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<1>
Accession Number
2021990596
Title
Sodium nitroprusside for advanced heart failure. A metanalysis of
literature data.
Source
Vascular Pharmacology. 148 (no pagination), 2023. Article Number: 107140.
Date of Publication: February 2023.
Author
Ghio S.; Mandurino-Mirizzi A.; La Rovere M.T.; Traversi E.; Lombardi C.;
Scelsi L.; Senni M.; Iacovoni A.
Institution
(Ghio, Scelsi) Division of Cardiology, Fondazione IRCCS Policlinico San
Matteo, Pavia, Italy
(Mandurino-Mirizzi) Cardiology Department, Vito Fazzi Hospital, Lecce,
Italy
(La Rovere, Traversi) Department of Cardiac Rehabilitation, IRCCS Istituti
Clinici Scientifici Maugeri, Pavia, Montescano, Italy
(Lombardi) Department of Medical and Surgical Specialties, Radiological
Sciences and Public Health, University of Brescia, Italy
(Senni, Iacovoni) Division of Cardiology, ASST Papa Giovanni XXIII,
Bergamo, Italy
Publisher
Elsevier Inc.
Abstract
Advanced heart failure (HF) is associated with a very poor prognosis and
places a big burden on health-care services. The gold standard treatment,
i.e. long-term mechanical circulatory support or heart transplantation, is
precluded in many patients but observational studies suggest that the use
of SNP might be associated with favourable long-term clinical outcomes. We
performed a metanalysis of published studies that compared sodium
nitroprusside (SNP) with optimal medical therapy to examine the safety and
efficacy of SNP as part of the treatment regimen of patients hospitalized
for advanced heart failure (HF). We searched PUBMED, EMBASE and WEB OF
SCIENCE for studies that compared SNP with optimal medical therapy in
advanced HF on July 2022. After screening 700 full-text articles, data
from two original articles were included in a combined analysis. The
analysis demonstrated a 66% reduction in the odds of death in advanced HF
patients treated with SNP. The results show the potential importance of
the inclusion of SNP in the treatment regimen of patients hospitalized
because of advanced HF and underlines that controlled, randomized studies
are still required in this condition.<br/>Copyright &#xa9; 2022 Elsevier
Inc.

<2>
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Accession Number
2019922603
Title
Early surgical aortic valve replacement in asymptomatic patients with
severe aortic stenosis: a systematic review and meta-analysis.
Source
Journal of Cardiovascular Medicine. 23(9) (pp 632-634), 2022. Date of
Publication: 01 Sep 2022.
Author
Ferlini M.; Munafo A.R.; Lanzillo G.; Aiello M.; Gazzoli F.; Mirizzi A.M.;
Magrini G.; Pelenghi S.; Visconti L.O.
Institution
(Ferlini, Mirizzi, Magrini, Visconti) Division of Cardiology, Fondazione
Irccs Policlinico San Matteo, Italy
(Aiello, Gazzoli, Pelenghi) Division of Cardiac Surgery, Fondazione Irccs
Policlinico San Matteo, Italy
(Munafo, Lanzillo) Department of Molecular Medicine, Unit of Cardiology,
University of Pavia, Pavia, Italy
Publisher
Lippincott Williams and Wilkins

<3>
Accession Number
2021393344
Title
Recommendations for the use of coronary and valve simulators in cardiac
surgical training: A systematic review.
Source
European Journal of Cardio-thoracic Surgery. 61(1) (pp 1-10), 2022. Date
of Publication: 01 Jan 2022.
Author
Whittaker G.; Salmasi M.Y.; Aydin A.; Magouliotis D.; Raja S.G.;
Asimakopoulos G.; Moorjani N.; Athanasiou T.
Institution
(Whittaker, Salmasi, Athanasiou) Department of Surgery and Cancer,
Imperial College London, London, United Kingdom
(Whittaker) Department of Cardiothoracic Surgery, Manchester University
NHS Foundation Trust, Wythenshawe Hospital, Manchester M23 9LT, United
Kingdom
(Aydin) MRC Centre for Transplantation, King's College London, London,
United Kingdom
(Magouliotis) Department of Cardiothoracic Surgery, University of
Thessaly, Larissa, Greece
(Raja, Asimakopoulos) Department of Cardiothoracic Surgery, Royal Brompton
& Harefield NHS Foundation Trust, London, United Kingdom
(Moorjani) Department of Cardiothoracic Surgery, Royal Papworth Hospital
NHS Foundation Trust, Cambridge, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The aim of this study was to systematically review the
simulators that are currently available for coronary artery bypass graft
and valve surgery and, in addition, to review the validation evidence
supporting them and to recommend several simulators for training based on
the analysis of results. <br/>METHOD(S): A systematic literature search of
the MEDLINE (1946 to May 2021) and EMBASE (1947 to May 2021) databases was
performed to identify simulators for coronary artery and valvular
procedures in cardiothoracic surgery. A selection of keywords and MeSH
terms was used to execute the literature search. After identification of
relevant articles, data were extracted and analysed. <br/>RESULT(S):
Thirty-seven simulators were found in 31 articles. Simulators were found
for coronary artery bypass graft (n = 24) and valve surgery (n = 13). The
majority of models were either benchtop (n = 28) or hybrid (n = 8)
modalities. Evidence of validity was demonstrated in 15 (40.5%)
simulators. Twenty-two (59.5%) simulators had no validation evidence, and
1 (2.7%) simulator had 3 or more elements of validity established.
<br/>CONCLUSION(S): Two simulators were recommended for supplemental
training in cardiothoracic surgery. Low-fidelity models can provide a
broad foundation for surgical skills' development whereas high-fidelity
simulators can be used for immersive training scenarios and appraisals.
These should be utilized in early training, at which point the learning
curve of trainees is steepest.<br/>Copyright &#xa9; 2021 The Author(s).
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<4>
Accession Number
2020884460
Title
Effects of pre-operative oral carbohydrates on insulin resistance and
postoperative recovery in diabetic patients undergoing coronary artery
bypass grafting: study protocol for a prospective, single-blind,
randomized controlled trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 1067. Date of
Publication: December 2022.
Author
Zhang S.; He L.; Yu Y.; Yuan X.; Yang T.; Yan F.; Xu F.; Zhang Y.; Pan S.;
Zhang H.; Chen Z.; Xie L.; Wu R.; Feng W.; Yao Y.
Institution
(Zhang, Yuan, Yang, Xu, Zhang, Pan, Zhang, Xie, Feng) Department of Adult
Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences &
Peking Union Medical College/National Center for Cardiovasular Diseases,
Beijing, China
(He) Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital,
Yunnan Province, Kunming, China
(He, Yu, Yan, Yao) Department of Anesthesiology, Fuwai Hospital, Chinese
Academy of Medical Sciences & Peking Union Medical College/National Center
for Cardiovascular Diseases, Beijing, China
(Chen, Wu) Department of Intensive Care Unit, Fuwai Hospital, Chinese
Academy of Medical Sciences & Peking Union Medical College/National Center
for Cardiovascular Diseases, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: Preoperative carbohydrates (CHO) supplement has been widely
investigated in nondiabetic patients undergoing a variety of surgeries. It
has been proved that preoperative CHO could alleviate postoperative
insulin resistance (IR) and improve patients' well-being in nondiabetic
patients. However, it remains controversial whether preoperative CHO could
yield similar effects in diabetic patients. Till now, seldom has the
administration of preoperative CHO been investigated in diabetic patients
and there are limited studies reporting IR and postoperative recovery of
diabetic patients undergoing cardiac surgery. Methods and analysis: We
present a prospective, single-center, single-blind, randomized,
no-treatment controlled trial of preoperative CHO on diabetic patients
undergoing off-pump coronary artery bypass grafting (OPCAB). A total of 62
patients will be enrolled and randomized to either Group CHO or Group
control (CTRL). Patients in Group CHO will consume CHO fluid containing 50
g carbohydrates orally the evening before surgery (20:00-24:00) while
their counterparts in Group CTRL will be fasted after 20:00 the evening
before surgery. The primary endpoint is postoperative IR assessed via
homeostasis model assessment (HOMA). The secondary endpoints are
postoperative levels of potential mediators relating to IR including
inflammatory factors and stress reaction characterized by serum cortisol.
Exploratory endpoints are in-hospital clinical endpoints. Continuous
variables will be compared by Student's t-test or Mann-Whitney U test.
Categorical variables will be compared with chi² test or
Fisher's exact test. All tests in the present study are two-tailed and
P<0.05 is considered statistically significant. All analyses will be
performed with R 4.0.4. <br/>Discussion(s): This is the first prospective
randomized controlled trial of preoperative CHO in diabetic patients
undergoing cardiac surgery, with the hypothesis that preoperative CHO
could improve postoperative IR and promote postoperative recovery. The
research may assist in improving the clinical outcomes of diabetic
patients undergoing OPCAB. Trial registration: The trial has been
prospectively registered with ClinicalTrials.gov
(https://register.clinicaltrials.gov) and Chinese Clinical Trial Registry
(http://www.chictr.org.cn). Registry number is NCT05540249 and
ChiCTR2000029664 respectively. Registered on Sept. 14, 2022. Clinical
trials unit: Fuwai Hospital, National Center for Cardiovascular Diseases,
Chinese Academy of Medical Sciences & Peking Union Medical College,
Beijing, China.<br/>Copyright &#xa9; 2022, The Author(s).

<5>
Accession Number
2017140067
Title
Surgical or percutaneous revascularization for isolated left anterior
descending stenoses: Are we in the same boat?.
Source
European Journal of Cardio-thoracic Surgery. 47(3) (pp 406-407), 2015.
Date of Publication: 01 Mar 2015.
Author
Stefanini G.G.; Windecker S.; Kolh P.
Institution
(Stefanini, Windecker) Department of Cardiology, Bern University Hospital,
Bern, Switzerland
(Kolh) Department of Cardiovascular Surgery, University Hospital (CHU ULg)
of Liege, Sart Tilman, Liege, Belgium
Publisher
European Association for Cardio-Thoracic Surgery

<6>
Accession Number
636682518
Title
Pyoderma Gangrenosum after Cardiac Surgery.
Source
Thoracic and Cardiovascular Surgeon. 71(1) (pp 53-61), 2023. Date of
Publication: 01 Jan 2023.
Author
Petrov A.; Kappert U.; Schmidt T.; Matschke K.E.; Wilbring M.
Institution
(Petrov, Kappert, Matschke, Wilbring) Department of Cardiac Surgery,
University Heart Center Dresden, Dresden, Germany
(Schmidt) Department of Cardiac Anesthesiology, University Heart Center
Dresden, Dresden, Germany
Publisher
Georg Thieme Verlag
Abstract
Background-Pyoderma gangrenosum after cardiac surgery is a rare,
noninfectious ulcerating skin disease mimicking sternal wound infection.
Methods-A systematic search of literature for pyoderma gangrenosum
complicating cases of cardiac surgery was conducted between September 1985
and September 2020 on PubMed and Cochrane databases. A systematic review
and detailed overview of clinical presentation, diagnostic, treatment, and
outcome is provided. Results-A total of 15 studies enclosing 15 patients
suffering from pyoderma gangrenosum following cardiac surgery were
identified. Onset of symptoms was observed after a median of 5 days.
Patients were predominantly male (81.3%) with a median age of 64 years.
Typical clinical presentation mimicked sternal site infection, mainly by
means of mediastinitis. Specific signs were rapid progression,
erythematous to violaceous color of the wound border, accompanied by
unspecific symptoms including fever, malaise, and severe pain.
Additionally, pathergy (development of ulcers at the sites of minor
cutaneous trauma) was reported frequently. Biopsy is mandatory with a
cutaneous neutrophilic inflammation confirming the diagnosis. Initial
treatment mostly (75.0% of reported cases) was misled, addressing
suspicion of surgical site infection. After correct diagnosis, the
treatment was switched to an immunosuppressive therapy. Full sternal wound
closure took between 5 weeks and 5 months. Reported case mortality was
12.5% in actually low-risk surgeries. Conclusion-Despite pyoderma
gangrenosum has typical signs, it remains an exclusion diagnosis. The
treatment is completely opposite to the main differential diagnosis-The
typical surgical site infection. Knowledge about diagnosis and treatment
is essential in the context of avoiding fatal mistreatment.<br/>Copyright
&#xa9; 2023 Georg Thieme Verlag. All rights reserved.

<7>
Accession Number
639396916
Title
Early anticoagulation after aortic valve replacement with porcine
bioprosthesis randomized control trial (ANTIPRO).
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 63(1) (no pagination),
2022. Date of Publication: 02 Dec 2022.
Author
Fernandez A.; Loza G.; Parma G.; Florio L.; Estigarribia J.; Soca G.;
Robaina R.; Duran A.; Brusich D.; Dayan V.
Institution
(Fernandez, Estigarribia, Soca, Robaina, Dayan) Instituto Nacional de
Cirugia Cardiaca, Montevideo, Uruguay
(Loza, Parma, Florio, Duran, Brusich, Dayan) Centro Cardiovascular
Universitario, Universidad de la Republica del Uruguay, Montevideo,
Uruguay
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Most evidence for anticoagulation (AC) in aortic bioprosthesis
is centred on embolic events, bleeding and reintervention risk. The effect
of AC on haemodynamics has not been previously assessed. Our hypothesis
was that patients with early AC after aortic valve replacement (AVR) with
porcine bioprosthesis have better haemodynamics at 1year of follow-up.
<br/>METHOD(S): Prospective, randomized, open-label trial conducted at 2
cardiac surgery centres. All patients undergoing AVR with porcine
bioprosthesis were consecutively recruited. The anticoagulated group
received warfarin + aspirin and the non-anticoagulated (control) only
aspirin. The primary outcome was mean gradient after 1year of AVR and
change in New York Heart Association class. Secondary outcomes were major
and minor bleeding, embolic events and prosthetic leak. <br/>RESULT(S): Of
140 participants in the study, 71 were assigned to the anticoagulated
group and 69 to the control group. The mean age of the overall population
was 72.4 (SD: 7.1) years. Global EuroSCORE was 7.65 (SD: 5.73). At 1year,
the mean gradient was similar between both groups [18.6 (SD: 1.1mmHg) and
18.1 (SD: 1.0mmHg) in the control and anticoagulated groups, respectively,
P=0.701]. No differences in functional class at 3months or 1year were
found among groups. No differences were found among groups in the
secondary outcomes. <br/>CONCLUSION(S): The addition of 3months of oral AC
to anti-aggregation treatment was not detected to affect bioprosthetic
haemodynamics nor functional class at 1 year after AVR. Likewise, AC does
not lead to the higher incidence of complications.<br/>Copyright &#xa9;
The Author(s) 2022. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<8>
Accession Number
639957857
Title
Predictive Efficacy of the Index of Microcirculatory Resistance for Acute
Allograft Rejection and Cardiac Events After Heart Transplantation: A
Systematic Review and Meta-Analysis.
Source
The heart surgery forum. 25(5) (pp E784-E792), 2022. Date of Publication:
30 Nov 2022.
Author
Lu Z.; Song G.; Bai X.
Institution
(Lu, Song, Bai) Department of Cardiovascular Surgery, Qilu Hospital of
Shandong University, Jinan, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: In patients treated by heart transplantation, the index of
microcirculatory resistance (IMR) has been found to have predictive
potential for subsequent acute allograft rejection (AAR) and long-time
cardiac events. When consulting related literature, the studies mostly
were single-center with small sample sizes. The question of whether IMR
can be utilized as a predictive biomarker is becoming increasingly
contentious. To confirm the predictive efficacy of IMR, researchers did a
systematic review and meta-analysis. <br/>METHOD(S): From inception to
April 2022, PubMed, EMBASE, Cochrane Library, Web of Science, Ovid,
ProQuest, and Scopus systematically were searched. The results were
presented as pooled ratio rate (RR) with 95% confidence intervals (CI).
Assessment of the quality, heterogeneity analyses, and publication bias
analysis also were performed. <br/>RESULT(S): A total of 616 patients were
studied in five trials. There were significant differences in subsequent
AAR (RR = 4.08; 95% CI: 2.69~6.17; P = 0.000) or long-time cardiac events
(RR=2.14; 95% CI: 1.44~3.19; P = 0.000) between IMR-high and IMR-low
patients in the forest plots. Patients treated with heart transplantation
in the high IMR group had better predictive efficacy than the low IMR
group. <br/>CONCLUSION(S): High IMR could predict the events of subsequent
AAR and cardiac events after heart transplantation. This will help reduce
the occurrence of adverse events and personalize treatment for patients.

<9>
Accession Number
639556922
Title
Long-term outcomes of mini-sternotomy versus conventional sternotomy for
aortic valve replacement: a randomized controlled trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 63(1) (no pagination),
2022. Date of Publication: 02 Dec 2022.
Author
Telyuk P.; Hancock H.; Maier R.; Batty J.A.; Goodwin A.; Owens W.A.;
Ogundimu E.; Akowuah E.
Institution
(Telyuk, Batty) Department of Cardiology, James Cook University Hospital,
Middlesbrough, United Kingdom
(Hancock, Maier) Newcastle Clinical Trials Unit, Newcastle upon Tyne,
United Kingdom
(Goodwin, Owens, Akowuah) Department of Cardiovascular Surgery, James Cook
University Hospital, Middlesbrough, United Kingdom
(Ogundimu) Department of Mathematical Sciences, Durham University, Durham,
United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Aortic valve replacement (AVR) for severe symptomatic aortic
stenosis is one of the most common cardiac surgical procedures with
excellent long-term outcomes. Multiple previous studies have compared
short-term outcomes of AVR with mini-sternotomy versus AVR with
conventional sternotomy. We have previously reported the results of the
randomized MAVRIC trial, which aimed to evaluate early postoperative
morbidity among patients undergoing mini-sternotomy and conventional
sternotomy AVR. We now report the long-term all-cause mortality,
reoperation, MACE outcomes and echocardiographic data from this trial.
<br/>METHOD(S): The prospective, randomized, single-centre, single-blind
MAVRIC (manubrium-limited mini-sternotomy versus conventional sternotomy
for aortic valve replacement) trial compared manubrium-limited
mini-sternotomy and conventional median sternotomy for the treatment of
patients with severe aortic stenosis. The previously reported primary
outcome was the proportion of patients receiving red cell transfusion
postoperatively and within 7days of the index procedure. Currently
reported exploratory analyses of a combined long-term all-cause mortality
and reoperation were compared between groups via the log-rank test.
Sensitivity analyses reviewed individual components of the combined end
point. The primary analysis and long-term exploratory analyses were based
on an intention-to-treat principle. <br/>RESULT(S): Between March 2014 and
June 2016, 270 patients were enrolled and randomized in a 1:1 fashion to
undergo mini-sternotomy AVR (n=135) or conventional median sternotomy AVR
(n=135). At the median follow-up of 6.1years, the composite outcome of
all-cause mortality and reoperation occurred in 18.5% (25/135) of patients
in the conventional sternotomy group and in 17% (23/135) of patients in
the mini-sternotomy group. The incidence of chronic kidney disease,
cerebrovascular accident and myocardial infarction was not significantly
different between 2 groups. Follow-up echocardiographic data suggested no
difference in peak and mean gradients or incidence of aortic regurgitation
between 2 approaches. <br/>CONCLUSION(S): This exploratory long-term
analysis demonstrated that, in patients with severe aortic stenosis
undergoing isolated AVR, there was no significant difference between
manubrium-limited mini-sternotomy and conventional sternotomy with respect
to all-cause mortality, rate of reoperation, MACE events and
echocardiographic data at the median of 6.1-year follow-up.<br/>Copyright
&#xa9; The Author(s) 2022. Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery. All rights
reserved.

<10>
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Accession Number
2022125796
Title
Application of 3D printing technology combined with PBL teaching model in
teaching clinical nursing in congenital heart surgery: A case-control
study.
Source
Medicine (United States). 100(20) (pp E25918), 2021. Date of Publication:
21 May 2021.
Author
Tan H.; Huang E.; Deng X.; Ouyang S.
Institution
(Tan, Huang, Ouyang) Department of Cardiovascular Surgery, Second Xiangya
Hospital of Central South University, Hunan Province, Changsha 410000,
China
(Tan, Huang, Ouyang) Clinical Nursing Teaching and Research Section,
Second Xiangya Hospital, Central South University, Changsha, China
(Deng) Heart Center, Hunan Children's Hospital, Changsha, China
Publisher
Lippincott Williams and Wilkins
Abstract
We aimed to explore the application of three-dimensional (3D) printing
technology with problem-based learning (PBL) teaching model in clinical
nursing education of congenital heart surgery, and to further improve the
teaching quality of clinical nursing in congenital heart surgery. In this
study, a total of 132 trainees of clinical nursing in congenital heart
surgery from a grade-A tertiary hospital in 2019 were selected and
randomly divided into 3D printing group or traditional group. The 3D
printing group was taught with 3D printed heart models combined with PBL
teaching technique, while the traditional group used conventional teaching
aids combined with PBL technique for teaching. After the teaching process,
the 2 groups of nursing students were assessed and surveyed separately to
evaluate the results. Compared to the traditional group, the theoretical
scores, clinical nursing thinking ability, self-evaluation for
comprehensive ability, and teaching satisfaction from the questionnaires
filled by the 3D printing group were all higher than the traditional
group. The difference was found to be statistically significant (P < .05).
Our study has shown the 3D printing technology combined with the PBL
teaching technique in the clinical nursing teaching of congenital heart
surgery achieved good results.<br/>Copyright &#xa9; 2021 Lippincott
Williams and Wilkins. All rights reserved.

<11>
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Accession Number
2022124711
Title
Patient satisfaction with deep versus light/moderate sedation for
non-surgical procedures: A systematic review and meta-analysis.
Source
Medicine (United States). 100(36) (pp E27176), 2021. Date of Publication:
10 Sep 2021.
Author
Hoshijima H.; Higuchi H.; Sato (boku) A.; Shibuya M.; Morimoto Y.;
Fujisawa T.; Mizuta K.; Hilmi I.
Institution
(Hoshijima, Mizuta) Division of Dento-oral Anesthesiology, Tohoku
University Graduate School of Dentistry, Seiryomachi 1-1, Aoba-ku, Sendai,
Japan
(Hoshijima) Department of Anesthesiology, Saitama Medical University
Hospital, Moroyama, Saitama, Japan
(Higuchi) Department of Dental Anesthesiology, Okayama University
Hospital, 2-5-1 Shikata Kitaku, Okayama, Japan
(Sato (boku)) Department of Anesthesiology, Aichi Gakuin University School
of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi, Japan
(Shibuya, Fujisawa) Dental Anesthesiology, Department of Oral
Pathobiological Science, Faculty of Dental Medicine, Graduate School of
Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Kita-ku, Sapporo,
Japan
(Morimoto) Department of Critical Care Medicine and Dentistry, Graduate
School of Dentistry, Kanagawa Dental University, 82, Inaoka-cho, Yokosuka,
Kanagawa, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Deep sedation relieves a patient's anxiety and stress during
the procedure by inducing patient unconsciousness. However, it remains
unclear whether deep sedation actually improves patient satisfaction with
the procedure. Therefore, we performed a systematic review and
meta-analysis to compare the satisfaction of patients undergoing deep
sedation with that of those undergoing light/moderate sedation during
non-surgical procedures. <br/>Method(s):A comprehensive literature search
was performed using electronic databases (search until September 2020).
The primary outcome was whether patient satisfaction was higher after deep
sedation or light/moderate sedation. The secondary outcome was the
relative safety of deep sedation compared with light/moderate sedation in
terms of oxygen saturation, systolic blood pressure, and heart rate. The
tertiary outcomes were the relative procedure and recovery times for deep
versus light/moderate sedation.Data from each of the trials were combined,
and calculations were made using DerSimonian and Laird random effects
models. The pooled effect estimates for patient satisfaction were
evaluated using relative risk (RR) with the 95% confidence interval (CI).
The pooled effect estimates for continuous data are expressed as weighted
mean difference with the 95% CI. We assessed heterogeneity with the
Cochrane Q statistic and the I statistic. The risk of bias assessment and
Grading of Recommendations Assessment, Development and Evaluation approach
were used as the quality assessment method. <br/>Result(s):After removing
unrelated studies and applying the exclusion criterion, 5 articles
satisfied the inclusion criteria. Patient satisfaction was significantly
higher in those who received deep sedation compared with light/moderate
sedation (relative risk = 1.12; 95% CI, 1.04-1.20; P = .003; Cochrane Q =
25.0; I = 76%).There was no significant difference in oxygen saturation,
systolic blood pressure, heart rate, and procedure times according to
whether the procedures were performed under deep or light/moderate
sedation. However, the recovery time was significantly prolonged in
patients under deep sedation. <br/>Conclusion(s):Our meta-analysis
suggests that deep sedation resulted in improved patient satisfaction
compared with light/moderate sedation. Deep sedation is recommended for
patients undergoing procedures because it improves patient satisfaction.
However, respiration and circulation should be carefully monitored both
intra-operatively and postoperatively.<br/>Copyright &#xa9; 2021
Lippincott Williams and Wilkins. All rights reserved.

<12>
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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).<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins. All rights
reserved.

<13>
Accession Number
2022129798
Title
COMPARATIVE OBSERVATIONAL PROSPECTIVE RANDOMIZED STUDY TO DETERMINE THE
EFFECT OF CLONIDINE AS AN ADJUNCT TO INDUCTION AGENTS IN PATIENTS
UNDERGOING CORONARY ARTERY BYPASS GRAFTING SURGERY.
Source
International Journal of Academic Medicine and Pharmacy. 5(1) (pp 89-94),
2023. Date of Publication: 2023.
Author
Sarkar R.S.; Sarkar M.; Sriarun T.V.
Institution
(Sarkar, Sarkar, Sriarun) Department of Anesthesiology, School of
Medicine, D. Y. Patil Deemed to be University, 11, Ayyappa Rd, Navi
Mumbai, Sector 7, Maharashtra, Nerul, India
Publisher
Necati Ozpinar
Abstract
Background: An alpha 2 adrenergic agonist, clonidine has been shown to
have perioperative effects such as decreased anaesthetic needs, improved
hemodynamic equilibrium, and analgesia, although its therapeutic utility
in cardiac surgery remains understudied. We attempted to observe the
effect of clonidine as an adjunct to induction agents and study the
intraoperative hemodynamics in patients undergoing coronary artery bypass
grafting surgery (CABG). <br/>Material(s) and Method(s): Eighty subjects
were recruited as per the eligibility criteria and subdivided into two
groups with forty subjects each, i.e., the control group receiving normal
saline and the case groups receiving I.V. clonidine as a pre-medication
dose of 4microg/kg in the OT. The patients were then induced with
injections of midazolam (0.1 mg/kg), fentanyl (5-10 microg/kg) and
vecuronium (0.1mg/kg). For maintenance, a sevoflurance (2%) sedation
mixture was used. Various intraoperative and hemodynamic parameters were
monitored at various timepoints. <br/>Result(s): In control groups,
parameters such as SBP, DBP, HR, MAP, and HCO3 significantly deviated from
baseline, albeit the case group displayed the stabilised effect of
clonidine over these parameters when compared to their baseline values. On
the other hand, parameters like CVP, K+, PCO2, PO2, ACT, and HCT values
significantly differed in both the groups upon intragroup comparison from
baseline. <br/>Conclusion(s): Upon comparison, premedication treatment
with intravenous clonidine as an adjunct to induction agents in patients
undergoing coronary artery bypass grafting surgery (CABG) reduced
hyperdynamic responses to anaesthesia and surgery.<br/>Copyright &#xa9;
2022 International Journal of Academic Medicine and Pharmacy. All rights
reserved.

<14>
Accession Number
2020953881
Title
Effect of posterior pericardiotomy in cardiac surgery: A systematic review
and meta-analysis of randomized controlled trials.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 1090102. Date of Publication: 23 Dec 2022.
Author
Soletti G.J.; Perezgrovas-Olaria R.; Harik L.; Rahouma M.; Dimagli A.;
Alzghari T.; Demetres M.; Bratton B.A.; Yaghmour M.; Satija D.; Lau C.;
Girardi L.N.; Salemo T.A.; Gaudino M.
Institution
(Soletti, Perezgrovas-Olaria, Harik, Rahouma, Dimagli, Alzghari, Bratton,
Yaghmour, Satija, Lau, Girardi, Gaudino) Department of Cardiothoracic
Surgery, Weill Cornell Medicine, New York, NY, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Salemo) Division of Cardiothoracic Surgery, University of Miami Miller
School of Medicine, Jackson Memorial Hospital, Miami, FL, United States
Publisher
Frontiers Media S.A.
Abstract
Background: Posterior pericardiotomy (PP) has been shown to reduce the
incidence of pericardial effusion and postoperative atrial fibrillation
(POAF) after cardiac surgery. However, the procedure and the totality of
its effects are poorly known in the cardiac surgery community. We
performed a study-level meta-analysis of randomized controlled trials
(RCTs) to evaluate the impact of PP in cardiac surgery patients.
<br/>Method(s): A systematic literature search was conducted on three
medical databases (Ovid MEDLINE, Ovid Embase, Cochrane Library) to
identify RCTs reporting outcomes of patients that received a PP or no
intervention after cardiac surgery. The primary outcome was the incidence
of POAF. Key secondary outcomes were operative mortality, incidence of
pericardial and pleural effusion, cardiac tamponade, length of stay (LOS),
pulmonary complications, amount of chest drainage, need for intra-aortic
balloon pump, and re-exploration for bleeding. <br/>Result(s): Eighteen
RCTs totaling 3,531 patients were included. PP was associated with a
significantly lower incidence of POAF (odds ratio [OR] 0.45, 95%
confidence interval [CI] 0.32-0.64, P < 0.0001), early (OR 0.18, 95% CI
0.10-0.34, P < 0.0001) and late pericardial effusion (incidence rate ratio
0.13, 95% CI 0.06-0.29, P < 0.0001), and cardiac tamponade (risk
difference -0.02, 95% CI -0.04 to -0.01, P = 0.001). PP was associated
with a higher incidence of pleural effusion (OR 1.42, 95% CI 1.06-1.90, P
= 0.02), but not pulmonary complications (OR 0.82, 95% CI 0.56-1.19; P =
0.38). No differences in other outcomes, including operative mortality,
were found. <br/>Conclusion(s): PP is a safe and effective intervention
that significantly decreases the incidence of POAF and pericardial
effusion following cardiac surgery. Systematic review registration:
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=261485,
identifier: CRD42021261485.<br/>Copyright &#xa9; 2022 Soletti,
Perezgrovas-Olaria, Harik, Rahouma, Dimagli, Alzghari, Demetres, Bratton,
Yaghmour, Satija, Lau, Girardi, Salemo and Gaudino.

<15>
[Use Link to view the full text]
Accession Number
2022126204
Title
Individualized positive end-expiratory pressure (PEEP) during one-lung
ventilation for prevention of postoperative pulmonary complications in
patients undergoing thoracic surgery: A meta-Analysis.
Source
Medicine (United States). 100(28) (pp E26638), 2021. Date of Publication:
16 Jul 2021.
Author
Li P.; Kang X.; Miao M.; Zhang J.; Hilmi I.
Institution
(Li, Kang, Miao, Zhang, Hilmi) Department of Anesthesia and Perioperative
Medicine, Henan Provincial People's Hospital, Henan, Zhengzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Positive end-expiratory pressure (PEEP) is an important part of
the lung protection strategies for one-lung ventilation (OLV). However, a
fixed PEEP value is not suitable for all patients. Our objective was to
determine the prevention of individualized PEEP on postoperative
complications in patients undergoing one-lung ventilation.
<br/>Method(s):We searched the PubMed, Embase, and Cochrane and performed
a meta-Analysis to compare the effect of individual PEEP vs fixed PEEP
during single lung ventilation on postoperative pulmonary complications.
Our primary outcome was the occurrence of postoperative pulmonary
complications during follow-up. Secondary outcomes included the partial
pressure of arterial oxygen and oxygenation index during one-lung
ventilation. <br/>Result(s):Eight studies examining 849 patients were
included in this review. The rate of postoperative pulmonary complications
was reduced in the individualized PEEP group with a risk ratio of 0.52
(95% CI:0.37-0.73; P = .0001). The partial pressure of arterial oxygen
during the OLV in the individualized PEEP group was higher with a mean
difference 34.20 mm Hg (95% CI: 8.92-59.48; P = .0004). Similarly, the
individualized PEEP group had a higher oxygenation index, MD: 49.07mmHg,
(95% CI: 27.21-70.92; P < .0001). <br/>Conclusion(s):Individualized PEEP
setting during one-lung ventilation in patients undergoing thoracic
surgery was associated with fewer postoperative pulmonary complications
and better perioperative oxygenation.<br/>Copyright &#xa9; 2021 Lippincott
Williams and Wilkins. All rights reserved.

<16>
[Use Link to view the full text]
Accession Number
2022126198
Title
Comparison of postprocedural new-onset atrial fibrillation between
transcatheter and surgical aortic valve replacement: A systematic review
and meta-Analysis based on 16 randomized controlled trials.
Source
Medicine (United States). 100(28) (pp E26613), 2021. Date of Publication:
16 Jul 2021.
Author
Ding Y.; Wan M.; Zhang H.; Wang C.; Dai Z.; Palmieri F.
Institution
(Ding, Zhang, Wang, Dai, Palmieri) Medical department, ZHEBEI MINGZHOU
hospital, No. 255, Park road, Wuxing District, HUZHOU 313000, China
(Wan) Outpatient Department, Zhebei Mingzhou hospital, Huzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Presently, transcatheter aortic valve replacement (TAVR) as an
effective and convenient intervention has been adopted extensively for
patients with severe aortic disease. However, after surgical aortic valve
replacement (SAVR) and TAVR, the incidence of new-onset atrial
fibrillation (NOAF) is prevalently found. This meta-Analysis was designed
to comprehensively compare the incidence of NOAF at different times after
TAVR and SAVR for patients with severe aortic disease. <br/>Method(s):A
systematic search of PubMed, Embase, Cochrane Library, and Web of Science
up to October 1, 2020 was conducted for relevant studies that comparing
TAVR and SAVR in the treatment of severe aortic disease. The primary
outcomes were the incidence of NOAF with early, midterm and long term
follow-up. The secondary outcomes included permanent pacemaker (PM)
implantation, myocardial infarction (MI), cardiogenic shock, as well as
mortality and other complications. Two reviewers assessed trial quality
and extracted the data independently. All statistical analyses were
performed using the standard statistical procedures provided in Review
Manager 5.2. <br/>Result(s):A total of 16 studies including 13,310
patients were identified. The pooled results indicated that, compared with
SAVR, TAVR experienced a significantly lower incidence of
30-day/in-hospital, 1-year, 2-year, and 5-year NOAF, with pooled risk
ratios (RRs) of 0.31 (95% confidence interval [CI] 0.23-0.41; 5725 pts),
0.30 (95% CI 0.24-0.39; 6321 pts), 0.48 (95% CI 0.38-0.61; 3441 pts), and
0.45 (95% CI 0.37-0.55; 2268 pts) respectively. In addition, TAVR showed
lower incidence of MI (RR 0.62; 95% CI 0.40-0.97) and cardiogenic shock
(RR 0.34; 95% CI 0.19-0.59), but higher incidence of permanent PM (RR
3.16; 95% CI 1.61-6.21) and major vascular complications (RR 2.22; 95% CI
1.14-4.32) at 30-day/in-hospital. At 1-and 2-year after procedure,
compared with SAVR, TAVR experienced a significantly higher incidence of
neurological events, transient ischemic attacks (TIA), permanent PM, and
major vascular complications, respectively. At 5-year after procedure,
compared with SAVR, TAVR experienced a significantly higher incidence of
TIA and re-intervention respectively. There was no difference in 30-day,
1-year, 2-year, and 5-year all-cause or cardiovascular mortality as well
as stroke between TAVR and SAVR. <br/>Conclusion(s):Our analysis showed
that TAVR was superior to SAVR in decreasing the both short and long term
postprocedural NOAF. TAVR was equal to SAVR in early, midterm and long
term mortality. In addition, TAVR showed lower incidence of
30-day/in-hospital MI and cardiogenic shock after procedure. However,
pooled results showed that TAVR was inferior to SAVR in reducing permanent
pacemaker implantation, neurological events, TIA, major vascular
complications, and re-intervention.<br/>Copyright &#xa9; 2021 Lippincott
Williams and Wilkins. All rights reserved.

<17>
[Use Link to view the full text]
Accession Number
2022126197
Title
The noninferiority of transcatheter aortic valve implantation compared to
surgical aortic valve replacement for severe aortic disease: Evidence
based on 16 randomized controlled trials.
Source
Medicine (United States). 100(28) (pp E26556), 2021. Date of Publication:
16 Jul 2021.
Author
Zhao P.-Y.; Wang Y.-H.; Liu R.-S.; Zhu J.-H.; Wu J.-Y.; Song B.; Rosa S.D.
Institution
(Zhao, Liu, Song, Rosa) Department of Cardiovascular Surgery, Lanzhou
University First Affiliated Hospital, No. 1, Donggang West Road, Cheng
Guan District, Gansu Province, Lanzhou 730000, China
(Wang, Zhu, Wu) Department of Cardiovascular Surgery, Qinghai University
Affiliated Hospital, Xi'ning, China
(Wang) Medical College of Qinghai University, Qinghai University, Xi'ning,
China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Currently, transcatheter aortic valve implantation (TAVI) as an
effective and convenient intervention has been adopted extensively for
patients with severe aortic disease. However, the efficacy and safety of
TAVI have not yet been well evaluated and its noninferiority compared with
traditional surgical aortic valve replacement (sAVR) still lack sufficient
evidence. This meta-Analysis was designed to comprehensively compare the
noninferiority of TAVI with sAVR for patients with severe aortic disease.
<br/>Method(s):A systematic search of PubMed, Embase, Cochrane Library,
and Web of Science up to October 1, 2020 was conducted for relevant
studies that comparing TAVI and sAVR in the treatment of severe aortic
disease. The primary outcomes were early, midterm and long term mortality.
The secondary outcomes included early complications and other late
outcomes. Two reviewers assessed trial quality and extracted the data
independently. All statistical analyzes were performed using the standard
statistical procedures provided in Review Manager 5.2. <br/>Result(s):A
total of 16 studies including 14394 patients were identified. There was no
difference in 30-day, 1-year, 2-year, and 5-year all-cause or
cardiovascular mortality as well as stroke between TAVI and sAVR.
Regarding to the 30-day outcomes, compared with sAVR, TAVI experienced a
significantly lower incidence of myocardial infarction (risk ratio [RR]
0.62; 95% confidence interval [CI] 0.40-0.97; 5441 pts), cardiogenic shock
(RR 0.34; 95% CI 0.19-0.59; 1936 pts), acute kidney injury (AKI) > stage 2
(RR 0.37; 95% CI 0.25-0.54; 5371 pts), and new-onset atrial fibrillation
(NOAF) (RR 0.29; 95% CI 0.24-0.35; 5371 pts) respectively, but higher
incidence of permanent pacemaker implantation (RR 3.16; 95% CI 1.61-6.21;
5441 pts) and major vascular complications (RR 2.22; 95% CI 1.14-4.32;
5371 pts). Regarding to the 1-and 2-year outcomes, compared with sAVR,
TAVI experienced a significantly lower incidence of NOAF, but higher
incidence of neurological events, transient ischemic attacks (TIA),
permanent pacemaker and major vascular complications respectively.
Regarding to the 5-year outcomes, compared with sAVR, TAVI experienced a
significantly lower incidence of NOAF, but higher incidence of TIA and
reintervention respectively. <br/>Conclusion(s):Our analysis shows that
TAVI was equal to sAVR in early, midterm and long term mortality for
patients with severe aortic disease. In addition, TAVI may be favorable in
reducing the incidence of both early, midterm and long term NOAF. However,
pooled results showed superiority of sAVR in reducing permanent pacemaker
implantation, neurological events, TIA, major vascular complications and
reintervention.<br/>Copyright &#xa9; 2021 Lippincott Williams and Wilkins.
All rights reserved.

<18>
[Use Link to view the full text]
Accession Number
2022125656
Title
Acupuncture for blunt chest trauma: A protocol for a double-blind
randomized control trial.
Source
Medicine (United States). 100(18) (pp E25667), 2021. Date of Publication:
07 May 2021.
Author
Kao P.-Y.; Ben-Arie E.; Lu T.-Y.; Ho W.-C.; Lee Y.-C.; Lin Y.-S.; Chen
C.-K.; Chen J.-X.; Huang T.-M.; Chen F.-P.
Institution
(Kao, Lu, Lin, Chen, Chen, Huang) Division of Thoracic Surgery, Department
of Surgery, China Medical University Hospital, Taichung, Taiwan (Republic
of China)
(Kao, Chen) Institute of Traditional Medicine, School of Medicine,
National Yang-Ming University, Taipei, Taiwan (Republic of China)
(Ben-Arie, Lee) Graduate Institute of Acupuncture Science, China Medical
University, Taichung, Taiwan (Republic of China)
(Ho) Department of Public Health, China Medical University, Taichung,
Taiwan (Republic of China)
(Lee) Department of Acupuncture, China Medical University Hospital,
Taichung, Taiwan (Republic of China)
(Chen) Center for Traditional Medicine, Taipei Veterans General Hospital,
Taipei, Taiwan (Republic of China)
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction:Blunt chest trauma (BCT) accounts for up to 65% of polytrauma
patients. In patients with 0 to 2 rib fractures, treatment interventions
are typically limited to oral analgesics and breathing exercises. Patients
suffering from BCT experience symptoms of severe pain, poor sleep, and
inability to perform simple daily life activities for an extended period
of time thereafter. In this trial, we aim to investigate the efficacy of
acupuncture as a functional and reliable treatment option for blunt chest
trauma patients. <br/>Method(s):The study is designed as a double-blind
randomized control trial. We will include 72 patients divided into 2
groups; the acupuncture group (Acu) and placebo group (Con). The
acupuncture group will receive true acupuncture using a uniquely designed
press tack needle. The control group will receive placebo acupuncture
treatment through the use of a similarly designed press tack needle
without the needle element. The acupoints selected for both groups are GB
34, GB 36, LI 4, LU 7, ST 36, and TH 5. Both groups will receive 1
treatment only following the initial visit to the medical facility and
upon diagnosis of BCT. Patient outcome measurements include: Numerical
Rating Scale, Face Rating Scale, respiratory function flowmeter, Verran
Snyder-Halpern sleep scale, and the total amount of allopathic medication
used. Follow-up time will be scheduled at 4 days, 2 weeks, and lastly 3
months.Expected outcome:The results of this study can potentially provide
a simple and cost-effective analgesic solution to blunt chest trauma
patients. This novel study design can serve as supporting evidence for
future double-blind studies within the field of acupuncture.Other
information:The study will be conducted in the thoracic surgical
department and acupuncture department in China Medical University
Hospital, Taichung, Taiwan. The study will be conducted on blunt chest
trauma patients and is anticipated to have minimum risk of adverse events.
Enrollment of the patients and data collection will start from March 2020.
Study completion time is expected in March 2022. <br/>Protocol
Registration:(CMUH109-REC1-002), (NCT04318496).<br/>Copyright &#xa9; 2021
Lippincott Williams and Wilkins. All rights reserved.

<19>
[Use Link to view the full text]
Accession Number
2022124699
Title
Increased FIO<inf>2</inf>influences SvO<inf>2</inf>interpretation and
accuracy of Fick-based cardiac output assessment in cardiac surgery
patients: A prospective randomized study.
Source
Medicine (United States). 100(36) (no pagination), 2021. Article Number:
e27020. Date of Publication: 10 Sep 2021.
Author
Lin S.-Y.; Chang F.-C.; Lin J.-R.; Chou A.-H.; Tsai Y.-F.; Liao C.-C.;
Tsai H.-I.; Chen C.-Y.; Chen R.
Institution
(Lin, Chang, Chou, Tsai, Liao, Tsai, Chen) Department of Anesthesiology,
Chang Gung Memorial Hospital, Linkou Medical Center, No.5, Fuxing Street,
Guishan District, Taoyuan City 333, Taiwan (Republic of China)
(Lin) College of Medicine, Taipei Medical University, Taipei, Taiwan
(Republic of China)
(Chang) College of Medicine, Fu Jen Catholic University, Taipei, Taiwan
(Republic of China)
(Lin) Clinical Informatics and Medical Statistics Research Center,
Graduate Institute of Clinical Medicine, Chang Gung University, Taoyuan,
Taiwan (Republic of China)
(Lin) Biostatistics, National Taiwan University, Taipei, Taiwan (Republic
of China)
(Chou, Tsai, Liao, Tsai, Chen) College of Medicine, Chang Gung University,
Taoyuan, Taiwan (Republic of China)
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction:The study aimed to reveal how the fraction of inspired oxygen
(FIO<inf>2</inf>) affected the value of mixed venous oxygen saturation
(SvO<inf>2</inf>) and the accuracy of Fick-equation-based cardiac output
(Fick-CO). <br/>Method(s):Forty two adult patients who underwent elective
cardiac surgery were enrolled and randomly divided into 2 groups:
FIO<inf>2</inf>< 0.7 or >0.85. Under stable general anesthesia,
thermodilution-derived cardiac output (TD-CO), SvO<inf>2</inf>, venous
partial pressure of oxygen, hemoglobin, arterial oxygen saturation,
arterial partial pressure of oxygen, and blood pH levels were recorded
before surgical incision. <br/>Result(s):Significant differences in
FIO<inf>2</inf>values were observed between the 2 groups (0.56 +/- 0.08 in
the <70% group and 0.92 +/- 0.03 in the >0.85 group; P < .001). The
increasing FIO<inf>2</inf>values lead to increases in SvO<inf>2</inf>,
venous partial pressure of oxygen, and arterial partial pressure of
oxygen, with little effects on cardiac output and hemoglobin levels. When
comparing to TD-CO, the calculated Fick-CO in both groups had moderate
Pearson correlations and similar linear regression results. Although the
FIO<inf>2</inf><0.7 group presented a less mean bias and a smaller limits
of agreement, neither group met the percentage error criteria of <30% in
Bland-Altman analysis. <br/>Conclusion(s):Increased FIO<inf>2</inf>may
influence the interpretation of SvO<inf>2</inf>and the exacerbation of
Fick-CO estimation, which could affect clinical management.Trial
Registration:ClinicalTrials.gov ID number: NCT04265924, retrospectively
registered (Date of registration: February 9, 2020).<br/>Copyright &#xa9;
2021 Lippincott Williams and Wilkins. All rights reserved.

<20>
Accession Number
2021027313
Title
Regression-based estimation of heterogeneous treatment effects when
extending inferences from a randomized trial to a target population.
Source
European Journal of Epidemiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Robertson S.E.; Steingrimsson J.A.; Dahabreh I.J.
Institution
(Robertson, Dahabreh) CAUSALab, Harvard T.H. Chan School of Public Health,
Boston, MA, United States
(Robertson, Dahabreh) Department of Epidemiology, Harvard T.H. Chan School
of Public Health, Boston, MA 02115, United States
(Steingrimsson) Department of Biostatistics, Brown University School of
Public Health, Providence, RI, United States
(Dahabreh) Department of Biostatistics, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
Publisher
Springer Science and Business Media B.V.
Abstract
Most work on extending (generalizing or transporting) inferences from a
randomized trial to a target population has focused on estimating average
treatment effects (i.e., averaged over the target population's covariate
distribution). Yet, in the presence of strong effect modification by
baseline covariates, the average treatment effect in the target population
may be less relevant for guiding treatment decisions. Instead, the
conditional average treatment effect (CATE) as a function of key effect
modifiers may be a more useful estimand. Recent work on estimating target
population CATEs using baseline covariate, treatment, and outcome data
from the trial and covariate data from the target population only allows
for the examination of heterogeneity over distinct subgroups. We describe
flexible pseudo-outcome regression modeling methods for estimating target
population CATEs conditional on discrete or continuous baseline covariates
when the trial is embedded in a sample from the target population (i.e.,
in nested trial designs). We construct pointwise confidence intervals for
the CATE at a specific value of the effect modifiers and uniform
confidence bands for the CATE function. Last, we illustrate the methods
using data from the Coronary Artery Surgery Study (CASS) to estimate CATEs
given history of myocardial infarction and baseline ejection fraction
value in the target population of all trial-eligible patients with stable
ischemic heart disease.<br/>Copyright &#xa9; 2023, Springer Nature B.V.

<21>
Accession Number
2018962374
Title
Effect of ventilation mode on postoperative pulmonary complications
following lung resection surgery: a randomised controlled trial.
Source
Anaesthesia. 77(11) (pp 1219-1227), 2022. Date of Publication: November
2022.
Author
Li X.-F.; Jin L.; Yang J.-M.; Luo Q.-S.; Liu H.-M.; Yu H.
Institution
(Li, Liu, Yu) Department of Anaesthesiology, West China Hospital of
Sichuan University, Chengdu, China
(Jin, Yang, Luo) Department of Anaesthesiology, Leshan People's Hospital,
Leshan, China
Publisher
John Wiley and Sons Inc
Abstract
The effect of intra-operative mechanical ventilation modes on pulmonary
outcomes after thoracic surgery with one-lung ventilation has not been
well established. We evaluated the impact of three common ventilation
modes on postoperative pulmonary complications in patients undergoing lung
resection surgery. In this two-centre randomised controlled trial, 1224
adults scheduled for lung resection surgery with one-lung ventilation were
randomised to one of three groups: volume-controlled ventilation;
pressure-controlled ventilation; and pressure-control with volume
guaranteed ventilation. Enhanced recovery after surgery pathways and
lung-protective ventilation protocols were implemented in all groups. The
primary outcome was a composite of postoperative pulmonary complications
within the first seven postoperative days. The outcome occurred in 270
(22%), with 87 (21%) in the volume control group, 89 (22%) in the pressure
control group and 94 (23%) in the pressure-control with volume guaranteed
group (p = 0.831). The secondary outcomes also did not differ across study
groups. In patients undergoing lung resection surgery with one-lung
ventilation, the choice of ventilation mode did not influence the risk of
developing postoperative pulmonary complications. This is the first
randomised controlled trial examining the effect of three ventilation
modes on pulmonary outcomes in patients undergoing lung resection
surgery.<br/>Copyright &#xa9; 2022 Association of Anaesthetists.

<22>
Accession Number
2017897442
Title
A Systematic Review of Warfarin Use in Post-Bariatric Surgery Patients:
Cases Compiled From a Literature Review.
Source
Annals of Pharmacotherapy. 57(2) (pp 193-197), 2023. Date of Publication:
February 2023.
Author
Patel P.H.; Ho T.; Upadhyay S.M.
Institution
(Patel) Department of Pharmacy Practice, Texas A&M University, Houston,
TX, United States
(Ho) Henry Ford Hospital, Detroit, MI, United States
(Upadhyay) Howard University Hospital, Washington, DC, United States
Publisher
SAGE Publications Inc.
Abstract
Objective: The objective of this review was to provide dosing
recommendations for percentage change in weekly warfarin dose and rates of
thrombotic and bleeding events in patients requiring long-term warfarin
therapy after bariatric surgery. <br/>Data Sources: A comprehensive
literature search of PubMed (through April 5, 2021), Cochrane Library, and
Google Scholar (through April 5, 2021) databases was completed using the
keywords warfarin OR vitamin k antagonist AND bariatric surgery. Study
selection and data extraction: Retrospective studies and matched-cohort
studies evaluating preoperative and postoperative use of warfarin after
bariatric surgery for obesity were considered. Weekly dose defined as sum
of daily doses of warfarin for 7 consecutive days was a required outcome
to be considered in this review. Patients were excluded from review if
post-operative dosage change was not reported. Data synthesis: Six studies
were included with a total of 160 patients who met the criteria. A
decrease in average warfarin dose was seen in all studies, with the
largest decrease occurring at 1 month postsurgery followed by an upward
trend toward baseline about 90 days postsurgery. While thrombotic events
were observed in none of the patients, there was an increased risk of
bleeding in patients, particularly in those who underwent roux-en-y
gastric bypass (RYGB) surgery. Relevance to patient care and clinical
practice: The study provides a specific warfarin dosing titration regimen,
as well as embolic and bleed risk in post-bariatric surgery population.
<br/>Conclusion(s): Clinicians may consider lowering warfarin weekly dose
by about 25% immediately postsurgery, with doses approaching closer to
baseline about 90 days postsurgery.<br/>Copyright &#xa9; The Author(s)
2022.

<23>
Accession Number
2021954158
Title
Cilostazol for Intermittent Claudication Caused by Peripheral Artery
Disease.
Source
American Family Physician. 105(4) (pp 366-367), 2022. Date of Publication:
01 Apr 2022.
Author
Lauters R.; Wilkin D.
Institution
(Lauters, Wilkin) Family Medicine Residency, Eglin Air Force Base,
Florida, United States
Publisher
American Academy of Family Physicians

<24>
Accession Number
2015144258
Title
CeRebrUm and CardIac Protection with ALlopurinol in Neonates with Critical
Congenital Heart Disease Requiring Cardiac Surgery with Cardiopulmonary
Bypass (CRUCIAL): study protocol of a phase III, randomized,
quadruple-blinded, placebo-controlled, Dutch multicenter trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 174. Date of
Publication: December 2022.
Author
Stegeman R.; Nijman M.; Breur J.M.P.J.; Groenendaal F.; Haas F.; Derks
J.B.; Nijman J.; van Beynum I.M.; Taverne Y.J.H.J.; Bogers A.J.J.C.;
Helbing W.A.; de Boode W.P.; Bos A.F.; Berger R.M.F.; Accord R.E.; Roes
K.C.B.; de Wit G.A.; Jansen N.J.G.; Benders M.J.N.L.
Institution
(Stegeman, Nijman, Groenendaal, Benders) Department of Neonatology,
Wilhelmina Children's Hospital, University Medical Center (UMC) Utrecht,
Utrecht University, KE 04.123.1, PO Box 85909, AB, Utrecht 3508,
Netherlands
(Stegeman, Nijman, Breur) Department of Pediatric Cardiology, Wilhelmina
Children's Hospital, UMC Utrecht, Utrecht University, Utrecht, Netherlands
(Stegeman, Nijman, Jansen) Department of Pediatric Intensive Care,
Wilhelmina Children's Hospital, UMC Utrecht, Utrecht University, Utrecht,
Netherlands
(Stegeman, Haas) Congenital Cardiothoracic Surgery, Wilhelmina Children's
Hospital, UMC Utrecht, Utrecht University, Utrecht, Netherlands
(Stegeman, Nijman, Groenendaal) Utrecht Brain Center, UMC Utrecht, Utrecht
University, Utrecht, Netherlands
(Derks) Department of Obstetrics, Wilhelmina Children's Hospital, UMC
Utrecht, Utrecht University, Utrecht, Netherlands
(van Beynum, Helbing) Department of Pediatrics, Division of Pediatric
Cardiology, Academic Center for Congenital Heart Disease, Erasmus Medical
Center (MC) - Sophia Children's Hospital, Rotterdam, Netherlands
(Taverne, Bogers) Department of Cardiothoracic Surgery, Erasmus MC,
Erasmus University Rotterdam, Rotterdam, Netherlands
(Helbing) Department of Pediatrics, Division of Pediatric Cardiology,
Academic Center for Congenital Heart Disease, Radboudumc - Amalia
Children's Hospital, Nijmegen, Netherlands
(de Boode) Department of Neonatology, Radboudumc, Radboud Institute for
Health Sciences, Amalia Children's Hospital, Nijmegen, Netherlands
(Bos) Division of Neonatology, Beatrix Children's Hospital, UMC Groningen,
University of Groningen, Groningen, Netherlands
(Berger) Center for Congenital Heart Diseases, Pediatric Cardiology,
Beatrix Children's Hospital, UMC Groningen, University of Groningen,
Groningen, Netherlands
(Accord) Center for Congenital Heart Diseases, Department of
Cardiothoracic Surgery, UMC Groningen, University of Groningen, Groningen,
Netherlands
(Roes) Department of Health Evidence, Section Biostatistics, Radboudumc,
Radboud University Nijmegen, Nijmegen, Netherlands
(de Wit) Julius Center for Health Sciences and Primary Care, UMC Utrecht,
Utrecht University, Utrecht, Netherlands
(Jansen) Department of Pediatrics, Beatrix Children's Hospital, UMC
Groningen, University of Groningen, Groningen, Netherlands
Publisher
BioMed Central Ltd
Abstract
Background: Neonates with critical congenital heart disease (CCHD)
undergoing cardiac surgery with cardiopulmonary bypass (CPB) are at risk
of brain injury that may result in adverse neurodevelopment. To date, no
therapy is available to improve long-term neurodevelopmental outcomes of
CCHD neonates. Allopurinol, a xanthine oxidase inhibitor, prevents the
formation of reactive oxygen and nitrogen species, thereby limiting cell
damage during reperfusion and reoxygenation to the brain and heart. Animal
and neonatal studies suggest that allopurinol reduces hypoxic-ischemic
brain injury and is cardioprotective and safe. This trial aims to test the
hypothesis that allopurinol administration in CCHD neonates will result in
a 20% reduction in moderate to severe ischemic and hemorrhagic brain
injury. <br/>Method(s): This is a phase III, randomized,
quadruple-blinded, placebo-controlled, multicenter trial. Neonates with a
prenatal or postnatal CCHD diagnosis requiring cardiac surgery with CPB in
the first 4 weeks after birth are eligible to participate. Allopurinol or
mannitol-placebo will be administered intravenously in 2 doses early
postnatally in neonates diagnosed antenatally and 3 doses perioperatively
of 20 mg/kg each in all neonates. The primary outcome is a composite
endpoint of moderate/severe ischemic or hemorrhagic brain injury on early
postoperative MRI, being too unstable for postoperative MRI, or mortality
within 1 month following CPB. A total of 236 patients (n = 188 with
prenatal diagnosis) is required to demonstrate a reduction of the primary
outcome incidence by 20% in the prenatal group and by 9% in the postnatal
group (power 80%; overall type 1 error controlled at 5%, two-sided),
including 1 interim analysis at n = 118 (n = 94 with prenatal diagnosis)
with the option to stop early for efficacy. Secondary outcomes include
preoperative and postoperative brain injury severity, white matter injury
volume (MRI), and cardiac function (echocardiography); postnatal and
postoperative seizure activity (aEEG) and regional cerebral oxygen
saturation (NIRS); neurodevelopment at 3 months (general movements);
motor, cognitive, and language development and quality of life at 24
months; and safety and cost-effectiveness of allopurinol.
<br/>Discussion(s): This trial will investigate whether allopurinol
administered directly after birth and around cardiac surgery reduces
moderate/severe ischemic and hemorrhagic brain injury and improves cardiac
function and neurodevelopmental outcome in CCHD neonates. Trial
registration: EudraCT 2017-004596-31. Registered on November 14, 2017.
ClinicalTrials.gov NCT04217421. Registered on January 3,
2020<br/>Copyright &#xa9; 2022, The Author(s).

<25>
Accession Number
2013509482
Title
The relationship between coronary stent strut thickness and the incidences
of clinical outcomes after drug-eluting stent implantation: A systematic
review and meta-regression analysis.
Source
Catheterization and Cardiovascular Interventions. 99(3) (pp 575-582),
2022. Date of Publication: February 15, 2022.
Author
Saito A.; Dai Z.; Ono M.; Kanie T.; Takaoka Y.; Mizuno A.; Komiyama N.;
Asano T.
Institution
(Saito, Dai, Ono, Kanie, Takaoka, Mizuno, Komiyama, Asano) Department of
Cardiovascular Medicine, St. Luke's International Hospital, St. Luke's
International University, Tokyo, Japan
(Dai) Department of Cardiovascular Medicine, Graduate School of Medicine,
The University of Tokyo, Tokyo, Japan
(Ono) Department of Cardiology, National University of Ireland, Galway
(NUIG), Galway, Ireland
(Ono) Department of Cardiology, Academic Medical Center, University of
Amsterdam, Amsterdam, Netherlands
(Mizuno) The Penn Medicine Nudge Unit, University of Pennsylvania,
Philadelphia, PA, United States
(Mizuno) Perelman School of Medicine, University of Pennsylvania,
Philadelphia, PA, United States
(Mizuno) Leonard Davis Institute of Health Economics, University of
Pennsylvania, Philadelphia, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Drug-eluting stents (DESs) have been developed with thinner
stent struts, and more biocompatible polymers and anti-proliferative drugs
to improve the clinical performance. However, it remains unclear whether
thinner struts are associated with favorable short- and long-term clinical
outcomes such as target lesion revascularization (TLR), periprocedural
myocardial infarction (PMI), and stent thrombosis (ST). <br/>Method(s): We
searched MEDLINE, Embase and other online sources for randomized
controlled trials (RCTs) comparing clinical outcomes between a DES and
other stent(s), with independent clinical event adjudication. We
investigated stent-related events (TLR, PMI, and ST) in 5 years. Each
outcome was analyzed with random-effects meta-regression model against
strut thickness, then adjusted for DES generation and patient and lesion
characteristics. <br/>Result(s): We identified 49 RCTs enrolling 97,465
patients, of which strut thickness ranged from 60 to 140 mum. Incidences
of 1-year TLR, PMI, and early ST were reduced with thinner stent struts,
when adjusted for stent generation (adjusted relative risk [RR] per 10 mum
increase 1.12 [95% CI 1.04-1.21], 1.15 [95% CI 1.05-1.26], and 1.15 [95%
CI 1.06-1.25], respectively). Strut thickness was not independently
associated with incidences of 5-year TLR, late and very late ST. In
addition, early DESs contributed to a higher incidence of very late ST
(adjusted RR 2.97 [95% CI 1.36-6.50]). <br/>Conclusion(s): In this
meta-regression analysis, a thinner strut thickness was associated with
reduced incidences of early stent-related adverse events (1-year TLR, PMI,
and early ST), but not with later events (5-year TLR, late ST, and very
late ST).<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC.

<26>
Accession Number
2013080682
Title
Influence of fractional flow reserve on grafts patency: Systematic review
and patient-level meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 99(3) (pp 730-735),
2022. Date of Publication: February 15, 2022.
Author
G. Toth G.; Collet C.; Langhoff Thuesen A.; Mizukami T.; Casselman F.;
Riber L.P.; Van Praet F.; Junker A.; Nagumo S.; De Bruyne B.; Okkels
Jensen L.; Barbato E.
Institution
(G. Toth) Division of Cardiology, University Heart Center Graz, Medical
University of Graz, Graz, Austria
(Collet, Mizukami, Nagumo, De Bruyne, Barbato) Cardiovascular Center
Aalst, OLV Clinic, Aalst, Belgium
(Langhoff Thuesen, Riber) Department of Cardiothoracic Surgery, Odense
University Hospital, Odense, Denmark
(Langhoff Thuesen, Junker, Okkels Jensen) Department of Cardiology, Odense
University Hospital, Odense, Denmark
(Mizukami) Clinical Research Institute for Clinical Pharmacology and
Therapeutics, Showa University, Tokyo, Japan
(Casselman, Van Praet) Departement of Cardiovascular and Thoracic Surgery,
OLV Hospital Aalst, Aalst, Belgium
(Nagumo) Division of Cardiology, Department of Internal medicine, Showa
University Fujigaoka Hospital, Kanagawa, Japan
(De Bruyne) Department of Cardiology, Universtiy Hospital Center Lausanne,
Lausanne, Switzerland
(Barbato) Department of Advanced Biomedical Sciences, University Federico
II, Naples, Italy
Publisher
John Wiley and Sons Inc
Abstract
Objective: To investigate the impact of invasive functional guidance for
coronary artery bypass graft surgery (CABG) on graft failure.
<br/>Background(s): Data on the impact of fractional flow reserve (FFR) in
guiding CABG are still limited. <br/>Method(s): Systematic review and
individual patient data meta-analysis were performed. Primary objective
was the risk of graft failure, stratified by FFR. Risk estimates are
reported as odds ratios (ORs) derived from the aggregated data using
random-effects models. Individual patient data were analyzed using mixed
effect model to assess relationship between FFR and graft failure. This
meta-analysis is registered in PROSPERO (CRD42020180444). <br/>Result(s):
Four prospective studies comprising 503 patients referred for CABG, with
1471 coronaries, assessed by FFR were included. Graft status was available
for 1039 conduits at median of 12.0 [IQR 6.6; 12.0] months. Risk of graft
failure was higher in vessels with preserved FFR (OR 5.74, 95% CI
1.71-19.29). Every 0.10 FFR units decrease in the coronaries was
associated with 56% risk reduction of graft failure (OR 0.44, 95% CI 0.34
to 0.59). FFR cut-off to predict graft failure was 0.79.
<br/>Conclusion(s): Surgical grafting of coronaries with functionally
nonsignificant stenoses was associated with higher risk of graft
failure.<br/>Copyright &#xa9; 2021 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<27>
Accession Number
2021131199
Title
External applicability of the Effect of ticagrelor on Health Outcomes in
diabEtes Mellitus patients Intervention Study (THEMIS) trial: An analysis
of patients with diabetes and coronary artery disease in the REduction of
Atherothrombosis for Continued Health (REACH) registry.
Source
International Journal of Cardiology. 370 (pp 51-57), 2023. Date of
Publication: 01 Jan 2023.
Author
Abtan J.; Bhatt D.L.; Elbez Y.; Ducrocq G.; Goto S.; Smith S.C.; Ohman
E.M.; Eagle K.A.; Fox K.; Harrington R.A.; Leiter L.A.; Mehta S.R.; Simon
T.; Petrov I.; Sinnaeve P.R.; Pais P.; Lev E.; Bueno H.; Wilson P.; Steg
P.G.
Institution
(Abtan, Elbez, Ducrocq, Steg) FACT (French Alliance for Cardiovascular
clinical Trials), Universite de Paris, Hopital Bichat (Assistance Publique
- Hopitaux de Paris) and INSERM U-1148, all in Paris, France
(Abtan, Bhatt) Brigham and Women's Hospital Heart & Vascular Center,
Harvard Medical School, Boston, MA, United States
(Goto) Department of Medicine (Cardiology), Tokai University School of
Medicine, Kanagawa, Isehara, Japan
(Smith) Division of Cardiology, Department of Medicine, University of
North Carolina, Chapel Hill, United States
(Ohman) Division of Cardiology, Department of Medicine, Duke University
School of Medicine, Durham, North Carolina, Duke Clinical Research
Institute, Durham, NC, United States
(Eagle) University of Michigan Cardiovascular Center, Ann Arbor, United
States
(Fox, Steg) National Heart and Lung Institute, Imperial College, London,
United Kingdom
(Fox) Institute of Cardiovascular Medicine and Science, Royal Brompton
Hospital, London, United Kingdom
(Harrington) Stanford Center for Clinical Research, Department of
Medicine, Stanford University, California, United States
(Leiter) Division of Endocrinology and Metabolism, Li Ka Shing Knowledge
Institute, St Michael's Hospital, University ot Toronto, ON, Canada
(Mehta) Population Health Research Institute and Department of Medicine,
McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
(Simon) Plateforme de Recherche Clinique de l'Est Parisien
(URCEST-CRCEST-CRB), Saint-Antoine Hospital, AP-HP, Paris, France
(Petrov) University Hospital Acibadem City Clinic Sofia, Sofia University
St. Kliment Ohridski, Bulgaria
(Sinnaeve) Department of Cardiovascular Medicine, University Hospitals
Leuven, Belgium
(Pais) Division of Clinical Research and Training, St. John's Research
Institute, Bangalore, India
(Lev) Department of Cardiology, Rabin Medical Center, Petach Tikva,
Department of Cardiology, Assuta Ashdod University Hospital, Ashdod,
Faculty of Medicine, Ben Gurion University, all in, Be'er Sheva, Israel
(Bueno) Cardiology Department, Hospital Universitario 12 de Octubre,
Centro Nacional de Investigaciones Cardiovasculares, CIBER de enfermedades
CardioVasculares (CIBERCV), Madrid, Spain
(Wilson) Mayo Clinic, Rochester, MN, United States
Publisher
Elsevier Ireland Ltd
Abstract
Aims: THEMIS is a double-blind, randomized trial of 19,220 patients with
diabetes mellitus and stable coronary artery disease (CAD) comparing
ticagrelor to placebo, in addition to aspirin. The present study aimed to
describe the proportion of patients eligible and reasons for ineligibility
for THEMIS within a population of patients with diabetes and CAD included
in the Reduction of Atherothrombosis for Continued Health (REACH)
registry. <br/>Methods and Results: The THEMIS eligibility criteria were
applied to REACH patients. THEMIS included patients >=50 years with type 2
diabetes and stable CAD as determined by either a history of previous
percutaneous coronary intervention, coronary artery bypass grafting, or
documentation of angiographic stenosis of >=50% of at least one coronary
artery. Patients with prior myocardial infarction or stroke were excluded.
In REACH, 10,156 patients had stable CAD and diabetes. Of these, 6515
(64.1%) patients had at least one exclusion criteria. From the remaining
population, 784 patients did not meet inclusion criteria (7.7%) mainly due
to absence of aspirin treatment (7.2%), yielding a 'THEMIS-eligible
population' of 2857 patients (28.1% of patients with diabetes and stable
CAD). The main reasons for exclusion were a history of myocardial
infarction (53.1%), use of oral anticoagulation (14.5%), or history of
stroke (12.9%). Among the 4208 patients with diabetes and a previous PCI,
1196 patients (28.4%) were eligible for inclusion in the THEMIS-PCI
substudy. <br/>Conclusion(s): In a population of patients with diabetes
and stable coronary artery disease, a sizeable proportion appear to be
'THEMIS eligible.' Clinical trial registration:
http://www.clinicaltrials.gov identifier: NCT01991795<br/>Copyright &#xa9;
2022 The Author(s)

<28>
Accession Number
2020990207
Title
Risk factors of early complications after thoracic and lumbar spinal
deformity surgery: a systematic review and meta-analysis.
Source
European Spine Journal. (no pagination), 2023. Date of Publication: 2023.
Author
Kuo C.C.; Soliman M.A.R.; Aguirre A.O.; Youngs D.; Kruk M.; Hess R.M.;
Nyabuto E.M.; Khan A.; Jowdy P.K.; Pollina J.; Mullin J.P.
Institution
(Kuo, Aguirre, Kruk) Jacobs School of Medicine and Biomedical Sciences at
University at Buffalo, Buffalo, NY, United States
(Soliman, Hess, Nyabuto, Khan, Jowdy, Pollina, Mullin) Department of
Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at
University at Buffalo, 100 High Street, Suite B4, Buffalo, NY 14203,
United States
(Soliman, Hess, Nyabuto, Khan, Jowdy, Pollina, Mullin) Department of
Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, NY,
United States
(Soliman) Department of Neurosurgery, Faculty of Medicine, Cairo
University, Cairo, Egypt
(Youngs) SUNY Upstate Medical University, Syracuse, NY, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: To determine risk factors increasing susceptibility to early
complications (intraoperative and postoperative within 6 weeks) associated
with surgery to correct thoracic and lumbar spinal deformity.
<br/>Method(s): We systematically searched the PubMed and EMBASE databases
for studies published between January 1990 and September 2021.
Observational studies evaluating predictors of early complications of
thoracic and lumbar spinal deformity surgery were included. Pooled odds
ratio (OR) or standardized mean difference (SMD) with 95% confidence
intervals (CI) was calculated via the random effects model.
<br/>Result(s): Fifty-two studies representing 102,432 patients met the
inclusion criteria. Statistically significant patient-related risk factors
for early complications included neurological comorbidity (OR = 3.45, 95%
CI 1.83-6.50), non-ambulatory status (OR = 3.37, 95% CI 1.96-5.77), kidney
disease (OR = 2.80, 95% CI 1.80-4.36), American Society of
Anesthesiologists score > 2 (OR = 2.23, 95% CI 1.76-2.84), previous spine
surgery (OR = 1.98, 95% CI 1.41-2.77), pulmonary comorbidity (OR = 1.94,
95% CI 1.21-3.09), osteoporosis (OR = 1.60, 95% CI 1.17-2.20),
cardiovascular diseases (OR = 1.46, 95% CI 1.20-1.78), hypertension (OR =
1.37, 95% CI 1.23-1.52), diabetes mellitus (OR = 1.84, 95% CI 1.30-2.60),
preoperative Cobb angle (SMD = 0.43, 95% CI 0.29, 0.57), number of
comorbidities (SMD = 0.41, 95% CI 0.12, 0.70), and preoperative lumbar
lordotic angle (SMD = - 0.20, 95% CI - 0.35, - 0.06). Statistically
significant procedure-related factors were fusion extending to the sacrum
or pelvis (OR = 2.53, 95% CI 1.53-4.16), use of osteotomy (OR = 1.60, 95%
CI 1.12-2.29), longer operation duration (SMD = 0.72, 95% CI 0.05, 1.40),
estimated blood loss (SMD = 0.46, 95% CI 0.07, 0.85), and number of levels
fused (SMD = 0.37, 95% CI 0.03, 0.70). <br/>Conclusion(s): These data may
contribute to development of a systematic approach aimed at improving
quality-of-life and reducing complications in high-risk
patients.<br/>Copyright &#xa9; 2023, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature.

<29>
Accession Number
2020989628
Title
Complications after early versus late mobilization after an incidental
durotomy: a systematic review and meta-analysis.
Source
European Spine Journal. (no pagination), 2023. Date of Publication: 2023.
Author
Najjar E.; Hassanin M.A.; Komaitis S.; Karouni F.; Quraishi N.A.
Institution
(Najjar, Hassanin, Komaitis, Karouni, Quraishi) Centre for Spinal Studies
and Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS
Trust, Nottingham NG7 2UH, United Kingdom
(Hassanin) Department of Orthopedic Surgery, Assiut University, Asyut,
Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: An incidental durotomy (IDT) is a frequent complication of
spinal surgery. The conventional management involving a period of flat bed
rest is highly debatable. Indeed, there are scanty data and no consensus
regarding the need or ideal duration of post-operative bed rest following
IDT. <br/>Objective(s): To systematically evaluate the literature
regarding the outcomes of mobilization within 24 h and after 24 h
following IDT in open lumbar or thoracic surgery with respect to the
length of hospital stay, minor and major complications. <br/>Method(s): A
systematic review of the literature using PubMed, Embase and Cochrane and
dating up until September 2022 was undertaken following Preferred
Reporting Items for Systematic Review and Meta-Analysis guidelines.
Quality of evidence was assessed using a modified version of Sackett's
Criteria of Evidence Support. <br/>Result(s): Out of 532 articles, 6
studies met the inclusion criteria (1 Level-I, 4 level-III and 1 Level-IV
evidence) and were analyzed. Overall, 398 patients of mean age 59.9 years
were mobilized within 24 h. The average length of stay (LOS) for this
group was 5.7 days. Thirty-four patients (8.5%) required reoperation while
the rate of minor complications was 25.4%. Additionally, 265 patients of
mean age 63 years with IDT were mobilized after 24 h. The average LOS was
7.8 days. Twenty patients (7.54%) required reoperation while the rate of
minor complications was 55%. Metanalysis comparing early to late
mobilization, showed a significant reduction in the risk of minor
complications and shorter overall LOS due to early mobilization, but no
significant difference in major complications and reoperation rates.
<br/>Conclusion(s): Although early mobilization after repaired incidental
dural tears in open lumbar and thoracic spinal surgery has a similar major
complication/ reoperation rates compared to late mobilization, it
significantly decreases the risk of minor complications and length of
hospitalization.<br/>Copyright &#xa9; 2023, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature.

<30>
Accession Number
2018963708
Title
The Effect of Aloe Vera Gel on Saphenous Vein Harvest Wound Healing and
Local Pain in Non-diabetic Patients Undergoing CABG Surgery: A Clinical
Trial.
Source
Shiraz E Medical Journal. 24(1) (no pagination), 2023. Article Number:
e122766. Date of Publication: Jan 2023.
Author
Mohamad-Abadi N.M.; Haghighat S.; Tajmir-Riahi M.; Asgari S.;
Eghbali-Babadi M.
Institution
(Mohamad-Abadi) Department of Critical Care Nursing, Faculty of Nursing
and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Haghighat, Eghbali-Babadi) Nursing and Midwifery Care Research Center,
Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Tajmir-Riahi) Cardiac Surgery Board, Department of Cardiac Surgery,
School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Asgari) Isfahan Cardiovascular Research Center, Cardiovascular Research
Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
Publisher
Brieflands
Abstract
Background: Coronary artery bypass graft (CABG) is a common surgical
procedure in patients with heart disease associated with pain and problems
with great saphenous veins (GSVs) wound healing. <br/>Objective(s): We
aimed to determine the effect of aloe vera gel on pain intensity, and GSVs
wound healing in non-diabetic patients undergoing CABG. <br/>Method(s): In
this clinical trial, 35 CABG candidate patients fulfilling admission
criteria were selected by convenience sampling, and their lower limbs were
randomly assigned to the intervention or control group. The wound care for
both groups was the same except for using aloe vera gel for the
intervention group from the first to the fourth days after surgery. Pain
intensity and GSVs wound healing data were collected by Redness, Edema,
Ecchymosis, Discharge, and Approximation (REEDA) scale and Visual Analog
Scale (VAS) questionnaires on the first, fourth, seventh, and fourteenth
days and analyzed by SPSS software. <br/>Result(s): On the seventh day,
the mean pain intensity in the intervention group was significantly lower
(P = 0.01). The mean scores of wound healing in the intervention limb
decreased faster; however, the wound healing score was not significantly
different between the two groups at any time (P > 0.05). Using aloe vera
gel reduced ecchymosis on the seventh and fourteenth days and reduced pain
on the seventh day compared to the control limb (P < 0.001).
<br/>Conclusion(s): Aloe vera gel can effectively reduce GSVs' pain
intensity and ecchymosis from the seventh day. The topical application of
this herb can have various degrees of effectiveness in decreasing pain and
speeding up the healing of surgical wounds.<br/>Copyright &#xa9; 2023,
Author(s).

<31>
Accession Number
2022064109
Title
Assessment of Repeat Revascularization in Percutaneous Coronary
Intervention Randomized Controlled Trials as a Surrogate for Mortality: A
Meta-Regression Analysis.
Source
Current Problems in Cardiology. 48(4) (no pagination), 2023. Article
Number: 101555. Date of Publication: April 2023.
Author
Khan S.U.; Lone A.N.; Akbar U.A.; Arshad H.B.; Arshad A.; Arora S.;
Kaluski E.; Aoun J.; Goel S.S.; Shah A.R.; Kleiman N.S.
Institution
(Khan, Arshad, Aoun, Goel, Shah, Kleiman) Department of Cardiology,
Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, United
States
(Lone, Kaluski) Guthrie Health System/Robert Packer Hospital, Sayre, PA,
United States
(Akbar) Division of infectious disease, the University of Louisville,
Louisville, KY, United States
(Arshad) Department of Medical Oncology, Ohio State University
Comprehensive Cancer Care Center, Columbus, OH, United States
(Arora) Department of Cardiology, Case Western Reserve University,
Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
The association of repeat revascularization after percutaneous coronary
intervention (PCI) with mortality is uncertain. To assess the association
of repeat revascularization after PCI with mortality in patients with
coronary artery disease (CAD). We identified randomized controlled trials
comparing PCI with coronary artery bypass graft (CABG) or optimal medical
therapy (OMT) using electronic databases through January 1, 2022. We
performed a random-effects meta-regression between repeat
revascularization rates after PCI (absolute risk difference [%] between
PCI and CABG or OMT) with the relative risks (RR) of mortality. We
assessed surrogacy of repeat revascularization for mortality using the
coefficient of determination (R2), with threshold of 0.80. In 33 trials
(21,735 patients), at median follow-up of 4 (2-7) years, repeat
revascularization was higher after PCI than CABG [RR: 2.45 (95% confidence
interval, 1.99-3.03)], but lower vs OMT [RR: 0.64 (0.46-0.88)]. Overall,
meta-regression showed that repeat revascularization rates after PCI had
no significant association with all-cause mortality [RR: 1.01 (0.99-1.02);
R2=0.10) or cardiovascular mortality [RR: 1.01 (CI: 0.99-1.03); R2=0.09].
In PCI vs CABG (R2=0.0) or PCI vs OMT trials (R2=0.28), repeat
revascularization did not meet the threshold for surrogacy for all-cause
or cardiovascular mortality (R2=0.0). We observed concordant results for
subgroup analyses (enrollment time, follow-up, sample size, risk of bias,
stent types, and coronary artery disease), and multivariable analysis
adjusted for demographics, comorbidities, risk of bias, MI, and follow-up
duration. In summary, this meta-regression did not establish repeat
revascularization after PCI as a surrogate for all-cause or cardiovascular
mortality.<br/>Copyright &#xa9; 2022

<32>
Accession Number
2020967041
Title
Incidence and Associations of Acute Kidney Injury after General Thoracic
Surgery: A System Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 12(1) (no pagination), 2023. Article Number:
37. Date of Publication: January 2023.
Author
Yu Y.; Xu S.; Yan B.; Tang X.; Zhang H.; Pan C.; Zhu S.
Institution
(Yu, Xu, Tang, Zhang, Pan, Zhu) Department of Anesthesiology, The First
Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou
310000, China
(Yan) Department of Anesthesiology, Haining People's Hospital, Haining
314499, China
Publisher
MDPI
Abstract
(1) Background: Acute kidney injury (AKI) is related to adverse outcomes
in critical illness and cardiovascular surgery. In this study, a
systematic literature review and meta-analysis was carried out to evaluate
the incidence and associations of AKI as a postoperative complication of
thoracic (including lung resection and esophageal) surgical procedures.
(2) Methods: Adopting a systematic strategy, the electronic reference
databases (PubMed, EMBASE, and Cochrane Library) were searched for
articles researching postoperative renal outcomes that were diagnosed
using RIFLE, AKIN or KDIGO consensus criteria in the context of a thoracic
operation. A random-effects model was applied to estimate the incidence of
AKI and, where reported, the pooled relative risk of mortality and
non-renal complications after AKI. The meta-analysis is registered in
PROSPERO under the number CRD42021274166. (3) Results: In total, 20
studies with information gathered from 34,826 patients after thoracic
surgery were covered. Comprehensively, the incidence of AKI was estimated
to be 8.8% (95% CI: 6.7-10.8%). A significant difference was found in the
mortality of patients with and without AKI (RR = 2.93, 95% CI: 1.79-4.79,
p < 0.001). Additionally, in patients experiencing AKI, cardiovascular and
respiratory complications were more common (p = 0.01 and p < 0.001,
respectively). (4) <br/>Conclusion(s): AKI is a common complication
associated with adverse outcomes following general thoracic surgery. An
important issue in perioperative care, AKI should be considered as a
highly significant prognostic indicator and an attractive target for
potential therapeutic interventions, especially in high-risk
populations.<br/>Copyright &#xa9; 2022 by the authors.

<33>
Accession Number
639983534
Title
A Randomized Comparison of Effects of Budesonide Spray and K-Y Gel as an
Endotracheal Tube Cuff Lubricant on Incidence of Postoperative Sore
Throat.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. (no pagination), 2023. Date of
Publication: 05 Jan 2023.
Author
Hintong T.; Chongvisal S.; Pipanmekaporn T.; Unchiti K.
Institution
(Hintong, Chongvisal, Pipanmekaporn, Unchiti) Department of Anesthesia,
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Publisher
NLM (Medline)
Abstract
PURPOSE: Postoperative sore throat (POST) is a frequent postoperative
complication. Pre-induction budesonide inhalation is effective in POST
prevention. However, it requires inhaler equipment and patient
cooperation. Budesonide spraying on the endotracheal (ETT) cuff is simple
and can be performed on most patients requiring endotracheal intubation.
This study aims to compare the effects of budesonide spray and K-Y gel as
an ETT cuff lubricant on the incidence and severity of POST. DESIGN:
Randomized and triple-blinded study. <br/>METHOD(S): One hundred patients
undergoing elective non-cardiac surgery were randomly allocated into the
budesonide group (n = 50) and the K-Y gel group (n = 50). In the
budesonide group, 200 mcg of budesonide was sprayed on the cuff of the
ETT. For the K-Y gel group, the ETT cuff was lubricated with K-Y gel. A
visual analog scale was used to assess the severity of POST at 2, 6, and
24 hours after surgery. Other complications of tracheal intubation and
adverse effects of budesonide were also recorded. FINDINGS: Compared to
the K-Y gel group, the budesonide group had a significantly lower overall
incidence of POST (30% versus 54%, P = .032) and reduced the risk of POST
by 24% (relative risk reduction = 24%, 95% CI, 5.23-42.77, P = .012) as
well as the incidence of hoarseness (8.6% vs 34%, P = .001) and cough (0%
vs 8%, P = 0.041). No incidence of drug-related side effects was reported
in both groups. <br/>CONCLUSION(S): Spraying budesonide on the ETT cuff
significantly reduces the incidence and severity of POST.<br/>Copyright
&#xa9; 2022 American Society of PeriAnesthesia Nurses. Published by
Elsevier Inc. All rights reserved.

<34>
Accession Number
639982155
Title
Low-Dose Versus Standard Warfarin After Mechanical Mitral Valve
Replacement: A Randomized Trial.
Source
The Annals of thoracic surgery. (no pagination), 2023. Date of
Publication: 04 Jan 2023.
Author
Chu M.W.A.; Ruel M.; Graeve A.; Gerdisch M.W.; Damiano R.J.; Smith R.L.;
Keeling W.B.; Wait M.A.; Hagberg R.C.; Quinn R.D.; Sethi G.K.; Floridia
R.; Barreiro C.J.; Pruitt A.L.; Accola K.D.; Dagenais F.; Markowitz A.H.;
Ye J.; Sekela M.E.; Tsuda R.Y.; Duncan D.A.; Swistel D.G.; Harville L.E.;
DeRose J.J.; Lehr E.J.; Alexander J.H.; Puskas J.D.
Institution
(Chu) London Health Sciences Centre, Western University, London, ON,
Canada
(Ruel) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Graeve) MultiCare Health System, Tacoma, WA, United States
(Gerdisch) Franciscan St. Francis Health, Indianapolis, IN, United States
(Damiano) Washington University SL, St. Louis, MO, United States
(Smith) Heart Hospital Baylor Plano, Plano, TX, United States
(Keeling) Emory University Hospital Midtown, Atlanta, GA, United States
(Wait) UT Southwestern Medical Center (St. Paul's), Dallas, TX, United
States
(Hagberg) Hartford Hospital, Hartford, CT, United States
(Quinn) Maine Medical Center, Portland, ME
(Sethi) University of Arizona, Tucson Heart Center, Tucson, AZ, United
States
(Floridia) Loma Linda University Medical Center, Loma Linda, CA, United
States
(Barreiro) Sentara Norfolk General Hospital, Norfolk, VA, United States
(Pruitt) St. Joseph Mercy Hospital, Ann Arbor, MI, United States
(Accola) Florida Hospital, Orlando, FL, Puerto Rico
(Dagenais) Institut universitaire de cardiologie et de pneumologie de
Quebec (IUCPQ), Quebec City, QC, Canada
(Markowitz) University Hospitals-Cleveland, Cleveland, OH, United States
(Ye) St. Paul's and Vancouver General Hospital, Vancouver, BC, Canada
(Sekela) University of Kentucky, Lexington, KY, United States
(Tsuda) Southern Arizona VA Medical Center, Tucson, AZ, United States
(Duncan) Novant Clinical Research Institute, Winston-Salem, NC, United
States
(Swistel) NYU Langone Hospitals, New York, NY
(Harville) University of Oklahoma Health Sciences Center, Oklahoma City,
OK, United States
(DeRose) Montefiore Medical Center, Bronx, NY, United States
(Lehr) Swedish Medical Center, Seattle, WA, United States
(Alexander) Duke University Medical Center, Durham, NC, United States
(Puskas) Mount Sinai Saint Luke's, New York, NY
Publisher
NLM (Medline)
Abstract
BACKGROUND: Current guidelines recommend a target international normalized
ratio (INR) range of 2.5 to 3.5 in patients with a mechanical mitral
prosthesis. The Prospective Randomized On-X Anticoagulation Clinical Trial
(PROACT) Mitral randomized controlled noninferiority trial assessed safety
and efficacy of warfarin at doses lower than currently recommended, in
patients with an On-X mechanical mitral valve. <br/>METHOD(S): After On-X
mechanical mitral valve replacement followed by at least 3 months of
standard anticoagulation, 401 patients at 44 North American centers were
randomized to low-dose warfarin (target INR 2.0 to 2.5) or standard-dose
warfarin (target INR 2.5 to 3.5). All patients were prescribed aspirin 81
mg daily and encouraged to use home INR testing. The primary endpoint was
the sum of the linearized rates of thromboembolism, valve thrombosis, and
bleeding events. The design was based on an expected 7.3% event rate and
1.5% noninferiority margin. <br/>RESULT(S): Mean patient follow-up was 4.1
years. Mean INR was 2.47 and 2.92 (P <.001) in the low-dose and
standard-dose warfarin groups, respectively. Primary endpoint rates were
11.9%/patient-year in the low-dose group and 12.0%/patient-year in the
standard-dose group (difference -0.07, 95% confidence intervals: -3.40,
3.26). The confidence interval exceeded 1.5%, thus noninferiority was not
achieved. Rates (%/patient-year) of the individual components of the
primary endpoint were 2.3% vs 2.5% for thromboembolism, 0.5% vs 0.5% for
valve thrombosis, and 9.13% vs 9.04% for bleeding. <br/>CONCLUSION(S):
Compared to standard-dose warfarin, low-dose warfarin did not achieve
noninferiority for the composite primary endpoint. (PROACT
Clinicaltrials.gov number, NCT00291525).<br/>Copyright &#xa9; 2023.
Published by Elsevier Inc.

<35>
Accession Number
2021886449
Title
Thoracic organ donation after circulatory determination of death.
Source
Transplantation Reports. 8(1) (no pagination), 2023. Article Number:
100125. Date of Publication: February 2023.
Author
Hatami S.; Conway J.; Freed D.H.; Urschel S.
Institution
(Hatami) Department of Medicine, University of Alberta, Edmonton, AB,
Canada
(Conway, Urschel) Department of Pediatrics, University of Alberta,
Edmonton, AB, Canada
(Freed) Department of Physiology, University of Alberta, Edmonton, AB,
Canada
(Freed) Biomedical Engineering, University of Alberta, Edmonton, AB,
Canada
(Freed) Department of Surgery, University of Alberta, Edmonton, AB, Canada
(Hatami, Freed, Urschel) Alberta Transplant Institute, Edmonton, AB,
Canada
(Freed, Urschel) Canadian Transplant Research Program, Canada
Publisher
Elsevier Inc.
Abstract
The availability of thoracic organ transplantation as the treatment of
choice for end-stage cardiac or pulmonary diseases is limited by the
insufficient number of donor organs from brain dead donors, especially for
organs where live-donation is not an option. Patients, who have not
progressed to brain death, but have exhausted therapeutic options and life
sustaining therapies are withdrawn can become donors with circulatory
determination of death (DCD) when they meet criteria for the definition of
this state. This approach can fulfill the wish of a patient to become an
organ donor and also help to increase the number of donor organs. The DCD
process exposes organs to prolonged warm ischemia that increases the
possibility of primary graft dysfunction and failure. However, new
technologies help in protecting the organs from cold preservation-related
ischemia and facilitate resuscitation and monitoring of viability after
the occurrence of the DCD-related ischemic insult. Herein, we review the
opportunities and challenges in DCD thoracic organ transplantation,
emerging techniques in preservation and monitoring of these organs and the
potential effect of DCD thoracic organ transplantation on expanding the
donor pool.<br/>Copyright &#xa9; 2022

<36>
Accession Number
2015266862
Title
Next-Day Discharge vs Early Discharge After Transcatheter Aortic Valve
Replacement: Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 47(10) (no pagination), 2022. Article
Number: 100998. Date of Publication: October 2022.
Author
Gupta R.; Mahajan S.; Mehta A.; Nyaeme M.; Mehta N.A.; Cheema A.; Khanal
L.; Malik A.H.; Aronow W.S.; Vyas A.V.; Mehta S.S.; Patel N.C.
Institution
(Gupta, Vyas, Patel) Lehigh Valley Heart Institute, Lehigh Valley Health
Network, Allentown, PA, United States
(Mahajan, Mehta, Nyaeme, Cheema, Khanal) Department of Internal Medicine,
Carle Foundation Hospital, Urbana, IL
(Mehta) Department of Cardiology, University of Missouri Kansas City,
Kansas City, MO
(Malik, Aronow) Department of Cardiology, Westchester Medical Center and
New York Medical College, Valhalla, NY
(Mehta) Heart and Vascular Institute, Carle Foundation Hospital, Urbana,
IL
Publisher
Elsevier Inc.
Abstract
With the growing utilization of transcatheter aortic valve replacement
(TAVR) as an alternative option to surgical valve replacement (SAVR) in
patients considered to be suboptimal for surgery, there is a need to
explore the possibility of next day discharge (NDD) and its potential
outcomes. The aim of our study is to compare outcomes and complications
following NDD vs the standard early discharge (ED) (less than 3 days). A
comprehensive literature search was performed in PubMed, Embase, and
Cochrane to identify relevant trials. Summary effects were calculated
using a DerSimonian and Laird random effects model as odds ratio with 95%
confidence intervals for all the clinical endpoints. Studies comparing
same-day or next-day discharge vs discharge within the next three days
were included in our analysis. 6 studies with 2,672 patients were
identified. The risk of bleeding and vascular complications was
significantly lower in patients with NDD compared to ED (OR 0.10, P <
0.00001 and OR 0.22, P = 0.002 respectively). The incidence of permanent
pacemaker (PPM) implants was significantly lower in patients who had NDD
compared to ED (OR 0.21, P = 0.0005). The incidence of 30 day mortality,
stroke, AKI and readmission rates was not different between the two
groups. NDD after TAVR allows for reduction in hospital stay and can
mitigate hospital costs without an increased risk of complications. Our
analysis shows that complication rate is comparable to ED, NDD is a
reasonable option for certain patients with severe aortic stenosis who
undergo TAVR. Further studies are needed to elucidate whether higher risk
patients who would benefit from an extended inpatient monitoring post
TAVR.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<37>
Accession Number
2020866041
Title
A randomized controlled trial (PAMI trial) on our new trend periareolar
minimally invasive (PAMI) technique versus inframammary approach for
minimally invasive cardiac surgery.
Source
Cardiothoracic Surgeon. 30(1) (no pagination), 2022. Article Number: 29.
Date of Publication: December 2022.
Author
El Adel M.; Nady M.A.; Amin A.; Khairy M.
Institution
(El Adel, Nady, Amin, Khairy) Cardiothoracic Surgery Departments, Faculty
of Medicine, Assiut University, Asyut, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: A minimally invasive approach has become standard for mitral
valve surgery. The periareolar approach has grown in popularity regarding
the cosmesis for patients. We have adopted a new modification to the
periareolar approach: the periareolar minimally invasive (PAMI) technique.
The objectives of the current study are to test the hypothesis that the
PAMI approach is more feasible and safer than the inframammary approach in
addition to identify risk factors and assess outcomes of both periareolar
and inframammary approach. <br/>Method(s): A randomized controlled trial
of 3 months compared the PAMI technique to the inframammary approach for
minimally invasive cardiac surgery. <br/>Result(s): A total of 102
patients were enrolled and randomized into two groups: 53 received
minimally invasive cardiac surgery through the periareolar approach, and
49 were the control group using the inframammary approach. Using
intention-to-treat analysis, the periareolar approach was superior to the
inframammary approach in surgical site infection (two cases in comparison
to 8 with P = 0.004), and the number needed to treat for effectiveness was
8. No early deaths occurred, 97 cases (95.1%) needed no reoperation, and 5
cases (4.9%) were reopened for bleeding. The primary endpoints compared
were the duration of procedure, duration of mechanical ventilation, amount
of bleeding, ICU stay, and hospital stay. We found no statistically
significant differences between the groups. At 3 months, the secondary
endpoints evaluated were the rate of surgical site infection, respiratory
complications, groin complications, pericardial effusion, breast hematoma,
and cosmoses using a Likert scale. We found no statistically significant
difference between the groups, except for surgical site infection (P =
0.004) and cosmesis (P< 0.001). <br/>Conclusion(s): The results of this
PAMI trial are suggestive that the PAMI technique is most probably
applicable for the right side of the heart, such as in atrial septal
defect closure, tricuspid disease, and mitral valve surgery. Trial
registration: PAMI Trial NCT04726488 Registered January 27,
2021.<br/>Copyright &#xa9; 2022, The Author(s).

<38>
Accession Number
2019913607
Title
Left ventricular volume change and long-term outcomes in ischaemic
cardiomyopathy with or without surgical revascularisation: A post-hoc
analysis of a randomised controlled trial.
Source
eClinicalMedicine. 53 (no pagination), 2022. Article Number: 101626. Date
of Publication: November 2022.
Author
Zhou Z.; Zhuang X.; Liu M.; Jian B.; Fu G.; Liao X.; Wu Z.; Liang M.
Institution
(Zhou, Jian, Fu, Wu, Liang) Department of Cardiac Surgery, First
Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
(Zhuang, Liu, Liao) Departement of Cardiology, First Affiliated Hospital
of Sun Yat-Sen University, Guangzhou, China
Publisher
Elsevier Ltd
Abstract
Background: Whether the association between post-therapeutic left
ventricular volume change and long-term outcomes in ischaemic
cardiomyopathy is influenced by the performance of coronary artery bypass
grafting (CABG) remains unclear. We sought to perform a post-hoc analysis
of the Surgical Treatment of Ischaemic Heart Failure (STICH) trial to
investigate this association in patients treated with medical therapy
(MED) with or without CABG. <br/>Method(s): From July 24, 2002, to May 5,
2007, 1212 patients with ischaemic cardiomyopathy were enrolled in the
STICH trial (NCT00023595) from 99 sites in 22 countries, and were randomly
assigned to undergo CABG plus MED or MED alone. We completed a post-hoc
analysis of this trial. Patients with paired left ventricular end-systolic
volume index (ESVI) measured at baseline and 4-months were included in our
analysis. The association between change in ESVI from baseline to 4-months
and cardiovascular mortality or all-cause mortality was assessed in MED
arm and CABG plus MED arm. <br/>Finding(s): 523 patients were included,
with 291 (55.6%) assigned to MED arm and 232 (44.4%) to CABG plus MED arm.
At a 4-month follow-up, ESVI reduction was more likely to occur among
patients undergoing CABG plus MED. After a median follow-up of 10.3 years,
for each 26% (1- standard deviation) decrement in ESVI, it was associated
with a 22% lower risk of cardiovascular mortality (HR 0.78; 95% CI,
0.65-0.94) and 19% lower risk of all-cause mortality (HR 0.81; 95% CI,
0.69-0.95) in MED arm, whereas this association was not shown in CABG plus
MED arm (cardiovascular mortality: HR 0.90; 95%CI, 0.74-1.10; all-cause
mortality: HR 0.93; 95%CI, 0.79-1.09). A 16% reduction in ESVI was
determined to be the most appropriate threshold of change in ESVI in the
MED arm. <br/>Interpretation(s): In patients with ischaemic
cardiomyopathy, left ventricular volume change was associated with
long-term prognosis after medical therapy alone, whereas was likely not an
optimal benchmark for evaluating the survival benefits associated with
CABG. A more than 16% reduction in ESVI might assist in therapeutic
efficacy assessment and prognostic evaluation in medically treated
patients. <br/>Funding(s): National Natural Science Foundation of China;
Natural Science Funds of Guangdong Province.<br/>Copyright &#xa9; 2022 The
Author(s)

<39>
Accession Number
2019568240
Title
Tricuspid Regurgitation Impact on Outcomes (TRIO): A Simple Clinical Risk
Score.
Source
Mayo Clinic Proceedings. 97(8) (pp 1449-1461), 2022. Date of Publication:
August 2022.
Author
Lara-Breitinger K.M.; Scott C.G.; Nkomo V.T.; Pellikka P.A.; Kane G.C.;
Chaliki H.P.; Shapiro B.P.; Eleid M.F.; Alkhouli M.; Greason K.L.; Pislaru
S.V.; Rihal C.S.
Institution
(Lara-Breitinger, Nkomo, Pellikka, Kane, Eleid, Alkhouli, Pislaru, Rihal)
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
(Scott) Division of Biomedical Statistics and Informatics, Mayo Clinic,
Rochester, MN
(Greason) Division of Cardiovascular Surgery, Mayo Clinic, Rochester, MN
(Chaliki) Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ
(Shapiro) Department of Cardiovascular Medicine, Mayo Clinic,
Jacksonville, FL
Publisher
Elsevier Ltd
Abstract
Objective: To determine which clinical variables infer the highest risk
for mortality in patients with notable tricuspid regurgitation (TR) and to
develop a clinical assessment tool (the Tricuspid Regurgitation Impact on
Outcomes [TRIO] score). <br/>Patients and Methods: A single-center
retrospective cohort of 13,608 patients with undifferentiated moderate to
severe TR at the time of index echocardiography between January 1, 2005,
and December 31, 2016, was included. Baseline demographic and clinical
data were obtained. Patients were randomly assigned to a training
(N=10,205) and a validation (N=3403) cohort. Median follow-up was 6.5
years (interquartile range, 0.8 to 11.0 years). Variables associated with
mortality were identified by Cox proportional hazards methods. A
geographically distinct cohort of 7138 patients was used for further
validation. The primary end point was all-cause mortality over 10 years.
<br/>Result(s): The 5-year probability of death was 53% for moderate TR,
63% for moderate-severe TR (hazard ratio [HR], 1.24 [95% CI, 1.17 to
1.31]; P<.001 vs moderate), and 71% for severe TR (HR, 1.55 [95% CI, 1.47
to 1.64]; P<.001 vs moderate). Factors associated with all-cause mortality
on multivariate analysis included age 70 years or older, male sex,
creatinine level greater than 2 mg/dL, congestive heart failure, chronic
lung disease, aspartate aminotransferase level of 40 U/L or greater, heart
rate of 90 beats/min or greater, and severe TR. Variables were assigned 1
or 2 points (HR, >1.5) and added to compute the TRIO score. The score was
associated with all-cause mortality (C statistic = 0.67) and was able to
separate patients into risk categories. Findings were similar in the
second, independent and geographically distinct cohort.
<br/>Conclusion(s): The TRIO score is a simple clinical tool for risk
assessment in patients with notable TR. Future prospective studies to
validate its use are warranted.<br/>Copyright &#xa9; 2022 Mayo Foundation
for Medical Education and Research

<40>
Accession Number
2013501749
Title
Post-ablation P wave characteristics correlate with recurrent atrial
fibrillation in the ABCD-AF cohort.
Source
Journal of Interventional Cardiac Electrophysiology. 64(2) (pp 437-442),
2022. Date of Publication: August 2022.
Author
Supanekar N.; Gilge J.L.; Ahmed A.; Patel P.J.
Institution
(Supanekar, Gilge, Ahmed, Patel) St Vincent Medical Group, 8333 Naab Road,
#400, Indianapolis, IN 46260, United States
Publisher
Springer
Abstract
Purpose: Atrial fibrillation (AF) ablation is a common procedure to reduce
cardiovascular morbidity but is limited by recurrence. The objective of
this study was to determine if post-ablation acute surface P wave
morphology and other electrocardiographic parameters correlate with AF
recurrence. <br/>Method(s): The Avoiding Bladder Catheters During AF
ablation (ABCD-AF) trial was a randomized, prospective trial in 160
subjects undergoing AF ablation. The present study examined correlation
between AF recurrence in follow-up and acute post-ablation
electrocardiographic P wave parameters. <br/>Result(s): Median follow-up
was 255 (188, 306) days. The ABCD-AF cohort had a mean age of 62.7 +/-
12.8 with 32.1% being females. Rate of recurrent AF was 35.8%, with a
median time to AF of 135 (109, 182) days. There was no baseline
demographic associated with AF recurrence. There was more AF recurrence in
those with longer follow-up (p = 0.001). Lead 2 PR interval, lead 2 P wave
duration/PR (Pdur/PR), lead V1 PR interval, and lead V1 Pdur/PR were all
significantly associated with recurrent AF (p = 0.03, 0.02, 0.01, 0.01).
Longer PR and shorter Pdur/PR predicted AF recurrence. In a multivariable
model, lead V1 Pdur/PR provided the best predictor of AF recurrence, with
an odds ratio of 0.018 (p = 0.016) per standard deviation change.
<br/>Conclusion(s): Shorter P wave duration combined with longer AV node
delay, as measured by proportion of the PR that the P wave occupies, was
the best predictor of AF recurrence post-ablation.<br/>Copyright &#xa9;
2021, Springer Science+Business Media, LLC, part of Springer Nature.

<41>
Accession Number
2017140152
Title
Prevention of surgical site sternal infections in cardiac surgery: a
two-centre prospective randomized controlled study.
Source
European Journal of Cardio-thoracic Surgery. 51(1) (pp 67-72), 2017. Date
of Publication: 01 Jan 2017.
Author
Schimmer C.; Gross J.; Ramm E.; Morfeld B.-C.; Hoffmann G.; Panholzer B.;
Hedderich J.; Leyh R.; Cremer J.; Petzina R.
Institution
(Schimmer, Morfeld, Leyh) Department of Cardiothoracic and Thoracic
Vascular Surgery, University Hospital Wurzburg, Wurzburg, Germany
(Gross, Ramm, Hoffmann, Panholzer, Cremer, Petzina) Department of
Cardiovascular Surgery, University Hospital Schleswig-Holstein, Campus
Kiel, Kiel, Germany
(Hedderich) Institute of Medical Informatics and Statistics, University
Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Surgical site infection (SSI) of the sternum is a devastating
complication in cardiac surgery. The aim of this prospective randomized
controlled two-centre clinical study was to compare the use of a
gentamicin-collagen sponge (Genta-Coll resorb) and of a
cyanoacrylate-based microbial skin sealant (InteguSeal) on the SSI rate of
the sternum. <br/>METHOD(S): We analysed data from 996 consecutive
patients following isolated coronary artery bypass grafting between 2012
and 2014. The patients were randomized into three groups: standard group
(S-group), Genta-Coll group (G-group) and InteguSeal group (I-group). The
primary study end-point was to analyse the incidence of superficial and
deep sternal SSI. The secondary study end-point was to determine
independent risk factors for an increased SSI rate. <br/>RESULT(S): Of the
996 patients investigated, 332 patients were in S-group, 336 patients in
G-group and 328 patients in I-group. The mean age was 67.7 +/- 9.4 years,
18.6% were women and the overall SSI rate was 6.2% with 2.2% deep sternal
wound infections. SSI rates were 8.3% (S-group), 5.4% (G-group) and 4.9%
(I-group) (P 0.16). Multiple regression analysis demonstrated a
preoperative body mass index (BMI) of >30 kg/m² (P 0.047),
re-thoracotomy for postoperative bleeding (P < 0.001) and sternum
instability (P < 0.001) as independent predictors for an increased SSI
rate. <br/>CONCLUSION(S): The application of InteguSeal or Genta-Coll
resorb had no significant influence on the incidence of the sternal SSI
rate in 996 consecutive cardiac surgery patients but demonstrated a trend
towards a benefit from using these prophylactic approaches. Multiple
regression analysis demonstrated a preoperative BMI of >30
kg/m², re-thoracotomy for bleeding and sternum instability as
independent predictors for an increased sternal SSI rate.<br/>Copyright
&#xa9; The Author 2016. Published by Oxford University Press on behalf of
the European Association for Cardio-Thoracic Surgery. All rights reserved.

<42>
Accession Number
2017140010
Title
Re: Preoperative intra-aortic counterpulsation in high-risk patients
undergoing cardiac surgery: A meta-analysis of randomized controlled
trials.
Source
European Journal of Cardio-thoracic Surgery. 51(1) (pp 193-194), 2017.
Date of Publication: 01 Jan 2017.
Author
Yang S.S.
Institution
(Yang) Department of Anesthesia, McGill University, Montreal, QC, Canada
Publisher
European Association for Cardio-Thoracic Surgery

<43>
Accession Number
2022062623
Title
Long-axis in-plane combined with short-axis out-of-plane technique in
ultrasound-guided arterial catheterization in infants: A randomized
controlled trial.
Source
Journal of Clinical Anesthesia. 85 (no pagination), 2023. Article Number:
111038. Date of Publication: May 2023.
Author
Wang Z.; Guo H.; Shi S.; Xu Y.; Ye M.; Bai L.; Tan Y.; Li Y.; Liu L.
Institution
(Wang, Guo, Shi, Xu, Ye, Bai, Tan, Li, Liu) Department of Anesthesiology,
Children's Hospital of Chongqing Medical University, China
(Xu, Ye, Bai, Tan, Li, Liu) National Clinical Research Center for Child
Health and Disorders, China
(Xu, Ye, Bai, Tan, Li, Liu) Ministry of Education Key Laboratory of Child
Development and Disorders, China
(Xu, Ye, Bai, Tan, Li, Liu) Chongqing Key Laboratory of Pediatrics, China
Publisher
Elsevier Inc.
Abstract
Study objective: To determine whether the long-axis in-plane (LAX-IP)
combined with short-axis out-of-plane (SAX-OOP) technique is more suitable
than modified dynamic needle tip positioning (MDNTP) technique for
ultrasound-guided radial artery catheterization in infants.
<br/>Design(s): A randomized controlled trial. <br/>Setting(s): Department
of Anesthesiology, Children's Hospital of Chongqing Medical University.
<br/>Patient(s): Overall, 72 patients, aged 1-12 months old, who were
primarily undergoing thoracic or cardiac surgery in the Children's
Hospital of Chongqing Medical University between July 1, 2021, and March
31, 2022, were selected. These patients were randomly divided into two
groups: i) the MDNTP group and ii) the LAX-IP combined with SAX-OOP group.
<br/>Intervention(s): Radial artery cannulation in the two groups was
performed using ultrasound-guided MDNTP or LAX-IP combined with SAX-OOP
technique. Measurements: The primary outcome was first-time success rate,
and the secondary outcomes included total success rate, cannulation time,
and incidence of complications. <br/>Main Result(s): In the LAX-IP
combined with SAX-OOP group, the first-time success rate was 75.0% (n =
27), total success rate was 97.2% (n = 35), cannulation time was 91.39 +/-
102.60 s, puncture attempts was 1.5 +/- 1.3 times, and local hematoma was
formed on the first day in one (2.8%) infant. In the MDNTP group, the
first-time success rate was 36.1% (n = 13) (P = 0.001; RR, 2.08; 95%
confidence interval, 1.29-3.34), total success rate was 91.7% (n = 33) (P
= 0.303; RR, 1.06; 95% confidence interval, 0.95-1.19), cannulation time
was 181.00 +/- 146.72 s(P = 0.047; Median difference,-89.61; 95%
confidence interval, -149.12 to -30.10), puncture attempts was 2.3 +/- 1.6
times (P = 0.133; Median difference,-0.81), and local hematoma was formed
on the first day in nine (25%) infants (P = 0.006; RR, 0.11; 95%
confidence interval, 0.01-0.83). No thrombosis occurred in any group.
<br/>Conclusion(s): The ultrasound-guided LAX-IP combined with SAX-OOP
technique for radial arterial catheterization in infants, which was
performed by anesthesia residents, exhibited an increased first-time
success rate, reduced cannulation time, and lower incidence of
complications than the MDNTP technique.<br/>Copyright &#xa9; 2022 Elsevier
Inc.

<44>
Accession Number
2020994555
Title
Revascularization strategies versus optimal medical therapy in chronic
coronary syndrome: A network meta-analysis.
Source
International Journal of Cardiology. 370 (pp 58-64), 2023. Date of
Publication: 01 Jan 2023.
Author
Galli M.; Benenati S.; Zito A.; Capodanno D.; Zoccai G.B.; Ortega-Paz L.;
Iaconelli A.; D'Amario D.; Porto I.; Burzotta F.; Trani C.; De Caterina
R.; Gaudino M.; Escaned J.; Angiolillo D.J.; Crea F.
Institution
(Galli, Burzotta, Trani, Crea) Catholic University of the Sacred Heart,
Rome, Italy
(Galli) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
(Benenati, Porto) Cardiovascular Disease Unit, IRCCS Ospedale Policlinico
San Martino, IRCCS Italian Cardiology Network, Genova, Italy
(Zito, Iaconelli, D'Amario, Burzotta, Trani, Crea) Department of
Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario
Agostino Gemelli IRCCS, Rome, Italy
(Capodanno) Division of Cardiology, Azienda Ospedaliero Universitaria
Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
(Zoccai) Department of Medical-Surgical Sciences and Biotechnologies,
Sapienza University, Latina, Rome, Italy
(Zoccai) Mediterranea Cardiocentro, Napoli, Italy
(Ortega-Paz, Angiolillo) Division of Cardiology, University of Florida
College of Medicine, Jacksonville, FL, United States
(Porto) Cardiovascular Disease Chair, Department of Internal Medicine
(Di.M.I.), University of Genoa, Genoa, Italy
(De Caterina) University of Pisa and University Cardiology Division, Pisa
University Hospital, Pisa, Italy
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York City, NY, United States
(Escaned) Hospital Clinico San Carlos IDISSC, Complutense University,
Madrid, Spain
(De Caterina) Fondazione VillaSerena per la Ricerca, Citta Sant'Angelo,
Pescara, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Background: The impact of myocardial revascularization on outcomes and
prognosis in patients with chronic coronary syndrome (CCS) without left
main (LM) disease or reduced left ventricle ejection fraction (LVEF) may
be influenced by the revascularization strategy adopted. <br/>Method(s):
We performed a network meta-analysis including 18 randomized controlled
trials comparing different revascularization strategies, including
angiography-guided percutaneous coronary intervention (PCI),
physiology-guided PCI and coronary artery bypass graft (CABG), in patients
with CCS without LM disease or reduced LVEF. <br/>Result(s): Compared with
medical therapy, all revascularization strategies were associated with a
reduction of the primary endpoint, as defined in each trial, the extent of
which was modest with angiography-guided PCI (IRR 0.86, 95% CI 0.75-0.99)
and greater with physiology-guided PCI (IRR 0.60, 95% CI 0.47-0.77) and
CABG (IRR 0.58, 95% CI 0.48-0.70). Moreover, angiography-guided PCI was
associated with an increase of the primary endpoint compared to
physiology-guided PCI (IRR 1.43, 95% CI 1.14-1.79) and CABG (IRR 1.49, 95%
CI 1.27-1.74). CABG was the only strategy associated with reduced
myocardial infarction (IRR 0.68, 95% CI 0.52-0.90), cardiovascular death
(IRR 0.76, 95% CI 0.64-0.89), and all-cause death (IRR 0.87, 95% CI
0.77-0.99), but increased stroke (IRR 1.69, 95% CI 1.04-2.76).
<br/>Conclusion(s): In CCS patients without LM disease or reduced LVEF,
physiology-guided PCI and CABG are associated with better outcomes than
angiography-guided PCI. Compared with medical therapy, CABG is the only
revascularization strategy associated with a reduction of myocardial
infarction and death rates, at the cost of higher risk of stroke. Study
registration: This study is registered in PROSPERO
(CRD42022313612).<br/>Copyright &#xa9; 2022 Elsevier B.V.

<45>
Accession Number
2020994377
Title
Meta-Analysis on the Association Between Nutritional Status and Outcomes
After Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. 186 (pp 109-116), 2023. Date of
Publication: 01 Jan 2023.
Author
Kazemian S.; Tavolinejad H.; Rashedi S.; Yarahmadi P.; Farrokhpour H.;
Kolte D.
Institution
(Kazemian, Tavolinejad, Rashedi, Yarahmadi, Farrokhpour) Tehran Heart
Center, Cardiovascular Diseases Research Institute, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Kazemian, Tavolinejad, Rashedi, Yarahmadi, Farrokhpour) Cardiac Primary
Prevention Research Center, Cardiovascular Diseases Research Institute,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Tavolinejad) Non-Communicable Diseases Research Center, Endocrinology and
Metabolism Population Sciences Institute, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Kolte) Cardiology Division, Massachusetts General Hospital and Harvard
Medical School, Boston, Massachusetts, United States
Publisher
Elsevier Inc.
Abstract
Malnutrition is a common co-morbidity among candidates for transcatheter
aortic valve implantation (TAVI). This study aimed to investigate the
association between nutritional status determined by objective nutritional
indices and outcomes of patients who underwent TAVI. We systematically
searched PubMed, Embase, Web of Science, Scopus, and Cochrane Library from
inception until April 18, 2022 to identify studies examining the
association of preprocedural nutritional status with post-TAVI outcomes.
Malnutrition was defined by objective nutritional indices-controlling
nutritional index, nutritional risk index, geriatric nutritional risk
index (GNRI), and prognostic nutritional index (PNI). The primary end
point was 1-year all-cause mortality. The review included 13 observational
studies and 6,785 patients who underwent TAVI. Malnutrition was associated
with a higher risk of 1-year all-cause mortality, as defined by either the
controlling nutritional index (hazard ratio [HR] 2.70, 95% confidence
interval [CI] 1.21 to 6.03, p = 0.015), GNRI (HR 1.79, 95% CI 1.09 to
2.93, p = 0.021), or PNI (HR 1.17, 95% CI 1.11 to 1.23, p <0.001). In the
meta-analysis of adjusted results, lower GNRI was independently associated
with higher 1-year mortality (HR 1.70, 95% CI 1.16 to 2.50, p = 0.006).
Lower GNRI was associated with increased risk of acute kidney injury
(relative risk [RR] 2.21, 95% CI 1.63 to 2.99, p <0.001) and 1-year
cardiovascular mortality (RR 2.50, 95% CI 1.66 to 3.78, p <0.001). Lower
PNI was associated with a higher risk of major vascular complications (RR
2.99, 95% CI 1.38 to 6.51, p = 0.006). In conclusion, baseline
malnutrition, as assessed by objective indices, is associated with worse
outcomes after TAVI. Future studies should focus on the value of
nutritional assessment and interventions to improve nutritional status in
patients who underwent TAVI.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<46>
Accession Number
2016352752
Title
Minimal fresh gas flow sevoflurane anesthesia and postoperative acute
kidney injury in on-pump cardiac surgery: a randomized comparative trial.
Source
Brazilian Journal of Anesthesiology (English Edition). 73(1) (pp 46-53),
2023. Date of Publication: 01 Jan 2023.
Author
Lineburger E.B.; Modolo N.S.P.; Braz L.G.; do Nascimento P.
Institution
(Lineburger) Hospital Sao Jose, Anestesiologia e Controle da Dor, SC,
Criciuma, Brazil
(Modolo, Braz, do Nascimento) Universidade Estadual Paulista "Julio de
Mesquita Filho" (UNESP), Faculdade de Medicina de Botucatu, Departamento
de Especialidades Cirurgicas e Anestesiologia, SP, Sao Paulo, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Background: Compound A is generated by sevoflurane when it reacts with
carbon dioxide absorbers with strong bases at minimal fresh gas flow (FGF)
and is nephrotoxic in animals. No conclusive data has shown increased risk
in humans. The aim of this study was to investigate if minimal FGF
promotes an increase in the incidence of acute kidney injury (AKI) when
compared to high FGF in patients undergoing on-pump cardiac surgery under
sevoflurane anesthesia. <br/>Method(s): Two hundred and four adult
patients scheduled for on-pump cardiac surgery under sevoflurane
anesthesia were randomly allocated to two groups differentiated by FGF:
minimal FGF (0.5 L.min^-1) or high FGF (2.0 L.min^-1).
Baseline creatinine measured before surgery was compared daily to values
assayed on the first five postoperative days, and 24-hour urinary output
was monitored, according to the KDIGO (Kidney Disease Improving Global
Outcomes) guideline to define postoperative cardiac surgery-associated
acute kidney injury (CSA-AKI). Creatinine measurements were also obtained
20 and 120 days after hospital discharge. <br/>Result(s): Postoperative
AKI occurred in 55 patients, 26 patients (29.5%) in the minimal FGF group
and 29 patients (31.5%) in the high FGF group (p = 0.774). Twenty days
after discharge, 11 patients (6.1%) still had CSA-AKI and 120 days after
discharge only 2 patients (1.6%) still had CSA-AKI. <br/>Conclusion(s):
When compared to high FGF, minimal FGF sevoflurane anesthesia during
on-pump cardiac surgery is not associated with increased risk of
postoperative AKI in this population at high risk for renal
injury.<br/>Copyright &#xa9; 2021 Sociedade Brasileira de Anestesiologia

<47>
Accession Number
2020851619
Title
Comparison of subcutaneous analgesic system and epidural analgesia for
postoperative pain control in open pediatric oncology operations: A
randomized controlled trial.
Source
Journal of Pediatric Surgery. 58(1) (pp 153-160), 2023. Date of
Publication: January 2023.
Author
Mehl S.C.; Johnson B.; Patel N.; Todd H.; Vasudevan S.; Nuchtern J.;
Naik-Mathuria B.
Institution
(Mehl, Todd, Vasudevan, Nuchtern, Naik-Mathuria) Michael E DeBakey
Department of Surgery, Baylor College of Medicine, Houston, TX, United
States
(Mehl, Johnson, Vasudevan, Nuchtern, Naik-Mathuria) Department of Surgery,
Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX,
United States
(Patel) Department of Pediatric Anesthesiology, Perioperative and Pain
Medicine, Texas Children's Hospital, Houston, TX, United States
Publisher
W.B. Saunders
Abstract
Purpose: Children undergoing open oncologic surgery can have significant
post-operative pain. The purpose of this trial was to compare a
surgeon-placed subcutaneous analgesic system (SAS) to epidural analgesia.
<br/>Method(s): Single center randomized controlled trial including
children <=18 years undergoing open tumor resection between October 2018
and April 2021. Randomization to SAS or epidural was done preoperatively
and perioperative pain management was standardized. Families were blinded
to the modality. Comparisons of oral morphine equivalents (OME) and pain
scores for three postoperative days, clinical outcome parameters, and
parental satisfaction following unblinding were completed using
non-parametric analyses. <br/>Result(s): Of 36 patients (SAS 18, Epidural
18), median age was 5 years (range <1-17). The Epidural cohort had less
OME demand on postoperative day one (SAS 0.76 mg/kg, Epidural 0.11 mg/kg;
p<0.01) and two (SAS 0.48 mg/kg, Epidural 0.07 mg/kg, p = 0.03). Pain
scores were similar on postoperative days 1-3 (0-2 in both groups). The
Epidural cohort had more device complications (SAS 11%, Epidural 50%; p =
0.03) and higher urinary catheter use (SAS 50%, Epidural 89%; p = 0.03).
More than 80% of parents would use the same device in the future (SAS
100%, Epidural 84%, p = 0.23). <br/>Conclusion(s): For children undergoing
open oncologic abdominal or thoracic surgery, early post-operative pain
control appears to be better with epidural analgesia; however, SAS has
decreased incidence of device complications and urinary catheter use.
Parental satisfaction is excellent with both modalities. SAS could be
considered as an alternative to epidural, especially in settings when
epidural placement is not available or contraindicated. <br/>Type of
Study: Treatment study, Randomized controlled trial. <br/>Level of
Evidence: Level 1.<br/>Copyright &#xa9; 2022

<48>
Accession Number
2018935218
Title
Intraoperative Intravenous Infusion of Esmketamine Has Opioid-Sparing
Effect and Improves the Quality of Recovery in Patients Undergoing
Thoracic Surgery: A Randomized, Double-Blind, Placebo-Controlled Clinical
Trial.
Source
Pain Physician. 25(9) (pp E1389-E1397), 2022. Date of Publication: 01 Dec
2022.
Author
Yuan J.; Chen S.; Xie Y.; Wang Z.; Xing F.; Mao Y.; Wang J.; Yang J.; Li
Y.; Fan X.
Institution
(Yuan, Chen, Xie, Wang, Xing, Mao, Yang, Fan) Department of
Anesthesiology, Pain and Perioperative Medicine, the First Affiliated
Hospital of Zhengzhou University, Henan Province, Zhengzhou, China
(Yuan, Chen, Xie, Wang, Xing, Mao, Yang, Fan) Henan Province International
Joint Laboratory of Pain, Cognition and Emotion, Henan Province,
Zhengzhou, China
(Wang) Massachusetts General Hospital Department of Anesthesia, Critical
Care and Pain Medicine, Harvard Medical School, Boston, MA, United States
(Li) Department of Anesthesiology, Tianjin Medical University General
Hospital, Tianjin Research Institute of Anesthesiology, Tianjin, China
Publisher
American Society of Interventional Pain Physicians
Abstract
Background: Postoperative thoracic surgery is often accompanied by severe
pain, and opioids are a cornerstone of postoperative pain management, but
their use may be limited by many adverse events. Several studies have
shown that the perioperative application of esketamine adjuvant therapy
can reduce postoperative opioid consumption. However, whether esketamine
has an opioid-sparing effect after thoracic surgery is unclear.
<br/>Objective(s): To explore the opioid-sparing effect of different doses
of esketamine infusion during thoracic surgery and its impact on patient
recovery. <br/>Study Design: Randomized controlled study. <br/>Setting(s):
A single-center study with a total of 120 patients. <br/>Method(s):
Patients were randomly allocated to 1 or 3 groups receiving intraoperative
intravenous infusions of esketamine 0.15 mg . kg^-1.
h^-1 (group K1), esketamine 0.25 mg . kg^-1.
h^-1(group K2), or placebo (group C). Postoperative opioid
consumption, and postoperative indicators like extubation time, PACU stay
time, and adverse events were recorded for each group. <br/>Result(s): The
consumption of hydromorphone during the first 24 and 48 postoperative
hours was significantly reduced in patients of group K2 compared to those
of group C and group K1. The time to extubation and post anesthesia care
unit (PACU) stay were significantly shorter in group K2 than in group K1
and group C. The time to first feed and off the bed time after surgery
were shorter in groups K1 and K2 than in group C. Patients in group K2
were significantly satisfied with patient controlled intravenous analgesia
(PCIA) than in groups K1 and C. <br/>Limitation(s): The sample size
calculation was based mainly on the index of hydromorphone consumption.
<br/>Conclusion(s): Intraoperative intravenous esketamine at 0.25 mg .
kg^-1 . h^-1 reduced postoperative opioids consumption
by 34% in postoperative 24 hours and 30% in postoperative 48 hours in
patients undergoing thoracic surgery. It also improved the quality of
perioperative recovery.<br/>Copyright &#xa9; 2022, American Society of
Interventional Pain Physicians. All rights reserved.

<49>
Accession Number
639966150
Title
The Primary Cardiomyopathy of Systemic Sclerosis on Cardiovascular
Magnetic Resonance Imaging.
Source
Arthritis and Rheumatology. Conference: American College of Rheumatology
Convergence, ACR 2022. Philadelphia, PA United States. 74(Supplement 9)
(pp 3034-3036), 2022. Date of Publication: September 2022.
Author
Chhikara S.; Kanda A.; Ismail M.; Ogugua F.; Rouf R.; Ismail K.; Bawaskar
P.; Molitor J.; Shenoy C.
Institution
(Chhikara) University of Minnesota, New York, NY, United States
(Kanda, Ismail, Ogugua, Rouf, Ismail, Bawaskar, Molitor, Shenoy)
University of Minnesota, Minneapolis, MN, United States
Publisher
John Wiley and Sons Inc.
Abstract
Background/Purpose: Cardiac disease in systemic sclerosis (SSc) may be
primary or secondary to coronary artery disease, pulmonary, or renal
disease. The prevalence of the primary cardiomyopathy of SSc is unknown.
Cardiovascular magnetic resonance imaging (CMR) can help accurately
determine the presence of, and the cause of cardiomyopathy. We aimed to
study the prevalence, the CMR features, and the prognostic implications of
the primary cardiomyopathy of SSc. <br/>Method(s): We performed a
retrospective cohort study of consecutive patients with SSc meeting the
2013 ACR/EULAR classification criteria who had a clinical CMR for
suspected cardiac involvement between 2005 and 2020 at our institution. We
defined the primary cardiomyopathy of SSc based on a recent systematic
literature review and preliminary data-driven, expert consensus-based
definition proposed under the auspices of the World Scleroderma Foundation
and the Heart Failure Association of the European Society of Cardiology.
We investigated the prevalence and the CMR features of the primary
cardiomyopathy of SSc, and its association with the long-term incidence of
death or major adverse cardiac events (MACE): heart failure
hospitalization, ventricular assist device implantation, heart
transplantation, and sustained ventricular tachycardia. <br/>Result(s): Of
130 patients with SSc who had CMR at a median of 3.6 years after
diagnosis, 80% were women, the median age was 58 years, 28% had diffuse
cutaneous SSc, 34% had pulmonary arterial hypertension, and 54% had
interstitial lung disease. On CMR, 22% had an abnormal left ventricular
ejection fraction (LVEF), and 40% had late gadolinium enhancement (LGE).
Based on abnormal LVEF and/or LGE not attributable to other causes and/or
complications, the prevalence of the primary cardiomyopathy of SSc was
21%. A third of these patients had a distinct LGE phenotype which was
widespread subendocardial LVLGE in a pattern that always involved the
lateral segments, but in some cases, also extended to other segments,
without respecting coronary artery territory distributions, and sometimes
also involving the right ventricular aspect of the septum, and the right
ventricular free wall. Over a median follow-up of 3.6 years after the CMR,
patients with the primary cardiomyopathy of SSc had a greater incidence of
death or MACE on Kaplan-Meier analyses (log-rank p=0.035). On
multivariable Cox proportional hazards regression analyses, the primary
cardiomyopathy of SSc was independently associated with greater long-term
death or MACE after adjustment for age, pulmonary hypertension,
interstitial lung disease, and renal dysfunction (hazard ratio 2.01; 95%
confidence interval 1.03-3.92; p=0.041). Prevalence, CMR features, and
prognostic implications of the primary cardiomyopathy of SSc.
Top-Prevalence of the primary cardiomyopathy of SSc. Middle-CMR features
of the primary cardiomyopathy of SSc. Bottom-Prognostic implications of
the primary cardiomyopathy of SSc. <br/>Conclusion(s): Among consecutive
patients with SSc meeting the 2013 ACR/EULAR classification criteria who
had clinical CMR for suspected cardiac involvement, the prevalence of the
primary cardiomyopathy of SSc was 21%. The primary cardiomyopathy of SSc
was independently associated with a greater long-term incidence of death
or MACE.

<50>
Accession Number
639963592
Title
Risk of Extended Major Adverse Cardiovascular Event Endpoints with
Tofacitinib vs TNF Inhibitors in Patients with Rheumatoid Arthritis: A
Post Hoc Analysis of a Phase 3b/4 Randomized Safety Study.
Source
Arthritis and Rheumatology. Conference: American College of Rheumatology
Convergence, ACR 2022. Philadelphia, PA United States. 74(Supplement 9)
(pp 4542-4546), 2022. Date of Publication: September 2022.
Author
Buch M.H.; Bhatt D.L.; Charles-Schoeman C.; Giles J.T.; Mikuls T.R.; Koch
G.; Ytterberg S.; Nagy E.; Jo H.; Kwok K.; Connell C.A.; Masri K.R.;
Yndestad A.
Institution
(Buch) Centre for Musculoskeletal Research, Division of Musculoskeletal
and Dermatological Sciences, Faculty of Biology, Medicine and Health,
University of Manchester, NIHR Manchester Biomedical Research Centre,
Manchester, United Kingdom
(Bhatt) Division of Cardiovascular Medicine, Brigham and Women's Hospital
and Harvard Medical School, Boston, MA, United States
(Charles-Schoeman) Division of Rheumatology, Department of Medicine,
University of California, Los Angeles, CA, United States
(Giles) Division of Rheumatology, Columbia University Vagelos College of
Physicians and Surgeons, New York, NY, United States
(Mikuls) Division of Rheumatology, University of Nebraska Medical Center
and VA Nebraska-Western Iowa Health Care System, Omaha, NE, United States
(Koch) Department of Biostatistics, University of North Carolina at Chapel
Hill, Chapel Hill, NC, United States
(Ytterberg) Division of Rheumatology, Mayo Clinic, Rochester, MN, United
States
(Nagy) Pfizer Ltd, Tadworth, Surrey, United Kingdom
(Jo, Kwok) Pfizer Inc, New York, NY, United States
(Connell) Pfizer Inc, Groton, CT, United States
(Masri) Pfizer Inc, Collegeville, PA, United States
(Yndestad) Pfizer Inc, Oslo, Norway
Publisher
John Wiley and Sons Inc.
Abstract
Background/Purpose: ORAL Surveillance (NCT02092467; a post-authorization
safety study of tofacitinib 5 and 10 mg twice daily [BID] vs TNF
inhibitors [TNFi]) found higher risk of major adverse cardiovascular (CV)
events (MACE) and venous thromboembolism (VTE) with tofacitinib vs TNFi.1
A post hoc analysis of ORAL Surveillance found higher risk of MACE with
tofacitinib vs TNFi in patients (pts) with history of atherosclerotic CV
disease (ASCVD); risk did not appear different with tofacitinib 5 mg BID
vs TNFi in pts without history of ASCVD.2 This post hoc analysis expands
on 3-point MACE (MACE-3; a composite of CV death, and non-fatal MI and
stroke) by evaluating risk of all adjudicated CV events as part of
extended MACE endpoints in ORAL Surveillance with tofacitinib vs TNFi.
<br/>Method(s): Pts with RA aged >=50 years and with >=1 additional CV
risk factor received tofacitinib 5 mg (N=1,455) or 10 mg (N=1,456) BID, or
TNFi (N=1,451). Extended MACE endpoints were based on MACE-3 and
sequentially added adjudicated ischemic CV events (ie hospitalization for
unstable angina [MACE-4], coronary revascularization procedures [MACE-5],
transient ischemic attack [MACE-6], and peripheral vascular disease
[MACE-7]), hospitalization for heart failure (HF; MACE-8), and VTE (MACE-8
plus VTE). Hazard ratios (HRs; time to first event analysis) were
evaluated with tofacitinib vs TNFi for extended MACE endpoints (risk
period up to first event of aggregated CV events) and for individual
component endpoints (risk period up to first event of individual CV
events), separately. Subgroup analyses by history of ASCVD were performed.
<br/>Result(s): For extended endpoints of adjudicated ischemic CV events
(ie MACE-4 to-7), HRs with tofacitinib vs TNFi were similar to HRs for
MACE-3 (Fig 1). Risk of MACE-8 was similar with combined tofacitinib doses
vs TNFi (HR [95% confidence intervals (CI)] 1.08 [0.81, 1.44]). Risk of
MACE-8 plus VTE was similar with tofacitinib 5 mg BID vs TNFi (HR 1.12
[0.82, 1.52]), but higher with tofacitinib 10 mg BID vs TNFi (HR 1.38
[1.02, 1.85]) (Fig 1). Risk of MI appeared higher with tofacitinib vs TNFi
(HR 1.74 [0.89, 3.41], combined doses), but risk of other individual
adjudicated CV events was generally similar (Fig 2). Across extended MACE
definitions (ie up to MACE-8), risk appeared higher with tofacitinib vs
TNFi in pts with history of ASCVD (Fig 3). <br/>Conclusion(s): In ORAL
Surveillance, risk of a composite of all ischemic CV events and HF (ie
MACE-8) did not appear different with tofacitinib vs TNFi. However, across
extended MACE endpoints risk was numerically higher with tofacitinib vs
TNFi in pts with a history of ASCVD. The totality of CV risk (ie MACE-8
plus VTE) was higher with tofacitinib 10 mg BID vs TNFi, driven by an
increase in VTE events. Limitations include low numbers of individual CV
events and not considering severity/frequency of multiple events. These
data highlight the need for a better understanding of risk of individual
CV events in pts with RA.

<51>
Accession Number
2022080940
Title
Cardiac surgery, ICU sedation, and delirium: Is dexmedetomidine the silver
bullet?.
Source
Current Opinion in Anaesthesiology. 36(1) (pp 50-56), 2023. Date of
Publication: 01 Feb 2023.
Author
Smith W.; Whitlock E.L.
Institution
(Smith, Whitlock) Department of Anesthesia and Perioperative Care,
University of California, San Francisco, San Francisco, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewDelirium is a marker of acute brain insufficiency and a
harbinger of poor outcomes and increased healthcare costs. Despite success
preventing delirium by nonpharmacologic measures, the incidence in the
postcardiac surgical ICU population remains high. Dexmedetomidine, a
selective alpha-2 agonist, is a plausible preventive agent with sedative,
anxiolytic, analgesic, sympatholytic and anti-inflammatory properties, and
is the subject of very active study in cardiac surgery populations.Recent
findingsRecent trials, including DEXACET (2019), DECADE (2020), LOWDEXDEL
(2021), and DIRECT (2022) individually, failed to show a benefit for
dexmedetomidine and highlighted associated risks. Meta-analyses have
offered conflicting results, highlighting the complexity of delirium, and
likely interaction of multiple etiological pathways; those that concluded
benefit often were driven by trials at high risk of bias. Meta-analyses
excluding biased trials currently suggest no benefit for dexmedetomidine
over control in unselected cardiac surgical populations.SummaryAlthough
using dexmedetomidine to prevent delirium in unselected cardiac surgical
patients is not supported by current evidence, there remains hope that it
may offer benefits in highly selected populations, and further trials are
ongoing.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins. All
rights reserved.

<52>
Accession Number
2022080936
Title
Spinal drain for aortic aneurysm repairs: Tool or toy?.
Source
Current Opinion in Anaesthesiology. 36(1) (pp 30-34), 2023. Date of
Publication: 01 Feb 2023.
Author
Bastug N.; Worrall E.; Webb L.; Larson R.
Institution
(Bastug, Worrall, Webb) Department of Anesthesiology
(Larson) Department of Vascular Surgery, Virginia Commonwealth University
Health System, Richmond, VA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewSpinal cord injury (SCI) is one of the biggest
complications in open and endovascular aortic repairs. Historically,
cerebrospinal fluid drains (CSFD) have been one of the most effective
modalities in reducing SCI and one of the most studied. CSFD placement
also carries its' own set of procedural risks. This editorial intends to
evaluate recent literature to determine whether CSFDs remain a valuable
tool in aortic repair.Recent findingsAs the surgical management of
thoracic aortic aneurysms has evolved, there has been an increasing number
of endovascular repairs. Current recommendations emphasize prophylactic
CSFD placement in endovascular repair cases deemed 'high risk.' However,
several meta-analyses differ on whether prophylactic CSFD placement
reduced the risk of SCI. The incidence of SCI decreased between 2014 and
2018, despite a similar rate of prophylactic CSFD placement suggesting
other techniques are being performed and may be effective in spinal cord
protection as well.SummaryThere has been conflicting data on whether CSFDs
have a role in reducing the risk of SCI in endovascular aortic repair.
Some studies suggest that there is no benefit to placement while others
suggest that routine prophylactic drains should be placed for all
endovascular cases. Despite this, efforts have been made to selectively
place CSFDs in those patients deemed at 'high risk' for SCI. CSFDs also
remain a part of rescue treatment for postoperative SCI. This suggests
that CSFDs continue to be a valuable tool that we need to better
comprehend. Future research is necessary to better understand how patient
risk factors can be balanced with perioperative management to help
identify patients who may benefit from CSFD placement.<br/>Copyright
&#xa9; 2023 Authors. All rights reserved.

<53>
Accession Number
2022080934
Title
Surgical left atrial appendage occlusion with concomitant cardiac surgical
procedures: Exacerbating heart failure or preventing stroke.
Source
Current Opinion in Anaesthesiology. 36(1) (pp 20-24), 2023. Date of
Publication: 01 Feb 2023.
Author
Mandell D.R.; Boisen M.L.
Institution
(Mandell, Boisen) Department of Anesthesiology and Perioperative Medicine,
University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewThe left atrial appendage (LAA) is a common source of
thromboembolic stroke in patients with atrial fibrillation. Current
guidelines recommend consideration of surgical LAA occlusion concomitant
with other cardiac surgical procedures based mostly on observational data
and a few small trials. Recently published results of several large
retrospective studies and one prospective trial are reviewed herein.Recent
findingsLarge retrospective studies using quality and administrative
databases show mixed results with regard to efficacy of surgical LAA
occlusion in preventing stroke, although most showed stroke reduction in
patients with a history of atrial fibrillation (AF). Safety concerns have
been raised based on nonrandomized data suggesting increased
complications. A recent large, multicenter international randomized study
with 3-year follow-up demonstrated significant reduction in stroke
following LAA occlusion with no differences in death or heart failure
exacerbations.SummaryMost patients with AF undergoing another cardiac
surgical procedure should be considered for concomitant LAA occlusion as
part of a heart team discussion. The choice of surgical closure technique
is critical. There is insufficient data to recommend LAA occlusion as an
alternative to anticoagulation.<br/>Copyright &#xa9; 2023 Authors. All
rights reserved.

<54>
Accession Number
2019682806
Title
Outcomes of Myocardial Revascularization in Diabetic Patients With Left
Main Coronary Artery Disease: A Multicenter Observational Study From Three
Gulf Countries.
Source
Cardiovascular Revascularization Medicine. 46 (pp 52-61), 2023. Date of
Publication: January 2023.
Author
Daoulah A.; Elfarnawany A.; Al Garni T.; Hersi A.S.; Alshehri M.;
Almahmeed W.; Yousif N.; Abuelatta R.; Alasmari A.; Elsheikh-Mohamed N.E.;
Alzahrani B.; Ghani M.A.; Amin H.; Hashmani S.; Hiremath N.; Alshali K.Z.;
Elmahrouk Y.; Kazim H.M.; Refaat W.; Selim E.; Jamjoom A.; Feteih M.N.;
El-Sayed O.; Al-Faifi S.M.; Dahdouh Z.; Aithal J.; Ibrahim A.M.; Elganady
A.; Qutub M.A.; Alama M.N.; Abohasan A.; Hassan T.; Balghith M.; Hussien
A.F.; Abdulhabeeb I.A.M.; Ahmad O.; Ramadan M.; Alqahtani A.H.; Abumelha
B.K.; Qenawi W.; Shawky A.; Ghonim A.A.; Elmahrouk A.; Alhamid S.;
Maghrabi M.; Haddara M.M.; Aljohar A.; Hurley W.T.; Alshahrani S.S.; Lotfi
A.
Institution
(Daoulah, Elfarnawany, Alasmari, Elsheikh-Mohamed, Jamjoom, El-Sayed,
Elmahrouk) Department of Cardiovascular Medicine, King Faisal Specialist
Hospital & Research Center, Jeddah, Saudi Arabia
(Al Garni, Alzahrani) Department of Cardiology, Prince Sultan Cardiac
Center, Riyadh, Saudi Arabia
(Hersi, Aljohar) Department of Cardiac Sciences, King Fahad Cardiac
Center, King Saud University, Riyadh, Saudi Arabia
(Alshehri, Qenawi, Shawky) Department of Cardiology, Prince Khaled Bin
Sultan Cardiac Center, Khamis Mushait, Saudi Arabia
(Almahmeed, Hashmani, Hiremath) Heart & Vascular Institute, Cleveland
Clinic Abu Dhabi, United Arab Emirates
(Yousif, Amin) Department of Cardiology, Mohammed Bin Khalifa Specialist
Cardiac Center, Awali, Bahrain
(Abuelatta, Ghani) Department of Cardiology, Madinah Cardiac Center,
Madinah, Saudi Arabia
(Alshali) Department of Medicine, Faculty of Medicine, King Abdulaziz
University, Jeddah, Saudi Arabia
(Elmahrouk) Faculty of Medicine, Tanta University, Tanta, Egypt
(Kazim, Selim, Maghrabi) Department of Cardiology, Alhada Armed Forces
Hospital, Taif, Saudi Arabia
(Refaat, Ramadan) Department of Cardiology, Prince Sultan Cardiac Center,
Al Hassa, Saudi Arabia
(Feteih, Al-Faifi) Department of Medicine, King Faisal Specialist Hospital
& Research Center, Jeddah, Saudi Arabia
(Dahdouh, Ahmad) Department of Cardiovascular Medicine, King Faisal
Specialist Hospital & Research Center, Riyadh, Saudi Arabia
(Aithal) Department of Cardiology, Yas Clinic, Khalifa City A, Abu Dhabi,
United Arab Emirates
(Ibrahim) Department of Cardiology, Saudi German Hospital, Jeddah, Saudi
Arabia
(Elganady) Department of Cardiology, Dr Erfan and Bagedo General Hospital,
Jeddah, Saudi Arabia
(Qutub, Alama, Ghonim) Cardiology Center of Excellence, Department of
Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
(Abohasan) Department of Cardiology, Prince Sultan Cardiac Center, Qassim,
Saudi Arabia
(Hassan) Department of Cardiology, Bugshan General Hospital, Jeddah, Saudi
Arabia
(Balghith) King Abdulaziz Cardiac Center, College of Medicine, King Saud
Bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
(Hussien) Department of Cardiology, International Medical Center, Jeddah,
Saudi Arabia
(Abdulhabeeb) Department of Cardiology, King Abdulaziz Specialist
Hospital, Al Jawf, Saudi Arabia
(Alqahtani) Department of Emergency Medicine, King Abdulaziz Medical City,
Riyadh, Saudi Arabia
(Abumelha) Department of Family Medicine, King Abdulaziz Medical City,
National Guard Hospital, Riyadh, Saudi Arabia
(Elmahrouk) Department of Cardiothoracic Surgery, Tanta University, Tanta,
Egypt
(Alhamid) Department of Emergency Medicine, King Fahad Medical City,
Riyadh, Saudi Arabia
(Haddara) Department of Anesthesia, King Faisal Specialist Hospital &
Research Center, Riyadh, Saudi Arabia
(Hurley) Department of Emergency Medicine, Cleveland Clinic Foundation,
Cleveland, OH 44195, United States
(Alshahrani) Department of Emergency Medicine, King Faisal Specialist
Hospital & Research Center, Riyadh, Saudi Arabia
(Lotfi) Department of Cardiovascular Medicine, Baystate Medical Center,
Tufts University School of Medicine, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Real-world data for managing patients with diabetes and left
main coronary artery (LMCA) disease are scarce. We compared percutaneous
coronary intervention (PCI) outcomes versus coronary artery bypass
grafting (CABG) in diabetes and LMCA disease patients. <br/>Method(s): We
retrospectively studied patients with LMCA presented to 14 centers from
2015 to 2019. The study included 2138 patients with unprotected LMCA
disease; 1468 (68.7 %) had diabetes. Patients were grouped into; diabetes
with PCI (n = 804) or CABG (n = 664) and non-diabetes with PCI (n = 418)
or CABG (n = 252). <br/>Result(s): In diabetes, cardiac (34 (5.1 %) vs. 22
(2.7 %); P = 0.016), non-cardiac (13 (2 %) vs. 6 (0.7 %); P = 0.027) and
total hospital mortality (47 (7.1 %) vs. 28 (3.5 %); P = 0.0019),
myocardial infarction (45 (6.8 %) vs. 11 (1.4 %); P = 0.001),
cerebrovascular events (25 (3.8 %) vs. 12 (1.5 %); P = 0.005) and minor
bleeding (65 (9.8 %) vs. 50 (6.2 %); P = 0.006) were significantly higher
in CABG patients compared to PCI; respectively. The median follow-up time
was 20 (10-37) months. In diabetes, total mortality was higher in CABG (P
= 0.001) while congestive heart failure was higher in PCI (P = 0.001).
There were no differences in major adverse cerebrovascular events and
target lesion revascularization between PCI and CABG. Predictors of
mortality in diabetes were high anatomical SYNTAX, peripheral arterial
disease, chronic kidney disease, and cardiogenic shock.
<br/>Conclusion(s): In this multicenter retrospective study, we found no
significant difference in clinical outcomes during the short-term
follow-up between PCI with second-generation DES and CABG except for lower
total mortality and a higher rate of congestive heart failure in PCI group
of patients. Randomized trials to characterize patients who could benefit
from each treatment option are needed.<br/>Copyright &#xa9; 2022 Elsevier
Inc.

<55>
Accession Number
2022081377
Title
Methylprednisolone for Heart Surgery in Infants - A Randomized, Controlled
Trial.
Source
New England Journal of Medicine. 387(23) (pp 2138-2149), 2022. Date of
Publication: 08 Dec 2022.
Author
Hill K.D.; Kannankeril P.J.; Jacobs J.P.; Baldwin H.S.; Jacobs M.L.;
O'Brien S.M.; Bichel D.P.; Graham E.M.; Blasiole B.; Resheidat A.; Husain
A.S.; Kumar S.R.; Kirchner J.L.; Gallup D.S.; Turek J.W.; Bleiweis M.;
Mettler B.; Benscoter A.; Wald E.; Karamlou T.; Van Bergen A.H.; Overman
D.; Eghtesady P.; Butts R.; Kim J.S.; Scott J.P.; Anderson B.R.; Swartz
M.F.; McConnell P.I.; Vener D.F.; Li J.S.
Institution
(Hill, Kannankeril, Jacobs, Baldwin, Kumar, Kirchner, Wald, Li) Duke
Pediatric and Congenital Heart Center, Durham, NC, United States
(Jacobs) Duke Clinical Research Institute, Durham, NC, United States
(O'Brien) Vanderbilt University Medical Center, Nashville, United States
(Bichel) The University of Florida Congenital Heart Center, Gainesville,
United States
(Graham) Johns Hopkins University School of Medicine, Baltimore, United
States
(Blasiole) The Medical University of South Carolina, Charleston, United
States
(Resheidat) The Upmc Children's Hospital of Pittsburgh, Pittsburgh, United
States
(Husain) The Section of Pediatric Cardiac Anesthesiology, Texas Children's
Hospital, Department of Anesthesiology, Baylor College of Medicine,
Houston, United States
(Gallup) The Division of Cardiology, Department of Pediatrics, University
of Texas Southwestern Medical Center, Dallas, United States
(Turek) The University of Utah-Primary Children's Hospital, Salt Lake
City, United States
(Bleiweis) The University of Southern California, The Heart Institute,
Children's Hospital of Los Angeles, Los Angeles, United States
(Karamlou) The University of Cincinnati, Cincinnati Children's Hospital
Medical Center, Cincinnati, United States
(Mettler, Vener) The Division of Pediatric Cardiac Surgery, Heart Vascular
and Thoracic Institute, Cleveland Clinic Children's, Cleveland, United
States
(Benscoter) The Department of Cardiothoracic Surgery, Nationwide
Children's Hospital, Ohio State University, Columbus, OH, United States
(Overman) Ann and Robert H. Lurie Children's Hospital of Chicago,
Northwestern University Feinberg School of Medicine, Chicago, United
States
(Anderson) The Advocate Children's Heart Institute, Advocate Children's
Hospital, Division of Pediatric Cardiac Critical Care, Oak Lawn, IL,
United States
(McConnell) Division of Cardiovascular Surgery, Children's Minnesota,
Minneapolis, United States
(Butts) Section of Pediatric Cardiothoracic Surgery, Washington University
School of Medicine, St. Louis, United States
(Van Bergen) The Division of Cardiology, Department of Pediatrics, Heart
Institute, Children's Hospital Colorado, University of Colorado School of
Medicine, Aurora, United States
(Eghtesady) Children's Wisconsin, Medical College of Wisconsin, Milwaukee,
United States
(Swartz) The Division of Pediatric Cardiology, New York-Presbyterian
Hospital, Columbia University Irving Medical Center, New York, United
States
(Kim, Scott) The University of Rochester Medical Center, Rochester, NY,
United States
Publisher
Massachussetts Medical Society
Abstract
Background Although perioperative prophylactic glucocorticoids have been
used for decades, whether they improve outcomes in infants after heart
surgery with cardiopulmonary bypass is unknown. Methods We conducted a
multicenter, prospective, randomized, placebo-controlled, registry-based
trial involving infants (<1 year of age) undergoing heart surgery with
cardiopulmonary bypass at 24 sites participating in the Society of
Thoracic Surgeons Congenital Heart Surgery Database. Registry data were
used in the evaluation of outcomes. The infants were randomly assigned to
receive prophylactic methylprednisolone (30 mg per kilogram of body
weight) or placebo, which was administered into the cardiopulmonary-bypass
pump-priming fluid. The primary end point was a ranked composite of death,
heart transplantation, or any of 13 major complications. Patients without
any of these events were assigned a ranked outcome based on postoperative
length of stay. In the primary analysis, the ranked outcomes were compared
between the trial groups with the use of odds ratios adjusted for
prespecified risk factors. Secondary analyses included an unadjusted odds
ratio, a win ratio, and safety outcomes. Results A total of 1263 infants
underwent randomization, of whom 1200 received either methylprednisolone
(599 infants) or placebo (601 infants). The likelihood of a worse outcome
did not differ significantly between the methylprednisolone group and the
placebo group (adjusted odds ratio, 0.86; 95% confidence interval [CI],
0.71 to 1.05; P=0.14). Secondary analyses (unadjusted for risk factors)
showed an odds ratio for a worse outcome of 0.82 (95% CI, 0.67 to 1.00)
and a win ratio of 1.15 (95% CI, 1.00 to 1.32) in the methylprednisolone
group as compared with the placebo group, findings suggestive of a benefit
with methylprednisolone; however, patients in the methylprednisolone group
were more likely than those in the placebo group to receive postoperative
insulin for hyperglycemia (19.0% vs. 6.7%, P<0.001). Conclusions Among
infants undergoing surgery with cardiopulmonary bypass, prophylactic use
of methylprednisolone did not significantly reduce the likelihood of a
worse outcome in an adjusted analysis and was associated with
postoperative development of hyperglycemia warranting insulin in a higher
percentage of infants than placebo. <br/>Copyright &#xa9; 2022
Massachusetts Medical Society.

<56>
Accession Number
2022087792
Title
The Analgesic Effects of the Addition of Intravenous Ibuprofen to a
Multimodal Analgesia Regimen for Pain Management After Pediatric Cardiac
Surgery: A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Abdelbaser I.; Abo-Zeid M.; Hayes S.; Taman H.I.
Institution
(Abdelbaser, Abo-Zeid, Hayes, Taman) Department of Anesthesia and Surgical
Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Publisher
W.B. Saunders
Abstract
Objective: Intravenous ibuprofen is used to control fever and pain. This
study aimed to assess the analgesic effects of the addition of intravenous
ibuprofen to a multimodal analgesia regimen for pain management after
pediatric cardiac surgery. <br/>Design(s): A randomized, controlled,
double-blinded, superiority study. <br/>Setting(s): University hospital.
<br/>Participant(s): Seventy-eight pediatric patients who underwent open
cardiac surgery using midline sternotomy incision were screened for
eligibility; 10 patients were excluded, leaving 68 patients (34 patients
in the ibuprofen group and 34 patients in the control group) for final
data analysis. <br/>Intervention(s): Patients were randomly allocated to
either the ibuprofen group, in which the patient received intravenous
ibuprofen infusion of 10 mg/kg/6 hours for 24 hours, or the control group,
in which the patient received a placebo 0.9% saline. <br/>Measurements and
Main Results: The primary endpoint was the 24-hour postoperative fentanyl
consumption, and the secondary endpoints were postoperative modified
objective pain score and the incidence of ibuprofen-related side effects
(eg, vomiting, epigastric pain, bleeding, and renal dysfunction). The mean
total fentanyl consumption (mug/kg) during the first postoperative 24
hours after extubation was significantly lower (p<0.001) in the ibuprofen
group (3.5 +/- 1.3) than the control group (5.1 +/- 1.4). The median
postoperative modified objective pain score was significantly lower (p <
0.05) in the ibuprofen group than the control group at 0 hours, 2 hours,
12 hours, 16 hours, 20 hours, and 24 hours postoperatively. Ibuprofen did
not cause significant increases in the incidences of bleeding, epigastric
pain, and vomiting. Postoperative renal dysfunction was not reported in
any patient. <br/>Conclusion(s): The addition of intravenous ibuprofen to
a multimodal analgesia regimen for pain management after pediatric cardiac
surgery improved postoperative analgesia in terms of reduction of opioid
consumption and pain scores.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<57>
Accession Number
2022079986
Title
Chiari network for the interventional cardiologist: A hidden enemy at the
heart gate - A systematic review of the literature.
Source
International Journal of Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Ali H.; Lupo P.; Cristiano E.; Nicoli L.; Foresti S.; De Ambroggi G.;
Anderson R.H.; De Lucia C.; Turturiello D.; Paganini E.M.; Bessi R.;
Farghaly A.A.A.; Butera G.; Cappato R.
Institution
(Ali, Lupo, Cristiano, Nicoli, Foresti, De Ambroggi, De Lucia,
Turturiello, Paganini, Bessi, Farghaly, Cappato) Arrhythmia &
Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan,
Italy
(Anderson) Institute of Genetic Medicine, Newcastle University, Newcastle
Upon Tyne, United Kingdom
(Farghaly) Cardiovascular Department, Assiut University, Assiut, Egypt
(Butera) Department of Paediatric Cardiology, Cardiac Surgery and Heart
Lung Transplantation, ERN GUARD HEART: Bambin Gesu Hospital and Research
Institute, IRCCS, Rome, Italy
(Butera) Department of Paediatric and Adult Congenital Heart Disease,
Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation
Trust, London, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Background: This study aimed to collect and analyze the literature data
regarding Chiari network (CN) and other right atrium (RA) remnants
comprising the Eustachian and Thebesian valves (EV, ThV) as a potential
entrapment site during different percutaneous cardiac procedures (PCP).
<br/>Methods and Results: A systematic search was conducted using Pubmed
and Embase databases following the PRISMA guidelines to obtain available
data concerning PCP associated with entrapment of inserted materials
within CN-EV-ThV. The final analysis included 41 patients who underwent
PCP with reported material entrapment within these RA remnants. The PCP
was atrial septal defect (ASD)/patent foramen ovale (PFO) closure,
catheter ablation, and pacemaker/defibrillator implantation in 44%, 22%,
and 17% of patients, respectively. The entrapped materials were ASD/PFO
devices, multipolar electrophysiology catheters, passive-fixation pacing
leads, and J-guidewires in about 30%, 20%, 15%, and 10% of patients,
respectively. Intraprocedural transthoracic, transoesophageal and
intracardiac echocardiography showed sensitivity to reveal these
structures of 20%, ~95%, and 100%, respectively. A percutaneous approach
successfully managed 70% of patients, while cardiovascular surgery was
required in 20% and three patients died (7.3%). <br/>Conclusion(s): CN and
other RA remnants may cause entrapment of various devices or catheters
during PCP requiring right heart access. The percutaneous approach, guided
by intraprocedural imaging, appears safe and effective in managing most
patients. Prevention includes recognizing these anatomical structures at
baseline cardiac imaging and intraprocedural precautions. Further studies
are needed to analyze the actual incidence of this condition, its clinical
impact and appropriate management.<br/>Copyright &#xa9; 2022 Elsevier B.V.

<58>
Accession Number
2021349065
Title
Effects of ferric carboxymaltose on hemoglobin level after cardiac
surgery: A randomized controlled trial.
Source
Anaesthesia Critical Care and Pain Medicine. 42(1) (no pagination), 2023.
Article Number: 101171. Date of Publication: February 2023.
Author
Houry M.; Tohme J.; Sleilaty G.; Jabbour K.; Bou Gebrael W.; Jebara V.;
Madi-Jebara S.
Institution
(Houry, Tohme, Jabbour, Bou Gebrael, Madi-Jebara) Department of Anesthesia
and Critical Care, Hotel-Dieu de France hospital, Universite Saint-Joseph,
Beirut, Lebanon
(Sleilaty, Jebara) Department of Cardiovascular and Thoracic Surgery,
Hotel-Dieu de France hospital, Universite Saint-Joseph, Beirut, Lebanon
(Sleilaty) Clinical Research Center, Faculty of Medicine, Universite
Saint-Joseph, Beirut, Lebanon
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Perioperative anemia is common in cardiac surgery. Few studies
investigated the effect of postoperative intravenous (IV) iron
supplementation and were mostly inconclusive. <br/>Method(s): Design: A
randomized single-center, double-blind, placebo-controlled, parallel-group
trial. <br/>Participant(s): 195 non-anemic patients were recruited from
December 2018 to December 2020: 97 patients received 1 g of ferric
carboxymaltose (FCM) and 98 patients received 100 mL of physiological
serum on postoperative day 1. Measurements: hemoglobin levels,
reticulocyte count, serum iron, serum ferritin, and transferrin saturation
were measured at induction of anesthesia, postoperative days 1, 5, and 30.
Transfusion rate, duration of mechanical ventilation, critical care unit
length of stay, and side effects associated with IV iron administration
were measured. The primary outcome was hemoglobin level on day 30.
Secondary outcomes included iron balance, transfused red cell packs, and
critical care unit length of stay. <br/>Result(s): At day 30, the
hemoglobine level was higher in the FCM group than in the placebo group
(mean 12.9 +/- 1.2 vs. 12.1 +/- 1.3 g/dL (95%CI 0.41-1.23, p-value
<0.001)). Patients in the FCM group received fewer blood units (median
1[0-2] unit vs. 2 [0-3] units, p-value = 0.037) and had significant
improvement in iron balance compared to the control group. No side effects
associated with FCM administration were reported. <br/>Conclusion(s): In
this randomized controlled trial, administration of FCM on postoperative
day 1 in non-anemic patients undergoing cardiac surgery increased
hemoglobin levels by 0.8 g/dL on postoperative day 30, leading to reduced
transfusion rate, and improved iron levels on postoperative day 5 and 30.
Clinical trial registry number: NCT03759964.<br/>Copyright &#xa9; 2022
Societe francaise d'anesthesie et de reanimation (Sfar)

<59>
Accession Number
2021965966
Title
Meta-Analysis Comparing Valve-in-Valve Transcatheter Mitral Valve
Replacement Versus Redo Surgical Mitral Valve Replacement in Degenerated
Bioprosthetic Mitral Valve.
Source
American Journal of Cardiology. 189 (pp 98-107), 2023. Date of
Publication: 15 Feb 2023.
Author
Ismayl M.; Abbasi M.A.; Mostafa M.R.; Aboeata A.; Vora A.N.; Ben-Dor I.;
Anavekar N.S.; Goldsweig A.M.
Institution
(Ismayl) Division of XXX, Department of Internal Medicine, Creighton
University School of Medicine, Omaha, NE, United States
(Abbasi, Anavekar) Division of Cardiovascular Medicine, Department of
Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
(Mostafa) Department of Internal Medicine, Rochester Regional/Unity
Hospital, Rochester, New York, United States
(Aboeata) Division of Cardiovascular Medicine, Department of Internal
Medicine, Creighton University School of Medicine, Omaha, NE, United
States
(Vora) UPMC Heart and Vascular Institute, Harrisburg, Pennsylvania, United
States
(Ben-Dor) Division of Interventional Cardiology, Medstar Washington
Hospital Center, Washington, District of Columbia, United States
(Goldsweig) Division of Cardiovascular Medicine, Department of Internal
Medicine, University of Nebraska Medical Center, Omaha, NE, United States
Publisher
Elsevier Inc.
Abstract
Valve-in-valve transcatheter mitral valve replacement (ViV-TMVR) and redo
surgical mitral valve replacement (redo-SMVR) are 2 treatment strategies
for patients with bioprosthetic mitral valve dysfunction. We conducted a
systematic review and meta-analysis to compare the outcomes of ViV-TMVR
versus redo-SMVR. We searched PubMed, EMBASE, Cochrane, and Google Scholar
for studies comparing outcomes of ViV-TMVR versus redo-SMVR in degenerated
bioprosthetic mitral valves. We used a random-effects model to calculate
odd ratios (ORs) with 95% confidence intervals (CIs). Outcomes included
in-hospital, 30-day, 1-year, and 2-year mortality, stroke, bleeding, acute
kidney injury, arrhythmias, permanent pacemaker insertion, and hospital
length of stay (LOS). A total of 6 observational studies with 707 subjects
were included. The median follow-up was 2.7 years. Despite their older age
and greater co-morbidity burden, patients who underwent ViV-TMVR had a
similar in-hospital mortality (OR 0.52, 95% CI 0.22 to 1.23, p = 0.14),
30-day mortality (OR 0.65, 95% CI 0.36 to 1.17, p = 0.15), 1-year
mortality (OR 0.97, 95% CI 0.63 to 1.49, p = 0.89), and 2-year mortality
(OR 1.17, 95% CI 0.65 to 2.13, p = 0.60) compared with redo-SMVR. ViV-TMVR
was associated with significantly lower periprocedural complications,
including stroke, bleeding, acute kidney injury, arrhythmias, and
permanent pacemaker insertion, and shorter hospital LOS than redo-SMVR. In
conclusion, ViV-TMVR was associated with better outcomes than redo-SMVR in
patients with degenerated bioprosthetic mitral valves, including lower
complication rates and shorter hospital LOS, with no significant
difference in mortality rates. Large-scale randomized trials are needed to
mitigate biases and confirm our findings.<br/>Copyright &#xa9; 2022
Elsevier Inc.

<60>
Accession Number
2018890462
Title
Prior Myocardial Infarction and Treatment Effect of Ticagrelor Versus
Prasugrel in Patients With Acute Coronary Syndromes-A Post-hoc Analysis of
the ISAR-REACT 5 Trial.
Source
Journal of the American Heart Association. 11(24) (no pagination), 2022.
Article Number: e027257. Date of Publication: 20 Dec 2022.
Author
Lahu S.; Scalamogna M.; Ndrepepa G.; Menichelli M.; Valina C.;
Hemetsberger R.; Witzenbichler B.; Bernlochner I.; Joner M.; Xhepa E.;
Hapfelmeier A.; Kufner S.; Sager H.B.; Mayer K.; Kessler T.; Laugwitz
K.-L.; Richardt G.; Schunkert H.; Neumann F.-J.; Kastrati A.; Cassese S.
Institution
(Lahu, Scalamogna, Ndrepepa, Joner, Xhepa, Kufner, Sager, Mayer, Kessler,
Schunkert, Kastrati, Cassese) Klinik fur Herz-und Kreislauferkrankungen,
Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich,
Germany
(Lahu, Bernlochner, Joner, Sager, Kessler, Laugwitz, Schunkert, Kastrati)
German Center for Cardiovascular Research (DZHK), Partner Site Munich
Heart Alliance, Munich, Germany
(Scalamogna) Department of Advanced Biomedical Sciences, University of
Naples Federico II, Naples, Italy
(Menichelli) Ospedale Fabrizio Spaziani, Cardiology, Frosinone, Italy
(Valina, Neumann) Department of Cardiology and Angiology II, University
Heart Center Freiburg-Bad Krozingen, Standort Bad Krozingen, Bad
Krozingen, Germany
(Hemetsberger, Richardt) Heart Center Bad Segeberg, Segeberger Kliniken
GmbH, Bad Segeberg, Bad Segeberg, Germany
(Witzenbichler) Helios Amper-Klinikum Dachau, Cardiology & Pneumology,
Dachau, Germany
(Bernlochner, Laugwitz) Medizinische Klinik und Poliklinik Innere Medizin
I (Kardiologie, Angiologie, Pneumologie), Klinikum rechts der Isar,
Munich, Germany
(Hapfelmeier) Technical University of Munich, School of Medicine,
Institute of AI and Informatics in Medicine, Munich, Germany
(Hapfelmeier) Technical University of Munich, School of Medicine,
Institute of General Practice and Health Services Research, Munich,
Germany
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The efficacy and safety of ticagrelor versus prasugrel in
patients with acute coronary syndrome and prior myo-cardial infarction
(MI) remain unstudied. We aimed to assess the treatment effect of
ticagrelor versus prasugrel according to prior MI status in patients with
ACS. METHODS AND RESULTS: Patients with acute coronary syndrome planned
for an invasive strategy and randomized to ticagre-lor or prasugrel in the
ISAR-REACT (Intracoronary Stenting and Antithrombotic Regimen: Rapid Early
Action for Coronary Treatment) 5 trial were included. The primary end
point was the composite of 1-year all-cause death, MI, or stroke; the
secondary safety end point was the composite of 1-year Bleeding Academic
Research Consortium type 3 to 5 bleeding. The study included 4015 patients
(prior MI=631 patients; no prior MI=3384 patients). As compared with
patients without prior MI, the primary end point occurred more frequently
in patients with prior MI (12.6% versus 7.2%; hazard ratio [HR], 1.78 [95%
CI, 1.38- 2.29]); the secondary safety end point appears to differ little
between patients with and without prior MI (5.8% versus 5.7%,
respectively; HR, 1.02 [95% CI, 0.71-1.45]). With regard to the primary
end point, ticagrelor versus prasugrel was associated with an HR of 1.62
(95% CI, 1.03- 2.55) in patients with prior MI and an HR of 1.28 (95% CI,
0.99-1.65) in patients without prior MI (P<inf>int</inf> =0.37). With
regard to the secondary safety end point, ticagrelor versus prasugrel was
associated with an HR of 1.28 (95% CI, 0.56- 2.91) in patients with prior
MI and an HR of 1.13 (95% CI, 0.82-1.55) in patients without prior MI
(P<inf>int</inf> =0.79). <br/>CONCLUSION(S): Patients with acute coronary
syndrome and prior MI are at higher risk for recurrent ischemic but not
bleeding events. Prasugrel is superior to ticagrelor in reducing the risk
of ischemic events without a tradeoff in bleeding regardless of prior MI
status. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT01944800.<br/>Copyright &#xa9; 2022 The Authors. Published
on behalf of the American Heart Association, Inc., by Wiley.

<61>
Accession Number
2020866060
Title
Effects of ultrasound-guided regional anesthesia in cardiac surgery: a
systematic review and network meta-analysis.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 409. Date
of Publication: December 2022.
Author
Dost B.; De Cassai A.; Balzani E.; Tulgar S.; Ahiskalioglu A.
Institution
(Dost) Department of Anesthesiology and Reanimation, Faculty of Medicine,
Ondokuz Mayis University, Kurupelit, Samsun TR55139, Turkey
(De Cassai) UOC Anesthesia and Intensive Care Unit, University Hospital of
Padua, Padua, Italy
(Balzani) Department of Surgical Science, University of Turin, Turin,
Italy
(Tulgar) Department of Anesthesiology and Reanimation, Samsun Training and
Research Hospital, Samsun University Faculty of Medicine, Samsun, Turkey
(Ahiskalioglu) Department of Anesthesiology and Reanimation, Ataturk
University School of Medicine, Erzurum, Turkey
(Ahiskalioglu) Clinical Research, Development and Design Application and
Research Center, Ataturk University School of Medicine, Erzurum, Turkey
Publisher
BioMed Central Ltd
Abstract
Background: The objective of this systematic review and network
meta-analysis was to compare the effects of single-shot ultrasound-guided
regional anesthesia techniques on postoperative opioid consumption in
patients undergoing open cardiac surgery. <br/>Method(s): This systematic
review and network meta-analysis involved cardiac surgical patients (age >
18 y) requiring median sternotomy. We searched PubMed, EMBASE, The
Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web
of Science. The effects of the single-shot ultrasound-guided regional
anesthesia technique were compared with those of placebo and no
intervention. We conducted a risk assessment of bias for eligible studies
and assessed the overall quality of evidence for each outcome.
<br/>Result(s): The primary outcome was opioid consumption during the
first 24 h after surgery. The secondary outcomes were pain after
extubation at 12 and 24 h, postoperative nausea and vomiting, extubation
time, intensive care unit discharge time, and length of hospital stay.
Fifteen studies with 849 patients were included. The regional anesthesia
techniques included pecto-intercostal fascial block, transversus thoracis
muscle plane block, erector spinae plane (ESP) block, and pectoralis nerve
block I. All the regional anesthesia techniques included significantly
reduced postoperative opioid consumption at 24 h, expressed as morphine
milligram equivalents (MME). The ESP block was the most effective
treatment (-22.93 MME [-34.29;-11.56]). <br/>Conclusion(s): In this
meta-analysis, we concluded that fascial plane blocks were better than
placebo when evaluating 24 h MMEs. However, it is still challenging to
determine which is better, given the paucity of studies available in the
literature. More randomized controlled trials are required to determine
which regional anesthesia technique is better. Trial registration:
PROSPERO; CRD42022315497.<br/>Copyright &#xa9; 2022, The Author(s).

<62>
Accession Number
2015201321
Title
Optimal effectiveness of heart failure management - an umbrella review of
meta-analyses examining the effectiveness of interventions to reduce
(re)hospitalizations in heart failure.
Source
Heart Failure Reviews. 27(5) (pp 1683-1748), 2022. Date of Publication:
September 2022.
Author
Hafkamp F.J.; Tio R.A.; Otterspoor L.C.; de Greef T.; van Steenbergen
G.J.; van de Ven A.R.T.; Smits G.; Post H.; van Veghel D.
Institution
(Hafkamp, Tio, Otterspoor, de Greef, van de Ven, Smits, Post, van Veghel)
Netherlands Heart Network, Veldhoven, Netherlands
(Tio, Otterspoor, de Greef, van Steenbergen, Post, van Veghel) Catharina
Hospital, Eindhoven, Netherlands
(van de Ven) St. Anna Hospital, Geldrop, Netherlands
(Smits) Primary care group Pozob, Veldhoven, Netherlands
Publisher
Springer
Abstract
Heart failure (HF) is a major health concern, which accounts for 1-2% of
all hospital admissions. Nevertheless, there remains a knowledge gap
concerning which interventions contribute to effective prevention of HF
(re)hospitalization. Therefore, this umbrella review aims to
systematically review meta-analyses that examined the effectiveness of
interventions in reducing HF-related (re)hospitalization in HFrEF
patients. An electronic literature search was performed in PubMed, Web of
Science, PsycInfo, Cochrane Reviews, CINAHL, and Medline to identify
eligible studies published in the English language in the past 10 years.
Primarily, to synthesize the meta-analyzed data, a best-evidence synthesis
was used in which meta-analyses were classified based on level of
validity. Secondarily, all unique RCTS were extracted from the
meta-analyses and examined. A total of 44 meta-analyses were included
which encompassed 186 unique RCTs. Strong or moderate evidence suggested
that catheter ablation, cardiac resynchronization therapy, cardiac
rehabilitation, telemonitoring, and RAAS inhibitors could reduce
(re)hospitalization. Additionally, limited evidence suggested that
multidisciplinary clinic or self-management promotion programs,
beta-blockers, statins, and mitral valve therapy could reduce HF
hospitalization. No, or conflicting evidence was found for the effects of
cell therapy or anticoagulation. This umbrella review highlights different
levels of evidence regarding the effectiveness of several interventions in
reducing HF-related (re)hospitalization in HFrEF patients. It could guide
future guideline development in optimizing care pathways for heart failure
patients.<br/>Copyright &#xa9; 2022, The Author(s).

<63>
Accession Number
2016680172
Title
Antiplatelet and myocardial protective effect of Shexiang Tongxin Dropping
Pill in patients undergoing percutaneous coronary intervention: A
randomized controlled trial.
Source
Journal of Integrative Medicine. 20(2) (pp 126-134), 2022. Date of
Publication: March 2022.
Author
Lin Y.-J.; Jiao K.-L.; Liu B.; Fang L.; Meng S.
Institution
(Lin, Jiao, Liu, Meng) Department of Cardiology, Xinhua Hospital, Shanghai
Jiaotong University School of Medicine, Shanghai 200092, China
(Fang) Haematopoiesis and Leukocyte Biology Laboratory, Baker Heart and
Diabetes Research Institute, Melbourne, VIC 3004, Australia
Publisher
Elsevier (Singapore) Pte Ltd
Abstract
Background: High on-clopidogrel platelet reactivity could be partially
explained by loss-of-function alleles of CYP2C19, the enzyme that converts
clopidogrel into its active form. Shexiang Tongxin Dropping Pill (STDP) is
a traditional Chinese medicine to treat angina pectoris. STDP has been
shown to improve blood flow in patients with slow coronary flow and
attenuate atherosclerosis in apolipoprotein E-deficient mice. However,
whether STDP can affect platelet function remains unknown.
<br/>Objective(s): The purpose of this study is to examine the potential
effects of STDP on platelet function in patients undergoing percutaneous
coronary intervention (PCI) for unstable angina. The interaction between
the effects of STDP with polymorphisms of CYP2C19 was also investigated.
Design, participants and intervention: This was a single-center,
randomized controlled trial in patients undergoing elective PCI for
unstable angina. Eligible subjects were randomized to receive STDP (210 mg
per day) plus dual antiplatelet therapy (DAPT) with clopidogrel and
aspirin or DAPT alone. <br/>Main Outcome Measure(s): The primary outcome
was platelet function, reflected by adenosine diphosphate (ADP)-induced
platelet aggregation and platelet microparticles (PMPs). The secondary
outcomes were major adverse cardiovascular events (MACEs) including
recurrent ischemia or myocardial infarction, repeat PCI and cardiac death;
blood biomarkers for myocardial injury including creatine kinase-MB
isoenzyme (CK-MB) and high-sensitive troponin I (hsTnI); and biomarkers
for inflammation including intercellular cell adhesion molecule-1
(ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), monocyte
chemoattractant protein-1 (MCP-1) and galectin-3. <br/>Result(s): A total
of 118 subjects (mean age: [66.8 +/- 8.9] years; male: 59.8%) were
included into analysis: 58 in the control group and 60 in the STDP group.
CYP2C19 genotype distribution was comparable between the 2 groups. In
comparison to the control group, the STDP group had significantly lower
CK-MB (P < 0.05) but similar hsTnI (P > 0.05) at 24 h after PCI, lower
ICAM-1, VCAM-1, MCP-1 and galectin-3 at 3 months (all P < 0.05) but not at
7 days after PCI (P > 0.05). At 3 months, the STDP group had lower PMP
number ([42.9 +/- 37.3] vs. [67.8 +/- 53.1] counts/muL in the control
group, P = 0.05). Subgroup analysis showed that STDP increased percentage
inhibition of ADP-induced platelet aggregation only in slow metabolizers
(66.0% +/- 20.8% in STDP group vs. 36.0% +/- 28.1% in the control group, P
< 0.05), but not in intermediate or fast metabolizers. The rate of MACEs
during the 3-month follow-up did not differ between the two groups.
<br/>Conclusion(s): STDP produced antiplatelet, anti-inflammatory and
cardioprotective effects. Subgroup analysis indicated that STDP inhibited
residual platelet reactivity in slow metabolizers only. Trial
registration: This study was registered on www.chictr.org.cn:
ChiCTR-IPR-16009785.<br/>Copyright &#xa9; 2022

<64>
Accession Number
2015891199
Title
Colchicine for Prevention of Atrial Fibrillation after Cardiac Surgery in
the Early Postoperative Period.
Source
Journal of Clinical Medicine. 11(5) (no pagination), 2022. Article Number:
1387. Date of Publication: March-1 2022.
Author
Shvartz V.; Le T.; Kryukov Y.; Sokolskaya M.; Ispiryan A.; Khugaeva E.;
Yurkulieva G.; Shvartz E.; Petrosyan A.; Bockeria L.; Bockeria O.
Institution
(Shvartz, Le, Sokolskaya, Ispiryan, Khugaeva, Yurkulieva, Petrosyan,
Bockeria, Bockeria) Department of Surgical Treatment for Interactive
Pathology, Bakoulev Scientific Center for Cardiovascular Surgery, Moscow
121552, Russian Federation
(Kryukov) Department of Cardiovascular Surgery, Arrhythmology and Clinical
Electrophysiology, Bakoulev Scientific Center for Cardiovascular Surgery,
Moscow 121552, Russian Federation
(Shvartz) National Medical Research Center for Therapy and Preventive
Medicine, Moscow 101990, Russian Federation
Publisher
MDPI
Abstract
Background. Postoperative atrial fibrillation (POAF) is a common
complication of cardiac surgery. It has been proven to be associated with
an increase in the incidence of early complications and mortality, an
increase in the rate of hospital stay duration, and economic costs of
their treatment. One of the pharmaceutical drugs recommended by the
American College of Cardiology (ACC)/American Heart Association (AHA) for
preventing POAF is colchicine (class IIB). However, the results of
research on the efficacy and safety of colchicine are ambiguous and,
consequently, require further study. Objective. Evaluating the efficacy of
short-term colchicine administration in the prevention of POAF in patients
after open-heart surgery. Materials and methods. Double-blind, randomized,
placebo-controlled clinical trial. The subjects were randomly assigned to
two groups: treatment group (n = 50) with subjects receiving 1 mg of
colchicine 24 h before the surgery, as well as on days 2, 3, 4, and 5 in
the postoperative period; and the control group (n = 51), receiving
placebo on the same schedule. The primary endpoint was the frequency of
POAF in both groups within 7 days after surgery. Results. The study
included 101 patients (82 men, 19 women). Baseline clinical, laboratory,
instrumental, and intraoperative data did not differ statistically
significantly between the groups. POAF was detected in 9 patients (18%) of
the treatment group and 15 subjects (29.4%) of the control group, which
had no statistical significance (odds ratio, OR 0.527; 95% Cl 0.206-1.349;
p = 0.178). No statistically significant differences were revealed for
most secondary endpoints, as well as between the groups for all laboratory
parameters. There were statistically significant differences between the
groups solely in the frequency of diarrhea: 16 (32%) patients in the
treatment group and 6 (11.8%) subjects in the control group (OR 3.529; 95%
Cl 1.249-9.972; p = 0.010). Conclusions. We did not detect any statistical
differences between the groups in terms of primary endpoints, which could
be due to the insufficient volume of the sample of the study. However, we
detected some trends of statistical differences among the groups in terms
of some parameters. Clinical Trials Registration. ClinicalTrials. Unique
identifier: NCT04224545.<br/>Copyright &#xa9; 2022 by the authors.
Licensee MDPI, Basel, Switzerland.

<65>
Accession Number
2016882153
Title
Serum albumin in patients undergoing transcatheter aortic valve
replacement: A meta-analysis.
Source
Reviews in Cardiovascular Medicine. 20(3) (pp 161-169), 2019. Date of
Publication: 30 Sep 2019.
Author
Hsieh W.C.; Aboud A.; Henry B.M.; Omara M.; Lindner J.; Pirk J.
Institution
(Hsieh) First Faculty of Medicine, Charles University, Prague 1200,
Czechia
(Hsieh, Lindner) 2nd Department of Cardiovascular Surgery, First Faculty
of Medicine, Charles University, General University Hospital in Prague,
Prague 1200, Czechia
(Aboud) Department of Cardiac and Thoracic Vascular Surgery, University of
Schleswig-Holstein, Lubeck Campus, Lubeck 23562, Germany
(Henry) Division of Cardiology, Cincinnati Children's Hospital Medical
Center, Cincinnati, OH 45229, United States
(Omara) Department of Thoracic and Cardiovascular Surgery, Research
Institute, Cleveland Clinic, Cleveland, OH 44195, United States
(Pirk) Department of Cardiology and Cardiac Surgery, Institute of Clinical
and Experimental Medicine IKEM, Prague 14021, Czechia
Publisher
IMR Press Limited
Abstract
Transcatheter aortic valve replacement is becoming a more common
therapeutic option for the treatment of aortic stenosis in patients at
high risk for invasive surgery, but detecting which patients will benefit
clinically can be challenging. Hypoalbuminemia is a useful prognostic
marker for chronic inflammation in this population. We carried out a
systematic review and meta-analysis of studies evaluating the prognostic
value of serum albumin level in patients undergoing transcatheter aortic
valve replacement. A literature search of PubMed, Embase, ScienceDirect,
Web of Science, SciELO, BIOSIS, Wanfang, and CNKI databases was conducted.
Articles published between January 2000 and December 2017 reporting on the
prognostic value of low levels of serum albumin in patients undergoing
transcatheter aortic valve replacement were analyzed according to
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines. 11 studies including 6456 patients met inclusion criteria for
meta-analysis. A lower serum albumin level was associated with a lower
survival rate at follow-up in patients who underwent transcatheter aortic
valve replacement. A subgroup analysis of eight studies reporting adjusted
hazard ratios indicated that low serum albumin was independently
correlated with increased post-operative mortality. The hazard ratio of
mortality risk associated with each 1 g/dL increment in serum albumin
level was 0.46, suggesting a potential dose-response relationship between
increased serum albumin level and increased survival rate in patients
undergoing transcatheter aortic valve replacement. This meta-analysis
provides strong evidence for the utility of serum albumin as a prognostic
marker in aortic stenosis patients undergoing transcatheter aortic valve
replacement, with low serum albumin levels (2.5-3.5 g/dL) suggesting poor
prognosis.<br/>Copyright &#xa9; 2019 Hsieh et al. Published by IMR Press.
All rights reserved.

<66>
Accession Number
2015601951
Title
Brain Death and Transplant in Islamic Countries.
Source
Experimental and Clinical Transplantation. 14(spp3) (pp 48-52), 2016. Date
of Publication: NOVEMBER 2016.
Author
Altinors N.; Haberal M.
Institution
(Altinors) Departments of Neurosurgery, Faculty of Medicine, Baskent
University, Ankara, Turkey
(Haberal) Departments of General Surgery, Faculty of Medicine, Baskent
University, Ankara, Turkey
(Altinors) Baskent University, Faculty of Medicine, Department of
Neurosurgery, 10.sokak No. 45, Bahcelievler, Ankara 06490, Turkey
Publisher
Baskent University
Abstract
Objectives: The aim of this study was to investigate the present status
regarding brain death, its conse-quences, and transplant activities in
Islamic countries. <br/>Material(s) and Method(s): A thorough literature
survey was conducted about transplant activities in Islamic countries, and
the Turkish Ministry of Health Web site was analyzed. Expert opinions
about the issue were obtained. <br/>Result(s): The present status of brain
death and transplant activities has shown a heterogeneous appearance in
the Islamic world. Our literature survey clearly revealed that transplant
is still in its early stages in many Islamic states. The legislative
framework, infrastructure, and related education needs radical
improvements in these states. <br/>Conclusion(s): The concept of death has
to be redefined and a consensus should be reached about brain death. The
pioneer countries like Turkey, Iran, and Saudi Arabia. which already have
considerable experience in transplant, should share their expertise and
know-ledge with the countries that need guidance.<br/>Copyright &#xa9;
Baskent University 2016 Printed in Turkey. All Rights Reserved.

<67>
Accession Number
639943676
Title
Risk of Bias in Randomized Clinical Trials Comparing Transcatheter and
Surgical Aortic Valve Replacement: A Systematic Review and Meta-analysis.
Source
JAMA network open. 6(1) (pp e2249321), 2023. Date of Publication: 03 Jan
2023.
Author
Barili F.; Brophy J.M.; Ronco D.; Myers P.O.; Uva M.S.; Almeida R.M.S.;
Marin-Cuartas M.; Anselmi A.; Tomasi J.; Verhoye J.-P.; Musumeci F.;
Mandrola J.; Kaul S.; Papatheodorou S.; Parolari A.
Institution
(Barili, Papatheodorou) Department of Epidemiology, Harvard T. H. Chan
School of Public Health, Boston, MA, United States
(Barili) Department of Cardiac Surgery, S. Croce Hospital, Cuneo, Italy
(Brophy) Department of Medicine, McGill Health University Center,
Montreal, QC, Canada
(Ronco, Parolari) Department of University Cardiac Surgery, IRCCS
Policlinico San Donato, Milan, Italy
(Myers) Division of Cardiac Surgery, CHUV-Lausanne University Hospital,
Lausanne, Switzerland
(Uva) Department of Cardiac Surgery, Hospital Santa Cruz, Carnaxide,
Portugal
(Uva) Department of Cardiac Surgery and Physiology, Porto University
Medical School, Porto, Portugal
(Almeida) University Center Assis Gurgacz Foundation, Cascavel, Parana,
Brazil
(Marin-Cuartas) University Department of Cardiac Surgery, Leipzig Heart
Center, Leipzig, Germany
(Anselmi, Tomasi, Verhoye) Department of Thoracic and Cardiovascular
Surgery, University Hospital of Rennes, Rennes, France
(Musumeci) Department of Cardiac Surgery and Heart Transplantation, San
Camillo Forlanini Hospital, Rome, Italy
(Mandrola) Baptist Health Louisville, Louisville, KY, United States
(Kaul) Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
Publisher
NLM (Medline)
Abstract
Importance: Recent European Society of Cardiology/European Association for
Cardio-Thoracic Surgery (ESC/EACTS) guidelines highlighted some concerns
about the randomized clinical trials (RCTs) comparing transcatheter aortic
valve implantation (TAVI) and surgical aortic valve replacement (SAVR) for
aortic stenosis. Quantification of these biases has not been previously
performed. <br/>Objective(s): To assess whether randomization protects
RCTs comparing TAVI and SAVR from biases other than nonrandom allocation.
<br/>Data Sources: A systematic review of the literature between January
1, 2007, and June 6, 2022, on MEDLINE, Embase, and Cochrane Central
Register of Controlled Trials was performed. Specialist websites were also
checked for unpublished data. Study Selection: The study included RCTs
with random allocation to TAVI or SAVR with a maximum 5-year follow-up.
Data Extraction and Synthesis: Data extraction was performed by 2
independent investigators following the PRISMA guidelines. A
random-effects meta-analysis was used for quantifying pooled rates and
differential rates between treatments of deviation from random assigned
treatment (DAT), loss to follow-up, and receipt of additional treatments.
<br/>Main Outcomes and Measures: The primary outcomes were the proportion
of DAT, loss to follow-up, and patients who were provided additional
treatments and myocardial revascularization, together with their ratio
between treatments. The measures were the pooled overall proportion of the
primary outcomes and the risk ratio (RR) in the TAVI vs SAVR groups.
<br/>Result(s): The search identified 8 eligible trials including 8849
participants randomly assigned to undergo TAVI (n=4458) or SAVR (n=4391).
The pooled proportion of DAT among the sample was 4.2% (95% CI,
3.0%-5.6%), favoring TAVI (pooled RR vs SAVR, 0.16; 95% CI, 0.08-0.36;
P<.001). The pooled proportion of loss to follow-up was 4.8% (95% CI,
2.7%-7.3%). Meta-regression showed a significant association between the
proportion of participants lost to follow-up and follow-up time (slope,
0.042; 95% CI, 0.017-0.066; P<.001). There was an imbalance of loss to
follow-up favoring TAVI (RR, 0.39; 95% CI, 0.28-0.55; P<.001). The pooled
proportion of patients who had additional procedures was 10.4% (95% CI,
4.4%-18.5%): 4.6% (95% CI, 1.5%-9.3%) in the TAVI group and 16.5% (95% CI,
7.5%-28.1%) in the SAVR group (RR, 0.27; 95% CI, 0.15-0.50; P<.001). The
imbalance between groups also favored TAVI for additional myocardial
revascularization (RR, 0.40; 95% CI, 0.24-0.68; P<.001). <br/>Conclusions
and Relevance: This study suggests that, in RCTs comparing TAVI vs SAVR,
there are substantial proportions of DAT, loss to follow-up, and
additional procedures together with systematic selective imbalance in the
same direction characterized by significantly lower proportions of
patients undergoing TAVI that might affect internal validity.

<68>
Accession Number
2021816629
Title
Comparison of Demographic, Clinical, Biochemical, and Imaging Findings in
Hypertrophic Cardiomyopathy Prognosis: A Network Meta-Analysis.
Source
JACC: Heart Failure. 11(1) (pp 30-41), 2023. Date of Publication: January
2023.
Author
Georgiopoulos G.; Figliozzi S.; Pateras K.; Nicoli F.; Bampatsias D.;
Beltrami M.; Finocchiaro G.; Chiribiri A.; Masci P.G.; Olivotto I.
Institution
(Georgiopoulos, Finocchiaro, Chiribiri, Masci) School of Biomedical
Engineering and Imaging Sciences, King's College London, United Kingdom
(Georgiopoulos, Bampatsias) Department of Clinical Therapeutics, National
and Kapodistrian University of Athens, Greece
(Figliozzi) Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy
(Pateras) Department of Biostatistics, Julius Center for Health Sciences
and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
(Nicoli) Humanitas Gavazzeni, Bergamo, Italy
(Beltrami, Olivotto) Department of Experimental and Clinical Medicine,
University of Florence, Meyer Children's Hospital and Careggi University
Hospital, Florence, Italy
Publisher
Elsevier Inc.
Abstract
Background: Despite hypertrophic cardiomyopathy (HCM) being the most
common inherited heart disease and conferring increased risk for heart
failure (HF) and sudden cardiac death (SCD), risk assessment in HCM
patients is still largely unresolved. <br/>Objective(s): This study aims
to synthesize and compare the prognostic impact of demographic, clinical,
biochemical, and imaging findings in patients with HCM. <br/>Method(s):
The authors searched PubMed, Embase, and Cochrane Library for studies
published from 1955 to November 2020, and the endpoints were: 1) all-cause
death; 2) an arrhythmic endpoint including SCD, sustained ventricular
tachycardia, ventricular fibrillation, or aborted SCD; and 3) a composite
endpoint including (1) or (2) plus hospitalization for HF or cardiac
transplantation. The authors performed a pairwise meta-analysis obtaining
the pooled estimate separately for the association between baseline
variables and study endpoints. A random-effects network meta-analysis was
subsequently used to comparatively assess the prognostic value of outcome
associates. <br/>Result(s): A total of 112 studies with 58,732 HCM
patients were included. Among others, increased brain natriuretic
peptide/N-terminal pro-B-type natriuretic peptide, late gadolinium
enhancement (LGE), positive genotype, impaired global longitudinal strain,
and presence of apical aneurysm conferred increased risk for the composite
endpoint. At network meta-analysis, LGE showed the highest prognostic
value for all endpoints and was superior to all other associates except
New York Heart Association functional class >class II. A multiparametric
imaging-based model was superior in predicting the composite endpoint
compared to a prespecified model based on conventional risk factors.
<br/>Conclusion(s): This network meta-analysis supports the development of
multiparametric risk prediction algorithms, including advanced imaging
markers additively to conventional risk factors, for refined risk
stratification in HCM. (Long-term prognosis of hypertrophic cardiomyopathy
according to genetic, clinical, biochemical and imaging findings: a
systemic review and meta-analysis; CRD42020185219)<br/>Copyright &#xa9;
2023 American College of Cardiology Foundation

<69>
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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2022, The Author(s), under
exclusive licence to The Japanese Association for Thoracic Surgery.

<70>
Accession Number
639858565
Title
Ross Procedure Versus Mechanical Versus Bioprosthetic Aortic Valve
Replacement: A Network Meta-Analysis.
Source
Journal of the American Heart Association. 12(1) (pp e8066), 2023. Date of
Publication: 03 Jan 2023.
Author
Yokoyama Y.; Kuno T.; Toyoda N.; Fujisaki T.; Takagi H.; Itagaki S.;
Ibrahim M.; Ouzounian M.; El-Hamamsy I.; Fukuhara S.
Institution
(Yokoyama) Department of Surgery St. Luke's University Health Network
Bethlehem PA
(Kuno) Department of Cardiology, Montefiore Medical Center Albert Einstein
College of Medicine New York NY
(Toyoda, Itagaki, El-Hamamsy) Department of Cardiovascular Surgery Icahn
School of Medicine at Mount Sinai New York NY
(Fujisaki) Department of Medicine Icahn School of Medicine at Mount Sinai,
Mount Sinai Morningside and West New York NY
(Takagi) Department of Cardiovascular Surgery Shizuoka Medical Center
Shizuoka Japan, Japan
(Ibrahim) Division of Cardiovascular Surgery Hospital of the University of
Pennsylvania Philadelphia PA
(Ouzounian) Division of Cardiovascular Surgery Peter Munk Cardiac Centre,
Toronto General Hospital and the University of Toronto, Canada
(Fukuhara) Department of Cardiac Surgery University of Michigan Ann Arbor
MI
Publisher
NLM (Medline)
Abstract
Background The Ross operation appears to restore normal survival in young
and middle-aged adults with aortic valve disease. However, there are
limited data comparing it with conventional aortic valve replacement.
Herein, we compared outcomes of the Ross procedure with mechanical and
bioprosthetic aortic valve replacement (M-AVR and B-AVR, respectively).
Methods and Results MEDLINE and EMBASE were searched through March 2022 to
identify randomized controlled trials and propensity score-matched studies
that investigated outcomes of patients aged >=16years undergoing the Ross
procedure, M-AVR, or B-AVR. The systematic literature search identified 2
randomized controlled trials and 8 propensity score-matched studies
involving a total of 4812 patients (Ross: n=1991; M-AVR: n=2019; and
B-AVR: n=802). All-cause mortality was significantly lower in the Ross
procedure group compared with M-AVR (hazard ratio [HR] [95% CI], 0.58
[0.35-0.97]; P=0.035) and B-AVR (HR [95% CI], 0.32 [0.18-0.59]; P<0.001)
groups. The reintervention rate was lower after the Ross procedure and
M-AVR compared with B-AVR, whereas it was higher after the Ross procedure
compared with M-AVR. Major bleeding rate was lower after the Ross
procedure compared with M-AVR. Long-term stroke rate was lower following
the Ross procedure compared with M-AVR and B-AVR. The rate of endocarditis
was also lower after the Ross procedure compared with B-AVR. Conclusions
Improved long-term outcomes of the Ross procedure are demonstrated
compared with conventional M-AVR and B-AVR options. These results
highlight a need to enhance the recognition of the Ross procedure and
revisit current guidelines on the optimal valve substitute for young and
middle-aged patients.

<71>
Accession Number
2021048430
Title
Sex differences among patients receiving ticagrelor monotherapy or aspirin
after coronary bypass surgery: A prespecified subgroup analysis of the
TiCAB trial.
Source
International Journal of Cardiology. 370 (pp 129-135), 2023. Date of
Publication: 01 Jan 2023.
Author
Sandner S.; Kastrati A.; Niessner A.; Boning A.; Zeymer U.; Conradi L.;
Danner B.; Zimpfer D.; Farber G.; Manville E.; Schunkert H.; von Scheidt
M.; Grothusen C.; Cremer J.; Attmann T.; Friedrich I.; Oberhoffer M.;
Knosalla C.; Walther T.; Wimmer-Greinecker G.; Siepe M.; Grubitzsch H.;
Joost A.; Schaefer A.; Misfeld M.; Laufer G.; Wiedemann D.; Englberger L.;
Hambrecht R.
Institution
(Sandner, Manville) Department of Cardiac Surgery, Medical University of
Vienna, Austria
(Kastrati, Schunkert, von Scheidt) Deutsches Herzzentrum Munchen,
Technische Universitat Munchen, Germany
(Kastrati, Schunkert, von Scheidt) German Center for Cardiovascular
Research, Heart Alliance, Munich, Germany
(Niessner) Department of Internal Medicine II, Division of Cardiology,
Medical University of Vienna, Austria
(Boning) Department of Cardiovascular Surgery, University Hospital
Giessen, Germany
(Zeymer) Department of Cardiology, Klinikum Ludwigshafen and Institut fur
Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany
(Conradi, Schaefer) Department of Cardiovascular Surgery, University Heart
and Vascular Center Hamburg, Hamburg, Germany
(Danner) Department of Cardiac, Thoracic and Vascular Surgery, University
Medical Center, Gottingen, Germany
(Zimpfer) Department of Cardiac Surgery, Medical University Graz, Graz,
Austria
(Farber) Department of Cardiothoracic Surgery, Universitatsklinikum Jena,
Jena, Germany
(Grothusen, Cremer, Attmann) Department of Cardiac Surgery,
Universitatsklinikum Schleswig-Holstein, Kiel, Germany
(Friedrich) Department of Cardiothoracic Sugery, Krankenhaus der
Barmherzigen Bruder Trier, Germany
(Oberhoffer) Department of Cardiac Surgery, Klinik und Poliklinik fur
Herz- und Gefaschirurgie, Johannes Gutenberg Universitat Mainz, Mainz,
Germany
(Knosalla) Department of Cardiothoracic and Vascular Surgery, German Heart
Institute Berlin, Berlin, Germany
(Knosalla) Germany and German Center for Cardiovascular Research, Partner
Site Berlin, Berlin, Germany
(Walther) Department of Cardiac Surgery, Universitatsklinikum Frankfurt,
Frankfurt am Main, Germany
(Wimmer-Greinecker) Department for Cardiothoracic Surgery, Heart and
Vessel Center Bad Bevensen, Bad Bevensen, Germany
(Siepe) Department of Cardiac Surgery, University Hospital Bern,
Switzerland
(Grubitzsch) Department of Cardiovascular Surgery, Charite
Universitatsmedizin Berlin, Berlin, Germany
(Joost) Department of Cardiology, Angiology and Intensive Care Medicine,
Medical Clinic II, University Hospital Schleswig-Holstein, Lubeck, Germany
(Misfeld) Department of Cardiac Surgery, Leipzig Heart Center, Leipzig,
Germany
(Laufer, Wiedemann) Department of Cardiac Surgery, Medical University of
Vienna, Vienna, Austria
(Englberger) Department of Cardiac Surgery, University Hospital Bern,
Bern, Switzerland
(Hambrecht) Department of Cardiology and Angiology, Klinikum Links der
Weser, Bremen, Germany
Publisher
Elsevier Ireland Ltd
Abstract
Background: There is limited evidence on the association of sex with
outcomes among patients undergoing coronary bypass surgery (CABG) and
treated with ticagrelor monotherapy or aspirin. <br/>Method(s): This was a
pre-specified sub-analysis of TiCAB, an investigator-initiated
placebo-controlled randomized trial. Primary efficacy endpoint was the
composite of cardiovascular death, myocardial infarction, stroke, or
repeat revascularization 1 year after CABG. Safety endpoint was BARC type
2, 3 or 5 bleeding. <br/>Result(s): A total of 280 (15.0%) women and 1579
(85.0%) men were included. Compared with men, women were older (66.1 +/-
10.2 vs. 70.1 +/- 9.3 years) with more acute presentation (17.0% vs
21.1%). The incidence of the primary endpoint was similar between women
and men (9.2% vs. 8.9%, HR 1.08, 95%CI 0.71-1.66, P = 0.71).
Cardiovascular death occurred more often in women (2.9% vs 1.0%, adjusted
HR 2.87, 95%CI 1.23-6.70, P = 0.02). The incidence of bleeding was similar
between the sexes (2.2% vs. 2.5%, HR 0.91, 95% CI 0.51-1.65, P = 0.77).
Ticagrelor vs aspirin was associated with a similar risk of the primary
endpoint in women (10.6% vs. 7.9%, HR 1.39, 95%CI 0.63-3.05, P = 0.42) and
men (9.5% vs. 8.2%, HR 1.15, 95%CI 0.82-1.62, P =
0.41;p<inf>interaction</inf> = 0.69), and a similar risk of bleeding in
women (2.9% vs. 1.4%, HR 2.09, 95%CI 0.38-11.41, P = 0.40) and men (2.2%
vs. 2.8%, HR 0.80, 95%CI 0.42-1.52, P = 0.49;p<inf>interaction</inf> =
0.35). <br/>Conclusion(s): Among women and men undergoing CABG, ticagrelor
monotherapy was associated with a similar risk of the primary efficacy
endpoint and bleeding compared with aspirin. The risk of cardiovascular
death was increased in women irrespective of antiplatelet
therapy.<br/>Copyright &#xa9; 2022 The Author(s)

<72>
Accession Number
2022007069
Title
Reassessing the July Effect: 30 Years of Evidence Show No Difference in
Outcomes.
Source
Annals of Surgery. 277(1) (pp E204-E211), 2023. Date of Publication: 01
Jan 2023.
Author
Zogg C.K.; Metcalfe D.; Sokas C.M.; Dalton M.K.; Hirji S.A.; Davis K.A.;
Haider A.H.; Cooper Z.; Lichtman J.H.
Institution
(Zogg, Davis) Yale School of Medicine, New Haven, CT, United States
(Zogg, Sokas, Dalton, Hirji, Cooper) Department of Surgery, Center for
Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical
School, Harvard T.H. Chan School of Public Health, Boston, MA, United
States
(Zogg, Lichtman) Yale School of Public Health, New Haven, CT, United
States
(Metcalfe) Nuffield Department of Orthopedics, Rheumatology, and
Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
(Haider) The Aga Khan University Medical College, Karachi, Pakistan
Publisher
Wolters Kluwer Health
Abstract
Objective: The aim of this study was to critically evaluate whether
admission at the beginning versus end of the academic year is associated
with increased risk of major adverse outcomes. Summary Background Data:
The hypothesis that the arrival of new residents and fellows is associated
with increases in adverse patient outcomes has been the subject of
numerous research studies since 1989. <br/>Method(s): We conducted a
systematic review and random-effects meta-analysis of July Effect studies
published before December 20, 2019, looking for differences in mortality,
major morbidity, and readmission. Given a paucity of studies reporting
readmission, we further analyzed 7 years of data from the Nationwide
Readmissions Database to assess for differences in 30-day readmission for
US patients admitted to urban teaching versus nonteach-ing hospitals with
3 common medical (acute myocardial infarction, acute ischemic stroke, and
pneumonia) and 4 surgical (elective coronary artery bypass graft surgery,
elective colectomy, craniotomy, and hip fracture) conditions using
risk-adjusted logistic difference-in-difference regression.
<br/>Result(s): A total of 113 studies met inclusion criteria; 92 (81.4%)
reported no evidence of a July Effect. Among the remaining studies,
results were mixed and commonly pointed toward system-level discrepancies
in efficiency. Metaanalyses of mortality [odds ratio (95% confidence
interval): 1.01 (0.98-1.05)] and major morbidity [1.01 (0.99-1.04)]
demonstrated no evidence of a July Effect, no differences between
specialties or countries, and no change in the effect over time. A total
of 5.98 million patient encounters were assessed for readmission. No
evidence of a July Effect on readmission was found for any of the 7
conditions. <br/>Conclusion(s): The preponderance of negative results over
the past 30 years suggests that it might be time to reconsider the need
for similarly-themed studies and instead focus on system-level factors to
improve hospital efficiency and optimize patient outcomes.<br/>Copyright
&#xa9; 2022 Authors. All rights reserved.

<73>
Accession Number
2021922053
Title
Nighttime dexmedetomidine for delirium prevention in non-mechanically
ventilated patients after cardiac surgery (MINDDS): A single-centre,
parallel-arm, randomised, placebo-controlled superiority trial.
Source
eClinicalMedicine. 56 (no pagination), 2023. Article Number: 101796. Date
of Publication: February 2023.
Author
Qu J.Z.; Mueller A.; McKay T.B.; Westover M.B.; Shelton K.T.; Shaefi S.;
D'Alessandro D.A.; Berra L.; Brown E.N.; Houle T.T.; Akeju O.
Institution
(Qu, Mueller, McKay, Shelton, Berra, Brown, Houle, Akeju) Department of
Anesthesia, Critical Care and Pain Medicine, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, United States
(Westover) Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA, United States
(Shaefi) Department of Anesthesia, Critical Care and Pain Medicine, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
(D'Alessandro) Division of Cardiac Surgery, Department of Surgery,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United
States
(Berra) Respiratory Care Services, Massachusetts General Hospital, Boston,
MA, United States
(Brown) Institute for Medical Engineering and Sciences, Massachusetts
Institute of Technology, Cambridge, MA, United States
Publisher
Elsevier Ltd
Abstract
Background: The delirium-sparing effect of nighttime dexmedetomidine has
not been studied after surgery. We hypothesised that a nighttime dose of
dexmedetomidine would reduce the incidence of postoperative delirium as
compared to placebo. <br/>Method(s): This single-centre, parallel-arm,
randomised, placebo-controlled superiority trial evaluated whether a short
nighttime dose of intravenous dexmedetomidine (1 mug/kg over 40 min) would
reduce the incidence of postoperative delirium in patients 60 years of age
or older undergoing elective cardiac surgery with cardiopulmonary bypass.
Patients were randomised to receive dexmedetomidine or placebo in a 1:1
ratio. The primary outcome was delirium on postoperative day one.
Secondary outcomes included delirium within three days of surgery, 30-,
90-, and 180-day abbreviated Montreal Cognitive Assessment scores, Patient
Reported Outcome Measures Information System quality of life scores, and
all-cause mortality. The study was registered as NCT02856594 on
ClinicalTrials.gov on August 5, 2016, before the enrolment of any
participants. <br/>Finding(s): Of 469 patients that underwent
randomisation to placebo (n = 235) or dexmedetomidine (n = 234), 75 met a
prespecified drop criterion before the study intervention. Thus, 394
participants (188 dexmedetomidine; 206 placebo) were analysed in the
modified intention-to-treat cohort (median age 69 [IQR 64, 74] years;
73.1% male [n = 288]; 26.9% female [n = 106]). Postoperative delirium
status on day one was missing for 30 (7.6%) patients. Among those in whom
it could be assessed, the primary outcome occurred in 5 of 175 patients
(2.9%) in the dexmedetomidine group and 16 of 189 patients (8.5%) in the
placebo group (OR 0.32, 95% CI: 0.10-0.83; P = 0.029). A non-significant
but higher proportion of participants experienced delirium within three
days postoperatively in the placebo group (25/177; 14.1%) compared to the
dexmedetomidine group (14/160; 8.8%; OR 0.58; 95% CI, 0.28-1.15). No
significant differences between groups were observed in secondary outcomes
or safety. <br/>Interpretation(s): Our findings suggested that in elderly
cardiac surgery patients with a low baseline risk of postoperative
delirium and extubated within 12 h of ICU admission, a short nighttime
dose of dexmedetomidine decreased the incidence of delirium on
postoperative day one. Although non-statistically significant, our
findings also suggested a clinical meaningful difference in the three-day
incidence of postoperative delirium. <br/>Funding(s): National Institute
on Aging ( R01AG053582).<br/>Copyright &#xa9; 2022 The Author(s)

<74>
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. <br/>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. <br/>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%. <br/>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)<br/>Copyright &#xa9; 2022

<75>
Accession Number
2020950006
Title
Externally mounted versus internally mounted leaflet aortic bovine
pericardial bioprosthesis: meta-analysis.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2023. Date
of Publication: 2023.
Author
Yokoyama Y.; Sakurai Y.; Kuno T.; Takagi H.; Fukuhara S.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Sakurai) Department of Surgery, Marshall University Joan Edwards School
of Medicine, Huntington, WV, United States
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, 111 East 210th St, Bronx, NY 10467-2401, United
States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
Publisher
Springer
Abstract
Background: Recent studies reported higher-than-expected rates of early
structural valve degeneration (SVD) and/or reoperation of externally
mounted leaflet aortic bioprosthesis compared with others. This
meta-analysis aims to compare the outcomes of bioprostheses with
externally versus internally mounted leaflet design in patients who
underwent surgical aortic valve replacement (SAVR). <br/>Method(s):
MEDLINE and EMBASE were searched through November 2021 to identify
comparative studies investigating outcomes following SAVR with either
externally or internally mounted leaflet aortic bioprosthesis. Outcomes of
interest were reoperation for SVD or any cause and all-cause mortality.
<br/>Result(s): Our analysis included 15 observational studies that
enrolled a total of 23,539 patients who underwent SAVR using externally
mounted (n = 9338; 39.7%) or internally mounted leaflet (n = 14,201;
60.3%) bioprostheses. Externally mounted valves consisted of the Trifecta
(Abbott, St Paul, MN) (n = 6146) and the Mitroflow (LivaNova, London, UK)
(n = 3192), and all internally mounted valves were the Perimount (Edwards
Lifesciences, Irvine, CA). Externally mounted valves compared with the
Perimount were associated with higher reoperation rates for SVD [hazard
ratio (HR) 3.55, 95% confidence interval (CI) 2.67-4.72; P < 0.001] and
any cause (HR 9.36, 95% CI 3.70-23.67; P < 0.001). Furthermore, externally
mounted valves demonstrated higher all-cause mortalities (HR 1.33, 95% CI
1.13-1.56; P < 0.001). <br/>Conclusion(s): The present study summarizing
updated evidence revealed higher reoperation rates and all-cause
mortalities in patients with externally mounted leaflet aortic
bioprostheses compared with those with internally mounted design. Choosing
the right SAVR valve type is critical part of lifetime management of
aortic valve disease.<br/>Copyright &#xa9; 2023, The Author(s), under
exclusive licence to The Japanese Association for Thoracic Surgery.

<76>
Accession Number
2021901570
Title
Five-year results of Amaze: a randomized controlled trial of adjunct
surgery for atrial fibrillation.
Source
European Journal of Cardio-thoracic Surgery. 62(5) (no pagination), 2022.
Article Number: ezac181. Date of Publication: 01 Nov 2022.
Author
Sharples L.D.; Mills C.; Chiu Y.-D.; Fynn S.; Holcombe H.M.; Nashef S.A.M.
Institution
(Sharples, Mills, Chiu, Fynn, Holcombe, Nashef) Royal Papworth Hospital,
Cambridge, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The Amaze trial showed that adding atrial fibrillation (AF)
surgery to cardiac operations increased return to sinus rhythm (SR)
without impact on quality of life or survival at 2 years. We report
outcomes to 5 years. <br/>METHOD(S): In a multicentre, phase III,
pragmatic, double-blind, randomized controlled superiority trial, cardiac
surgery patients with >3 months of AF were randomized 1:1 to adjunct AF
surgery or control. Primary outcomes of 1-year SR restoration and 2-year
quality-adjusted survival were already reported. This study reports on
rhythm, survival, quality-adjusted survival, stroke, medication and safety
to 5 years. <br/>RESULT(S): Between 2009 and 2014, 352 patients were
randomized. By 5 years 79 died, 58 withdrew, 34 were lost to follow-up and
the remaining 182 provided data. AF surgery significantly increased the
odds of remaining in SR at 5 years {odds ratio = 2.98 [95% confidence
interval (CI) 1.23, 7.17], P = 0.015}. There was a non-significant
decrease in stroke incidence [odds ratio = 0.605 (95% CI 0.284, 1.287), P
= 0.19], but no improved survival [5-year survival: AF surgery 77.3% (95%
CI 71.1%, 83.5%), controls 77.8% (95% CI 71.7%, 84.0%), P = 0.85].
Quality-adjusted survival difference was negligible (-0.03; 95% CI -0.33,
0.27, P = 0.85). The composite of survival free of stroke and AF was
better in the AF surgery group [odds ratio = 2.34 (95% CI 1.03, 5.31)].
There were no other differences. <br/>CONCLUSION(S): Adjunct AF surgery
confers a higher rate of SR to 5 years and a better composite outcome of
survival free of stroke and AF but has no impact on overall or
quality-adjusted survival or other clinical outcomes. Clinical trial
registration number: ISRCTN82731440.<br/>Copyright &#xa9; 2022 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery.

<77>
Accession Number
2014435538
Title
Coronary artery revascularizations and cognitive decline - A systematic
review.
Source
Current Problems in Cardiology. 47(10) (no pagination), 2022. Article
Number: 100960. Date of Publication: October 2022.
Author
Lappalainen L.; Rajamaki B.; Tolppanen A.-M.; Hartikainen S.
Institution
(Lappalainen, Rajamaki, Tolppanen, Hartikainen) School of Pharmacy,
University of Eastern Finland, FI, Kuopio, Finland
(Rajamaki, Tolppanen, Hartikainen) Kuopio Research Center of Geriatric
Care, University of Eastern Finland, FI, Kuopio, Finland
Publisher
Elsevier Inc.
Abstract
Coronary artery disease (CAD) is a risk factor for cognitive decline. The
aim of this study was to systematically review recent literature on
whether coronary artery revascularizations are associated to cognitive
decline and dementia. Pubmed, Scopus, and CINAHL (EBSCO) were searched
systematically from January 2009 to September 2020. Studies were conducted
on persons with CAD undergoing coronary artery bypass grafting (CABG) or
percutaneous coronary intervention (PCI) procedure compared to other
coronary artery disease treatments, and the outcome was cognitive decline
or dementia. Altogether four of the 680 reviewed articles met inclusion
criteria. Results were inconsistent, and the outcome measurements
heterogeneous between studies. Our findings indicate an evidence gap in
the current understanding of long-term outcomes following coronary artery
revascularization. However, evidence of long-term effects on cognition
would complement our understanding of their benefits. There is a need for
more studies on long-term cognitive outcomes after coronary artery
revascularizations.<br/>Copyright &#xa9; 2021 The Authors

<78>
Accession Number
2017959294
Title
Machine learning and artificial intelligence in cardiac transplantation: A
systematic review.
Source
Artificial Organs. 46(9) (pp 1741-1753), 2022. Date of Publication:
September 2022.
Author
Naruka V.; Arjomandi Rad A.; Subbiah Ponniah H.; Francis J.; Vardanyan R.;
Tasoudis P.; Magouliotis D.E.; Lazopoulos G.L.; Salmasi M.Y.; Athanasiou
T.
Institution
(Naruka, Athanasiou) Department of Cardiothoracic Surgery, Imperial
College NHS Trust, Hammersmith Hospital, London, United Kingdom
(Naruka, Arjomandi Rad, Subbiah Ponniah, Vardanyan, Salmasi, Athanasiou)
Department of Surgery and Cancer, Faculty of Medicine, Imperial College
London, London, United Kingdom
(Francis) Faculty of Medicine, University of Edinburgh, Edinburgh, United
Kingdom
(Tasoudis, Magouliotis, Lazopoulos, Athanasiou) Department of
Cardiothoracic Surgery, University Hospital Thessaly, Larissa, Greece
(Lazopoulos) Department of Cardiac Surgery, University Hospital of
Heraklion, Crete, Greece
Publisher
John Wiley and Sons Inc
Abstract
Background: This review aims to systematically evaluate the currently
available evidence investigating the use of artificial intelligence (AI)
and machine learning (ML) in the field of cardiac transplantation.
Furthermore, based on the challenges identified we aim to provide a series
of recommendations and a knowledge base for future research in the field
of ML and heart transplantation. <br/>Method(s): A systematic database
search was conducted of original articles that explored the use of ML
and/or AI in heart transplantation in EMBASE, MEDLINE, Cochrane database,
and Google Scholar, from inception to November 2021. <br/>Result(s): Our
search yielded 237 articles, of which 13 studies were included in this
review, featuring 463 850 patients. Three main areas of application were
identified: (1) ML for predictive modeling of heart transplantation
mortality outcomes; (2) ML in graft failure outcomes; (3) ML to aid
imaging in heart transplantation. The results of the included studies
suggest that AI and ML are more accurate in predicting graft failure and
mortality than traditional scoring systems and conventional regression
analysis. Major predictors of graft failure and mortality identified in ML
models were: length of hospital stay, immunosuppressive regimen,
recipient's age, congenital heart disease, and organ ischemia time. Other
potential benefits include analyzing initial lab investigations and
imaging, assisting a patient with medication adherence, and creating
positive behavioral changes to minimize further cardiovascular risk.
<br/>Conclusion(s): ML demonstrated promising applications for improving
heart transplantation outcomes and patient-centered care, nevertheless,
there remain important limitations relating to implementing AI into
everyday surgical practices.<br/>Copyright &#xa9; 2022 The Authors.
Artificial Organs published by International Center for Artificial Organ
and Transplantation (ICAOT) and Wiley Periodicals LLC.

<79>
Accession Number
2017043742
Title
Direct aortic route versus transaxillary route for transcatheter aortic
valve replacement: A systematic review and meta-analysis.
Source
PeerJ. 8 (no pagination), 2020. Article Number: e9102. Date of
Publication: May 2020.
Author
Lee H.-A.; Su I.-L.; Chen S.-W.; Wu V.C.-C.; Chen D.-Y.; Chu P.-H.; Chou
A.-H.; Cheng Y.-T.; Lin P.-J.; Tsai F.-C.
Institution
(Lee, Su, Chen, Cheng, Lin, Tsai) Department of Thoracic and
Cardiovascular Surgery, Chang Gung Memorial Hospital, Linkou Medical
Center, Chang Gung University, Taoyuan, Taiwan (Republic of China)
(Wu, Chen, Chu) Department of Cardiology, Chang Gung Memorial Hospital,
Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan (Republic of
China)
(Chou) Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou
Medical Center, Chang Gung University, Taoyuan, Taiwan (Republic of China)
Publisher
PeerJ Inc.
Abstract
Background: The transfemoral route is contraindicated in nearly 10% of
transcatheter aortic valve replacement (TAVR) candidates because of
unsuitable iliofemoral vessels. Transaxillary (TAx) and direct aortic
(DAo) routes are the principal nonfemoral TAVR routes; however, few
studies have compared their outcomes. <br/>Method(s): We performed a
systematic review and meta-analysis to compare the rates of mortality,
stroke, and other adverse events of TAx and DAo TAVR. The study was
prospectively registered with PROSPERO (registration number:
CRD42017069788). We searched Medline, PubMed, Embase, and Cochrane
databases for studies reporting the outcomes of DAo or TAx TAVR in at
least 10 patients. Studies that did not use the Valve Academic Research
Consortium definitions were excluded. We included studies that did not
directly compare the two approaches and then pooled rates of events from
the included studies for comparison. <br/>Result(s): In total, 31 studies
were included in the quantitative meta-analysis, with 2,883 and 2,172
patients in the DAo and TAx TAVR groups, respectively. Compared with TAx
TAVR, DAo TAVR had a lower Society of Thoracic Surgery (STS) score,
shorter fluoroscopic time, and less contrast volume use. The 30-day
mortality rates were significantly higher in the DAo TAVR group (9.6%, 95%
confidence interval (CI) = [8.4-10.9]) than in the TAx TAVR group (5.7%,
95% CI = [4.8-6.8]; P for heterogeneity <0.001). DAo TAVR was associated
with a significantly lower risk of stroke in the overall study population
(2.6% vs. 5.8%, P for heterogeneity <0.001) and in the subgroup of studies
with a mean STS score of >=8 (1.6% vs. 6.2%, P for heterogeneity = 0.005).
DAo TAVR was also associated with lower risks of permanent pacemaker
implantation (12.3% vs. 20.1%, P for heterogeneity = 0.009) and valve
malposition (2.0% vs. 10.2%, P for heterogeneity = 0.023) than was TAx
TAVR. <br/>Conclusion(s): DAo TAVR increased 30-day mortality rate
compared with TAx TAVR; by contrast, TAx TAVR increased postoperative
stroke, permanent pacemaker implantation, and valve malposition risks
compared with DAo TAVR.<br/>Copyright &#xa9; 2020 Lee et al.

<80>
[Use Link to view the full text]
Accession Number
2016744592
Title
Spontaneous Breathing Trial for Prediction of Extubation Success in
Pediatric Patients Following Congenital Heart Surgery: A Randomized
Controlled Trial.
Source
Pediatric Critical Care Medicine. 20(10) (pp 940-946), 2019. Date of
Publication: 01 Oct 2019.
Author
Ferreira F.V.; Sugo E.K.; Aragon D.C.; Carmona F.; Carlotti A.P.C.P.
Institution
(Ferreira, Sugo, Aragon, Carmona, Carlotti) Department of Pediatrics,
Division of Pediatric Critical Care, Ribeirao Preto Medical School,
University of Sao Paulo, Ribeirao Preto, Brazil
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: To evaluate the usefulness of a spontaneous breathing trial
for predicting extubation success in pediatric patients in the
postoperative period after cardiac surgery compared with a physician-led
weaning. <br/>Study Design: Randomized, controlled trial. <br/>Setting(s):
PICU of a tertiary-care university hospital. <br/>Patient(s): A population
of pediatric patients following cardiac surgery for congenital heart
disease. <br/>Intervention(s): Patients on mechanical ventilation for more
than 12 hours after surgery who were considered ready for weaning were
randomized to the spontaneous breathing trial group or the control group.
The spontaneous breathing trial was performed on continuous positive
airway pressure with the pressure support of 10 cmH<inf>2</inf>O, the
positive end-expiratory pressure of 5 cmH<inf>2</inf>O, and the fraction
of inspired oxygen less than or equal to 0.5 for 2 hours. Patients in the
control group underwent ventilator weaning according to clinical judgment.
<br/>Measurements and Main Results: The primary endpoint was extubation
success defined as no need for reintubation within 48 hours after
extubation. Secondary outcomes were PICU length of stay, hospital length
of stay, occurrence rate of ventilator-associated pneumonia, and
mortality. One hundred and ten patients with the median age of 8 months
were included in the study: 56 were assigned to the spontaneous breathing
trial group and 54 were assigned to the control group. Demographic and
clinical data and Risk Adjustment for Congenital Heart Surgery-1
classification were similar in both groups. Patients undergoing the
spontaneous breathing trial had greater extubation success (83% vs 68%, p
= 0.02) and shorter PICU length of stay (median 85 vs 367 hr, p < 0.0001)
compared with the control group, respectively. There was no significant
difference between groups in hospital length of stay, occurrence rate of
ventilator-associated pneumonia, and mortality. <br/>Conclusion(s):
Pediatric patients with congenital heart disease undergoing the
spontaneous breathing trial postoperatively had greater extubation success
and shorter PICU length of stay compared with those weaned according to
clinical judgment.<br/>Copyright &#xa9; 2019 by the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies

<81>
[Use Link to view the full text]
Accession Number
2016744591
Title
The Effect of Levosimendan Versus Milrinone on the Occurrence Rate of
Acute Kidney Injury Following Congenital Heart Surgery in Infants: A
Randomized Clinical Trial.
Source
Pediatric Critical Care Medicine. 20(10) (pp 947-956), 2019. Date of
Publication: 01 Oct 2019.
Author
Thorlacius E.M.; Suominen P.K.; Wahlander H.; Keski-Nisula J.; Vistnes M.;
Ricksten S.-E.; Synnergren M.; Romlin B.S.; Castellheim A.
Institution
(Thorlacius, Ricksten, Romlin, Castellheim) Department of Anesthesiology
and Intensive Care Medicine, Sahlgrenska Academy, University of
Gothenburg, Queen Silvia Children's Hospital, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Suominen, Keski-Nisula) Department of Anesthesia and Intensive Care,
Children's Hospital, Helsinki University Central Hospital, Helsinki,
Finland
(Wahlander) Department of Pediatric Cardiology, Sahlgrenska Academy,
University of Gothenburg, Queen Silvia Children's Hospital, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Vistnes) Department of Internal Medicine, Diakonhjemmet Hospital,
Institute for Experimental Medical Research, Oslo University Hospital,
University of Oslo, Oslo, Norway
(Synnergren) Department of Pediatric Thoracic Surgery, Queen Silvia
Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: It has been shown that, in contrast to other inotropic agents,
levosimendan improves glomerular filtration rate after adult cardiac
surgery. The aim of this study was to investigate the efficacy of
levosimendan, compared with milrinone, in preventing acute kidney
dysfunction in infants after open-heart surgery with cardiopulmonary
bypass. <br/>Design(s): Two-center, double-blinded, prospective,
randomized clinical trial. <br/>Setting(s): The study was performed in two
tertiary pediatric centers, one in Sweden (Gothenburg) and one in Finland
(Helsinki). <br/>Patient(s): Infants between 1 and 12 months old,
diagnosed with Tetralogy of Fallot, complete atrioventricular septal
defect or nonrestrictive ventricular septal defect, undergoing total
corrective cardiac surgery with cardiopulmonary bypass.
<br/>Intervention(s): Seventy-two infants were randomized to receive a
perioperative infusion of levosimendan (0.1 microg/kg/min) or milrinone
(0.4 microg/kg/min). The infusion was initiated at the start of
cardiopulmonary bypass and continued for 26 hours. <br/>Measurements and
Main Results: The primary outcome variable was the absolute value of serum
creatinine data on postoperative day 1. Secondary outcomes included the
following: 1) acute kidney injury according to the serum creatinine
criteria of the Kidney Diseases: Improving Global Outcomes; 2) acute
kidney injury with serum creatinine corrected for fluid balance; 3) plasma
neutrophil gelatinase-associated lipocalin; 4) cystatin C; 5) urea; 6)
lactate; 7) hemodynamic variables; 8) use of diuretics in the PICU; 9)
need of dialysis; 10) length of ventilator therapy; and 11) length of PICU
stays. There was no significant difference in postoperative serum
creatinine between the treatment groups over time (p = 0.65). The
occurrence rate of acute kidney injury within 48 hours was 46.9% in the
levosimendan group and 39.5% in the milrinone group (p = 0.70). There were
no significant differences in other secondary outcome variables between
the groups. <br/>Conclusion(s): Levosimendan compared with milrinone did
not reduce the occurrence rate of acute kidney injury in infants after
total corrective heart surgery for atrioventricular septal defect,
ventricular septal defect, or Tetralogy of Fallot.<br/>Copyright &#xa9;
2019 by the Society of Critical Care Medicine and the World Federation of
Pediatric Intensive and Critical Care Societies

<82>
Accession Number
2016785759
Title
The Effect of Classic Chest Physiotherapy on Postoperative Pain Scores and
Hospital Stay in Patients Undergoing Off-Pump Coronary Artery
BypassGraftSurgery:ARandomizedClinicalTrial.
Source
Galen Medical Journal. 7 (no pagination), 2018. Article Number: e838. Date
of Publication: 31 Mar 2018.
Author
Zolfaghari M.; Mirhosseini S.J.; Baghbeheshti M.; Bauer B.A.
Institution
(Zolfaghari, Baghbeheshti) Student Research Committee, Shahid Sadoughi
University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Mirhosseini) Department of Cardiovascular Surgery, Afshar Hospital,
Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Islamic
Republic of
(Bauer) Complementary and Integrative Medicine, Division General Internal
Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United
States
Publisher
Shiraz University of Medical Sciences
Abstract
Background: Background: Chest physiotherapy (CPT) is a care that increases
the mobilization of several structures from both muscle and subcutaneous
tissue. We planned to investigate the effect of classic CPT on pain,
fatigue, satisfaction, and hospital length of stay (LOS) in patients
undergoing off-pump coronary artery bypass graft (CABG). <br/>Material(s)
and Method(s): This study was a randomized controlled trial that conducted
on 50 patients undergoing elective off-pump CABG. The patients have been
randomly divided into two groups; in the group A (n=25) patients received
physiotherapy at a single session of classic CPT, 4 times during 2nd to
5th days for 15 minutes in every session, in the group B (n=25) patients
had not protocol of this exercise therapy (control). <br/>Result(s):The
average age of all participants was 62.08 +/-9.08 years. Of the 50
patients, 33 (66%) was male. Classic CPT significantly decreased pain
(P=0.04), hospital LOS (P=0.010) and could increase in patients'
satisfaction (P<0.001). However, it had no considerable effect on fatigue
(P=0.725). <br/>Conclusion(s): According to our findings, classic CPT
could improve postoperative care after off-pump CABG
surgery.<br/>Copyright&#xa9; 2018, Galen Medical Journal.

<83>
Accession Number
639941637
Title
The effectiveness of a motivational text-messaging program for smoking
cessation after coronary angioplasty: a quasi-experimental study.
Source
BMC research notes. 16(1) (pp 1), 2023. Date of Publication: 02 Jan 2023.
Author
Mobaraki M.S.; Khademian Z.; Shirazi F.
Institution
(Mobaraki) Student Research Committee, School of Nursing and Midwifery,
Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Khademian) Department of Nursing, School of Nursing and Midwifery, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Shirazi) Community Based Psychiatric Care Research Center, Department of
Nursing, School of Nursing and Midwifery, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Smoking is an important risk factor of coronary artery stenosis
after angioplasty. Therefore, this investigation aimed to determine the
effectiveness of a motivational text-messaging program for smoking
cessation after coronary angioplasty. This quasi-experimental study was
conducted on 100 patients after angioplasty. The patients were divided
randomly into two intervention and control groups. The intervention group
received 32 text messages about smoking cessation for 2 months. The
control group received only routine training. The primary and secondary
outcomes were success and self-efficacy in quitting smoking cigarettes,
respectively. Both groups filled out the related questionnaires before and
after the intervention. The data were analyzed using SPSS software version
22 and Chi-square tests, independent t-test, and paired t-test. P<0.05 was
considered significant. <br/>RESULT(S): Success in quitting cigarette
smoking was significantly higher in the intervention group (n=29, 61.7%)
compared to the control group (n=2, 4.3%) (p<0.001). Moreover, after the
intervention, the mean score of self-efficacy in the intervention group
(11.01+/-44.75) was significantly higher than the control group
(6.51+/-3.11) and also higher than before the intervention (5.51+/-2.44)
(P<0.001). The motivational text-messaging program can improve
self-efficacy and success in smoking cessation in patients after coronary
angioplasty.<br/>Copyright &#xa9; 2023. The Author(s).

<84>
Accession Number
2022012138
Title
Percutaneous angio-guided versus surgical veno-arterial ECMO implantation
in patients with cardiogenic shock or cardiac arrest.
Source
Archives of Cardiovascular Diseases Supplements. Conference: JESFC 2023.
Paris France. 15(1) (pp 163-164), 2023. Date of Publication: January 2023.
Author
Gallet R.; Saiydoun G.; Gall E.; Martin-Tuffreau A.-S.; Boukantar M.;
Folliguet T.; Teiger E.
Institution
(Gallet) Cardiologie, hopital Henri-Mondor AP-HP, Creteil
(Saiydoun, Martin-Tuffreau, Boukantar, Folliguet) Chirurgie cardiaque,
hopital Henri-Mondor AP-HP, Creteil
(Gall) Cardiologie, hopital Lariboisiere AP-HP, Paris
(Teiger) Cardiologie, CHU Henri Mondor, Creteil
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Veno-arterial Extracorporeal Membrane Oxygenation (VA-ECMO)
has gained increasing place into the management of patients with
refractory cardiogenic shock or cardiac arrest. Although surgical approach
is the reference for ECMO insertion, percutaneous approach has been
associated with fewer complications. Angio-guided percutaneous
implantation and explantation may further decrease the rate of
complication. <br/>Objective(s): We aimed to compare outcome and
complication rates in patients supported with VA-ECMO through percutaneous
angio-guided versus surgical approach. <br/>Method(s): We included all
patients with emergent peripheral femoro-femoral VA-ECMO implantation for
refractory cardiogenic shock or cardiac arrest in our center from March
2018 to March 2021. Survival and major complications (major bleeding, limb
ischemia and groin infection) rates were compared between the percutaneous
angio-guided and the surgical groups. <br/>Result(s): One hundred twenty
patients received VA-ECMO, 59 through surgical approach and 61 through
angio-guided percutaneous approach. Patients' baseline characteristics and
severity scores were equally balanced between the 2 groups. Thirty-day
mortality was not significantly different between the 2 approaches.
However, angio-guided percutaneous insertion was associated with fewer
major vascular complications (42% vs. 11%, P > 0.0001) and a higher rate
of ECMO explantation. In multivariate analysis, percutaneous angio-guided
implantation of ECMO was independently associated with a lower probability
of major complications. <br/>Conclusion(s): Compared to surgical approach,
angio-guided percutaneous VA-ECMO implantation is associated with fewer
major vascular complications. Large prospective randomized clinical trials
are needed to confirm those results and address their impact on
mortality.<br/>Copyright &#xa9; 2022

<85>
Accession Number
2022012106
Title
Prognostic value of cardiac power output in chronic heart failure
patients: A systematic review.
Source
Archives of Cardiovascular Diseases Supplements. Conference: JESFC 2023.
Paris France. 15(1) (pp 40), 2023. Date of Publication: January 2023.
Author
El Kai C.; Geagea M.; Saad E.; Azar R.; Abdel Massih T.
Institution
(El Kai, Geagea, Azar, Abdel Massih) Service de cardiologie, CHU Hotel
Dieu de France, Beyrouth, Lebanon
(Saad) Faculte de medecine, universite Saint-Joseph de Beyrouth, Beyrouth,
Lebanon
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Cardiac power output (CPO) is a parameter that reflects the
cardiac pumping capacity by including the flow (cardiac output) and
pressure (mean blood pressure). Many studies showed its association with
cardiovascular outcomes in heart failure (HF) patients. <br/>Objective(s):
This systematic review aims to determine the prognostic value of CPO and
its derived parameters in patients with Chronic Heart Failure.
<br/>Method(s): Pubmed, Embase, Cochrane, and Scopus were searched from
inception to February 2022 using the terms "Heart Failure" and "Cardiac
Power". Only studies evaluating the prognostic value of CPO and its
derived parameters in patients suffering from chronic HF were included.
Prognosis endpoints were mortality, left ventricular assist device (LVAD)
implantation, and heart transplant. Studies on animals, transplanted
patients, LVAD patients, and acute heart failure patients were excluded.
<br/>Result(s): Thirteen studies (Fig. 1) were included in this review (8
prospective and 5 retrospective cohort). Resting Cardiac Power Index (CPI)
was shown to predict worse LVAD and transplant-free survival independently
of peak VO2 (Oxygen consumption), as well as death and major cardiac
events. Resting CPO also predicted LVAD and transplant-free survival. Peak
CPO during exercise could predict LVAD and transplant-free survival,
overall survival, cardiac-related death, and the risk of major cardiac
events. Peak CPO was also able to better identify LVAD and transplant-free
survival than peak VO2, especially in patients with a peak VO2 < 14
mL/kg/min. One study showed that peak CPO was a better predictor of
mortality than resting CPO and peak oxygen consumption (peak VO2). Two
studies showed that peak CPO to left ventricular mass (CPOM) during
exercise was the best independent predictor of all-cause mortality in
ischemic HF and had an incremental prognostic value for predicting LVAD
and transplant-free survival. However, in the multivariate analysis of 2
other studies, peak CPO was not an independent predictor of
cardiac-related or all-cause mortality. <br/>Conclusion(s): CPO and other
derived parameters can better predict overall and cardiac-related
survival, as well as LVAD and transplant-free survival in patients with
stable chronic HF compared to traditional echocardiographic and
cardiopulmonary testing parameters. Moreover, the results of this review
suggest a novel approach for heart transplant candidates using peak CPO to
further subclassify patients with a peak VO2 < 14 mL/kg/min.<br/>Copyright
&#xa9; 2022

<86>
Accession Number
639946637
Title
Cost-effectiveness of Fibrinogen Concentrate vs Cryoprecipitate for
Treating Acquired Hypofibrinogenemia in Bleeding Adult Cardiac Surgical
Patients.
Source
JAMA surgery. (no pagination), 2023. Date of Publication: 04 Jan 2023.
Author
Abrahamyan L.; Tomlinson G.; Callum J.; Carcone S.; Grewal D.; Bartoszko
J.; Krahn M.; Karkouti K.
Institution
(Abrahamyan, Tomlinson, Carcone, Krahn, Karkouti) Toronto General Hospital
Research Institute, University Health Network, Toronto, ON, Canada
(Abrahamyan, Carcone, Krahn) Toronto Health Economics and Technology
Assessment (THETA) Collaborative, University Health Network, Toronto, ON,
Canada
(Abrahamyan, Tomlinson, Bartoszko, Krahn, Karkouti) Institute of Health
Policy, Management and Evaluation, University of Toronto, Toronto, ON,
Canada
(Tomlinson) Biostatistics Research Unit, University Health Network,
Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre and Queen's University, Kingston, Ontario, Canada
(Grewal, 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
(Bartoszko, Karkouti) Peter Munk Cardiac Centre, University Health
Network, Toronto, ON, Canada
Publisher
NLM (Medline)
Abstract
Importance: Excessive bleeding requiring fibrinogen replacement is a
serious complication of cardiac surgery. However, the relative
cost-effectiveness of the 2 available therapies-fibrinogen concentrate and
cryoprecipitate-is unknown. <br/>Objective(s): To determine
cost-effectiveness of fibrinogen concentrate vs cryoprecipitate for
managing active bleeding in adult patients who underwent cardiac surgery.
<br/>Design, Setting, and Participant(s): A within-trial economic
evaluation of the Fibrinogen Replenishment in Surgery (FIBERS) randomized
clinical trial (February 2017 to November 2018) that took place at 4
hospitals based in Ontario, Canada, hospitals examined all in-hospital
resource utilization costs and allogeneic blood product (ABP) transfusion
costs incurred within 28 days of surgery. Participants included a subset
of 495 adult patients from the FIBERS trial who underwent cardiac surgery
and developed active bleeding and acquired hypofibrinogenemia requiring
fibrinogen replacement. <br/>Intervention(s): Fibrinogen concentrate (4 g
per dose) or cryoprecipitate (10 units per dose) randomized (1:1) up to 24
hours postcardiopulmonary bypass. <br/>Main Outcomes and Measures:
Effectiveness outcomes included number of ABPs administered within 24
hours and 7 days of cardiopulmonary bypass. ABP transfusion (7-day) and
in-hospital resource utilization (28-day) costs were evaluated and a
multivariable net benefit regression model built for the full sample and
predefined subgroups. <br/>Result(s): Patient level costs for 495 patients
were evaluated (mean [SD] age 59.2 [15.4] years and 69.3% male.)
Consistent with FIBERS, ABP transfusions and adverse events were similar
in both treatment groups. Median (IQR) total 7-day ABP cost was CAD $2280
(US dollars [USD] $1697) (CAD $930 [USD $692]-CAD $4970 [USD $3701]) in
the fibrinogen concentrate group and CAD $2770 (USD $1690) (IQR, CAD $1140
[USD $849]-CAD $5000 [USD $3723]) in the cryoprecipitate group. Median
(interquartile range) total 28-day cost was CAD $38180 (USD $28431) $(IQR,
CAD $26350 [USD $19622]-CAD $65080 [USD $48463]) in the fibrinogen
concentrate group and CAD $38790 (USD $28886) (IQR, CAD $26180 [USD
$19495]-CAD $70380 [USD $52409]) in the cryoprecipitate group. After
exclusion of patients who were critically ill before surgery (11%) due to
substantial variability in costs, the incremental net benefit of
fibrinogen concentrate vs cryoprecipitate was positive (probability of
being cost-effective 86% and 97% at $0 and CAD $2000 (USD $1489)
willingness-to-pay, respectively). Net benefit was highly uncertain for
nonelective and patients with critical illness. <br/>Conclusions and
Relevance: Fibrinogen concentrate is cost-effective when compared with
cryoprecipitate in most bleeding adult patients who underwent cardiac
surgery with acquired hypofibrinogenemia requiring fibrinogen replacement.
The generalizability of these findings outside the Canadian health system
needs to be verified.

<87>
Accession Number
639945826
Title
Transcatheter Edge-to-Edge Repair for Secondary Mitral Regurgitation with
3^rd Generation Devices in Heart Failure Patients-Results from
the Global EXPAND Post-Market Study.
Source
European journal of heart failure. (no pagination), 2023. Date of
Publication: 04 Jan 2023.
Author
Orban M.; Rottbauer W.; Williams M.; Mahoney P.; von Bardeleben R.S.;
Price M.J.; Grasso C.; Lurz P.; Zamorano J.L.; Asch F.M.; Maisano F.; Kar
S.; Hausleiter J.
Institution
(Orban, Hausleiter) Ludwig-Maximilians Universitat, Medizinische Klinik I,
Munich, Germany
(Orban, Hausleiter) Partner site German Centre for Cardiovascular Research
(DZHK), Munich Heart Alliance, Munich, Germany
(Rottbauer) Department of Internal Medicine II, Ulm University Medical
Center, Ulm, Germany
(Williams) Heart Valve Center, New York University Langone Health, NY,
United States
(Mahoney) Sentera Heart and Valve and Structural Disease Center, Norfolk,
VA, United States
(von Bardeleben) Department of Cardiology, University Medical Center of
Mainz, Mainz, Germany
(Price) Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA,
United States
(Grasso) Department of Cardiology, Ferrarotto Hospital, University of
Catania, Catania, Italy
(Lurz) Department of Cardiology, Heart Center Leipzig - University
Hospital, Leipzig, Germany
(Zamorano) Hospital Ramon y Cajal, Madrid, Spain
(Asch) Cardiovascular Core Laboratories, MedStar Health Research
Institute, WA, United States
(Maisano) San Raffaele University Hospital, Milan, Italy
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
Publisher
NLM (Medline)
Abstract
AIMS: Mitral valve transcatheter edge-to-edge repair (M-TEER) is a
guideline-recommended treatment option for patients with secondary mitral
regurgitation (SMR). The purpose of this analysis is to report
contemporary real-world outcomes in SMR patients treated with 3rd
generation MitraClip systems. METHODS AND RESULTS: EXPAND is a
prospective, multi-center, international, single arm study with 1041
patients treated for MR with MitraClip NTR/XTR, with 30-day and 1-year
follow-up (FU). All echocardiograms were analyzed by an independent
echocardiographic core lab. Study outcomes included: procedural outcomes,
durability of MR reduction, and major adverse events including all-cause
mortality and hospitalizations for heart failure (HFH). A subgroup of 413
symptomatic patients (age 74.7+/-10.1years, 58% male) with severe SMR were
included. MR reduction to MR<=1+ and MR<=2+ was achieved in 93.0% and
98.5% of patients, respectively, which was sustained at 1-year-FU.
All-cause mortality was 17.7% at 1-year-FU, and the combined endpoint of
all-cause mortality or 1st HFH occurred in 34% of patients. This combined
endpoint was significantly less frequently observed in MR<=1+ patients
(Kaplan-Maier-estimates: 29.7% vs. 69.9% for MR<=1+ vs. MR<=2+; p<0.0001).
NYHA functional class improved significantly from baseline (NYHA<=II:17%)
to 1-year-FU (NYHA<=II:78%) (p<0.0001). While MR reduction was comparable
between NTR-only vs. XTR-only treated patients, less XTR clips were
required for achieving MR reduction. <br/>CONCLUSION(S): Under real-world
conditions, optimal sustained MR reduction to MR<=1+ was achieved in a
high percentage of patients with 3rd generation MitraClip, which
translated into symptomatic improvement and low event rates. These results
appear to be comparable with recent randomized clinical trials. This
article is protected by copyright. All rights reserved.

<88>
Accession Number
2020841745
Title
Cardiopulmonary bypass parameters improve the prediction of 30-day
mortality following cardiac surgery.
Source
Perfusion (United Kingdom). (no pagination), 2022. Date of Publication:
2022.
Author
Newland R.F.; Baker R.A.
Institution
(Newland, Baker) Cardiothoracic Surgery, Division of Surgery &
Perioperative Medicine, Flinders Medical Centre & Cardiothoracic Surgery,
Department of Surgery, College of Medicine and Public Health, Flinders
University, Bedford Park, SA, Australia
Publisher
SAGE Publications Ltd
Abstract
Currently 30-day mortality is commonly used as a quality indicator for
cardiac surgery; however, prediction models have not included the role of
cardiopulmonary bypass (CPB). We hypothesized that reproducing currently
utilised prediction model methods of 30-day mortality using the Australian
and New Zealand Collaborative Perfusion Registry (ANZCPR) would identify
relevant CPB predictors. Nine centers in Australia and New Zealand
collected data using the ANZCPR between 2011-2020. CPB parameter selection
was determined by evaluating association with 30-day mortality. Data were
divided into model creation (n = 15,073) and validation sets (n = 15,072).
Bootstrap sampling and automated variable selection methods were used to
develop candidate models. The final model was selected using prediction
mean square error and Bayesian Information Criteria. The average receiver
operating characteristic (ROC), p-value for Hosmer-Lemeshow chi-squared
test and MSE were obtained from multifold validation. In total, 30,145
patients were included, of which 735 (2.4%) died within 30 day of surgery.
The area under the ROC curve for the model including CPB parameters was
significantly greater than preoperative risk factors only (0.829 vs 0.783,
p < 0.001). CPB parameters included in the predictive model were CPB time,
red blood cell transfusion, mean arterial pressure <50 mmHg, minimum
oxygen delivery, cardiac index <1.6 L/min/m². CPB parameters
improve the prediction of 30-day mortality. Randomised trials designed to
evaluate modifiable CPB parameters will determine their impact on
mortality.<br/>Copyright &#xa9; The Author(s) 2022.