37(Supplement 1) (pp 3), 2021. Date of Publication:
December 2021.
Author
Goetz G.; Hawlik K.; Wild C.
Publisher
Cambridge University Press
Abstract
Introduction. The idea of using extracorporeal cytokine adsorption therapy
(ECAT) is to remove cytokines from the blood in order to restore a
balanced immune response. Yet, it is unclear as to whether the use of ECAT
improves patient-relevant outcomes. Hence, the aim of this article is to
synthesize the currently available evidence with regard to a potential
clinical benefit of ECAT used in cardiac surgery or sepsis. Methods. We
conducted an updated systematic review summarizing the body of evidence
with regard to a potential clinical benefit of ECAT. The study followed
the PRISMA statement and the European Network for Health Technology
Assessment (EUnetHTA) guidelines. The quality of the individual studies
and the strength of the available evidence was assessed using the Cochrane
risk of bias tool (v.1) and the GRADE approach respectively. Mortality,
organ function, length of stay in the intensive care unit and length of
hospitalization, as well as adverse events, were defined as critical
outcomes. Results. For the preventive treatment of ECAT in patients
undergoing cardiac surgery, we found very low-quality inconclusive
evidence for mortality (5 randomized controlled trials (RCTs), n = 163),
length of stay in the intensive care unit (5 RCTs, n = 163), and length of
hospitalization (3 RCTs, n = 101). In addition, very low-quality
inconclusive evidence was found for (serious) adverse events (4 RCTs, n =
148). For the therapeutic treatment of ECAT in patients with sepsis/
septic shock, we found very lowquality inconclusive evidence for mortality
up to 60-day follow-up (2 RCTs, n = 117), organ function (2 RCTs, n = 117)
and length of stay in the intensive care unit (1 study, n = 20).
Similarly, very low-quality inconclusive evidence was found for (serious)
adverse events (2 RCTs, n = 117). There are currently eighteen ongoing
RCTs on the use of ECAT. Conclusions. There is a lack of reliable data on
the clinical benefit of using ECAT as an add-on treatment preventively in
cardiac surgery and therapeutically in patients with sepsis or septic
shock. While theoretical advantages are anticipated, the current available
evidence is inconclusive and was not able to establish the efficacy and
safety of ECAT in combination with standard care in the investigated
indications. In light of the available RCTs, we strongly recommend the
consideration of studies with patient-relevant endpoints and adequate
statistical power, instead of investing further research funds on small
studies that may not shed more light onto the potential clinical benefit
of ECAT. The results of ongoing RCTs are awaited to guide the decision on
whether further research funds should be invested in ECAT research or to
conclude that the intervention may not show clinical benefits for
patients.

<23>
[Use Link to view the full text]
Accession Number
2022329887
Title
BioMatrix Versus Orsiro Stents for Coronary Artery Disease: A Multicenter,
Randomized, Open-Label Study.
Source
Circulation: Cardiovascular Interventions. 16(1) (pp E012307), 2023. Date
of Publication: 01 Jan 2023.
Author
Yoon C.-H.; Kwun J.-S.; Choi Y.J.; Park J.J.; Kang S.-H.; Suh J.-W.; Youn
T.-J.; Kim M.-K.; Cha K.S.; Lee S.-H.; Hong B.-K.; Rha S.-W.; Kang W.C.;
Lee J.-H.; Kim S.-H.; Chae I.-H.
Institution
(Yoon, Kwun, Park, Kang, Kim, Suh, Youn, Chae) Cardiovascular Center,
Department of Internal Medicine, Seoul National University, Bundang
Hospital, South Korea
(Choi) Sejong General Hospital, Bucheon, South Korea
(Kim) Catholic Kwandong University International St Mary's Hospital,
Incheon, South Korea
(Cha) Pusan National University Hospital, South Korea
(Lee) Wonju Severance Hospital, Yonsei University, College of Medicine,
South Korea
(Hong) Gangnam Severance Hospital, Yonsei University, College of Medicine,
Seoul, South Korea
(Rha) Korea University Guro Hospital, Seoul, South Korea
(Kang) Gachon University, Gil Medical Center, Incheon, South Korea
(Lee) Chungnam National University Hospital, Daejeon, South Korea
(Kim) Seoul Metropolitan Government Seoul National University Boramae
Medical Center, Seoul, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Comparative studies of ultrathin-strut biodegradable polymer
sirolimus-eluting stent (BP-SES) have reported promising results and
validated its excellent outcomes in terms of safety and efficacy. However,
there are limited studies comparing BP drug-eluting stents with struts of
different thicknesses. We compared the long-term clinical outcomes of
patients treated with an ultrathin-strut BP-SES or a thick-strut
biodegradable polymer biolimus-eluting stent (BP-BES). Method(s): The
BIODEGRADE trial (Biomatrix and Orsiro Drug-Eluting Stents in Angiographic
Result in Patients With Coronary Artery Disease) is a multicenter
prospective randomized study comparing coronary revascularization in
patients with ultrathin-strut BP-SES and thick-strut BP-BES with the
primary end point of target lesion failure at 18 months posttreatment. We
performed the prespecified analysis of 3-year clinical outcomes.
 Result(s): In total, 2341 patients were randomized to receive
treatment with ultrathin-strut BP-SES (N=1175) or thick-strut BP-BES
(N=1166). The 3-year incidence rate of target lesion failure was 3.2% for
BP-SES and 5.1% for BP-BES (P=0.023). The difference was primarily due to
differences in ischemia-driven target lesion revascularization (BP-SES,
1.5%; BP-BES, 2.8%; P=0.035) between groups. A landmark analysis of the
late follow-up period showed significant differences in target lesion
failure, with outcomes being better in BP-SES. Cardiac death and target
lesion revascularization were significantly lower in the BP-SES group.
 Conclusion(s): In a large, randomized trial, the long-term clinical
outcome of target lesion failure at 3 years was significantly better among
patients treated with the ultrathin-strut BP-SES. The results indicate the
superiority of the ultrathin-strut BP-SES compared with the thick-strut
BP-BES. Registration: URL: https://clinicaltrials.gov; Unique identifier:
NCT02299011. Copyright © 2023 Lippincott Williams and Wilkins.
All rights reserved.

<24>
Accession Number
2021150164
Title
Metalloproteinases in Cardiac Surgery: A Systematic Review.
Source
Biomolecules. 13(1) (no pagination), 2023. Article Number: 113. Date of
Publication: January 2023.
Author
Serraino G.F.; Jiritano F.; Costa D.; Ielapi N.; Battaglia D.; Bracale
U.M.; Mastroroberto P.; Andreucci M.; Serra R.
Institution
(Serraino, Jiritano, Battaglia, Mastroroberto) Department of Experimental
and Clinical Medicine, University "Magna Graecia" of Catanzaro, Catanzaro
88100, Italy
(Costa) Department of Law, Economics and Sociology, University "Magna
Graecia" of Catanzaro, Catanzaro 88100, Italy
(Costa, Ielapi, Serra) Interuniversity Center of Phlebolymphology (CIFL),
International Research and Educational Program in Clinical and
Experimental Biotechnology, Department of Surgical and Medical Sciences,
University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100,
Italy
(Ielapi) Department of Public Health and Infectious Disease, "Sapienza"
University of Rome, Roma 00185, Italy
(Bracale) Department of Public Health, University Federico II of Naples,
Naples 80138, Italy
(Andreucci) Department of Health Sciences, University "Magna Graecia" of
Catanzaro, Catanzaro 88100, Italy
(Serra) Department of Medical and Surgical Sciences, University "Magna
Graecia" of Catanzaro, Catanzaro 88100, Italy
Publisher
MDPI
Abstract
The role of matrix metalloproteinases (MMPs) in routine cardiac operations
including cardiopulmonary bypass (CPB) is still poorly explored. The
purpose of this systematic review was to thoroughly summarize and discuss
the existing knowledge of the MMP profile in cardiac surgery. All studies
meeting the inclusion criteria (i.e., those reporting detailed data about
MMP release during and after CPB) were selected after screening the
literature published between July 1975 and August 2022. Fifteen trials
that enrolled a total of 431 participants were included. MMP levels were
found to be significantly correlated with CPB in all included studies. The
gelatinases MMP-2 and MMP-9 were highly released in cardiac surgery with
CPB. MMP-9 levels were found to be increased after CPB start and during
the duration of CPB. Particularly, it is overexpressed both in the
myocardial tissue and circulating in the bloodstream. Also, MMP-2 levels
increased after CPB both in plasma and in myocardial tissue. MMP-7, MMP-8,
and MMP-13 levels increased after CPB start and remained elevated up to 6
h later. Increased levels of MMPs were associated with adverse
post-operative outcomes. Conversely, TIMP-1 decreased with CPB. Mechanical
and pharmacological strategies were applied in two studies to analyze
their effect on the inflammatory response to cardiac surgery and CPB and
on postoperative outcomes. New targeted MMP inhibitor therapies could
protect against systemic inflammatory response syndrome after CPB and
should be the subject of future large prospective multicenter randomized
clinical trials. Copyright © 2023 by the authors.

<25>
Accession Number
2021120340
Title
Endobronchial metastasis secondary to occulting renal cell carcinoma:
literature review and a rare case report.
Source
BMC Pulmonary Medicine. 23(1) (no pagination), 2023. Article Number: 28.
Date of Publication: December 2023.
Author
Abdul Rahman S.-A.; Abdul Rahman A.; Rajab S.; Mansour S.; Mansour M.;
Salloum E.; Alshehabi Z.
Institution
(Abdul Rahman, Abdul Rahman, Mansour, Mansour, Salloum) Faculty of
Medicine, Cancer Research Center, Tishreen University, Latakia, Syrian
Arab Republic
(Rajab) Department of Thoracic Surgery, Tishreen University Hospital,
Latakia, Syrian Arab Republic
(Alshehabi) Department of Pathology, Cancer Research Center, Tishreen
University, Latakia, Syrian Arab Republic
Publisher
BioMed Central Ltd
Abstract
Background: Endobronchial Metastasis from extrathoracic tumors is a rare
neoplasm that accounts for approximately 1.1% of total endobronchial
malignancies. The most common primary tumors associated with EBM are from
the colorectal, breast, and kidney regions. Although it represents a late
manifestation in the context of tumor progression, it can rarely antedate
the diagnosis of the primary tumor. Case presentation: A 67-years-old male
was referred from another city hospital to our thoracic surgery department
due to a 4-months history of hemoptysis and productive cough. A chest
X-ray and computed tomography scan showed a soft-tissue mass within the
left main bronchus and atelectasis of the anterior segment of the left
upper lobe. Furthermore, a flexible bronchoscopy revealed a hypervascular
lesion occluding completely the left upper lobe bronchus. The patient
underwent lobectomy and pathological examination suggested endobronchial
metastasis from clear cell renal cell carcinoma. A second computed
tomography scan of the abdomen and pelvis showed a well-defined mass
arising from the lateral aspect of the right kidney; therefore, the
patient underwent right radical nephrectomy three weeks later and
pathology confirmed the diagnosis of clear renal cell carcinoma with
endobronchial metastasis. Conclusion(s): Despite its rarity,
physicians should consider the possibility of endobronchial metastases in
the setting of endobronchial lesions. Proper diagnostic approaches should
also be considered to rule out the potential of asymptomatic extrathoracic
neoplasms. In this manuscript, we aimed to report a rare case -the first
from Syria to our knowledge- of an endobronchial metastasis that preceded
the diagnosis of renal cell carcinoma. Importantly, we reviewed the
existing literature and discussed the diagnostic and treatment
approaches. Copyright © 2023, The Author(s).

<26>
Accession Number
640073541
Title
Effect of BMI on patients undergoing transcatheter aortic valve
implantation: A systematic review and meta-analysis.
Source
Progress in cardiovascular diseases. (no pagination), 2023. Date of
Publication: 16 Jan 2023.
Author
Gupta R.; Mahmoudi E.; Behnoush A.H.; Khalaji A.; Malik A.H.; Sood A.;
Bandyopadhyay D.; Zaid S.; Goel A.; Sreenivasan J.; Patel C.; Vyas A.V.;
Lavie C.J.; Patel N.C.
Institution
(Gupta, Patel, Vyas, Patel) Department of Cardiology, Lehigh Valley Health
Network, Allentown, PA, United States
(Mahmoudi, Behnoush, Khalaji) Universal Scientific Education and Research
Network, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Malik, Bandyopadhyay) Department of Cardiology, Westchester Medical
Center and New York Medical College, Valhalla, NY, United States
(Sood) Department of Internal Medicine, Wright Center for Graduate Medical
Education, Scranton, PA, United States
(Zaid, Goel) Department of Cardiology, Houston Methodist DeBakey Heart and
Vascular Institute, Houston, TX, United States
(Sreenivasan) Department of Cardiovascular Medicine, Yale University
School of Medicine, New Haven, CT, United States
(Lavie) John Ochsner Heart and Vascular Institute, Ochsner Clinical
School, University of Queensland School of Medicine, New Orleans, LA,
United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The relationship of body mass index (BMI) and an "obesity
paradox" with cardiovascular risk prediction is controversial. This
systematic review and meta-analysis aims to compare the associations of
different BMI ranges on transcatheter aortic valve implantation (TAVI)
outcomes. METHOD(S): International databases, including PubMed, the
Web of Science, and the Cochrane Library, were systematically searched for
observational and randomized controlled trial studies investigating TAVI
outcomes in any of the four BMI categories: underweight, normal weight,
overweight, and obese with one of the predefined outcomes. Primary
outcomes were in-hospital, 30-day, and long-term all-cause mortality.
Random-effects meta-analysis was performed to calculate the odds ratio
(OR) or standardized mean differences (SMD) with 95% confidence interval
(CI) for each paired comparison between two of the BMI categories.
 RESULT(S): A total of 38 studies were included in our analysis,
investigating 99,829 patients undergoing TAVI. There was a trend toward
higher comorbidities such as hypertension, diabetes, and dyslipidemia in
overweight patients and individuals with obesity. Compared with
normal-weight, patients with obesity had a lower rate of 30-day mortality
(OR 0.42, 95% CI 0.25-0.72, p<0.01), paravalvular aortic regurgitation (OR
0.63, 95% CI 0.44-0.91, p=0.01), 1-year mortality (OR 0.48, 95% CI
0.24-0.96, p=0.04), and long-term mortality (OR 0.69, 95% CI 0.51-0.94,
p=0.02). However, acute kidney injury (OR 1.16, 95% CI 1.04-1.30, p=0.01)
and permanent pacemaker implantation (OR 1.25, 95% CI 1.05-1.50, p=0.01)
odds were higher in patients with obesity. Noteworthy, major vascular
complications were significantly higher in underweight patients in
comparison with normal weight cases (OR 1.62, 95% CI 1.07-2.46, p=0.02).
In terms of left ventricular ejection fraction (LVEF), patients with
obesity had higher post-operative LVEF compared to normal-weight
individuals (SMD 0.12, 95% CI 0.02-0.22, p=0.02). CONCLUSION(S): Our
results suggest the presence of the "obesity paradox" in TAVI outcomes
with higher BMI ranges being associated with lower short- and long-term
mortality. BMI can be utilized for risk prediction of patients undergoing
TAVI. Copyright © 2022. Published by Elsevier Inc.

<27>
Accession Number
640073453
Title
Transcatheter versus surgical aortic valve replacement in lower-risk and
higher-risk patients: a meta-analysis of randomized trials.
Source
European heart journal. (no pagination), 2023. Date of Publication: 20
Jan 2023.
Author
Ahmad Y.; Howard J.P.; Arnold A.D.; Madhavan M.V.; Cook C.M.; Alu M.; Mack
M.J.; Reardon M.J.; Thourani V.H.; Kapadia S.; Thyregod H.G.H.;
Sondergaard L.; Jorgensen T.H.; Toff W.D.; Van Mieghem N.M.; Makkar R.R.;
Forrest J.K.; Leon M.B.
Institution
(Ahmad, Forrest) Yale School of Medicine, Yale University, CT 06510, 135
College Street, New Haven, United States
(Howard, Arnold) National Heart and Lung Institute, Imperial College
London, Du Cane Road, London W120HS, United Kingdom
(Madhavan, Leon) Division of Cardiology, Department of Medicine, Columbia
University Medical Center/New York-Presbyterian Hospital, W. 168th St. New
York, NY 10032, United States
(Madhavan, Alu, Leon) Clinical Trials Center, The Cardiovascular Research
Foundation, 1700 Broadway, New York, NY 10019, USA
(Cook) Essex Cardiothoracic Center, Nether Mayne, Basildon SS16 5NL,
United Kingdom
(Mack) Department of Cardiovascular Disease, Baylor Scott and White
Health, 4700 Alliance Blvd, Plano, United States
(Reardon) Houston Methodist DeBakey Heart & Vascular Center, 6565 Fannin
St Suite 1901, Houston TX 77030, United States
(Thourani) Department of Cardiovascular Surgery, Marcus Valve Center,
Piedmont Heart and Vascular Institute, 95 Collier Rd NW Suite 5015,
Atlanta, United States
(Kapadia) Cleveland Clinic OH 44195, United States
(Thyregod, Sondergaard, Jorgensen) Heart Centre, Rigshospitalet,
Copenhagen University Hospital, Blegdamsvej 9 ,2100 Copenhagen O, Section
2151, Denmark
(Toff) Department of Cardiovascular Sciences, University of Leicester and
NIHR Leicester Biomedical Research Centre, Glenfield Hospital ,University
Rd, Leicester LE1 7RH, United Kingdom
(Van Mieghem) Department of Interventional Cardiology, Thoraxcenter,
Erasmus University Medical Center, Dr. Molewaterplein 40, Rotterdam 3015
GD, Netherlands
(Makkar) Cedars-Sinai Medical Center, Smidt Heart Institute, S San Vicente
Blvd, Los Angeles, CA 90048, USA
Publisher
NLM (Medline)
Abstract
AIMS: Additional randomized clinical trial (RCT) data comparing
transcatheter aortic valve implantation (TAVI) with surgical aortic valve
replacement (SAVR) is available, including longer term follow-up. A
meta-analysis comparing TAVI to SAVR was performed. A pragmatic risk
classification was applied, partitioning lower-risk and higher-risk
patients. METHODS AND RESULTS: The main endpoints were death, strokes, and
the composite of death or disabling stroke, occurring at 1 year (early) or
after 1 year (later). A random-effects meta-analysis was performed. Eight
RCTs with 8698 patients were included. In lower-risk patients, at 1 year,
the risk of death was lower after TAVI compared with SAVR [relative risk
(RR) 0.67; 95% confidence interval (CI) 0.47 to 0.96, P = 0.031], as was
death or disabling stroke (RR 0.68; 95% CI 0.50 to 0.92, P = 0.014). There
were no differences in strokes. After 1 year, in lower-risk patients,
there were no significant differences in all main outcomes. In higher-risk
patients, there were no significant differences in main outcomes.
New-onset atrial fibrillation, major bleeding, and acute kidney injury
occurred less after TAVI; new pacemakers, vascular complications, and
paravalvular leak occurred more after TAVI. CONCLUSION(S): In
lower-risk patients, there was an early mortality reduction with TAVI, but
no differences after later follow-up. There was also an early reduction in
the composite of death or disabling stroke, with no difference at later
follow-up. There were no significant differences for higher-risk patients.
Informed therapy decisions may be more dependent on the temporality of
events or secondary endpoints than the long-term occurrence of main
clinical outcomes. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<28>
Accession Number
2021119137
Title
Reduction of permanent pacemaker implantation by using the cusp overlap
technique in transcatheter aortic valve replacement: a meta-analysis.
Source
Clinical Research in Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Rawish E.; Macherey S.; Jurczyk D.; Patz T.; Jose J.; Stiermaier T.; Eitel
I.; Frerker C.; Schmidt T.
Institution
(Rawish, Jurczyk, Patz, Stiermaier, Eitel, Frerker, Schmidt) University
Hospital Schleswig-Holstein, Medical Clinic II, University Heart Center
Lubeck, Lubeck, Germany
(Rawish, Stiermaier, Eitel, Frerker, Schmidt) DZHK (German Centre for
Cardiovascular Research), Partner Site Hamburg/Kiel/Lubeck, Lubeck,
Germany
(Macherey) University of Cologne, Faculty of Medicine and University
Hospital Cologne, Clinic III for Internal Medicine, Cologne, Germany
(Jose) Cardiac Valve and Structural Heart Disease Clinic, Christian
Medical College Hospital, Vellore, India
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The need for permanent pacemaker (PPM) implantation is a
common complication after transcatheter aortic valve replacement (TAVR).
Deep implantation position is a risk factor for PPM implantation. Thus, in
the field of self-expandable (SE) transcatheter heart valves (THV) cusp
overlap projection (COP) technique was implemented to reduce parallax,
allowing a more precise guidance of implantation depth. Aim(s): This
meta-analysis aims to report the outcome of patients undergoing TAVR with
SE THV using COP versus conventional implantation technique (CIT).
 Method(s): Systematical search in MEDLINE and EMBASE yielded five
observational controlled studies comparing both implantation techniques
for the SE Evolut prosthesis (Medtronic Intern. Ltd., CA, USA) and
fulfilling the inclusion criteria for meta-analysis. Result(s):
Totally, 1227 patients were included, comprising 641 who underwent COP and
586 CIT TAVR. Incidence of post-procedural need for PPM implantation was
significantly lower in COP group (9.8% vs 20.6%; OR = 0.43; p < 0.00001).
This was accompanied by significantly higher implantation position in COP
group (mean difference distance from distal end of the intraventricular
portion of the THV to the non-coronary cusp (NCC): - 1.03 mm; p =
0.00001). Incidence of new-onset left bundle branch block did not differ.
Regarding procedural and 30-day mortality, technical success,
post-procedural aortic regurgitation, and rates of multiple device
implantation, no difference between COP and CIT was found.
 Conclusion(s): COP is an effective and safe implantation technique to
reduce the need for a permanent pacemaker implantation during TAVR with SE
Evolut prosthesis. Graphical abstract: [Figure not available: see
fulltext.] Copyright © 2023, The Author(s).

<29>
Accession Number
640082607
Title
Dual or single antiplatelet therapy after coronary surgery for acute
coronary syndrome (TACSI trial): Rationale and design of an
investigator-initiated, prospective, multinational, registry-based
randomized clinical trial.
Source
American heart journal. (no pagination), 2023. Date of Publication: 18
Jan 2023.
Author
Malm C.J.; Alfredsson J.; Erlinge D.; Gudbjartsson T.; Gunn J.; James S.;
Moller C.H.; Nielsen S.J.; Sartipy U.; Tonnessen T.; Jeppsson A.
Institution
(Malm, Nielsen, Jeppsson) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden; Department of Cardiothoracic Surgery, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Alfredsson) Department of Health, Medicine and Caring Sciences,;
Linkoping University, Linkoping, Sweden; Department of Cardiology,
Linkoping University Hospital, Linkoping, Sweden
(Erlinge) Department of Cardiology, Clinical Sciences, Lund University,
Lund, Sweden
(Gudbjartsson) Department of Cardiothoracic Surgery, Landspitali
University Hospital, Reykjavik, Iceland; Faculty of Medicine, University
of Iceland, Reykjavik, Iceland
(Gunn) Heart Center, Turku University Hospital and University of Turku,
Turku, Finland
(James) Department of Medical Sciences, Cardiology, Uppsala University,
Uppsala, Sweden
(Moller) Department for Cardiothoracic Surgery, Rigshospitalet, Copenhagen
University Hospital, Denmark; Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
(Sartipy) Department of Molecular Medicine and Surgery, Karolinska
Institutet, Stockholm, Sweden; Department of Cardiothoracic Surgery,
Karolinska University Hospital, Stockholm, Sweden
(Tonnessen) Department of Cardiothoracic Surgery, Oslo University
Hospital, Norway; University of Oslo, Oslo, Norway
Publisher
NLM (Medline)
Abstract
The TACSI trial (ClinicalTrials.gov Identifier: NCT03560310) tests the
hypothesis that one-year treatment with dual antiplatelet therapy (DAPT)
with acetylsalicylic acid (ASA) and ticagrelor is superior to only ASA
after isolated coronary artery bypass grafting (CABG) in patients with
acute coronary syndrome. The TACSI trial is an investor-initiated
pragmatic, prospective, multinational, multicenter, open-label,
registry-based randomized trial with 1:1 randomization to DAPT with ASA
and ticagrelor or ASA only, in patients undergoing first isolated CABG,
with a planned enrollment of 2200 patients at Nordic cardiac surgery
centers. The primary efficacy endpoint is a composite of time to all cause
death, myocardial infarction, stroke, or new coronary revascularization
within 12 months after randomization. The primary safety endpoint is time
to hospitalization due to major bleeding. Secondary efficacy endpoints
include time to the individual components of the primary endpoint,
cardiovascular death and rehospitalization due to cardiovascular causes.
High-quality health-care registries are used to assess primary and
secondary endpoints. The patients will be followed for 10 years. The TACSI
trial will give important information useful for guiding the antiplatelet
strategy in acute coronary syndrome patients treated with
CABG. Copyright © 2023. Published by Elsevier Inc.

<30>
Accession Number
640077577
Title
Pacemaker implantation associated with tricuspid repair in the setting of
mitral valve surgery: Insights from a Cardiothoracic Surgical Trials
Network randomized trial.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2022. Date of Publication: 08 Dec 2022.
Author
Ailawadi G.; Voisine P.; Raymond S.; Gelijns A.C.; Moskowitz A.J.; Falk
V.; Overbey J.R.; Chu M.W.A.; Mack M.J.; Bowdish M.E.; Krane M.; Yerokun
B.; Conradi L.; Bolling S.F.; Miller M.A.; Taddei-Peters W.C.; Fenton
K.N.; Jeffries N.O.; Kramer R.S.; Geirsson A.; Moquete E.G.; O'Sullivan
K.; Hupf J.; Hung J.; Beyersdorf F.; Bagiella E.; Gammie J.S.; O'Gara
P.T.; Iribarne A.; Borger M.A.; Gillinov M.
Institution
(Ailawadi, Bolling) Department of Cardiac Surgery, University of Michigan
Health System, Mich, Ann Arbor, United States
(Voisine) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec (IUCPQ), Quebec, Canada
(Raymond, Gelijns, Moskowitz, Overbey, Moquete, O'Sullivan, Hupf,
Bagiella) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, New York, NY
(Falk) Department of Cardiothoracic and Vascular Surgery, Department of
Cardiovascular Surgery, Charite Universitatsmedizin Berlin, German Centre
for Cardiovascular Research, DZHK, Partner Site Berlin, Berlin, Germany
(Chu) Division of Cardiac Surgery, London Health Sciences Centre, Western
University, London, ON, Canada
(Mack) Cardiac and Thoracic Surgery, Baylor Scott & White Health, Plano,
United States
(Bowdish) Department of Surgery and Population and Public Health Sciences,
Keck School of Medicine of USC, University of Southern California, Los
Angeles, Mexico
(Krane, Geirsson) Division of Cardiac Surgery, Department of Surgery, Yale
School of Medicine, New Haven, United States
(Yerokun) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University, Durham, NC, United States
(Conradi) University Heart and Vascular Center Hamburg, Hamburg, Germany
(Miller, Taddei-Peters, Fenton) Division of Cardiovascular Sciences,
National Heart, Lung, Blood Institute, National Institutes of Health,
Bethesda, Md, Liberia
(Jeffries) National Heart, Lung, Blood Institute, National Institutes of
Health, Bethesda, Md, Liberia
(Kramer) Thoracic Surgery (Cardiothoracic Vascular Surgery), Internal
Medicine, Maine Medical Center, Portland, Maine
(Hung) Division of Cardiology, Massachusetts General Hospital, Mass,
Boston, United States
(Beyersdorf) Department of Cardiovascular Surgery, University Heart Center
Freiburg, Freiburg, Germany
(Gammie) Cardiac Surgery, Johns Hopkins Heart and Vascular Institute,
Baltimore, Md, Liberia
(O'Gara) Cardiovascular Medicine, Brigham and Women's Hospital, Mass,
Boston, United States
(Iribarne) Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center,
NH, Lebanon
(Borger) Leipzig Heart Center, University of Leipzig, Leipzig, Germany
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVES: In a recent trial, tricuspid annuloplasty (TA) during mitral
valve surgery (MVS) for degenerative mitral regurgitation and moderate or
less tricuspid regurgitation (TR) reduced the composite rate of death,
reoperation for TR, or TR progression at 2 years. However, this benefit
was counterbalanced by an increase in implantation of permanent pacemakers
(PPMs). In this study, we analyzed the timing, indications, and risk
factors for these implantations. METHOD(S): We randomized 401
patients (MVS alone = 203; MVS + TA = 198). Potential risk factors for
PPMs were assessed using multivariable time-to-event models with death and
PPM implantation for heart failure indications as competing risks.
 RESULT(S): A PPM was implanted in 36 patients (9.6; 95% CI, 6.8-13.0)
within 2 years of randomization, with 30/187 (16.0%) in the MVS + TA and
6/188 (3.2%) in the MVS groups (rate ratio, 5.08; 95% CI, 2.16-11.94; P <
.001). Most (29/36; 80.6%) implantations occurred within 30 days
postoperatively. Independent risk factors for PPM implantation within 2
years were TA (hazard ratio [HR], 5.94; 95% CI, 2.27-15.53; P < .001),
increasing age (5 years, HR, 1.23; 95% CI, 1.01-1.52; P = .04), and left
ventricular ejection fraction (LVEF; HR, 0.96; 95% CI, 0.92-0.99; P =
.02). In the subset of TA recipients (n = 197), age (5 years, HR, 1.05;
95% CI, 1.00-1.10; P = .04) and LVEF (HR, 0.95; 95% CI, 0.91-0.99; P =
.01) were associated with PPM within 2 years. CONCLUSION(S):
Concomitant TA, age, and baseline LVEF were risk factors for PPM
implantation in patients who underwent MVS for degenerative mitral
regurgitation. Although TA was effective in preventing progression of TR,
innovation is needed to identify ways to decrease PPM implantation
rates. Copyright © 2022 The American Association for Thoracic
Surgery. All rights reserved.

<31>
Accession Number
640077347
Title
Transcatheter Aortic Valve Replacement vs. Surgical Aortic Valve
Replacement for Long-Term Mortality Due to Stroke and Myocardial
Infarction: A Meta-Analysis during the COVID-19 Pandemic.
Source
Medicina (Kaunas, Lithuania). 59(1) (no pagination), 2022. Date of
Publication: 21 Dec 2022.
Author
Ion A.C.; Serbanoiu L.I.; Plesu E.; Busnatu S.S.; Andrei C.L.
Institution
(Ion, Serbanoiu, Plesu, Busnatu, Andrei) Faculty of Medicine, Department
5, Cardiology, Carol Davila University of Medicine and Pharmacy, Bucharest
020021, Romania
(Ion, Serbanoiu, Plesu, Busnatu, Andrei) Cardiology Department, Bagdasar
Arseni Emergency Hospital, Bucharest 041915, Romania
Publisher
NLM (Medline)
Abstract
Background and objectives: One of the leading causes of mortality and
morbidity in people over the age of 50 is stroke. The acceptance of
transcatheter aortic valve replacement (TAVR) as a treatment option for
severe symptomatic aortic stenosis (AS) has increased as a result of
numerous randomized clinical trials comparing surgical aortic valve
replacement (SAVR) and TAVR in high- and intermediate-risk patients,
showing comparable clinical outcomes and valve hemodynamics.
 Material(s) and Method(s): An electronic search of Medline, Google
Scholar and Cochrane Central was carried out from their inception to 28
September 2022 without any language restrictions. Result(s): Our
meta-analysis demonstrated that, as compared with SAVR, TAVR was not
linked with a lower stroke ratio or stroke mortality. It is clear from
this that the SAVR intervention techniques applied in the six studies were
successful in reducing cardiogenic consequences over time.
 Conclusion(s): A significantly decreased rate of mortality from
cardiogenic causes was associated with SAVR. Additionally, when TAVR and
SAVR were compared for stroke mortality, the results were nonsignificant
with a p value of 0.57, indicating that none of these procedures could
decrease stroke-related mortality.

<32>
Accession Number
2016604060
Title
Role of Platelets in Acute Lung Injury After Extracorporeal Circulation in
Cardiac Surgery Patients: A Systemic Review.
Source
Current Problems in Cardiology. 47(11) (no pagination), 2022. Article
Number: 101088. Date of Publication: November 2022.
Author
Sandeep B.; Xiao Z.; Zhao F.; Feng Q.; Gao K.
Institution
(Sandeep, Xiao, Gao) Department of Cardiothoracic Surgery, Chengdu Second
People's Hospital, Sichuan, Chengdu, China
(Zhao, Feng) Department of Intensive Care Unit, Chengdu Second People's
Hospital, Sichuan, Chengdu, China
Publisher
Elsevier Inc.
Abstract
In vitro circulation (cardiopulmonary bypass, CPB) has been widely used in
heart surgery. In the past, it was believed that the reduction of platelet
count and impaired platelet function during cardiac surgery were the main
causes of acute lung injury (ALI). ALI is a life-threatening clinical
syndrome in critically ill patients due to an uncontrolled systemic
inflammatory response resulting from direct injury to the lung or indirect
injury in the setting of a systemic process. Platelets have an emerging
and incompletely understood role in a myriad of ALI after extracorporeal
circulation in cardiac surgery patients. An electronic literature search
was performed using Pubmed, Scopus and Cinahl investigating ALI,
pathogenesis, and role of platelets, treatment and management for ALI
patients. Many studies have shown that in vitro circulation is a
nonphysiological process that can lead to a decrease in the number of
platelets and impaired platelet function, as well as varying degrees of
lung damage. The relationship between the effects of in vitro circulation
on platelets and acute lung injury is still controversial. This review
article discusses the role of platelets in lung injury after
cardiopulmonary bypass and resent development in the management of
ALI. Copyright © 2021 Elsevier Inc.

<33>
Accession Number
2016548013
Title
Meta-Analysis of Transcatheter Aortic Valve Implantation Using the Sapien
3 Versus Sapien 3 Ultra Valves.
Source
American Journal of Cardiology. 168 (pp 170-172), 2022. Date of
Publication: 01 Apr 2022.
Author
Abdelfattah O.M.; Sayed A.; Ghonim M.; Saleh Y.; Genereux P.; Goel S.S.;
Krishnaswamy A.; Yun J.; Kapadia S.R.
Institution
(Abdelfattah) Department of Internal Medicine
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Atlantic Health System, Morristown, NJ, United States
(Sayed, Ghonim) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Saleh, Goel) Department of Cardiology, Houston Methodist Hospital, Texas,
Houston
(Krishnaswamy, Yun, Kapadia) Heart Vascular and Thoracic Institute,
Department of Cardiovascular Medicine, Cleveland Clinic, Ohio, Cleveland
(Saleh) Gagnon Cardiovascular Institute, Morristown Medical Center,
Atlantic Health System, New Jersey, Morristown, Egypt
Publisher
Elsevier Inc.

<34>
Accession Number
2014816611
Title
The role of the electrocardiogram in the recognition of cardiac transplant
rejection: A systematic review and meta-analysis.
Source
Clinical Cardiology. 45(3) (pp 258-264), 2022. Date of Publication: March
2022.
Author
Hashim H.T.; Ramadhan M.A.; Ahmad S.; Shah J.; Varney J.; Motawea K.R.;
Kandil O.A.
Institution
(Hashim, Ramadhan) College of Medicine, University of Baghdad, Baghdad,
Iraq
(Ahmad) Punjab Medical College, Faisalabad, Pakistan
(Shah) Drexel University College of Medicine, Philadelphia, PA, United
States
(Varney) School of Medicine, American University of the Caribbean, St
Maarten, United States
(Motawea, Kandil) Faculty of Medicine, Alexandria University, Alexandria,
Egypt
Publisher
John Wiley and Sons Inc
Abstract
Background: In cardiac transplant recipients, the electrocardiogram (ECG)
is a noninvasive measure of early allograft rejection. The ECG can predict
an acute cellular rejection, thus shortening the time to recognition of
rejection. Earlier diagnosis has the potential to reduce the number and
severity of rejection episodes. Methodology: A systematic literature
review was conducted to identify and select the original research reports
on using electrocardiography in diagnosing cardiac transplant rejection in
accordance with the PRISMA guidelines. Studies included reported
sensitivity and specificity of ECG readings in heart transplant recipients
during the first post-transplant year. Data were analyzed with Review
manager version 5.4. p-value was used in testing the significant
difference. Result(s): After the removal of duplicates, 98 articles
were eligible for screening. After the full-text screening, a total of 17
papers were included in the review based on the above criteria. A
meta-analysis of five studies was done. Conclusion(s): In heart
transplant recipients, a noninvasive measure of early allograft rejection
has the potential to reduce the number and severity of rejection episodes
by reducing the time and cost of surveillance of rejection and shortening
the time to recognition of rejection. Copyright © 2022 The
Authors. Clinical Cardiology published by Wiley Periodicals LLC

<35>
Accession Number
2020976082
Title
The effect of massage therapy on pain after surgery: A comprehensive
meta-analysis.
Source
Complementary Therapies in Medicine. 71 (no pagination), 2022. Article
Number: 102892. Date of Publication: December 2022.
Author
Liu C.; Chen X.; Wu S.
Institution
(Liu, Wu) Department of Cancer Rehabilitation, Lishui Hospital of
Traditional Chinese Medicine, Affiliated to Zhejiang University of
Traditional Chinese Medicine, Zhejiang, Lishui, China
(Chen) The Second Affiliated Hospital of Wenzhou Medical University,
Zhejiang, Wenzhou, China
Publisher
Churchill Livingstone
Abstract
Background: Findings on the usefulness of massage therapy (MT) in
postoperative pain management are often inconsistent among studies.
 Objective(s): This study's aim is to conduct a meta-analysis of
randomized controlled trials (RCT) to clarify the effects of massage
therapy in the treatment of postoperative pain. Method(s): Three
databases (PubMed, Embase, and Cochrane Central Register of Controlled
Trials) were searched for RCTs published from database inception through
January 26, 2021. The primary outcome was pain relief. The quality of RCTs
was appraised with the Cochrane Collaboration risk of bias tool. The
random-effect model was used to calculate the effect sizes and
standardized mean difference (SMD) with 95 % confidential intervals (CIs)
as a summary effect. The heterogeneity test was conducted through
I2. Subgroup and sensitivity analyses were used to explore the
source of heterogeneity. Possible publication bias was assessed using
visual inspection of funnel plot asymmetry. Result(s): The analysis
included 33 RCTs and showed that MT is effective in reducing postoperative
pain (SMD, -1.32; 95 % CI, -2.01 to -0.63; p = 0.0002; I2 =
98.67 %). A similar significant effect was found for both short (immediate
assessment) and long terms (assessment performed 4-6 weeks after the MT).
Remarkably, we found neither the duration per session nor the dose had an
impact on the effect of MT and there seemed to be no difference in the
effects of different MT types. In addition, MT seemed to be more effective
for adults. Furthermore, MT had better analgesic effects on cesarean
section and heart surgery than orthopedic surgery. Limitation(s):
Publication bias is possible due to the inclusion of studies in English
only. Additionally, the included studies were extremely heterogeneous.
Double-blind research on MT is difficult to implement, and none of the
included studies is double-blind. There was some heterogeneity and
publication bias in the included studies. In addition, there is no uniform
evaluation standard for the operation level of massage practitioners,
which may lead to research implementation bias. Conclusion(s): MT is
effective in reducing postoperative pain in both short and long
terms. Copyright © 2022 The Authors

<36>
Accession Number
640055331
Title
Gender-related differences on outcome following transcatheter mitral valve
repair (TMVR): a systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 18(1) (pp 31), 2023. Date of
Publication: 17 Jan 2023.
Author
Yi K.; Gao J.; Wang W.-X.; Ma Y.-H.; Wang W.; He S.E.; Xu X.-M.; Li P.-F.;
You T.
Institution
(Yi, You) Department of Cardiovascular Surgery, Gansu Provincial Hospital,
No. 204, Gansu ProvinceDonggang West Road, Lanzhou 730000, China
(Yi, Gao, Wang, He, Xu, Li, You) Gansu International Scientific and
Technological Cooperation Base of Diagnosis and Treatment of Congenital
Heart Disease, Lanzhou, China
(Gao, Xu, Li) First Clinical Medical College of Lanzhou University,
Lanzhou, China
(Gao) Department of Pediatrics, First Affiliated Hospital of SunYat-sen
University, Guangzhou, China
(Wang) First Clinical Medical College of Gansu University of Chinese
Medicine, Lanzhou, China
(Ma) Department of Neurosurgery, West China Hospital of Sichuan
University, Chengdu, China
(Wang) Department of Cardiac Surgery, First Hospital of China Medical
University, Shenyang, China
(He) Second Clinical Medical College of Lanzhou University, Lanzhou, China
(Xu) Division of Gastroenterology, Seventh Affiliated Hospital of Sun
Yat-Sen University, Shenzhen, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The effect of gender on patients with mitral valve
regurgitation (MR) undergoing transcatheter mitral valve repair (TMVR)
remains to be defined. The aim of the present study is a comprehensive
meta-analysis of studies that investigate differences between men and
women after TMVR. METHOD(S): A systematic literature search was
carried out on eight databases to collect all relevant studies on
gender-related outcomes of TMVR before March 1, 2021. The main outcomes of
interest were mortality, cardiac function, MR class and other
complications. RESULT(S): A total of eight literatures were included,
all of which were retrospective observational studies. Compared to women
patients, men had lower postoperative New York Heart Association (NYHA)
class (OR=1.53, 95%CI [1.23, 1.91], P=0.0001) and higher incidence of
postoperative acute kidney injury (AKI) (OR=1.25, 95%CI [1.16, 1.34],
P<0.05). There were no significant difference on mortality in 30 days
(OR=0.95, 95%CI [0.81, 1.11], P=0.53) and in 2 years (OR=0.99, 95%CI
[0.75, 1.30], P=0.93), mitral valve regurgitation (MR) class (OR=1.30,
95%CI [0.97, 1.75], P=0.08) and incidence of myocardial infarction (MI)
(OR=0.88, 95%CI [0.65, 1.18], P=0.38), stroke (OR=0.80, 95%CI [0.63,
1.02], P=0.08) and bleeding in hospital (OR=0.84, 95%CI [0.59, 1.19],
P=0.32). CONCLUSION(S): Our meta-analysis demonstrates that men
undergoing TMVR have worse preoperative diseases (diabetes mellitus,
coronary artery disease, renal failure and myocardial infarction) while
they have superior postoperative NYHA class at one-year. There are no
significantly difference in other indexes between men and
women. Copyright © 2023. The Author(s).

<37>
Accession Number
2021935017
Title
EE294 Cost-Effectiveness of Left Ventricular Assist Devices as Destination
Therapy: An Economic Modelling Study.
Source
Value in Health. Conference: ISPOR Europe 2022. Vienna Austria. 25(12
Supplement) (pp S111), 2022. Date of Publication: December 2022.
Author
Saygin Avsar T.; Jackson L.; Barton P.; Beese S.; Lim S.; Queen D.; Price
M.; Moore D.
Institution
(Saygin Avsar) University College London, LON, West Drayton, United
Kingdom
(Jackson, Barton, Beese, Price, Moore) University of Birmingham,
Birmingham, United Kingdom
(Lim, Queen) University of Birmingham Hospitals, Birmingham, United
Kingdom
Publisher
Elsevier Ltd
Abstract
Objectives: In the UK, Left Ventricular Assist Devices (LVADs) are not
commissioned by the NHS as destination therapy (advanced heart failure
patients who are ineligible for heart transplantation). Existing economic
evaluations of LVADs for these patients have limitations. This study aimed
to estimate the cost-effectiveness of LVADs as destination therapy in the
UK compared to optimal medical therapy. Method(s): A cost-utility
analysis from an NHS perspective was conducted, using a novel Markov model
with a lifetime horizon and monthly cycles. The model development was
informed by systematic reviews and guidance from clinicians, patients and
commissioners. The costs were in UK at 2019 prices, and a discount rate of
3.5% was employed. The analysis was repeated incorporating the probability
of transition to heart transplant (HT). Exploratory sub-group analyses
estimated the impact of severity of heart failure (INTERMACS profiles) on
cost-effectiveness. Uncertainty was measured in deterministic and
probabilistic sensitivity analyses. Result(s): LVAD produced an
additional 2.20 (95% CI 1.99 - 2.42) QALYs at an incremental cost of
140,375 (95% CI 116,889 - 166,018) compared to medical management. Thus,
the incremental cost-effectiveness ratio per QALY (ICER) was 63,870. The
probability of cost-effectiveness was 2% at a threshold of 50,000 per QALY
gained, reaching 100% at a threshold of 90,000. The ICER remained above
50,000 if a small proportion of patients receiving LVAD become eligible
for a heart transplant and in sub-group analyses based on INTERMACS
profiles. The deterministic sensitivity analysis revealed that varying the
ongoing outpatient costs for medical management had a significant impact
on the results. Conclusion(s): In contrast to two recent UK studies,
this study found that LVADs are not cost-effective as destination therapy
in the UK at a threshold of 50,000 per QALY gained. Robust data on ongoing
costs for medical management are needed. Funding(s): UK NIHR-HTA
programme: NIHR128996 Copyright © 2022

<38>
Accession Number
2021094682
Title
Music therapy for pain and anxiety in patients after cardiac valve
replacement: a randomized controlled clinical trial.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
32. Date of Publication: December 2023.
Author
Dong Y.; Zhang L.; Chen L.-W.; Luo Z.-R.
Institution
(Dong, Zhang, Chen, Luo) Department of Cardiovascular Surgery and Cardiac
Disease Center, Union Hospital, Fujian Medical University, Fuzhou 350001,
China
(Dong, Zhang, Chen, Luo) Key Laboratory of Cardio-Thoracic Surgery (Fujian
Medical University), Fujian Province University, Fuzhou, China
Publisher
BioMed Central Ltd
Abstract
Objective: This study aimed to assess how listening to music after cardiac
valve replacements affected patients' pain, anxiety, and vital signs.
 Method(s): In Fuzhou, China's Fujian Medical University Union
Hospital, the cardiac surgery division conducted a randomized controlled
clinical experiment. 86 patients were enrolled, and 43 were assigned
randomly to each group (control and experimental group). The standard
treatment was given to the control group, while the experimental group was
given standard treatment + a 15-min music intervention 3 times. Indicators
include pain, anxiety and vital signs (respiratory rate, heart rate, and
blood pressure). Result(s): In comparison to the control group, the
experimental group, over time, demonstrated a statistically substantial
decrease in pain, anxiety, systolic blood pressure, heart rate and
respiratory rate (all P < 0.001), yet, there were no discernible
variations (P > 0.05) in diastolic blood pressure. Conclusion(s): In
conclusion, these results provide additional proof for using music therapy
to minimize cardiac postoperative pain and anxiety, as well as systolic
blood pressure, heart rate and respiratory rate. Moreover, it should be
regarded as a supplementary treatment for pain and anxiety after cardiac
valve replacement and other medical procedures with comparable
postoperative pain. Copyright © 2023, The Author(s).

<39>
Accession Number
2021030768
Title
Coronary Revascularization in Patients With Diabetes: A Meta-analysis of
Randomized Controlled Trials and Propensity-Matched Studies.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2023. Date of Publication: 2023.
Author
Ahmed A.; Varghese K.S.; Fusco P.J.; Mathew D.M.; Mathew S.M.; Ahmed S.;
Rogando D.O.; Salazar S.A.; Pandey R.; Awad A.K.; Levy K.H.; Hernandez M.;
Calixte R.
Institution
(Ahmed, Varghese, Fusco, Mathew, Mathew, Ahmed, Rogando, Salazar, Pandey,
Awad, Levy, Hernandez) City University of New York School of Medicine, New
York, NY, United States
(Calixte) Epidemiology and Biostatistics, SUNY Downstate Health Sciences
University, Brooklyn, NY, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: Patients with diabetes have poorer outcomes with coronary
artery disease (CAD) and pose a unique clinical population for
revascularization. We performed a pairwise meta-analysis of randomized
trials (RCTs) and propensity-matched observational studies (PMS) to
compare the clinical outcomes of coronary artery bypass grafting (CABG)
and percutaneous coronary intervention (PCI) in patients with diabetes.
 Method(s): A comprehensive literature search was performed to
identify RCT and PMS studies comparing CABG with PCI in patients with
diabetes with concurrent CAD. Studies were pooled using the random-effects
model to perform a pairwise meta-analysis. Primary outcomes included
long-term all-cause mortality, cardiac mortality, myocardial infarction
(MI), major adverse cardiac and cerebrovascular events (MACCE), and repeat
revascularization. Meta-regression was used to explore the effects of
baseline risk factors on primary outcomes with moderate to high
heterogeneity. Result(s): A total of 18 RCTs and 9 PMS with 28,846
patients were included. PCI was associated with increased long-term
all-cause mortality (risk ratio [RR] = 1.34, P < 0.001), cardiac mortality
(RR = 1.52, P < 0.001), MI (RR = 1.51, P = 0.009), MACCE (RR = 1.65, P <
0.001), and repeat revascularization (RR = 2.48, P < 0.001) compared with
CABG. There was no difference in long-term stroke between the 2 groups (RR
= 0.95, P = 0.82). At meta-regression, a greater proportion of female
patients in studies was associated with a decreased protective benefit for
CABG for long-term all-cause mortality but an increased protective benefit
for long-term MI and repeat revascularization. Conclusion(s):
Revascularization of patients with diabetes using CABG is associated with
significantly reduced long-term mortality, MI, MACCE, and repeat
revascularizations. Future studies exploring the influence of gender on
revascularization outcomes are necessary to elucidate the ideal treatment
modality in patients with diabetes. (Figure presented.). Copyright
© The Author(s) 2023.

<40>
Accession Number
640063816
Title
Contribution of Turkey in Liver Transplant Research: A Scopus Database
Search.
Source
Experimental and clinical transplantation : official journal of the Middle
East Society for Organ Transplantation. (no pagination), 2023. Date of
Publication: 16 Jan 2023.
Author
Sahin S.; Alkan S.
Institution
(Sahin) From the Department of Cardiovascular Surgery, Canakkale Onsekiz
Mart University, Faculty of Medicine, Canakkale, Turkey
Publisher
NLM (Medline)
Abstract
OBJECTIVES: In 2001, Turkey performed its the first successful heart
transplant. Since 2011, 765 heart transplants have been conducted among 15
heart transplant centers. The scientific impact of Turkish articles on
heart transplantation remains uncertain. The purpose of this study was to
evaluate Turkey's contributions in international heart transplant
research. MATERIALS AND METHODS: The bibliometric study approach was used
to assess publications on heart transplantation, which included analysis
of year of publication, organizations/authors, sponsorship, keywords,
citations, and other characteristics. Titles, abstracts, and key words
were searched in the Web of Science database for terms that included
"heart" or "cardiac" and "transplantation." Methods for both quantitative
and qualitative data analysis were used. RESULT(S): During the
analysis period of 1970 through 2021, 6370 article publications were
retrieved with an average of 20.88 citations/article and 133 018 total
citations. H index was 129. Most of the retrieved articles were from
research areas of surgery (n = 2876; 45.14%), followed by transplantation
(n = 2818; 44.23%) and cardiovascular system cardiology (n = 2522;
39.59%). Annual citation growth showed slow growth until 1986. The highest
number of citations was seen in 2021 (n = 702). The United States led
countries on articles (n = 2924; 45.9%), followed by Germany (n = 458;
7.19%), England (n = 411; 6.45%), Canada (n = 384; 6.02%), France (n =
330; 5.18%), and Spain (n = 329; 5.16%). The other 84 countries totaled
753 (11.82%) articles. Turkey ranked eighteenth with 87 publications, with
Baskent University (n = 37) and Ege University (n = 13) being the leading
centers on heart transplant research in Turkey. CONCLUSION(S):
Publications from the United States continue to increase. The workload of
both transplant surgery and research and publishing is challenging and
Turkish researchers are encouraged to make strides at innovations.

<41>
Accession Number
640061952
Title
Cusp-overlap versus coplanar view in transcatheter aortic valve
implantation with self-expandable valves: A meta-analysis of comparative
studies.
Source
Catheterization and cardiovascular interventions : official journal of the
Society for Cardiac Angiography & Interventions. (no pagination), 2023.
Date of Publication: 19 Jan 2023.
Author
Sa M.P.; Van den Eynde J.; Jacquemyn X.; Erten O.; Dokollari A.; Sicouri
S.; Ramlawi B.
Institution
(Sa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau Heart
Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Sa, Erten, Dokollari, Sicouri, Ramlawi) Department of Cardiothoracic
Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA,
United States
(Van den Eynde, Jacquemyn) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
Publisher
NLM (Medline)
Abstract
BACKGROUND: Permanent pacemaker implantation (PPI) is a common
complication after transcatheter aortic valve implantation (TAVI). The
cusp-overlap view (COV) was adopted to reduce PPI risk after TAVI with
self-expandable valves (SEVs); however, the evidence remains scarce. We
performed a systematic review with meta-analysis comparing COV and the
standard coplanar view (CPV) technique to evaluate their effectiveness and
safety. METHOD(S): Following the PRISMA statement, data were
extracted from studies published by August 2022 and found in
PubMed/MEDLINE, EMBASE, CENTRAL/CCTR, ClinicalTrials.gov, SciELO, LILACS,
and Google Scholar. The primary outcome of interest was post-procedural
PPI and the secondary outcomes were new left bundle branch block (LBBB),
moderate/severe paravalvular leak (PVL), valve dislocation (pop-out); need
of second transcatheter heart valve, 30-day mortality, stroke, conversion
to surgery, coronary obstruction, implantation depth (mm), and post-TAVI
mean gradients (mmHg). RESULT(S): Eleven studies met our eligibility
criteria and included 1464 patients in the COV group and 1743 patients in
the CPV group. Patients who underwent TAVI with COV had lower risk of PPI
(odds ratio 0.48; 95% confidence interval [CI] 0.33-0.70; p=0.001) and
higher implantation depths with COV (mean difference -0.83; 95% CI -1.2 to
-0.45; p<0.001). We did not observe any statistically significant
differences in the rates of new LBBB, moderate/severe PVL, valve
dislocation, need of second transcatheter heart valve, 30-day mortality,
stroke, conversion to surgery, coronary obstruction, and post-TAVI mean
gradients (mmHg). CONCLUSION(S): In TAVI with SEVs, the application
of COV is associated with lower risk of PPI compared with the standard CPV
without increasing risk for adverse outcomes. Copyright © 2023
Wiley Periodicals LLC.

<42>
[Use Link to view the full text]
Accession Number
2017207366
Title
Prophylactic Penehyclidine Inhalation for Prevention of Postoperative
Pulmonary Complications in High-risk Patients: A Double-blind Randomized
Trial.
Source
Anesthesiology. 136(4) (pp 551-566), 2022. Date of Publication: 01 Apr
2022.
Author
Yan T.; Liang X.-Q.; Wang G.-J.; Wang T.; Li W.-O.; Liu Y.; Wu L.-Y.; Yu
K.-Y.; Zhu S.-N.; Wang D.-X.; Sessler D.I.
Institution
(Yan, Liang, Wang, Wang, Li, Liu, Wu, Wang) The Departments of
Anesthesiology and Critical Care Medicine, Peking University First
Hospital, Beijing, China
(Yu) Respiratory and Critical Care Medicine, Peking University First
Hospital, Beijing, China
(Zhu) Biostatistics, Peking University First Hospital, Beijing, China
(Wang) The Department of Anesthesiology, Aerospace Central Hospital,
Peking University Aerospace School of Clinical Medicine, Beijing, China
(Li) The Department of Anesthesiology, Plastic Surgery Hospital, Chinese
Academy of Medical Science, Peking Union Medical College, Beijing, China
(Liu) The Department of Anesthesiology, Beijing Fangshan Liangxiang
Hospital, Beijing, China
(Wu) The Department of Anesthesiology, Beijing Ditan Hospital, Capital
Medical University, Beijing, China
(Sessler) The Outcomes Research Consortium, Cleveland, OH, United States
(Sessler) The Department of Outcomes Research, Cleveland Clinic,
Cleveland, OH, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Postoperative pulmonary complications are common. Aging and
respiratory disease provoke airway hyperresponsiveness, high-risk surgery
induces diaphragmatic dysfunction, and general anesthesia contributes to
atelectasis and peripheral airway injury. This study therefore tested the
hypothesis that inhalation of penehyclidine, a long-acting muscarinic
antagonist, reduces the incidence of pulmonary complications in high-risk
patients over the initial 30 postoperative days. Method(s): This
single-center double-blind trial enrolled 864 patients age over 50 yr who
were scheduled for major upper-abdominal or noncardiac thoracic surgery
lasting 2 h or more and who had an Assess Respiratory Risk in Surgical
Patients in Catalonia score of 45 or higher. The patients were randomly
assigned to placebo or prophylactic penehyclidine inhalation from the
night before surgery through postoperative day 2 at 12-h intervals. The
primary outcome was the incidence of a composite of pulmonary
complications within 30 postoperative days, including respiratory
infection, respiratory failure, pleural effusion, atelectasis,
pneumothorax, bronchospasm, and aspiration pneumonitis. Result(s): A
total of 826 patients (mean age, 64 yr; 63% male) were included in the
intention-to-treat analysis. A composite of pulmonary complications was
less common in patients assigned to penehyclidine (18.9% [79 of 417]) than
those receiving the placebo (26.4% [108 of 409]; relative risk, 0.72; 95%
CI, 0.56 to 0.93; P = 0.010; number needed to treat, 13). Bronchospasm was
less common in penehyclidine than placebo patients: 1.4% (6 of 417) versus
4.4% (18 of 409; relative risk, 0.327; 95% CI, 0.131 to 0.82; P = 0.011).
None of the other individual pulmonary complications differed
significantly. Peak airway pressures greater than 40 cm H<inf>2</inf>O
were also less common in patients given penehyclidine: 1.9% (8 of 432)
versus 4.9% (21 of 432; relative risk, 0.381; 95% CI, 0.171 to 0.85; P =
0.014). The incidence of other adverse events, including dry mouth and
delirium, that were potentially related to penehyclidine inhalation did
not differ between the groups. Conclusion(s): In high-risk patients
having major upper-abdominal or noncardiac thoracic surgery, prophylactic
penehyclidine inhalation reduced the incidence of pulmonary complications
without provoking complications. Copyright © 2022 Lippincott
Williams and Wilkins. All rights reserved.

<43>
Accession Number
2013619342
Title
Impact of minimal invasive extracorporeal circulation on perioperative
intravenous fluid management in coronary artery bypass surgery.
Source
Perfusion (United Kingdom). 38(1) (pp 135-141), 2023. Date of Publication:
January 2023.
Author
Ellam S.; Rasanen J.; Hartikainen J.; Selander T.; Juutilainen A.; Halonen
J.
Institution
(Ellam) Department of Anesthesiology and Operative Services, Kuopio
University Hospital, Kuopio, Finland
(Rasanen, Hartikainen, Juutilainen, Halonen) School of Medicine,
University of Eastern Finland, Kuopio, Finland
(Hartikainen, Halonen) Heart Center, Kuopio University Hospital, Kuopio,
Finland
(Selander) Research Support Services, Kuopio University Hospital, Kuopio,
Finland
Publisher
SAGE Publications Ltd
Abstract
Objective: Compare the use of blood products and intravenous fluid
management in patients scheduled for coronary artery bypass surgery and
randomized to minimal invasive extracorporeal circulation (MiECC) and
conventional extracorporeal circulation (CECC). Method(s): A total of
240 patients who were scheduled for their first on-pump CABG, were
randomized to MiECC or CECC groups. The study period was the first 84
hours after surgery. Hemoglobin <80 g/l was used as transfusion trigger.
 Result(s): Red blood cell transfusions intraoperatively were given
less often in the MiECC group (23.3% vs 9.2%, p = 0.005) and the total
intravenous fluid intake was significantly lower in the MiECC group (3300
ml [2950-4000] vs 4800 ml [4000-5500], p < 0.001). Hemoglobin drop also
was lower in the MiECC group (35.5 +/- 8.9 g/l vs 50.7 +/- 9 g/l, p <
0.001) as was hemoglobin drop percent (25.3 +/- 6% vs 35.3 +/- 5.9%, p <
0.001). Chest tube drainage output was higher in the MiECC group (645 ml
[500-917.5] vs 550 ml [412.5-750], p = 0.001). Particularly, chest tube
drainage in up to 600 ml category, was in benefit of CECC group (59.1% vs
40.8%, p = 0.003). ROC curve analysis showed that patients with hemoglobin
level below 95 g/l upon arrival to intensive care unit was associated with
increased risk of developing postoperative atrial fibrillation (POAF) (p =
0.002, auc = 0.61, cutoff <95, sensitivity = 0.47, positive predictive
value = 0.64). Conclusion(s): MiECC reduced the intraoperative need
for RBC transfusion and intravenous fluids compared to the CECC group,
also reducing hemoglobin drop compared to the CECC group in CABG surgery
patients. Postoperative hemoglobin drop was a predictor of
POAF. Copyright © The Author(s) 2021.

<44>
Accession Number
2013496714
Title
Predicting atrial fibrillation after cardiac surgery: a scoping review of
associated factors and systematic review of existing prediction models.
Source
Perfusion (United Kingdom). 38(1) (pp 92-108), 2023. Date of Publication:
January 2023.
Author
Fleet H.; Pilcher D.; Bellomo R.; Coulson T.G.
Institution
(Fleet) Melbourne Medical School, The University of Melbourne, Melbourne,
VIC, Australia
(Pilcher, Coulson) Department of Epidemiology and Preventative Medicine,
Monash University, Melbourne, VIC, Australia
(Bellomo, Coulson) Centre for Integrated Critical Care, The University of
Melbourne, Parkville, VIC, Australia
(Coulson) Department of Anaesthesia, Austin Hospital, Melbourne, VIC,
Australia
Publisher
SAGE Publications Ltd
Abstract
Introduction: Postoperative atrial fibrillation (POAF) is common after
cardiac surgery and associated with increased hospital length of stay,
patient morbidity and mortality. We aimed to identify factors associated
with POAF and evaluate the accuracy of available POAF prediction models.
 Method(s): We screened articles from Ovid MEDLINE and
PubMed Central (PMC) and included studies that evaluated risk
factors associated with POAF or studies that designed or validated POAF
prediction models. We only included studies in cardiac surgical patients
with sample size n 50 and a POAF outcome group 20. We summarised factors
that were associated with POAF and assessed prediction model performance
by reviewing reported calibration and discriminative ability.
 Result(s): We reviewed 232 studies. Of these, 142 fulfilled the
inclusion criteria. Age was frequently found to be associated with POAF,
while most other variables showed contradictory findings, or were assessed
in few studies. Overall, 15 studies specifically developed and/or
validated 12 prediction models. Of these, all showed poor discrimination
or absent calibration in predicting POAF in externally validated cohorts.
 Conclusion(s): Except for age, reporting of factors associated with
POAF is inconsistent and often contradictory. Prediction models have low
discrimination, missing calibration statistics, are at risk of bias and
show limited clinical applicability. This suggests the need for studies
that prospectively collect AF relevant data in large cohorts and then
proceed to validate findings in external data sets. Copyright ©
The Author(s) 2021.

<45>
Accession Number
2013279605
Title
Comparative clinical efficacy of novel bidirectional cannula in cardiac
surgery via peripheral cannulation for cardiopulmonary bypass.
Source
Perfusion (United Kingdom). 38(1) (pp 44-50), 2023. Date of Publication:
January 2023.
Author
Gunaydin S.; Babaroglu S.; Budak A.B.; Sayin B.; Cayhan V.; Ozisik K.
Institution
(Gunaydin, Babaroglu, Budak, Ozisik) Department of Cardiovascular Surgery,
Ankara City Hospital, University of Health Sciences, Ankara, Turkey
(Sayin, Cayhan) Department of Radiology, Ankara City Hospital, University
of Health Sciences, Ankara, Turkey
Publisher
SAGE Publications Ltd
Abstract
Objectives: The aim of this study is to evaluate the safety and efficacy
of the novel bidirectional cannula that ensures stable distal perfusion
compared to conventional cannula in patients undergoing femoral arterial
cannulation for cardiopulmonary bypass (CPB). Method(s): During a
1-year period, 64 patients undergoing surgery via peripheral cannulation
were prospectively randomized to receive 19 F bidirectional (BiflowTM,
LivaNova, Italy) or 19 F conventional (HLS Peripheral cannula, Getinge
GroupTM, Germany) cannula with 6 F downstream line (BicakcilarTM, Turkey)
for femoral artery cannulation. The primary outcome included the efficacy
(adequacy of antegrade/retrograde comparative flow via cannula measured by
doppler ultrasonography) and the secondary outcome was the safety
(early/late complications and adverse events). Result(s): Percent
flow (distal/proximal) after cannulation measured by doppler
ultrasonography was significantly better in study group (33.1 +/- 5
ml/min) versus downstream cannula (16.1 +/- 4, p = 0.012). SpO<inf>2</inf>
measured by near infrared spectroscopy (NIRS) also demonstrated
significantly better saturation in distal calf of the cannulated leg in
bidirectional cannula group (67.5% +/- 10% vs 52.5 +/- 8, p = 0.04). The
incidence of serious adverse events was seroma on femoral region (one
patient), superficial wound infection (one patient), pseudo-hematoma (two
patients) in bidirectional cannula group and in-hospital femoral
embolectomy/artery repair (two patients), superficial wound infection
(three patients), cannulation site hematoma (three patients) in
conventional cannula group. Conclusion(s): This study demonstrates
that in patients undergoing femoral arterial cannulation for CPB during
cardiac surgery, the use of a novel bidirectional cannula is safe and easy
to insert and provides stable distal perfusion of the cannulated
limb. Copyright © The Author(s) 2021.

<46>
[Use Link to view the full text]
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
O'Brien S.M.; Rosenberg Y.; Kirby R.; Newman J.D.; Berger J.S.; Sidhu
M.S.; Harrington R.A.; Boden W.E.; Stone G.W.; Mark D.B.; Spertus J.A.;
Hochman J.S.; 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.; White H.D.; 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.; Lopez-Sendon J.;
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.

<47>
Accession Number
2019925288
Title
Troponin as a predictor of outcomes in transcatheter aortic valve
implantation: systematic review and meta-analysis.
Source
General Thoracic and Cardiovascular Surgery. 71(1) (pp 12-19), 2023. Date
of Publication: January 2023.
Author
Khuong J.N.; Liu Z.; Campbell R.; Jackson S.M.; Borg Caruana C.; Ramson
D.M.; Penny-Dimri J.C.; Perry L.A.
Institution
(Khuong, Liu, Jackson, Perry) Department of Anaesthesia, Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Khuong, Liu, Jackson) Melbourne Medical School, University of Melbourne,
Melbourne, VIC, Australia
(Campbell) Department of Medicine, University of New South Wales, Sydney,
NSW, Australia
(Borg Caruana) Department of Medicine, Deakin University, Geelong, VIC,
Australia
(Ramson, Penny-Dimri) Department of Medicine, Monash University,
Melbourne, VIC, Australia
Publisher
Springer
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is emerging as
a therapeutic gold standard in the management of aortic stenosis. However,
post-procedural complications of this procedure are being increasingly
recognised. We therefore performed this systematic review and
meta-analysis on the prognostic value of elevated troponin prior to TAVI
to predict risk of post-procedural complications. Method(s): We
searched Medline (Ovid), Embase (Ovid), and the Cochrane Library from
inception until May 2022, and included studies on the association between
elevated pre-procedural troponin with 30-day mortality, long-term
mortality, and post-procedural myocardial injury (PPMI). We generated
summary odds ratios (OR) and hazards ratios (HR) using random-effects
meta-analysis and performed subgroup analyses to evaluate differences in
troponin threshold selection. Inter-study heterogeneity was tested using
the I2 test. Result(s): We included 10 studies involving
4200 patients. Serum troponin elevation prior to TAVI was significantly
associated with long-term mortality [HR = 2.09 (95% CI 1.30-3.36)], but
not with 30-day mortality [OR 1.76 (95% CI 0.96-3.22)]. Subgroup analysis
showed a trend towards increased effect size and statistical significance
for 30-day mortality as troponin elevation was more narrowly defined. Two
studies reported on PPMI and found no statistically significant mean
difference between groups. Conclusion(s): Raised serum troponin is
associated with increased long-term mortality following TAVI. Further
clarification on the optimal troponin threshold for risk identification is
required. High-quality studies that utilise ROC analysis for threshold
selection are warranted. Copyright © 2022, The Author(s), under
exclusive licence to The Japanese Association for Thoracic Surgery.

<48>
Accession Number
2021324792
Title
Effect of the Paravertebral Block on Chronic Postsurgical Pain After
Thoracic Surgery: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(2) (pp 252-260),
2023. Date of Publication: February 2023.
Author
Na H.-S.; Koo C.-H.; Koo B.-W.; Ryu J.-H.; Jo H.; Shin H.-J.
Institution
(Na, Koo, Koo, Ryu, Jo, Shin) Department of Anesthesiology and Pain
Medicine, Seoul National University Bundang Hospital, Gyeonggi, Seongnam,
South Korea
(Na, Koo, Koo, Ryu, Shin) Department of Anesthesiology and Pain Medicine,
Seoul National University College of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objective: This study aimed to identify the benefits of thoracic
paravertebral block (PVB) by focusing on its role in reducing chronic
postsurgical pain (CPSP) after thoracic surgery. Design(s): A
systematic review and meta-analysis of randomized controlled trials
(RCTs). Setting(s): Electronic databases, including PubMed, EMBASE,
CENTRAL, Scopus, and Web of Science, were searched to identify studies.
 Participant(s): Patients undergoing thoracic surgeries.
 Intervention(s): Paravertebral block for postoperative analgesia.
Measurement and Main Results: A total of 1,028 adult patients from 10 RCTs
were included in the final analysis. The incidence of CPSP at 3 months
after surgery was not reduced in the PVB group compared with the no-block
(odds ratio [OR] 0.59, 95% CI 0.34-1.04; p = 0.07; I2 = 6.96%)
and other-block (OR 1.39, 95% CI 0.30-6.42; p = 0.67; I2 =
77.75%) groups. The PVB did not significantly reduce the incidence of CPSP
after 6 months from surgery when compared with no block (OR 0.44, 95% CI
0.08-2.53; p = 0.36; I2 = 87.53%) and other blocks (OR 1.17,
95% CI 0.71-1.95; p = 0.93; I2 = 45.75%). The PVB significantly
decreased postoperative pain at 24 and 48 hours at rest compared with the
no- block group. The pain score was higher in the PVB group than in the
other block groups 48 hours after surgery at rest. Conclusion(s):
Thoracic PVB does not prevent CPSP after thoracic surgery. Further large
RCTs are required to confirm and validate the authors'
results. Copyright © 2022 Elsevier Inc.

<49>
Accession Number
2021158825
Title
Late outcomes of valve-in-valve transcatheter aortic valve implantation
versus re-replacement: Meta-analysis of reconstructed time-to-event data.
Source
International Journal of Cardiology. 370 (pp 112-121), 2023. Date of
Publication: 01 Jan 2023.
Author
Sa M.P.; Van den Eynde J.; Simonato M.; Hirji S.; Erten O.; Jacquemyn X.;
Tasoudis P.; Dokollari A.; Sicouri S.; Weymann A.; Ruhparwar A.; Arora R.;
Clavel M.-A.; Pibarot P.; Ramlawi B.
Institution
(Sa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau Heart
Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Sa, Erten, Tasoudis, Dokollari, Sicouri, Ramlawi) Department of
Cardiothoracic Surgery Research, Lankenau Institute for Medical Research,
PA, United States
(Van den Eynde, Jacquemyn) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Simonato) Yale School of Medicine, New Haven, CT, United States
(Hirji) Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Weymann, Ruhparwar) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University of Duisburg-Essen, Essen, Germany
(Arora) Department of Surgery, Section of Cardiac Surgery, Max Rady
College of Medicine, University of Manitoba, Winnipeg, MB, Canada
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Faculty of Medicine, Universite
Laval, Quebec City, Quebec, Canada
Publisher
Elsevier Ireland Ltd
Abstract
Aims: To evaluate all-cause mortality in ViV-TAVI versus redo SAVR in
patients with failed bioprostheses. Method(s): Study-level
meta-analysis of reconstructed time-to-event data from Kaplan-Meier curves
of non-randomized studies published by September 30, 2021. Result(s):
Ten studies met our eligibility criteria and included a total of 3345
patients (1676 patients underwent ViV-TAVI and 1669 patients underwent
redo SAVR). Pooling all the studies, ViV-TAVI showed a lower risk of
all-cause mortality in the first 44 days [hazard ratio (HR) 0.67, 95%
confidence interval (CI) 0.49-0.93, P = 0.017], with an HR reversal after
197 days favoring redo SAVR (HR 1.53; 95% CI 1.22-1.93; P < 0.001).
Pooling only the matched populations (1143 pairs), ViV-TAVI showed a lower
risk of all-cause mortality in the first 55 days [hazard ratio (HR) 0.63,
95% confidence interval (CI) 0.45-0.89, P < 0.001], with a reversal HR
after 212 days favoring redo SAVR (HR 1.57; 95% CI 1.22-2.03; P < 0.001).
The Cox regression model showed a statistically significant association of
prosthesis-patient mismatch (PPM) with all-cause mortality during
follow-up for ViV-TAVI (HR 1.03 per percentage increase in the study- and
treatment arm-level proportion of PPM, 95% 1.02-1.05, P < 0.001).
 Conclusion(s): ViV-TAVI is associated with a strong protective effect
immediately after the procedure in comparison with redo SAVR, however,
this initial advantage reverses over time and redo SAVR seems to be a
protective factor for all-cause mortality after 6 months. Considering that
these results are the fruit of pooling data from observational studies,
they should be interpreted with caution and trials are
warranted. Copyright © 2022 Elsevier B.V.

<50>
Accession Number
2021036039
Title
Evaluation of right ventricle systolic function after tetralogy of Fallot
repair: A systematic review comparing cardiac magnetic resonance and
global longitudinal strain.
Source
Echocardiography. 40(1) (pp 4-14), 2023. Date of Publication: January
2023.
Author
Oliveira A.L.A.; de Oliveira M.E.P.; Guimaraes L.V.; Trindade G.M.; Chaves
G.M.; Goncalves A.C.P.; de Souza T.J.F.; Moraes L.S.; Lujan V.S.C.; Faria
L.S.D.P.; Manuel V.
Institution
(Oliveira) Faculdade Pernambucana de Saude, Pernambuco, Brazil
(de Oliveira) Universidade Vila Velha, Espirito Santo, Brazil
(Guimaraes) Universidade Metropolitana de Santos, Sao Paulo, Brazil
(Trindade, Goncalves) Universidad Cristiana de Bolivia, Santa Cruz,
Bolivia
(Chaves) Universidade Municipal de Sao Caetano do Sul - Campus Bela Vista,
Sao Paulo, Brazil
(de Souza) Universidade do Oeste Paulista, Sao Paulo, Brazil
(Moraes) Faculdade Alfredo Nasser, Goias, Brazil
(Lujan) Faculdade de Ensino Superior da Amazonia Reunida, Para, Brazil
(Faria) Centro Universitario de Volta Redonda, Rio de Janeiro, Brazil
(Manuel) Cardiothoracic Center, Clinica Girassol, Luanda, Angola
(Manuel) Division of Cardiovascular Surgery, Heart Institute (InCor),
Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao
Paulo, Sao Paulo, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Background: Most patients who undergo tetralogy of Fallot (TOF) repair
experience late right ventricle (RV) dysfunction due to pulmonary valve
regurgitation (PVR). Cardiac magnetic resonance (CMR) is the gold standard
method for evaluating RV during follow-up. Global longitudinal strain
(GLS) has been introduced as a novel method for the assessment of RV
dysfunction. We aimed to compare the feasibility of GLS and CMR for
assessing RV function after TOF repair. Method(s): We systematically
reviewed the English literature using PubMed, SciELO and Google Scholar
for articles published between January 1, 2015, and December 31, 2020.
Articles evaluating RV function comparing by GLS and CMR after TOF repair
were included. Result(s): Nine studies including 465 patients were
analyzed. Most patients were men (280; 60%), the male:female ratio was
1.5:1, and the age range was.8 to 57.7 years. The mean follow-up time was
6 to 32 months. The correlation between RV GLS and RV ejection fraction
(EF) by CMR was negative for the articles and varied from moderate to
strong (r = -.45, r = -.60, r = -.76). Conclusion(s): Right ventricle
GLS can be considered for routine follow-up of TOF repair patients, even
though CMR remains the noninvasive gold standard method. Using a single
parameter may not allow comparison of the accuracy of 3D RV EF by using
CMR and GLS. Further studies with a larger number of patients undergoing
TOF repair are required to evaluate the correlation between these
examinations. Copyright © 2022 Wiley Periodicals LLC.

<51>
[Use Link to view the full text]
Accession Number
2022124831
Title
Programmed intermittent bolus infusion vs. continuous infusion for erector
spinae plane block in video-assisted thoracoscopic surgery: A
double-blinded randomised controlled trial.
Source
European Journal of Anaesthesiology. 40(2) (pp 130-137), 2023. Date of
Publication: 01 Feb 2023.
Author
Taketa Y.; Takayanagi Y.; Irisawa Y.; Fujitani T.
Institution
(Taketa, Takayanagi, Irisawa, Fujitani) Department of Anaesthesiology and
Critical Care, Ehime Prefectural Central Hospital, Matsuyama, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDThe optimal form of administration for erector spinae plane
block has not been established.OBJECTIVETo compare the efficacy of
programmed intermittent bolus infusion (PIB) and continuous infusion for
erector spinae plane block.DESIGNA prospective, randomised, double-blind
study.SETTINGA single centre between June 2019 and March
2020.PATIENTSIncluded patients had an American Society of
Anesthesiologists physical status 1 to 3 and were scheduled for
video-assisted thoracic surgery.INTERVENTIONSPatients were randomised to
receive continuous infusion (0.2% ropivacaine 8 ml h-1; Group
C) or PIB (0.2% ropivacaine 8 ml every 2 h; Group P).MAIN OUTCOME
MEASURESThe primary outcome was the number of desensitised dermatomes in
the midclavicular line, measured 21 h after first bolus
injection.RESULTSFifty patients were randomly assigned to each group;
finally, the data of 24 and 25 patients in Group C and P, respectively,
were analysed. The mean difference in the number of desensitised
dermatomes in the midclavicular line at 5 and 21 h after the initial bolus
administration was 1.0 [95% confidence interval (CI) 0.5 to 1.5] and 1.6
(95% CI 1.1 to 2.0), respectively, which was significantly higher in Group
P than in Group C (P < 0.001). The median difference in rescue morphine
consumption in the early postoperative period (0 to 24 h) was 4 (95% CI 1
to 8) mg, which was significantly lower in Group P (P = 0.035). No
significant difference in the postoperative numerical rating scale score
was found between the groups.CONCLUSIONSPIB for erector spinae plane block
in video-assisted thoracic surgery resulted in a larger anaesthetised area
and required a lower anaesthetic dose to maintain the analgesic effect.
Therefore, it is more suitable for erector spinae plane block than
continuous infusion.TRIAL REGISTRATIONUMIN Clinical Trials Registry
(UMIN-CTR, ID: UMIN000036574, Principal investigator: Taro Fujitani,
04/22/2019,
https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R0000416
71). Copyright © 2023 Lippincott Williams and Wilkins. All rights
reserved.

<52>
Accession Number
2020189137
Title
Postoperative recovery with continuous erector spinae plane block or
video-assisted paravertebral block after minimally invasive thoracic
surgery: a prospective, randomised controlled trial.
Source
British Journal of Anaesthesia. 130(1) (pp e137-e147), 2023. Date of
Publication: January 2023.
Author
Moorthy A.; Ni Eochagain A.; Dempsey E.; Wall V.; Marsh H.; Murphy T.;
Fitzmaurice G.J.; Naughton R.A.; Buggy D.J.
Institution
(Moorthy, Wall, Murphy, Buggy) Division of Anaesthesiology, Mater
Misericordiae University Hospital, Dublin, Ireland
(Moorthy, Buggy) School of Medicine, University College, Dublin, Ireland
(Ni Eochagain, Dempsey, Marsh, Naughton) Department of Anaesthesiology, St
James's University Hospital, Dublin, Ireland
(Fitzmaurice) Department of Cardiothoracic Surgery, St James's University
Hospital, Dublin, Ireland
(Buggy) EuroPeriscope, ESA-IC Onco-Anaesthesiology Research Group,
Brussels, Belgium
(Buggy) Outcomes Research, Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Ltd
Abstract
Background: PROcedure SPECific Postoperative Pain ManagemenT (PROSPECT)
guidelines recommend erector spinae plane (ESP) block or paravertebral
block (PVB) for postoperative analgesia after video-assisted thoracoscopic
surgery (VATS). However, there are few trials comparing the effectiveness
of these techniques on patient-centric outcomes, and none evaluating
chronic postsurgical pain (CPSP). Furthermore, there are no available
trials comparing ultrasound-guided ESP with surgically placed PVB in this
patient cohort. Method(s): We conducted a two-centre, prospective,
randomised, double-blind, controlled trial, comparing
anaesthesiologist-administered, ultrasound-guided ESP catheter with
surgeon-administered, video-assisted PVB catheter analgesia among 80 adult
patients undergoing VATS. Participants received a 20 ml bolus of
levobupivacaine 0.375% followed by infusion of levobupivacaine 0.15%
(10-15 ml h-1) for 48 h. Primary outcome was Quality of
Recovery-15 score (QoR-15) at 24 h. Secondary outcomes included QoR-15 at
48 h, peak inspiratory flow (ml s-1) at 24 h and 48 h, area
under the pain verbal response score vs time curve (AUC), opioid
consumption, Comprehensive Complication Index, length of stay, and CPSP at
3 months after surgery. Result(s): Median (25-75%) QoR-15 at 24 h was
higher in ESP (n=37) compared with PVB (n=37): 118 (106-134) vs 110
(89-121) (P=0.03) and at 48 h: 131 (121-139) vs 120 (111-133) (P=0.03).
There were no differences in peak inspiratory flow, AUC, Comprehensive
Complication Index, length of hospital stay, and opioid consumption.
Incidence of CPSP at 3 months was 12 (34%) for ESP and 11 (31%) for PVB
(P=0.7). Conclusion(s): Compared with video-assisted, surgeon-placed
paravertebral catheter, erector spinae catheter improved overall QoR-15
scores at 24 h and 48 h but without differences in pain or opioid
consumption after minimally invasive thoracic surgery. Clinical trial
registration: NCT04729712. Copyright © 2022 British Journal of
Anaesthesia

<53>
Accession Number
2022217330
Title
The Effect of Cryotherapy Application on Postoperative Pain: A Systematic
Review and Meta-analysis.
Source
Annals of Surgery. 277(2) (pp E257-E265), 2023. Date of Publication: 01
Feb 2023.
Author
Muaddi H.; Lillie E.; Silva S.; Cross J.-L.; Ladha K.; Choi S.; Mocon A.;
Karanicolas P.
Institution
(Muaddi, Karanicolas) Department of Surgery, Division of General Surgery,
University of Toronto, Toronto, ON, Canada
(Lillie, Silva, Cross, Karanicolas) Sunnybrook Research Institute,
Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Ladha, Choi) Department of Anesthesia and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Ladha) Department of Anesthesia, St. Michael's Hospital, Toronto, ON,
Canada
(Choi) Department of Anesthesia, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Mocon) Department of Anesthesia, North York General Hospital, Toronto,
ON, Canada
(Karanicolas) Department of Surgery, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Muaddi, Karanicolas) Institute of Health Policy Management and
Evaluation, University of Toronto, Toronto, ON, Canada
Publisher
Wolters Kluwer Health
Abstract
Objective: To systematically review and meta-analyze whether the
application of cryotherapy on closed incisions reduces postoperative pain
and opioid consumption. Background(s): Reduction of acute pain and
opioid use is important in the postoperative phase of patient care.
"Cryotherapy" refers to the use of low temperatures for therapeutic
purposes. Method(s): MEDLINE, EMBASE, Cochrane Central Register of
Controlled Trials and Online registries of clinical trial were search
until October 2019. RCT that examined postoperative application of
cryotherapy over surgical incisions in adults compared to no cryotherapy
were eligible. Selection, extraction, and risk of bias appraisal were
completed in duplicate. Data were synthesized using random effects
meta-analyses. The outcomes of interest were postoperative pain, opioid
use, hospital length of stay (LOS) and surgical site infection (SSI).
 Result(s): Fifty-one RCTs (N = 3425 patients) were included. With
moderate certainty evidence, patients treated with cryotherapy experienced
a reduction in pain on postoperative day 1 (standardized mean differences
-0.50, 95% CI -0.71 to -0.29, l2= 74%) and day 2 (standardized
mean differences -0.63, 95% CI -0.91 to -0.35, I2= 83%)
relative to without cryotherapy application. With moderate certainty of
evidence, cryotherapy reduces opioid consumption in morphine
milliequivalents and morphine milliequivalents/kg, (mean differences
-7.43, 95% CI -12.42, -2.44, I2= 96%) and (mean differences
-0.89, 95% CI -1.45, -0.33, I2= 99%), respectively. With low
certainty evidence, cryotherapy does not affect hospital LOS or rate of
SSI. Conclusion(s): Cryotherapy is a pragmatic, noncostly
intervention that reduces postoperative pain and opioid consumption with
no effect on SSI rate or hospital LOS. Copyright © 2023
Lippincott Williams and Wilkins. All rights reserved.

<54>
Accession Number
2019734786
Title
Selection of Vascular Closure Devices in Transcatheter Aortic Valve
Replacement: Systematic Review and Network Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 46 (pp 78-84), 2023. Date of
Publication: January 2023.
Author
Sakata T.; Kuno T.; Fujisaki T.; Yokoyama Y.; Misumida N.; Sugiura T.;
Latib A.
Institution
(Sakata) Cardiovascular Research Institute, Icahn School of Medicine at
Mount Sinai, New York, United States
(Kuno, Latib) Division of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, New York, United States
(Fujisaki) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Morningside and West, New York, United States
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
PA, United States
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, United States
(Sugiura) Department of Cardiothoracic & Vascular Surgery, Montefiore
Medical Center, Albert Einstein College of Medicine, New York, United
States
Publisher
Elsevier Inc.
Abstract
Various vascular closure devices (VCDs) are commonly used for percutaneous
transcatheter aortic valve replacement (TAVR). However, superiority and
safety profile among them remain unclear. We compared periprocedural
complications among various VCDs in patients undergoing TAVR. PubMed and
EMBASE were searched through January 2022 to identify clinical studies
comparing any 2 VCDs of Prostar, Proglide and MANTA in patients who
underwent TAVR. Studies using surgical cut-down or alternative access
other than transfemoral approach were excluded. We analyzed the odds
ratios (ORs) of vascular complications (VC), bleeding, acute kidney injury
and all-cause mortality using a network meta-analysis. All outcomes were
defined by Valve Academic Research Consortium 2 criteria. Two randomized
controlled trials and 15 observational studies were identified, yielding a
total of 11,344 patients including Prostar (n = 4499), Proglide (n =
5705), or MANTA group (n = 1140). The rates of major VC and
life-threatening and major bleeding were significantly lower in Proglide
compared to Prostar (OR [95 % CI] = 0.54 [0.32-0.89], 0.68 [0.52-0.90],
and 0.49 [0.26-0.95], respectively). There was no significant difference
in major VC and bleeding between Proglide and MANTA groups. Proglide was
associated with a lower rate of acute kidney injury (0.56 [0.34-0.92]) and
red blood cell transfusion (0.39 [0.16-0.98]) compared to Prostar. There
was no significant difference in additional interventions and 30-day
overall mortality among three groups. In this network meta-analysis of VCD
in patients undergoing TAVR, MANTA and Proglide had comparable outcomes
while Proglide appears superior to Prostar in terms of major VC and
bleeding. Copyright © 2022 Elsevier Inc.

<55>
Accession Number
2019640418
Title
The diuretic effect of adding aminophylline or theophylline to furosemide
in pediatric populations: a systematic review.
Source
European Journal of Pediatrics. 182(1) (pp 1-8), 2023. Date of
Publication: January 2023.
Author
Van Siang Lian Mang P.; Hui J.C.; Tan R.S.J.; Hasan M.S.; Choo Y.M.;
Abosamak M.F.; Ng K.T.
Institution
(Van Siang Lian Mang, Hui) Queen Elizabeth University Hospital, Glasgow,
United Kingdom
(Tan) School of Medicine, University of Leeds, Leeds, United Kingdom
(Hasan, Ng) Department of Anaesthesiology, Faculty of Medicine, Universiti
Malaya, Kuala Lumpur 50603, Malaysia
(Choo) Department of Paediatrics, Faculty of Medicine, Universiti Malaya,
Kuala Lumpur 50603, Malaysia
(Abosamak) Department of Anaesthesia and Intensive Care Medicine, Faculty
of Medicine, Tanta University, Tanta, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
The diuretic effect of the combined furosemide and
aminophylline/theophylline among pediatric patients remains unclear. The
primary aim of this systematic review was to examine the clinical diuretic
effects (urine output and fluid balance) of co-administration of
furosemide and aminophylline/theophylline as compared to furosemide alone
in pediatric population. Ovid MEDLINE, CENTRAL, and EMBASE were searched
from its inception until March 2022 for observational studies and
randomized controlled trials (RCTs) comparing the administration of
furosemide versus furosemide and aminophylline/theophylline in pediatric
population. Case reports, case series, commentaries, letters to editors,
systematic reviews, and meta-analyses were excluded. Five articles with a
total sample population of 187 patients were included in this systematic
review. As compared to the furosemide alone, our pooled data demonstrated
that co-administration of furosemide and aminophylline/theophylline was
associated with higher urine output (mean difference: 2.91 [90% CI 1.54 to
4.27], p < 0.0001, I2 = 90%) and a more negative fluid balance
(mean difference - 28.27 [95% CI: - 46.21 to - 10.33], p = 0.002,
I2 = 56%) than those who received furosemide alone.
 Conclusion(s): This is the first paper summarizing the evidence of
combined use of furosemide with aminophylline/theophylline in pediatric
population. Our systematic review demonstrated that the co-administration
of furosemide and aminophylline/theophylline could potentially yield
better diuretic effects of urine output and negative fluid balance than
furosemide alone in pediatric patients with fluid overload. Given the
substantial degree of heterogeneity and low level of evidence, future
adequately powered trials are warranted to provide evidence regarding the
combined use of aminophylline/theophylline and furosemide as diuretic in
the pediatric population.What is Known:* Fluid overload is associated with
poor prognosis for children in the intensive care unit.* The ineffective
result of furosemide alone, even at high dose, as diuretic agent for
children with diuretic resistant fluid overload in the intensive care
unit.What is New:* This is the first systematic review that compares
furosemide alone and co-administration of furosemide and
aminophylline/theophylline.* This paper showed potential benefit of
co-administration of furosemide and aminophylline/theophylline promoting
urine output and negative fluid balance compared to furosemide
alone. Copyright © 2022, The Author(s), under exclusive licence
to Springer-Verlag GmbH Germany, part of Springer Nature.

<56>
Accession Number
2018960853
Title
Comparative study of a modified double-lumen tube ventilation control
connector and traditional connector in clinical use: a
randomised-controlled trial.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 281. Date
of Publication: December 2022.
Author
Liu C.; Zhao Y.; Li Y.; Guan H.; Feng J.; Cheng S.; Wang X.; Wang Y.; Sun
X.
Institution
(Liu, Zhao, Li, Guan, Feng, Cheng, Wang, Wang, Sun) Department of
Anesthesiology, The Second Hospital of Jilin University, No.218, Ziqiang
street, Nanguan District, Jilin Province, Changchun City 130000, China
Publisher
BioMed Central Ltd
Abstract
Background: A Y-shaped rotatable connector (YRC) for double-lumen tubes
(DLT) is invented and compared with the traditional connector (Y-shaped
connector, YC). Method(s): Sixty patients with ASA grade I-III, aged
>= 18 years, who needed to insert a DLT for thoracic surgery were
recruited and assigned into the YRC group (n = 30) and the YC group (n =
30) randomly. The primary endpoints included the inhaled air concentration
(Fi) and the exhaled air concentration (Et) of sevoflurane before and
after the switch between two-lung ventilation and one-lung ventilation at
different times, positioning time, and switching time. The secondary
endpoints were the internal gas volume of the two connectors, airway
pressure, and the sputum suction time. Result(s): The Et and Fi of
the YRC group and the YC group were significantly different (all p < 0.05)
at 5s, 10s, and 30s after the patient switched from two-lung ventilation
to one-lung ventilation. The positioning time of the YRC group was less
than YC group (89.75 +/- 14.28 s vs 107.80 +/- 14.96 s, p < 0.05), as well
as the switching time (3.60 +/- 1.20 s vs 9.05 +/- 2.53 s, p < 0.05) and
the internal gas volume (17.20 ml vs 24.12 ml). There was no difference in
airway pressure and the sputum suction time in two groups.
 Conclusion(s): Compared with YC, YRC was beneficial for maintaining
depth of anesthesia, improves efficiency for the switch between one-lung
and two-lung ventilation, and shortens the tube positioning
time. Copyright © 2022, The Author(s).

<57>
Accession Number
2020953900
Title
Knowledge mapping visualization of the pulmonary ground-glass opacity
published in the web of science.
Source
Frontiers in Oncology. 12 (no pagination), 2022. Article Number: 1075350.
Date of Publication: 22 Dec 2022.
Author
Li X.; Zhang G.; Gao S.; Xue Q.; He J.
Institution
(Li, Zhang, Gao, Xue, He) Department of Thoracic Surgery, National Cancer
Center/National Clinical Research Center for Cancer/Cancer Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Objectives: With low-dose computed tomography(CT) lung cancer screening,
many studies with an increasing number of patients with ground-glass
opacity (GGO) are published. Hence, the present study aimed to analyze the
published studies on GGO using bibliometric analysis. The findings could
provide a basis for future research in GGO and for understanding past
advances and trends in the field. Method(s): Published studies on GGO
were obtained from the Web of Science Core Collection. A bibliometric
analysis was conducted using the R package and VOSviewer for countries,
institutions, journals, authors, keywords, and articles relevant to GGO.
In addition, a bibliometric map was created to visualize the relationship.
 Result(s): The number of publications on GGO has been increasing
since 2011. China is ranked as the most prolific country; however, Japan
has the highest number of citations for its published articles. Seoul
National University and Professor Jin Mo Goo from Korea had the highest
publications. Most top 10 journals specialized in the field of lung
diseases. Radiology is a comprehensive journal with the greatest number of
citations and highest H-index than other journals. Using bibliometric
analysis, research topics on "prognosis and diagnosis," "artificial
intelligence," "treatment," "preoperative positioning and minimally
invasive surgery," and "pathology of GGO" were identified. Artificial
intelligence diagnosis and minimally invasive treatment may be the future
of GGO. In addition, most top 10 literatures in this field were guidelines
for lung cancer and pulmonary nodules. Conclusion(s): The publication
volume of GGO has increased rapidly. The top three countries with the
highest number of published articles were China, Japan, and the United
States. Japan had the most significant number of citations for published
articles. Most key journals specialized in the field of lung diseases.
Artificial intelligence diagnosis and minimally invasive treatment may be
the future of GGO. Copyright © 2022 Li, Zhang, Gao, Xue and He.

<58>
Accession Number
2019003841
Title
The Effectiveness of Virtual Reality Interventions on Smoking, Nutrition,
Alcohol, Physical Activity and/or Obesity Risk Factors: A Systematic
Review.
Source
International Journal of Environmental Research and Public Health. 19(17)
(no pagination), 2022. Article Number: 10821. Date of Publication:
September 2022.
Author
Tatnell P.; Atorkey P.; Tzelepis F.
Institution
(Tatnell, Atorkey, Tzelepis) School of Medicine and Public Health,
University of Newcastle, Callaghan, NSW 2308, Australia
(Tatnell, Atorkey, Tzelepis) Hunter New England Population Health, Hunter
New England Local Health District, Wallsend, NSW 2287, Australia
(Atorkey, Tzelepis) Hunter Medical Research Institute, New Lambton
Heights, NSW 2305, Australia
Publisher
MDPI
Abstract
To our knowledge, no systematic reviews have examined the effectiveness of
virtual reality (VR) interventions across all smoking, nutrition, alcohol,
physical activity, and/or obesity (SNAPO) risk factors. This systematic
review assessed the effectiveness of VR interventions on reducing SNAPO
risks compared to control groups or other interventions. MEDLINE, EMBASE,
Scopus, PsycINFO, and CENTRAL were searched to identify eligible studies
published to 7 October 2021. Two reviewers independently completed
screening, data extraction and quality assessment. Twenty-six studies were
included, five on smoking, twelve on physical activity (PA), six on
obesity, one on PA and obesity, one on obesity and nutrition, and one on
obesity, nutrition and PA. VR was effective for smoking cessation in three
studies and for smoking reduction in four studies. Seven studies had
significantly higher PA in the VR group, and one study found significantly
higher PA in a comparator group. Two studies showed VR was more effective
at reducing BMI or weight than comparators. Three multiple health risks
studies showed mixed results. The remaining studies found no significant
difference between VR and control/comparators. VR appears promising for
the treatment of smoking, nutrition, PA, and obesity risks; however,
further randomised trials are needed. Copyright © 2022 by the
authors.

<59>
Accession Number
2020223816
Title
Efficacy and Safety of Concomitant Tricuspid Repair in Patients Undergoing
Mitral Valve Surgery: a Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 47(12) (no pagination), 2022. Article
Number: 101360. Date of Publication: December 2022.
Author
Yasmin F.; Najeeb H.; Naeem U.; Moeed A.; Zaidi F.; Asghar M.S.; Aamir M.
Institution
(Yasmin, Najeeb, Naeem, Moeed, Zaidi) Department of Internal Medicine, Dow
Medical College, Dow University of Health Sciences, Karachi, Pakistan
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, MN,
Rochester, Pakistan
(Aamir) Leyhigh Valley Heart Institute, Leyhigh Valley Health Network,
Allentown, PA, United States
Publisher
Elsevier Inc.
Abstract
Tricuspid valve repair (TVR) is recommended for patients with moderate
primary tricuspid regurgitation (TR), those with moderate TR, and a
history of heart failure without annular dilation, while being essential
for patients with severe secondary TR undergoing MVS. The meta-analysis
aimed to evaluate the efficacy and safety of tricuspid valve repair in
patients undergoing MVS. We systematically searched PubMed, Embase, and
Google Scholar through January 2022, and studies comparing patients with
TVR and those without TVR were selected. The primary outcomes were 30-day,
and all-cause mortality. In this meta-analysis, 20 studies were included
with a patient population of 72,422. No significant differences were
observed between patients undergoing TVR with MVS, in comparison to MVS
group only for the primary outcomes i.e., 30-day mortality (RR: 1.14, 95%
CI [0.69, 1.87], and all-cause mortality (RR: 1.16, 95% CI [0.86, 1.57].
From the secondary outcomes, pacemaker insertion (RR: 2.62, 95% CI [2.24,
3.06]), new-onset TR or progression (RR: 0.32, 95% CI [0.16, 0.66]),
stroke (RR: 1.22, 95% CI [1.05, 1.42]), cross-clamp time (WMD: 17.67, 95%
CI [13.96, 21.37]), surgery time (WMD: 43.59, 95% CI [37.07, 50.10]), ICU
time (WMD: 19.50, 95% CI [9.31, 29.67]), and ventilation time (WMD: 6.62,
95% CI [0.69, 12.55]) were significant. However, major bleeding events,
atrial fibrillation, renal failure, heart failure hospitalization,
postoperative MI, wound infection, early or prolonged morbidity,
cardiopulmonary bypass time, and duration of hospital stay were
non-significant. Our meta-analysis has furthered the discussion for
weighing the risks and benefits of pursuing TVR during MVS. Copyright
© 2022 Elsevier Inc.

<60>
Accession Number
2015093537
Title
Does ramadan fasting affect the therapeutic and clinical outcomes of
warfarin? a systematic review and meta-analysis.
Source
European Journal of Clinical Pharmacology. 78(5) (pp 755-763), 2022. Date
of Publication: May 2022.
Author
Rabea E.M.; Abbas K.S.; Awad D.M.; Elgoweini N.H.; El-Sakka A.A.; Mahmoud
N.H.; Abdelazeem B.
Institution
(Rabea, Abbas, Awad, Elgoweini, Mahmoud) Faculty of Medicine, Alexandria
University, Alexandria, Egypt
(El-Sakka) Faculty of Medicine, Suez Canal University, Ismailia, Egypt
(Abdelazeem) McLaren Health Care, Flint, MI, United States
(Abdelazeem) Michigan State University, East Lansing, MI, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Warfarin's therapeutic effect is affected by many factors,
including diet modifications. The impact of Ramadan fasting on warfarin is
controversial. The aim of this systematic review and meta-analysis was to
investigate the effect of Ramadan fasting on patients taking warfarin.
 Method(s): A literature search was done in PubMed, WOS, Scopus, and
Embase from inception to May 24, 2021. All relevant studies measuring the
international normalized ratio (INR), time in therapeutic range (TTR), or
the number of patients within therapeutic range before, during, and after
Ramadan were assessed by full-text screening for achieving all of the
inclusion criteria. We used the Newcastle-Ottawa Scale for quality
assessment and RevMan 5.4 software for meta-analysis. Result(s): A
total of five studies with 446 patients were included in the
meta-analysis. The patients served as their own control. Our pooled
analyses showed no significant difference during Ramadan compared to
pre-Ramadan (MD: 0.08; 95% CI: - 0.00, 0.15; P = 0.06) and post-Ramadan
(MD: - 0.00; 95% CI: - 0.14, 0.14; P = 1.00, respectively). There was only
a significant increase in the risk ratio of supratherapeutic INR when
comparing post-Ramadan vs. pre-Ramadan (RR: 1.69; 95% CI: 1.22, 2.33; P =
0.001). However, there was no significant risk for supratherapeutic INR
during Ramadan compared to pre-Ramadan or post-Ramadan; the number of
patients within the therapeutic range of INR during Ramadan compared to
pre-Ramadan; and TTR during Ramadan, pre-Ramadan, and post-Ramadan.
 Conclusion(s): Ramadan fasting did not affect INR level, TTR, or the
number of patients within the therapeutic range before, during, and after
Ramadan. However, there was a possibility of achieving a supratherapeutic
INR post-Ramadan compared to pre-Ramadan. Therefore, INR monitoring and
warfarin dose adjustments accordingly are recommended after
Ramadan. Copyright © 2022, The Author(s), under exclusive licence
to Springer-Verlag GmbH Germany, part of Springer Nature.

<61>
Accession Number
2013832787
Title
Risk factors for acute kidney injury after pediatric cardiac surgery: a
meta-analysis.
Source
Pediatric Nephrology. 37(3) (pp 509-519), 2022. Date of Publication: March
2022.
Author
Van den Eynde J.; Delpire B.; Jacquemyn X.; Pardi I.; Rotbi H.; Gewillig
M.; Kutty S.; Mekahli D.
Institution
(Van den Eynde, Kutty) Helen B. Taussig Heart Center, The Johns Hopkins
Hospital and School of Medicine, Baltimore, United States
(Van den Eynde, Delpire, Jacquemyn, Pardi, Gewillig) Department of
Cardiovascular Sciences, University Hospitals Leuven, KU Leuven,
Herestraat 49, Leuven 3000, Belgium
(Rotbi) Faculty of Medicine, Radboud University, Nijmegen, Netherlands
(Rotbi) Department of Physiology, Radboud University Medical Center,
Radboud Institute for Health Sciences, Nijmegen, Netherlands
(Gewillig) Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Mekahli) Department of Pediatric Nephrology, University Hospitals of
Leuven, Leuven, Belgium
(Mekahli) PKD Research Group, GPURE, Department of Development and
Regeneration, KU Leuven, Leuven, Belgium
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Cardiac surgery-associated acute kidney injury (AKI) is
associated with increased morbidity and mortality in both adults and
children. Objective(s): This study aimed to identify clinical risk
factors for AKI following cardiac surgery in the pediatric population.
Data sources: PubMed/MEDLINE, Embase, Scopus, and reference lists of
relevant articles were searched for studies published by August 2020.
Study eligibility criteria: Studies were included if (1) the population
consisted of pediatric patients (< 18 years old), (2) patients underwent
cardiac surgery, (3) risk factors were compared between patients who
developed AKI and those who did not, and (4) studies were prospective or
retrospective observational studies or randomized controlled trials.
Participants and interventions: Children undergoing pediatric cardiac
surgery. Study appraisal and synthesis methods: Random-effects
meta-analysis was performed, comparing potential risk factors between
pediatric patients who developed CS-AKI and those who did not.
 Result(s): Sixty-one publications including a total of 19,680
participants (AKI: 7257 participants; no AKI: 12,423 participants) were
included from studies published between 2008 and 2020. The pooled
estimated incidence of AKI was 34.3% (95% confidence interval 30.0-38.8%,
I2 = 96.8%). Binary risk factors that were significantly and
consistently associated with AKI were the presence of pulmonary
hypertension, cyanotic heart disease, univentricular heart, risk
adjustment for congenital heart surgery 1 (RACHS-1) score >= 3,
vasopressor use, cardiopulmonary bypass use, reoperation, and sepsis.
Significant continuous risk factors included younger age, lower body
weight, lower preoperative creatinine, higher preoperative estimated
glomerular filtration rate (eGFR), higher RACHS-1 score, longer surgery
time, longer cardiopulmonary bypass time, longer aortic cross-clamp time,
and higher red blood cell transfusion volume. Limitation(s): Results
are limited by heterogeneity and potential residual confounding.
Conclusions and implications of key findings: Our meta-analysis identified
clinical risk factors that are associated with AKI in children undergoing
cardiac surgery. This might help clinicians anticipate and manage more
carefully this population and implement standardized preventive
strategies. Systematic review registration number: CRD42021262699.
Graphical abstract: A higher resolution version of the Graphical abstract
is available as Supplementary information. [Figure not available: see
fulltext.] Copyright © 2021, The Author(s), under exclusive
licence to International Pediatric Nephrology Association.

<62>
Accession Number
2013682380
Title
Effects of cardiac rehabilitation in low-and middle-income countries: A
systematic review and meta-analysis of randomised controlled trials.
Source
Progress in Cardiovascular Diseases. 70 (pp 119-174), 2022. Date of
Publication: 01 Jan 2022.
Author
Mamataz T.; Uddin J.; Ibn Alam S.; Taylor R.S.; Pakosh M.; Grace S.L.
Institution
(Mamataz) Faculty of Health, York University, Bethune 222B, 4700 Keele
Street, Toronto, ON M3J 1P3, Canada
(Uddin) Department of Cardiac Surgery, Ibrahim Cardiac Hospital & Research
Institute (ICHRI), Shahbag, Dhaka, Bangladesh
(Ibn Alam) Videncenter for Rehabilitering og Palliation REHPA, University
of South Denmark, Nyborg, Denmark
(Taylor) MRC/CSO Social and Public Health Sciences Unit & Robertson Centre
for Biostatistics, Institute of Health and Well Being, School of Medicine,
Dentistry & Nursing, University of Glasgow, UK, United Kingdom
(Pakosh) Library & Information Services, Toronto Rehabilitation Institute,
University Health Network, University of Toronto, Toronto, ON, Canada
(Grace) Faculty of Health, York University, Bethune 368, 4700 Keele
Street, Toronto, ON M3J 1P3, Canada
(Grace) KITE & Peter Munk Cardiac Centre, University Health Network,
University of Toronto, Toronto, ON, Canada
Publisher
W.B. Saunders
Abstract
Objectives: To assess the effectiveness of cardiac rehabilitation (CR) in
low- and middle-income countries (LMICs), given previous reviews have
included scant trials from these settings and the great need there.
 Method(s): Six electronic databases (PubMed, Medline, Embase, CINAHL,
Cochrane Library, and APA PsycINFO) were searched from inception-May 2020.
Randomised controlled CR (i.e., at least initial assessment and structured
exercise; any setting; some Phase II) trials with any clinical outcomes
(e.g., mortality and morbidity, functional capacity, risk factor control
and psychosocial well-being) or cost, with usual care (UC) control or
active comparison (AC), in acute coronary syndrome with or without
revascularization or heart failure patients in LMICs were included. With
regard to data extraction and data synthesis, two reviewers independently
vetted identified citations and extracted data from included trials; Risk
of bias was assessed using Cochrane's tool. Certainty of evidence was
ascertained based on the Grading of Recommendations Assessment,
Development and Evaluation (GRADE) framework. A random-effects model was
used to calculate weighted mean differences and 95% confidence intervals
(CI). Result(s): Twenty-six trials (6380 participants; 16.9% female;
median follow-up = 3 months) were included. CR meaningfully improved
functional capacity (VO<inf>2peak</inf> vs UC: 5 trials; mean difference
[MD] = 3.13 ml/kg/min, 95% CI = 2.61 to 3.65; I2 = 9.0%);
moderate-quality evidence), systolic blood pressure (vs UC: MD = -5.29
mmHg, 95% CI = -8.12 to -2.46; I2 = 45%; low-quality evidence),
low-density lipoprotein cholesterol (vs UC: MD = -16.55 mg/dl, 95% CI =
-29.97 to -3.14; I2 = 74%; very low-quality evidence), body
mass index (vs AC: MD = -0.84 kg/m2, 95% CI = -1.61 to -0.07;
moderate-quality evidence; I2 = 0%), and quality of life (QoL;
vs UC; SF-12/36 physical: MD = 6.05, 95% CI = 1.77 to 10.34; I2
= 93%, low-quality evidence; mental: MD = 5.38, 95% CI = 1.13 to 9.63;
I2 = 84%; low-quality evidence), among others. There were no
evidence of effects on mortality or morbidity. Qualitative analyses
revealed CR was associated with lower percutaneous coronary intervention,
myocardial infarction, better cardiovascular function, and biomarkers, as
well as return to life roles; there were other non-significant effects.
Two studies reported low cost of home-based CR. Conclusion(s): Low to
moderate-certainty evidence establishes CR as delivered in LMICs improves
functional capacity, risk factor control and QoL. While more high-quality
research is needed, we must augment access to CR in these settings.
Systematic review registration: PROSPERO (CRD42020185296). Copyright
© 2021 The Author(s)

<63>
Accession Number
2013627775
Title
The effects of high-intensity interval training, Nordic walking and
moderate-to-vigorous intensity continuous training on functional capacity,
depression and quality of life in patients with coronary artery disease
enrolled in cardiac rehabilitation: A randomized controlled trial (CRX
study).
Source
Progress in Cardiovascular Diseases. 70 (pp 73-83), 2022. Date of
Publication: 01 Jan 2022.
Author
Reed J.L.; Terada T.; Cotie L.M.; Tulloch H.E.; Leenen F.H.; Mistura M.;
Hans H.; Wang H.-W.; Vidal-Almela S.; Reid R.D.; Pipe A.L.
Institution
(Reed, Terada, Mistura, Hans, Vidal-Almela) Exercise Physiology and
Cardiovascular Health Lab, University of Ottawa Heart Institute, 40 Ruskin
Street, Ottawa, ON K1Y 4W7, Canada
(Reed) School of Epidemiology and Public Health, Faculty of Medicine,
University of Ottawa, Ottawa, Canada
(Reed, Vidal-Almela) School of Human Kinetics, Faculty of Health Sciences,
University of Ottawa, Ottawa, Canada
(Reed, Terada, Cotie, Tulloch, Mistura, Hans, Vidal-Almela, Reid, Pipe)
Division of Cardiac Prevention and Rehabilitation, University of Ottawa
Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada
(Tulloch, Leenen, Reid, Pipe) School of Medicine, Faculty of Medicine,
University of Ottawa, Ottawa, Canada
(Leenen, Wang) Brain and Heart Research Group, University of Ottawa Heart
Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada
(Vidal-Almela) Institut du savoir Montfort, Hopital Montfort, Ottawa,
Canada
Publisher
W.B. Saunders
Abstract
Background: Coronary artery disease (CAD) patients undergoing
revascularization procedures often experience ongoing, diminished
functional capacity, high rates of depression and markedly low quality of
life (QoL). In CAD patients, studies have demonstrated that high-intensity
interval training (HIIT) is superior to traditional moderate-to-vigorous
intensity continuous training (MICT) for improving functional capacity,
whereas no differences between Nordic walking (NW) and MICT have been
observed. Mental health is equally as important as physical health, yet
few studies have examined the impact of HIIT and NW on depression and QoL.
The purpose of this randomized controlled trial (RCT) was to compare the
effects of 12 weeks of HIIT, NW and MICT on functional capacity in CAD
patients. The effects on depression severity, brain-derived neurotrophic
factor (BDNF) and QoL were also examined. Method(s): CAD patients who
underwent coronary revascularization procedures were randomly assigned to:
(1) HIIT (4 x 4-min of high-intensity work periods at 85%-95% peak heart
rate [HR]), (2) NW (resting HR [RHR] + 20-40 bpm), or (3) MICT (RHR +
20-40 bpm) twice weekly for 12 weeks. Functional capacity (six-min walk
test [6MWT]), depression (Beck Depression Inventory-II [BDI-II]), BDNF
(from a blood sample), and general (Short-Form 36 [SF-36]) and
disease-specific (HeartQoL) QoL were measured at baseline and follow-up.
Linear mixed-effects models for repeated measures were used to test the
effects of time, group and time x group interactions. Result(s): N =
135 CAD patients (aged 61 +/- 7 years; male: 85%) participated. A
significant time x group interaction (p = 0.042) showed greater increases
in 6MWT distance (m) for NW (77.2 +/- 60.9) than HIIT (51.4 +/- 47.8) and
MICT (48.3 +/- 47.3). BDI-II significantly improved (HIIT: -1.4 +/- 3.7,
NW: -1.6 +/- 4.0, MICT: -2.3 +/- 6.0 points, main effect of time: p <
0.001) whereas BDNF concentrations did not change (HIIT: -2.5 +/- 9.6, NW:
-0.4 +/- 7.7, MICT: -1.2 +/- 6.4 ng/mL, main effect of time: p > 0.05).
Significant improvements in SF-36 and HeartQoL values were observed (main
effects of time: p < 0.05). HIIT, NW and MICT participants attended 17.7
+/- 7.5, 18.3 +/- 8.0 and 16.1 +/- 7.3 of the 24 exercise sessions,
respectively (p = 0.387). Conclusion(s): All exercise programmes
(HIIT, NW, MICT) were well attended, safe and beneficial in improving
physical and mental health for CAD patients. NW was, however,
statistically and clinically superior in increasing functional capacity, a
predictor of future cardiovascular events. Copyright © 2021
Elsevier Inc.

<64>
Accession Number
2021080771
Title
A meta-analysis examined the effect of topical vancomycin application in
decreasing sternal wound infections post cardiac surgery.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Zhang Y.; Zhang P.; Li H.; Chi H.; Zheng N.; Pan X.; Tang C.
Institution
(Zhang, Zhang, Li, Chi, Zheng, Pan, Tang) Department of Cardiovascular
Surgery, Sixth Medical Center, General Hospital of the Chinese People's
Liberation Army, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
To assess the impact of topical vancomycin (TV) application in decreasing
sternal wound infections (SWIs) post cardiac surgery (CS), we lead a
meta-analysis. Twenty-three thousand seven hundred and forty five
participants had CS at the outset of the investigations, according to a
thorough evaluation of the literature done up to November 2022; 8730 of
them used TV, while 15 015 were controls. To assess the effectiveness of
TV application in lowering SWIs following CS, odds ratios (OR) with 95%
confidence intervals (CIs) were computed with dichotomous technique with a
fixed- or random-effect model. The TV had significantly lower SWIs post CS
(OR, 0.34; 95% CI, 0.20-0.57; P <.001), and deep SWIs post CS (OR, 0.26;
95% CI, 0.11-0.65; P =.004) compared with control as shown in Figures 2
and 3. Yet, there was no significant difference found amongst TV and
control in superficial SWIs post CS (OR, 0.30; 95% CI, 0.07-1.30; P
=.011). The TV had significantly lower SWIs, and deep SWIs post CS, and no
significant difference was found in superficial SWIs post CS compared with
control. The low number of included studies in this meta-analysis for
superficial SWIs calls for precaution when analysing the
outcomes. Copyright © 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons
Ltd.

<65>
Accession Number
2012315448
Title
Comparison of ultrasound-guided femoral artery cannulation versus
palpation technique in neonates undergoing cardiac surgery.
Source
Journal of Vascular Access. 24(1) (pp 27-34), 2023. Date of Publication:
January 2023.
Author
Salik F.; Bicak M.
Institution
(Salik, Bicak) Department of Anesthesiology and Reanimation, Diyarbakir
Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
Publisher
SAGE Publications Ltd
Abstract
Objectives: Palpation technique for femoral artery cannulation can be very
difficult, especially in neonates. In this study, we evaluated whether
ultrasound-guided cannulation of the femoral artery is superior to
palpation technique in neonates undergoing cardiac surgery.
 Method(s): Forty neonates undergoing cardiac surgery were
prospectively randomized into two groups (Ultrasound group and Palpation
group). Access time, number of attempts, number of successful cannulations
on first attempt, success rate, number of cannulas used, inadvertent
access, and complications were compared between the two groups. Cost
analyses of the cannulation were performed in two groups. Result(s):
In the ultrasound group, access time for femoral artery cannulation was
shorter (6.4 +/- 3.0 and 10.2 +/- 4.4, p = 0.003) and the number of
attempts (1.4 +/- 0.6 and 2.3 +/- 0.8, p < 0.001) was lower compared to
the palpation group. The number of successful cannulations on
first-attempt (15 (75%) and 5 (25%), p = 0.002) and the success rate (95%
(19) and 60% (12), p = 0.008) were higher in the ultrasound group. The
number of cannulas used in the ultrasound group was less than the
palpation group (p = 0.001). The cost of intervention was higher in the
palpation group compared to the ultrasound group (p = 0.048).
 Conclusion(s): The ultrasound-guided cannulation of the femoral
artery in neonates is superior to the palpation technique based on the
increased of the number of successful first-attempt cannulation and
success rate, and the reducing of the access time, number of attempts,
number of cannulas used, and cost of cannulation. Copyright © The
Author(s) 2021.

<66>
Accession Number
2020121884
Title
Prophylactic Left Atrial Appendage Exclusion in Cardiac Surgery Patients
With Elevated CHA<inf>2</inf>DS<inf>2</inf>-VASc Score: Results of the
Randomized ATLAS Trial.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 17(6) (pp 463-470), 2022. Date of Publication: November/December
2022.
Author
Gerdisch M.W.; Garrett H.E.; Mumtaz M.A.; Grehan J.F.; Castillo-Sang M.;
Miller J.S.; Zorn G.L.; Gall S.A.; Johnkoski J.A.; Ramlawi B.
Institution
(Gerdisch) Franciscan Health Indianapolis, IN, United States
(Garrett) Cardiovascular Surgery Clinic, Memphis, TN, United States
(Mumtaz) University of Pittsburgh Medical Center Central PA, Harrisburg,
PA, United States
(Grehan) Allina Health System, St. Paul, MN, United States
(Castillo-Sang) The Christ Hospital, Cincinnati, OH, United States
(Miller) Emory University Hospital, Atlanta, GA, United States
(Zorn) University of Kansas, Medical Center, Kansas City, KS, United
States
(Gall) CVA Heart Institute, Kingsport, TN, United States
(Johnkoski) Aspirus Wausau Hospital, WI, United States
(Ramlawi) Lankenau Heart Institute, Philadelphia, PA, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: Patients with elevated CHA<inf>2</inf>DS<inf>2</inf>-VASc
scores are at high risk for atrial fibrillation (AF) and thromboembolic
events (TE) after cardiac surgery. Left atrial appendage exclusion (LAAE)
is a permanent, continuous approach to stroke prevention in AF, overcoming
limitations of oral anticoagulation (OAC). We report ATLAS trial results
focused on LAAE technical success and perioperative safety and TE rates
with and without LAAE in cardiac surgery patients who developed
postoperative AF (POAF). Method(s): ATLAS (NCT02701062) was a
prospective, multicenter, feasibility trial. Patients age >=18 years,
undergoing structural heart procedure, with no preoperative AF,
CHA<inf>2</inf>DS<inf>2</inf>-VASc >=2, and HAS-BLED >=2 were randomized
2:1 to LAAE or no LAAE. Patients who developed POAF and/or received LAAE
were followed for 1 year. LAAE was evaluated with intraoperative
transesophageal echocardiography. Result(s): A total of 562 patients
were randomized to LAAE (n = 376) or no LAAE (n = 186). Mean
CHA<inf>2</inf>DS<inf>2</inf>-VASc (3.4 vs 3.4) and HAS-BLED (2.8 vs 2.9)
scores were similar for LAAE and no LAAE groups. LAAE success (no flow nor
residual stump >10 mm) was 99%. One LAAE-related serious adverse event
(0.27%) occurred and was resolved without sequelae. There were 44.3% of
patients who developed POAF. Through 1 year, 3.4% of LAAE patients and
5.6% of no LAAE patients had TE. OAC was used by 32.5% of POAF patients.
Bleeding was higher with OAC than without (16.1% vs 5.4%, P = 0.008).
 Conclusion(s): ATLAS demonstrated a high rate of successful LAAE with
low LAAE-related serious adverse events in cardiac surgery patients. Study
results should be considered in future trial design to further evaluate
prophylactic LAAE for stroke prevention in cardiac surgery patients with
elevated stroke risk. Copyright © The Author(s) 2022.

<67>
Accession Number
638215904
Title
Bioresorbable flow diverters for the treatment of intracranial aneurysms:
Review of current literature and future directions.
Source
Journal of NeuroInterventional Surgery. 15(2) (pp 178-182), 2022. Date of
Publication: 30 May 2022.
Author
Oliver A.A.; Carlson K.D.; Bilgin C.; Arturo Larco J.L.; Kadirvel R.;
Guillory R.J.; Dragomir Daescu D.; Kallmes D.F.
Institution
(Oliver, Dragomir Daescu, Kallmes) Biomedical Engineering and Physiology,
Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, United
States
(Oliver, Bilgin, Kadirvel, Kallmes) Radiology, Mayo Clinic, Rochester, MN,
United States
(Oliver, Carlson, Dragomir Daescu) Physiology and Biomedical Engineering,
Mayo Clinic, Rochester, MN, United States
(Arturo Larco) Neurosurgery, Mayo Clinic, Rochester, MN, United States
(Guillory) Biomedical Engineering, Michigan Technological University,
Houghton, MI, United States
Publisher
BMJ Publishing Group
Abstract
The use of flow diverters is a rapidly growing endovascular approach for
the treatment of intracranial aneurysms. All FDA-approved flow diverters
are composed of nitinol or cobalt-chromium, which will remain in the
patient for the duration of their life. Bioresorbable flow diverters have
been proposed by several independent investigators as the next generation
of flow diverting devices. These devices aim to serve their transient
function of occluding and healing the aneurysm prior to being safely
resorbed by the body, eliminating complications associated with the
permanent presence of conventional flow diverters. Theoretical advantages
of bioresorbable flow diverters include (1) reduction in device-induced
thrombosis; (2) reduction in chronic inflammation and device-induced
stenosis; (3) reduction in side branch occlusion; (4) restoration of
physiological vasomotor function; (5) reduction in imaging artifacts; and
(6) use in pediatric applications. Advances made in the similar
bioresorbable coronary stenting field highlight some of these advantages
and demonstrate the feasibility and safety of bioresorbable endovascular
devices in the clinic. The current work aims to review the progress of
bioresorbable flow diverters, identify opportunities for further
investigation, and ultimately stimulate the advancement of this
technology. Copyright © 2022 by the Author(s).

<68>
Accession Number
2020657803
Title
A Systematic Review and Meta-Analysis of Robot-Assisted Mitral Valve
Repair.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 17(6) (pp 471-481), 2022. Date of Publication: November/December
2022.
Author
Fatehi Hassanabad A.; Nagase F.N.I.; Basha A.M.; Hammal F.; Menon D.; Kent
W.D.T.; Ali I.S.; Nagendran J.; Stafinski T.
Institution
(Fatehi Hassanabad, Basha, Kent, Ali) Section of Cardiac Surgery,
Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming
School of Medicine, University of Calgary, AB, Canada
(Nagase, Menon, Stafinski) Health Technology & Policy Unit (HTPU), School
of Public Health, University of Alberta, Edmonton, AB, Canada
(Hammal) School of Public Health, University of Alberta, Edmonton, AB,
Canada
(Nagendran) Division of Cardiac Surgery, Department of Surgery,
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB,
Canada
Publisher
SAGE Publications Ltd
Abstract
Objective: Robot-assisted surgery is a minimally invasive approach for
repairing the mitral valve. This study aimed to assess its safety and
clinical efficacy when compared with conventional sternotomy, partial
sternotomy, and right minithoracotomy. Method(s): A systematic review
of peer-reviewed studies comparing robot-assisted mitral valve repair with
conventional sternotomy, partial sternotomy, and right minithoracotomy was
conducted following Cochrane Collaboration guidelines. Meta-analyses were
performed where possible. Result(s): The search strategy yielded 15
primary studies, of which 12 compared robot-assisted with conventional
sternotomy, 2 compared robot-assisted with partial sternotomy, and 6
compared robot-assisted with right minithoracotomy. The overall quality of
evidence was low, and there was a lack of data on long-term outcomes.
Individual studies and pooled data demonstrated that robotic procedures
were comparable to conventional sternotomy and other minimally invasive
approaches with respect to the rates of stroke, renal failure, reoperation
for bleeding, and mortality. Robot-assisted mitral valve repair was
superior to conventional sternotomy with reduced atrial fibrillation,
intensive care unit and hospital stay, pain, time to return to normal
activities, and physical functioning at 1 year. However, robot-assisted
mitral valve repair had longer cardiopulmonary, aortic cross-clamp, and
procedure times compared with all other surgical approaches.
 Conclusion(s): Based on current evidence, robot-assisted mitral valve
repair is comparable to other approaches for safety and early
postoperative outcomes, despite being associated with longer operative
times. Ideally, future studies will be randomized controlled trials that
compare between robot-assisted surgery, conventional surgery, and other
minimally surgery approaches focusing on hard clinical outcomes and
patient-reported outcomes. Copyright © The Author(s) 2022.

<69>
Accession Number
640045828
Title
Quality Of Economic Evaluation Of Coronary Stents Based On CHEERS: A
Scoping Review.
Source
International Journal of Technology Assessment in Health Care. Conference:
Annual Meeting of the Health Technology Assessment International, HTAi
2022. Virtual. 38(Supplement 1) (pp S93), 2022. Date of Publication:
December 2022.
Author
Ren Y.F.; Li F.M.; Chen Y.
Publisher
Cambridge University Press
Abstract
Introduction. The study aims to systematically review all articles on the
economic evaluation (EE) of coronary stenting, to critically assess the
reporting quality, and to summarize the results. Methods. A systematic
search was undertaken through seven databases (PubMed, Web of Science,
Embase, CNKI, Wanfang data, Vip data and SinoMed.) from inception until
March 2021, to identify economic evaluation articles comparing coronary
stenting with other therapies, or among different stenting procedures.
After screening articles and extracting data independently, we summarized
methods, contents, and outcomes of the included articles and appraised
their methodological quality using the CHEERS (Consolidated Health
Economic Evaluation Reporting Standards) checklists. Then, the literature
scores were standardized as a proportion of the total score, and stepwise
multiple regression was constructed to verify the factors that might
influence the quality of literature. Results. Of the 3,622 publications
identified, 59 articles were included in this review. There were 33
cost-effectiveness studies and 26 were cost-utility studies. The quality
of the reports varied between studies, with a standardized mean score of
0.76 (0.40-0.98). According to the Cheers checklist, Introduction had the
lowest overall score (0.53), with many articles deficient in the
description of the study's perspective; Discussion had the highest overall
score (0.86), with nearly three-quarters of the articles reporting the
full content; Title and abstract, Methods, Results, and Other scored 0.71,
0.78, 0.74 and 0.66, respectively. According to the results of the
stepwise multiple regression model, Published year, National type, and
Type of economic analysis research were significantly associated with the
quality of literature. Conclusion. The quality of current research reports
on the economics of coronary stenting is generally satisfactory, but there
is potential for improvement and high quality reports can provide evidence
to support decision making for policy makers.

<70>
Accession Number
640044770
Title
Effectiveness And Safety Of Transcatheter Therapy Interventions Devices
For Treatment Of Tricuspid Regurgitation.
Source
International Journal of Technology Assessment in Health Care. Conference:
Annual Meeting of the Health Technology Assessment International, HTAi
2020. Virtual. 36(Supplement 1) (pp 35-36), 2020. Date of Publication:
December 2020.
Author
Carpintero E.E.G.; Freixa J.G.; Gomez L.M.S.
Publisher
Cambridge University Press
Abstract
Introduction. Tricuspid regurgitation (TR) is defined as incompetence of
the tricuspid valve (TV), which produces the movement of blood flow from
the right ventricle (RV) to the right atrium during systole. Pathological
TR is functional in nearly 80-90 percent of cases, secondary to volume
and/or pressure overload in the RV. Surgical intervention of TR is
associated with mortality rates of 10 percent. Transcatheter therapy
interventions (TTI) can be an alternative for severe TR. The aim of this
study is to assess effectiveness and safety of TTI. Methods. A systematic
review was carried out. The scientific literature search was performed in
major medical databases. Studies analyzing the efficacy and safety of the
devices were included. Outcomes related with mortality rates, TR volume
reduction, echocardiographic findings and adverse events were analyzed.
The methodological quality of the studies was analyzed with the Canadian
Institute of Health Economics Quality Appraisal Checklist. Results. Nine
studies comprising 557 patients were included (two first-in-human studies,
one retrospective, five single arm prospective studies and one
international registry). The studies were small with short follow up. The
outcome of procedural success ranged from 80 to 100 percent. Mortality
rates at 30 days were lower than 5 percent. Improvements in reduction of
TR, European System for Cardiac Operative Risk Evaluation (EuroSCORE),
heart failure symptoms or quality of life scores were observed in all
studies. Conclusions. TTI for moderate-severe TR show significant
reduction of annulus dimension, improvements in heart failure symptoms and
quality of life, which are maintained in mid-term follow up. TTI present
lower rates of major serious adverse events. No differences were observed
between different TTI devices in terms of procedural success, mortality or
safety. Randomized studies comparing TTI with optimal medical therapy are
needed to confirm the preliminary clinical impact in patients with severe
TR, and define aspects such as patient selection, risk factors associated
with procedural success or mortality rates.

<71>
Accession Number
2019055844
Title
Preclinical Large Animal In-Vivo Experiments for Surgically Implanted
Atrioventricular Valve: Reappraisal and Systematic Review.
Source
Current Cardiology Reviews. 19(1) (no pagination), 2023. Article Number:
e170622206130. Date of Publication: January 2023.
Author
Sazzad F.; Kollengode R.; Beverly C.L.X.; Kiat T.Y.; Ganesh G.; Kofidis T.
Institution
(Sazzad, Kollengode, Beverly, Kiat, Ganesh, Kofidis) Department of
Surgery, Yong Loo Lin School of Medicine, National University of
Singapore, Kent Ridge, Singapore
(Sazzad, Kollengode, Kofidis) Department of Cardiac, Thoracic and Vascular
Surgery, National University Heart Center, Kent Ridge, Singapore
Publisher
Bentham Science Publishers
Abstract
Background: The development of atrioventricular bioprosthesis has
witnessed an increasing drive toward clinical translation over the last
few decades. A significant challenge in the clinical translation of an
atrioventricular bioprosthesis from bench to bedside is the appropriate
choice of a large animal model to test the safety and effectiveness of the
device. Method(s): We conducted a systematic review of pre-clinical
in vivo studies that would enable us to synthesize a recommended
framework. PRISMA (Preferred Reporting Items for Systematic Reviews and
MetaAnalyses) guidelines were followed to identify and extract relevant
articles. Result(s): Sheep was the most common choice of animal, with
nine out of the 12 included studies being conducted on sheep. There were
acute and chronic studies based on our search criteria. An average of ~20
and 5 animals were used for chronic and acute studies. One out of three
acute studies and eight out of nine chronic studies were on stented heart
valve bioprosthesis. All analyses were conducted on the implantation of
atrioventricular valves with trileaflet, except for one chronic study on
unileaflet valves and one chronic and acute study on bileaflet valves.
 Conclusion(s): Understanding the variance in past pre-clinical study
designs may increase the appropriate utilization of large animal models.
This synthesized evidence provides a pre-clinical in vivo studies
framework for future research on an atrioventricular
bioprosthesis. Copyright © 2023 Bentham Science Publishers.

<72>
Accession Number
2022257134
Title
Heparin Rebound: An In-Depth Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Stone M.E.; Vespe M.W.
Institution
(Stone, Vespe) Icahn School of Medicine at Mount Sinai, New York, NY,
United States
Publisher
W.B. Saunders
Abstract
The common conception of "heparin rebound" invokes heparin returning to
circulation in the postoperative period after apparently adequate
intraoperative reversal with protamine. This is believed to portend
increased postoperative bleeding and provides the rationale for
administering additional empiric doses of protamine in response to
prolonged coagulation tests and/or bleeding. However, the relevant
literature of the last 60+ years provides only a weak level of evidence
that "rebounded" heparin itself is a significant etiology of postoperative
bleeding after cardiac surgery with cardiopulmonary bypass. Notably, many
of the most frequently cited heparin rebound investigators ultimately
concluded that although exceedingly low levels of heparin activity could
be detected by anti-Xa assay in some (but not all) patients
postoperatively, there was no correlation with actual bleeding. An
understanding of the literature requires a careful reading of the details
because the investigators lacked standardized definitions for "heparin
rebound" and "adequate reversal" while studying the phenomenon with
significantly different experimental methodologies and laboratory tests.
This review was undertaken to provide a modern understanding of the
"heparin rebound" phenomenon to encourage an evidence-based approach to
postoperative bleeding. Literature searches were conducted via PubMed
using the following MeSH terms: heparin rebound, heparin reversal,
protamine, platelet factor 4, and polybrene. Relevant English language
articles were reviewed, with subsequent references obtained from the
internal citations. Perspective is provided for both those who use
HepCon-guided management and those who do not, as are practical
recommendations for the modern era based on the published data and
conclusions of the various investigators. Copyright © 2022
Elsevier Inc.

<73>
Accession Number
2022257125
Title
Direct intramyocardial injection of VEGF mRNA in patients undergoing
coronary artery bypass grafting.
Source
Molecular Therapy. (no pagination), 2023. Date of Publication: 2023.
Author
Anttila V.; Saraste A.; Knuuti J.; Hedman M.; Jaakkola P.; Laugwitz K.-L.;
Krane M.; Jeppsson A.; Sillanmaki S.; Rosenmeier J.; Zingmark P.; Rudvik
A.; Garkaviy P.; Watson C.; Pangalos M.N.; Chien K.R.; Fritsche-Danielson
R.; Collen A.; Gan L.-M.
Institution
(Anttila, Saraste) Heart Centre, Turku University Hospital and University
of Turku, Turku, Finland
(Saraste, Knuuti) Turku PET Centre, Turku University Hospital and
University of Turku, Turku, Finland
(Hedman, Jaakkola) Heart Centre, Kuopio University Hospital, Kuopio,
Finland
(Hedman) Institute of Clinical Medicine, University of Eastern Finland,
Kuopio, Finland
(Laugwitz) First Medical Department (Cardiology, Angiology and
Pneumology), Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany
(Krane) German Centre for Cardiovascular Research (DZHK), Munich Heart
Alliance, Munich, Germany
(Krane) Department of Cardiovascular Surgery, German Heart Centre Munich,
Technical University of Munich, Munich, Germany
(Krane) Division of Cardiac Surgery, Yale School of Medicine, Yale
University, New Haven, CT, United States
(Jeppsson, Gan) Department of Molecular and Clinical Medicine, Institute
of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
(Jeppsson) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Sillanmaki) Department of Clinical Physiology and Nuclear Medicine,
Kuopio University Hospital, Kuopio, Finland
(Rosenmeier, Zingmark, Garkaviy, Fritsche-Danielson, Collen, Gan) Research
and Early Clinical Development, Cardiovascular, Renal and Metabolism,
BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
(Rudvik) Early Biometrics & Statistical Innovation, Data Science &
Artificial Intelligence, R&D, AstraZeneca, Gothenburg, Sweden
(Watson) Study Management Early, Cardiovascular, Renal, and Metabolism,
BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
(Pangalos) BioPharmaceuticals Research and Development, AstraZeneca,
Cambridge, United Kingdom
(Chien) Department of Cell and Molecular Biology, Karolinska Institutet,
Stockholm, Sweden
(Gan) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
Publisher
Cell Press
Abstract
Vascular endothelial growth factor A (VEGF-A) has therapeutic
cardiovascular effects, but delivery challenges have impeded clinical
development. We report the first clinical study of naked mRNA encoding
VEGF-A (AZD8601) injected into the human heart. EPICCURE
(ClinicalTrials.gov: NCT03370887) was a randomized, double-blind study of
AZD8601 in patients with left ventricular ejection fraction (LVEF) 30%-50%
who were undergoing elective coronary artery bypass surgery. Thirty
epicardial injections of AZD8601 (total 3 mg) or placebo in
citrate-buffered saline were targeted to ischemic but viable myocardial
regions mapped using quantitative [15O]-water positron emission
tomography. Seven patients received AZD8601 and four received placebo and
were followed for 6 months. There were no deaths or treatment-related
serious adverse events and no AZD8601-associated infections, immune
reactions, or arrhythmias. Exploratory outcomes indicated potential
improvement in LVEF, Kansas City Cardiomyopathy Questionnaire scores, and
N-terminal pro-B-type natriuretic peptide levels, but the study is limited
in size, and significant efficacy conclusions are not possible from the
dataset. Naked mRNA without lipid encapsulation may provide a safe
delivery platform for introducing genetic material to cardiac muscle, but
further studies are needed to confirm efficacy and safety in a larger
patient pool. Copyright © 2022

<74>
Accession Number
640054461
Title
Patient-reported outcome measures in congenital heart surgery: a
systematic review.
Source
Cardiology in the young. (pp 1-5), 2023. Date of Publication: 18 Jan
2023.
Author
Francis J.; Prothasis S.; George J.; Stoica S.
Institution
(Francis) Department of Medical Science, University of Edinburgh, 47
Little France Crescent, EdinburghEH164TJ, United Kingdom
(Prothasis) Department of Medical Science, University of Aberdeen,
Polwarth Building, AberdeenAB25 2ZD, United Kingdom
(George) Department of Cardiac Surgery, Great Ormond Street Hospital,
LondonWC1N 3JH, United Kingdom
(Stoica) Department of Cardiac Surgery, Bristol Children's Hospital,
BristolBS2 8BJ, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patient-reported outcome measures are commonly used to
evaluate the effectiveness of treatments. CHD remains the most common
congenital malformation. There has been a gradual shift in evaluating the
outcome of surgery for CHD from mortality to morbidity and now to
self-reported outcomes. AIMS: We aimed to review studies assessing
patient-reported outcome measures as a useful marker of outcome for
patients, both children and adults, who underwent surgery for CHD.
 METHOD(S): A systematic database search was conducted of original
articles that explored the application of patient-reported outcome
measures in the CHD surgical setting in PubMed and SCOPUS from inception
to February 2022. RESULT(S): Our search yielded 1511 papers, of which
six studies were included in this review after screening abstract and
full-text, with a total sample size of 5734 patients. The main areas of
discussion were the utility of patient-reported outcome measures,
determinants of patient-reported outcome measures, and the need for a
congenital cardiac surgery-specific patient-reported outcome measure for
paediatric patients and their parents/guardians and adult patients.
 CONCLUSION(S): This systematic review reports the use of
patient-reported outcome measures to be a useful indicator to gain insight
into the patients' perspective to provide holistic and patient-centred
management. However, further studies are required to assess the utility of
patient-reported outcome measures in a congenital cardiac surgical
setting.

<75>
Accession Number
2022050115
Title
Pre-operative short-term pranayama (yoga) decreases intraoperative opioid
consumption in patients undergoing on-pump cardiac surgery.
Source
Indian Journal of Anaesthesia. 66(12) (pp 873-876), 2022. Date of
Publication: December 2022.
Author
Azeez A.; Puri G.; Samra T.; Singh M.
Institution
(Azeez) Department of Anaesthesia, Kasturba Medical College, Manipal,
Karnataka, Udupi, India
(Puri, Samra) Department of Anaesthesia and Intensive Care, Post Graduate
Institute of Medical Education and Research, Chandigarh, India
(Singh) Govt. College of Yoga Education & Health, Chandigarh, India
Publisher
Wolters Kluwer Medknow Publications

<76>
Accession Number
2018458090
Title
A systematic review and meta-analysis of non-vitamin K antagonist oral
anticoagulants vs vitamin K antagonists after transcatheter aortic valve
replacement in patients with atrial fibrillation.
Source
European Journal of Clinical Pharmacology. 78(10) (pp 1589-1600), 2022.
Date of Publication: October 2022.
Author
Ooi A.J.Q.; Wong C.; Tan T.W.E.; Ng T.P.; Teo Y.N.; Teo Y.H.; Syn N.L.;
Djohan A.H.; Lim Y.; Yeo L.L.L.; Tan B.Y.Q.; Chan M.Y.-Y.; Poh K.-K.; Kong
W.K.F.; Chai P.; Yeo T.-C.; Yip J.W.; Kuntjoro I.; Sia C.-H.
Institution
(Ooi, Wong, Tan, Ng, Teo, Teo, Syn, Yeo, Tan, Chan, Poh, Kong, Chai, Yeo,
Yip, Sia) Yong Loo Lin School of Medicine, National University of
Singapore, Singapore, Singapore
(Djohan, Lim, Chan, Poh, Kong, Chai, Yeo, Yip, Kuntjoro, Sia) Department
of Cardiology, National University Heart Centre, Singapore 119228,
Singapore
(Yeo, Tan) Division of Neurology, Department of Medicine, National
University Hospital, Singapore, Singapore
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Transcatheter aortic valve replacement (TAVR) is increasingly
carried out in patients with aortic valvular conditions. Atrial
fibrillation (AF) is a common comorbidity among patients undergoing TAVR.
Despite this, there remains a paucity of data and established guidelines
regarding anticoagulation use post-TAVR in patients with AF.
 Method(s): Four databases were searched from inception until 12
October 2021. A title and abstract sieve, full-text review and data
extraction were conducted by independent authors, and articles including
patients without AF were excluded. The Review Manager (Version 5.4) was
utilised in data analysis. Result(s): A total of 25,199 post-TAVR
patients with AF were included from seven articles, with 9764 patients on
non-vitamin K antagonist oral anticoagulants (NOAC) and 15,435 patients on
vitamin K antagonists (VKA). In this analysis, there was a significantly
lower risk of all-cause mortality at 1 year (RR: 0.75, CI: 0.58-0.97, p =
0.04, I2 = 56%), and bleeding at 1 year (RR: 0.73, CI:
0.68-0.79, p = < 0.00001, I2 = 0%), between patients on NOAC
and VKA. There were no detectable differences between patients on NOAC and
VKA for all-cause mortality at 2 years, stroke within 30 days, stroke
within 1 year, ischaemic stroke at 1 year and life-threatening bleeding at
30 days. Conclusion(s): While the results of this analysis reveal
NOAC as a potential alternate treatment modality to VKA in post-TAVR
patients with AF, further research is needed to determine the full safety
and efficacy profile of NOAC (PROSPERO: CRD42021283548). Copyright
© 2022, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<77>
Accession Number
2020206279
Title
Design of the remede System Therapy (reST) study: A prospective
non-randomized post-market study collecting clinical data on safety and
effectiveness of the remede system for the treatment of central sleep
apnea.
Source
Sleep Medicine. 100 (pp 238-243), 2022. Date of Publication: December
2022.
Author
Goldberg L.R.; Fox H.; Stellbrink C.; Bozkurt B.; Boehmer J.P.; Mora J.I.;
Doshi R.; Morgenthaler T.I.; Levy W.C.; Meyer T.E.; McKane S.W.; Germany
R.
Institution
(Goldberg, Mora) University of Pennsylvania, PA, Philadelphia 19104,
United States
(Fox) Clinic for General and Interventional Cardiology Angiology, Herz-
und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen 32545,
Germany
(Stellbrink) Bielefeld Medical Center, Bielefeld 33604, Germany
(Bozkurt) Baylor College of Medicine and Michael E. Debakey VA Medical
Center, TX, Houston 77030, United States
(Boehmer) Penn State Health Milton S. Hershey Medical Center, PA, Hershey
17033, United States
(Doshi) Honor Health, AZ, Scottsdale 85258, United States
(Morgenthaler) Mayo Clinic, MN, Rochester 55905, United States
(Levy) University of Washington, WA, Seattle 98195, United States
(Meyer, McKane, Germany) ZOLL Respicardia, Inc., MN, Minnetonka 55343,
United States
Publisher
Elsevier B.V.
Abstract
Background: Central sleep apnea (CSA) is a disorder defined by lack of
respiratory drive from the brain stem on breathing efforts. There is a
lack of established therapies for CSA and most available therapies are
limited by poor patient adherence, limited randomized controlled studies,
and potentially adverse cardiovascular effects. The remede System (ZOLL
Respicardia, Inc., Minnetonka, Minnesota) uses transvenous phrenic nerve
stimulation to stimulate the diaphragm, thereby restoring a more normal
breathing pattern throughout the sleep period. Method(s): The remede
System Therapy (reST) Study is a prospective non-randomized multicenter
international study evaluating long-term safety and effectiveness of the
remede System in the post-market setting. Up to 500 adult patients with
moderate to severe CSA will be enrolled and followed up to 5 years at
approximately 50 sites in the United States and Europe. Safety objectives
include evaluation of adverse events related to the implant procedure,
device or delivered therapy, death, and hospitalizations. Effectiveness
endpoints include assessment of changes in sleep-disordered breathing
metrics from polysomnograms and home sleep tests, changes in daytime
sleepiness using the Epworth Sleepiness Scale, and changes in QoL using
the PROMIS-29 and Patient Global Assessment questionnaires. The subgroup
of patients with heart failure will undergo additional assessments
including echocardiography to assess cardiac reverse remodeling, 6-min
walk distance, QoL assessment by Kansas City Cardiomyopathy Questionnaire
and measurement of biomarkers. Conclusion(s): This will be the
largest prospective study evaluating long-term safety and effectiveness of
transvenous phrenic nerve stimulation for the treatment of moderate to
severe CSA in adult patients. Copyright © 2022 The Authors

<78>
Accession Number
2020333814
Title
Opioid-free postoperative analgesia compared to traditional analgesia
after thoracic surgery: scoping review.
Source
Revista da Associacao Medica Brasileira. 68(8) (pp 1109-1114), 2022. Date
of Publication: 2022.
Author
de Andrade R.R.; de Oliveira Lima N.; Ribeiro M.V.M.R.; da Silva Ramos
F.W.; de Sousa-Rodrigues C.F.; Barbosa F.T.
Institution
(de Andrade, de Sousa-Rodrigues) Universidade Federal de Alagoas,
Institute of Health and Biological Sciences, AL, Maceio, Brazil
(de Oliveira Lima) Universidade Federal de Alagoas, AL, Maceio, Brazil
(Ribeiro) Centro Universitario CESMAC, Faculty of Medicine, AL, Maceio,
Brazil
(da Silva Ramos) Centro Universitario CESMAC, Faculty of Biomedicine, AL,
Maceio, Brazil
(Barbosa) Universidade Federal de Alagoas, Faculty of Medicine, AL,
Maceio, Brazil
Publisher
Associacao Medica Brasileira

<79>
Accession Number
2020610915
Title
Depth of anaesthesia and mortality after cardiac or noncardiac surgery: a
systematic review and meta-analysis of randomised controlled trials.
Source
British Journal of Anaesthesia. 130(2) (pp e317-e329), 2023. Date of
Publication: February 2023.
Author
Payne T.; Braithwaite H.; McCulloch T.; Paleologos M.; Johnstone C.;
Wehrman J.; Taylor J.; Loadsman J.; Wang A.Y.; Sanders R.D.
Institution
(Payne, Wehrman, Taylor, Loadsman, Sanders) Central Clinical School
Faculty of Medicine and Health, The University of Sydney, Sydney, NSW,
Australia
(Payne, Braithwaite, McCulloch, Paleologos, Johnstone, Loadsman, Wang,
Sanders) Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney
Local Health District, Sydney, NSW, Australia
(Wang) Northern Clinical School, Faculty of Medicine and Health, The
University of Sydney, NSW, Australia
(Sanders) NHMRC Clinical Trials Centre, University of Sydney, NSW,
Australia
(Sanders) Institute of Academic Surgery, Royal Prince Alfred Hospital,
Sydney Local Health District, Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Recent randomised controlled trials have failed to show a
benefit in mortality by using processed electroencephalography (pEEG) to
guide lighter anaesthesia. We performed a meta-analysis of mortality data
from randomised trials of pEEG monitoring to assess the evidence of any
protective effect of pEEG-guided light anaesthesia compared with deep
anaesthesia in adults aged >=18 yr. Method(s): Our study followed the
Preferred Reporting Items for Systematic Reviews and Meta-analyses
(PRISMA) guidelines. In February 2022, we searched three databases
(Cochrane CENTRAL, OVID Medline, EMBASE) for RCTs of pEEG monitoring that
provided mortality data at 30 days, 90 days, and/or 1 yr or longer.
 Result(s): We included 16 articles from 12 RCTs with 48 827 total
participants. We observed no statistically significant mortality reduction
with light anaesthesia compared with deep anaesthesia in patients aged
>=18 yr when all studies were pooled (odds ratio [OR]=0.99; 95% confidence
interval (CI), 0.92-1.08). This result did not change significantly when
analysing mortality at 30 days, 90 days, 1 yr or longer. We observed no
mortality benefit for pEEG monitoring compared with usual care (OR=1.02;
95% CI, 0.89-1.18), targeting higher pEEG index values compared with lower
values (OR=0.89; 95% CI, 0.60-1.32), or low pEEG index value alerts
compared with no alerts (OR=1.02; 95% CI, 0.41-2.52). Conclusion(s):
pEEG-guided lighter anaesthesia does not appear to reduce the risk of
postoperative mortality. The absence of a plausible rationale for why
deeper anaesthesia should increase mortality has hampered appropriate
design of definitive clinical trials. Clinical trial registration:
CRD42022285195 (PROSPERO). Copyright © 2022 British Journal of
Anaesthesia

<80>
Accession Number
2011652785
Title
Oxygen delivery-guided perfusion for the prevention of acute kidney
injury: A randomized controlled trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(2) (pp 750-760.e5),
2023. Date of Publication: February 2023.
Author
Mukaida H.; Matsushita S.; Yamamoto T.; Minami Y.; Sato G.; Asai T.; Amano
A.
Institution
(Mukaida, Minami, Sato) Department of Clinical Engineering, Juntendo
University Hospital, Tokyo, Japan
(Mukaida, Matsushita, Yamamoto, Asai, Amano) Department of Cardiovascular
Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
Publisher
Elsevier Inc.
Abstract
Objectives: The reduction of postoperative acute kidney injury in patients
undergoing cardiopulmonary bypass surgery using an oxygen delivery-guided
perfusion strategy (oxygen delivery strategy) for cardiopulmonary bypass
management compared with a fixed flow perfusion (conventional strategy)
remains controversial. The purpose of this study was to determine whether
a oxygen delivery strategy would reduce the incidence of postoperative
acute kidney injury in patients undergoing cardiopulmonary bypass surgery.
 Method(s): We randomly enrolled 300 patients undergoing
cardiopulmonary bypass surgery. Patients were randomly assigned to a
oxygen delivery strategy (maintaining a oxygen delivery index value >300
mL/min/m2 through pump flow adjustments during cardiopulmonary
bypass) or a conventional strategy (a target pump flow was determined on
the basis of the body surface area). The primary end point was the
development of acute kidney injury. Secondary end points were the red
blood cell transfusion rate and number of red blood cell units, intubation
time, postoperative length of stay in the intensive care unit and the
hospital, predischarge estimated glomerular filtration rate, and hospital
mortality. Result(s): Acute kidney injury occurred in 20 patients
(14.6%) receiving the oxygen delivery strategy and in 42 patients (30.4%)
receiving the conventional strategy (relative risk, 0.48; 95% confidence
interval, 0.30-0.77; P = .002). The secondary end points were not
significantly different between strategies. In a prespecified subgroup
analysis of patients who had nadir hematocrit less than 23% or body
surface area less than 1.40 m2, the oxygen delivery strategy
seemed to be superior to the conventional strategy and the existence of
quantitative interactions was suggested. Conclusion(s): An oxygen
delivery strategy for cardiopulmonary bypass management was superior to a
conventional strategy with respect to preventing the development of acute
kidney injury. Copyright © 2021 The American Association for
Thoracic Surgery

<81>
Accession Number
2019558118
Title
Prevalence and Predictors of Chronic Postsurgical Pain After
Video-Assisted Thoracoscopic Surgery: A Systematic Review and
Meta-analysis.
Source
Pain and Therapy. 12(1) (pp 117-139), 2023. Date of Publication: February
2023.
Author
Chen W.-C.; Bai Y.-Y.; Zhang L.-H.; Liu Y.-B.; Liu C.-Y.; Liang J.-W.; He
H.-F.
Institution
(Chen, Bai, Zhang, Liu, Liu, Liang, He) Department of Anesthesiology, The
Second Affiliated Hospital, Fujian Medical University, 34 Zhongshan North
Road, Quanzhou, China
Publisher
Adis
Abstract
Introduction: Determining the prevalence of chronic postsurgical pain
(CPSP) after video-assisted thoracoscopic surgery (VATS) and identifying
CPSP predictors should improve the prognosis of patients undergoing VATS.
Although several studies have investigated predictors of CPSP after VATS,
there were significant dissimilarities in the findings due to the
confounding of predictors. Method(s): PubMed, Cochrane, MEDLINE, Web
of Science, Chinese Biomedical Literature, and China National Knowledge
Infrastructure databases were comprehensively searched using the Medical
Subject Headings terms "pain, postoperative," "thoracic surgery,
video-assisted," and all related free terms from inception until March 27,
2022. The Stata metaprop package was used to comprehensively analyze the
incidence of CPSP following VATS. Furthermore, the pooled odds ratios (OR)
or the standardized mean differences (SMD) and their corresponding 95%
confidence intervals (95% CI) were calculated, and qualitative analyses
were performed for predictors that could not be assessed quantitatively to
evaluate the effects of the included risk factors on the occurrence of
CPSP. Unadjusted odds ratios were utilized to consider the impact of
non-significant estimates if the original study did not report them.
 Result(s): Of the 4302 studies, 183 were considered eligible, and 17
were finally included in this study. The overall incidence of CPSP after
VATS was 35.3% (95% CI 27.1-43.5%). The qualitative synthesis results
revealed that female sex, age, and acute postoperative pain were definite
predictors of CPSP after VATS. The number of ports, operation time,
duration of drainage, and insufficient analgesia were also considered
predictors. Consistent, quantitative synthesis results also showed that
the aforementioned predictors were closely related to the occurrence of
CPSP after VATS. Only by quantitative analysis, postoperative chemotherapy
and an educational level less than junior school were also risk factors
for CPSP. Other predictors displayed no evidence or unclear evidence of
association with CPSP after VATS. Conclusion(s): This study
preliminarily determined the incidence of CPSP after VATS based on the
existing literature. Female sex, age, and acute pain were identified as
risk factors for CPSP after VATS, and other potential risk factors were
also identified and analyzed. However, as a result of the inclusion of
retrospective studies and inevitable limitations in this systematic review
and meta-analysis, the results of this study still need to be verified by
large-scale prospective clinical studies. Trial Registration:
CRD42022323179. Copyright © 2022, The Author(s).

<82>
Accession Number
639819276
Title
The effect of applying telehealth education to home care of infants after
congenital heart disease surgery.
Source
International journal for quality in health care : journal of the
International Society for Quality in Health Care. 35(1) (no pagination),
2023. Date of Publication: 14 Jan 2023.
Author
Zhang Q.-L.; Lin S.-H.; Lin W.-H.; Chen Q.; Cao H.
Institution
(Zhang, Lin, Lin, Chen, Cao) Department of Cardiac Surgery, Fujian
Children's Hospital (Fujian Branch of Shanghai Children's Medical Center),
College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics,
Fujian Medical University, No. 966 of Hengyu Road, Fuzhou, Fujian 350001,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The purpose of this study was to investigate the effect of
applying telehealth education to home care of infants after congenital
heart disease (CHD) surgery. METHOD(S): A prospective randomized
controlled study was conducted from July 2020 to February 2021 in Fujian
Children's Hospital to compare the home care condition of infants after
CHD surgery between the intervention group and the control group.
 RESULT(S): At 3months after discharge, parents' caring ability and
CHD knowledge in the intervention group were significantly better than
those in the control group and were significantly improved compared with
those at discharge time (P<0.05). The parental care burden in the
intervention group was significantly lower than that in the control group
and was significantly lower than that at discharge time (P<0.05). During
the follow-up period, the rate of loss of follow-up and complications in
the intervention group were significantly lower than those in the control
group (P<0.05). CONCLUSION(S): Telehealth education via WeChat can
effectively improve the knowledge of disease and home care ability of
parents of infants after CHD surgery and reduce their home care burden,
which can effectively reduce the incidence of complications and lost to
follow-up rate after discharge. Copyright © The Author(s) 2023.
Published by Oxford University Press on behalf of International Society
for Quality in Health Care. All rights reserved. For permissions, please
e-mail: journals.permissions@oup.com.

<83>
Accession Number
2014389923
Title
Effects of percutaneous balloon mitral valvuloplasty in patients with
mitral stenosis and atrial fibrillation: a systematic review and
meta-analysis.
Source
Acta Cardiologica. 77(10) (pp 890-899), 2022. Date of Publication: 2022.
Author
Liu B.; Wang Y.; Liu Y.; Wu P.; Li T.
Institution
(Liu, Wang, Liu, Wu, Li) Heart Central, Third Central Hospital of Tianjin,
Tianjin, China
(Liu) Tianjin Key Laboratory of Extracorporeal Life Support for Critical
Diseases, Tianjin, China
(Liu) Artificial Cell Engineering Technology Research Center, Tianjin,
China
(Liu) Tianjin Institute of Hepatobiliary Disease, Tianjin, China
Publisher
Taylor and Francis Ltd.
Abstract
Objective: The study aimed to systematically review the existing
literature and assess the effects of percutaneous balloon mitral
valvuloplasty (PBMV) in patients with mitral stenosis and atrial
fibrillation (AF) as opposed to sinus rhythm (SR). Method(s):
Eligible studies were identified from six electronic databases before June
2021. The primary outcome was mitral valve area (MVA), and secondary
outcomes were hemodynamic measurements, in-hospital complications, and
long-term outcomes. Relative risks (RRs) or weighted mean differences
(WMDs) with 95% confidence intervals (CIs) were used as effect sizes.
 Result(s): Fifteen studies were included involving 6351 patients. For
the primary outcome, the AF group obtained less favourable changes in MVA
(WMD: -0.10, 95%CI: -0.14, -0.06) and a significantly smaller
postoperative and long-term MVA (WMD: -0.13, 95%CI: -0.18, -0.08 and WMD:
-0.10, 95%CI: -0.17, -0.03, respectively) compared to the SR group. For
secondary outcome, the AF group was associated with suboptimal outcomes as
following (WMD/RR, [95%CI]): higher LAP (1.37, [0.86, 1.87]), more
embolism (2.85, [1.44, 5.63]), lower event-free survival (0.89, [0.80,
1.00]), higher incidences of mitral valve replacement (2.20, [1.40,
3.46]), re-PBMV (2.28, [1.63, 3.19]), and mortality (3.28, [2.42, 4.44]).
No significant differences were found in other outcomes.
 Conclusion(s): The currently available evidence suggests that PBMV
may be less effective in patients with AF than in those with SR. However,
early treatment and appropriate management of AF patients undergoing PBMV
may benefit the immediate and long-term outcomes. Copyright ©
2021 Belgian Society of Cardiology.

<84>
Accession Number
2021040705
Title
Effects of different doses of glucocorticoids on postoperative atrial
fibrillation: a meta-analysis.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
16. Date of Publication: December 2023.
Author
Zhou Z.; Long Y.; He X.; Li Y.
Institution
(Zhou, Long, He, Li) Department of Cardiology, Chongqing Traditional
Chinese Medicine Hospital, Chongqing 400025, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative atrial fibrillation (POAF) is the most common
arrhythmia after cardiac surgery, and its occurrence is closely related to
inflammation. This paper intends to apply meta-analysis to investigate the
effect of glucocorticoids on POAF. Method(s): PubMed, Embase, Web of
Science, and Cochrane Library were searched using the internationally
recognized systematic evaluation and retrieval strategy. Two review
authors independently selected relevant studies and extracted data based
on the Cochrane handbook for systematic reviews of interventions approach.
Stata 17 was used for data analysis. In the subgroup analysis, we grouped
the participant data according to differences in glucocorticoids dose and
type of surgery. At the same time, we also conducted a meta-analysis on
the possible infection and gastrointestinal injury caused by
glucocorticoids use. Result(s): 27 studies and 14,442 patients were
finally included. Results from the random-effects model indicated that the
incidence of POAF was lower in glucocorticoid group (RR 0.80, 95% CI
0.71-0.92, P = 0.001). According to the subgroup analysis result, low
doses of glucocorticoids reduced the incidence of POAF (RR 0.81, 95% CI
0.71-0.92, P = 0.001). The effect of high doses glucocorticoids on the
POAF was not statistically significant (RR 0.81, 95% CI 0.56-1.19, P =
0.286). In the coronary artery bypass grafting (CABG) subgroup, the
glucocorticoids reduced the incidence of POAF (RR 0.71, 95% CI 0.58-0.87,
P = 0.001). In the CABG OR Valvular Surgery group, the effect of
glucocorticoids on POAF was not statistically significant (RR 0.88, 95% CI
0.75-1.03, P = 0.108). 15 studies documented postoperative complications
of infection, two studies were excluded from the system because the end
point event was 0, and meta-analysis showed no increased risk of infection
from glucocorticoid use (RR 0.85, 95% CI 0.68-1.06, P = 0.158). Eight
studies documented the effects of glucocorticoids on gastrointestinal
diseases, and meta-analysis showed no differences between the two groups
(RR 1.12, 95% CI 0.83-1.50, P = 0.450). Conclusion(s): The use of
glucocorticoids can reduce the incidence of POAF. The subgroup analysis
result showed that low-dose glucocorticoids were more effective than
high-dose glucocorticoids in inhibiting POAF. The use of glucocorticoids
in CABG alone can better inhibit the occurrence of POAF. The effects of
glucocorticoids on infection and gastrointestinal injury were not
statistically significant. Review registration: PROSPERO,
CRD42022304521. Copyright © 2023, The Author(s).

<85>
Accession Number
2022143069
Title
Sphingomonas paucimobilis native valve endocarditis and mycotic cerebral
aneurysm in a patient with Crohn's disease: Case report and review of
literature.
Source
IDCases. 31 (no pagination), 2023. Article Number: e01687. Date of
Publication: January 2023.
Author
Assi F.; Hammoud R.; Ezzedine A.; Rahal H.
Institution
(Assi, Hammoud, Ezzedine, Rahal) Faculty of Medical Sciences, Lebanese
University, Beirut, Lebanon
(Rahal) Bahman Hospital, Haret Hreik, Lebanon
Publisher
Elsevier Ltd
Abstract
This report describes a case of Sphingomonas paucimobilis bacteremia and
infective endocarditis with a mycotic aneurysm in a young patient with
Crohn's disease. Our patient reported prolonged intermittent fever
followed by sudden hemiparesis and a tonic clonic convulsion. His blood
cultures showed growth of Sphingomonas paucimobilis, and further cardiac
imaging revealed the presence of a vegetation with severe valvular
regurgitation. Cerebral angiography showed middle cerebral artery
occlusion and aneurysm. The patient was treated with meropenem for 6
weeks, coupled with aortic valve replacement, and coiling of the aneurysm.
Our patient recovered with good results. S. paucimobilis is an
opportunistic gram-negative pathogen of growing importance in the clinical
setting. Copyright © 2023

<86>
Accession Number
640040982
Title
Quantitative flow ratio versus fractional flow reserve for guiding
percutaneous coronary intervention: design and rationale of the randomised
FAVOR III Europe Japan trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2023. Date of Publication: 17 Jan 2023.
Author
Andersen B.K.; Sejr-Hansen M.; Westra J.; Campo G.; Efterkhari A.; Tu S.;
Escaned J.; Koltowski L.; Stahli B.E.; Erglis A.; Jarusevicius G.;
Ziubryte G.; Ramunddal T.; Liu T.; Wijns W.; Landmesser U.; Maillard L.;
Matsuo H.; Christiansen E.H.; Holm N.R.
Institution
(Andersen, Sejr-Hansen, Westra, Christiansen, Holm) Department of
Cardiology, Aarhus University Hospital, Skejby, Denmark
(Campo) Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara,
Ferrara, Italy and Maria Cecilia Hospital, GVM Care & Research, Cotignola
(RA), Italy
(Efterkhari) Department of Cardiology, Aalborg University Hospital,
Aalborg, Denmark
(Tu) School of Biomedical Engineering, Shanghai Jiao Tong University,
Shanghai, China
(Escaned) Hospital Clinico San Carlos IdISSC, Complutense University of
Madrid, Madrid, Spain
(Koltowski) Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
(Stahli) Department of Cardiology, University Heart Center, University
Hospital Zurich, Zurich, Switzerland
(Erglis) Department of Cardiology, Riga Stradins University, Riga, Latvia
(Jarusevicius, Ziubryte) Department of Cardiology, Hospital of Lithuanian
University of Health Sciences Kauno Klinikos, Lithuania and Institute of
Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
(Ramunddal) Department of Cardiology, Sahlgrenska University Hospital,
Goteborg, Sweden
(Liu) Department of Cardiology, HagaZiekenhuis, The Hague, Netherlands
(Wijns) Lambe Institute for Translational Medicine and Curam, National
University of Ireland, Galway, Ireland
(Landmesser) Department of Cardiology (CBF), Charite - Universitatsmedizin
Berlin, Berlin, Germany
(Maillard) GCS ES Axium Rambot, Clinique Axium, Aix-en-Provence, France
(Matsuo) Department of Cardiovascular Medicine, Gifu Heart Center, Gifu,
Japan
Publisher
NLM (Medline)
Abstract
Quantitative flow ratio (QFR) is a computation of fractional flow reserve
(FFR) based on invasive coronary angiographic images. Calculating QFR is
less invasive than measuring FFR and may be associated with lower costs.
Current evidence supports the call for an adequately powered randomised
comparison of QFR and FFR for the evaluation of intermediate coronary
stenosis. The aim of the FAVOR III Europe Japan trial is to investigate if
a QFR-based diagnostic strategy yields a non-inferior 12-month clinical
outcome compared with a standard FFR-guided strategy in the evaluation of
patients with intermediary coronary stenosis. FAVOR III Europe Japan is an
investigator-initiated, randomised, clinical outcome, non-inferiority
trial scheduled to randomise 2,000 patients with either 1) stable angina
pectoris and intermediate coronary stenosis, or 2) indications for
functional assessment of at least 1 non-culprit lesion after acute
myocardial infarction. Up to 40 international centres will randomise
patients to either a QFR-based or a standard FFR-based diagnostic
strategy. The primary endpoint of major adverse cardiovascular events is a
composite of all-cause mortality, any myocardial infarction, and any
unplanned coronary revascularisation at 12 months. QFR could emerge as an
adenosine- and wire-free alternative to FFR, making the functional
evaluation of intermediary coronary stenosis less invasive and more
cost-effective.

<87>
Accession Number
640040327
Title
Impact of Prosthesis-Patient Mismatch After Transcatheter Aortic Valve
Replacement: Meta-Analysis of Kaplan-Meier-Derived Individual Patient
Data.
Source
JACC. Cardiovascular imaging. (no pagination), 2022. Date of Publication:
30 Aug 2022.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Tasoudis P.; Dokollari A.;
Torregrossa G.; Sicouri S.; Clavel M.-A.; Pibarot P.; Ramlawi B.
Institution
(Sa) Department of Cardiothoracic Surgery, Lankenau Heart Institute,
Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania, USA;
Department of Cardiothoracic Surgery Research, Lankenau Institute for
Medical Research, Wynnewood, Pennsylvania, USA. Electronic address:
michel_pompeu@yahoo.com.br
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Tasoudis, Dokollari, Sicouri) Department of Cardiothoracic Surgery
Research, Lankenau Institute for Medical Research, Wynnewood, PA, United
States
(Torregrossa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood,
Pennsylvania, USA; Department of Cardiothoracic Surgery Research, Lankenau
Institute for Medical Research, Wynnewood, Pennsylvania, USA
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada;
Department of Medicine, Faculty of Medicine, Universite Laval, Quebec
City, Quebec, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: It remains controversial whether prosthesis-patient mismatch
(PPM) (in general considered moderate if indexed effective orifice area is
0.65-0.85 cm2/m2 and severe when <0.65 cm2/m2) affects the outcomes after
transcatheter aortic valve replacement (TAVR). OBJECTIVE(S): The
purpose of this study is to evaluate the time-varying effects and
association of PPM with the risk of overall mortality. METHOD(S):
Study-level meta-analysis of reconstructed time-to-event data from
Kaplan-Meier curves of studies published by December 30, 2021.
 RESULT(S): In total, 23 studies met our eligibility criteria and
included a total of 81,969 patients included in the Kaplan-Meier curves
(19,612 with PPM and 62,357 without PPM). Patients with moderate/severe
PPM had a significantly higher risk of mortality compared with those
without PPM (HR: 1.09 [95% CI: 1.04-1.14]; P < 0.001). In the first 30
months after the procedure, mortality rates were significantly higher in
the moderate/severe PPM group (HR: 1.1 [95% CI: 1.05-1.16]; P < 0.001). In
contrast, the landmark analysis beyond 30 months yielded a reversal of the
HR (0.83 [95% CI: 0.68-1.01]; P = 0.064), but without statistical
significance. In the sensitivity analysis, although we observed that
severe PPM showed higher risk of mortality in comparison with no PPM (HR:
1.25 [95% CI: 1.16-1.36]; P < 0.001), we did not observe a statistically
significant difference for mortality between moderate PPM and no PPM (HR:
1.03 [95% CI: 0.96-1.10]; P = 0.398). CONCLUSION(S): Severe PPM, but
not moderate PPM, was associated with higher risk of mortality following
TAVR. These results provide support to implementation of preventive
strategies to avoid severe PPM following TAVR. Copyright © 2022
American College of Cardiology Foundation. Published by Elsevier Inc. All
rights reserved.

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