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<1>
Accession Number
2015843350
Title
Effects of adding low-dose ketamine to etomidate on serum cortisol levels
in critically ill cardiac patients: a randomized clinical trial.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 114. Date
of Publication: December 2022.
Author
Elhamamsy M.M.; Aldemerdash A.M.; Zahran F.B.; Ezz G.F.M.; AlSaud S.A.;
Boules M.L.; Abdelhady M.A.; Hamed M.A.
Institution
(Elhamamsy, Aldemerdash, Zahran, AlSaud) King Saud University, Riyadh,
Saudi Arabia
(Ezz, Boules, Abdelhady) Department of Anesthesiology, Faculty of
Medicine, Zagazig University, Zagazig, Egypt
(Hamed) Department of Anesthesiology, Faculty of Medicine, Fayoum
University, Fayoum 63511, Egypt
Publisher
BioMed Central Ltd
Abstract
Background: Etomidate was associated with an inhibition of adrenal steroid
synthesis. This study aimed to evaluate the effects of adding low-dose
ketamine to etomidate to minimize the decrease in serum cortisol level in
critically ill cardiac patients. Method(s): Sixty adult cardiac
patients, >= 18 years, who underwent upper endoscopy and Colonoscopy to
manage acute anemia in the cardiac intensive care units were enrolled.
Patients were randomly divided into two groups: (group (E): n = 30)
received etomidate 0.2 mg/kg IV followed by etomidate 0.05 mg/kg IV, and
(group (KE): n = 30) received ketamine 0.5 mg/kg IV, then etomidate 0.1
mg/kg IV, followed by etomidate 0.05 mg/kg IV. The primary outcome was
Serum cortisol level at 6 h after the procedure. Result(s): The mean
postoperative cortisol level was significantly lower in group E (295.60
+/- 49.218 nmol/L) versus group KE (461.00 +/- 67.946 nmol/L), with 95% CI
= 351.94 to 404.66; p = 0.000. In addition, the estimated serum cortisol
reduction level was also significant between groups; In group E, the
estimated cortisol level decreased nearly 53% from 632.40 +/- 35.066
nmol/L to 295.60 +/- 49.218 nmol/L 6 hours postoperative. While in group
KE, the estimated cortisol level decreased only 27% from 639.13 +/- 43.035
nmol/L to 461.00 +/- 67.946 nmol/L. Conclusion(s): Single-dose
ketamine (0.5 mg/kg) was helpful to decrease the total dose of etomidate
and hence decreased the percentage of serum cortisol level in such
critically ill patients with preservation of patient satisfaction. Trial
Registration: This study is registered on ClinicalTrials.gov (NCT04857450;
principal investigator: Mostafa Mohammed Elsaid Elhamamsy; registration
date: 23/04/ 2021). Copyright © 2022, The Author(s).

<2>
Accession Number
2019735819
Title
Risk Factors for Postrepair Elevated Mitral Gradient: A Post-hoc Analysis
of a Randomized Trial.
Source
Annals of Thoracic Surgery. 115(2) (pp 437-443), 2023. Date of
Publication: February 2023.
Author
Hibino M.; Pandey A.K.; Chan V.; Mazer C.D.; Rumman R.; Dhingra N.K.;
Bonneau C.; Verma R.; Yokoyama Y.; Quan A.; Teoh H.; Cheema A.; de
Varennes B.E.; Yanagawa B.; Leong-Poi H.; Connelly K.A.; Bisleri G.; Verma
S.
Institution
(Hibino) Division of Cardiac Surgery, University Hospitals Cleveland
Medical Center, Case Western Reserve University, Cleveland, Ohio
(Hibino, Dhingra, Quan, Teoh, Yanagawa, Bisleri, Verma) Division of
Cardiac Surgery, Li Ka Shing Knowledge Institute of St Michael's Hospital,
Toronto, ON, Canada
(Hibino, Yanagawa, Bisleri, Verma) Department of Surgery, University of
Toronto, Toronto, ON, Canada
(Pandey) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Chan) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Chan) School of Epidemiology, Public Health and Preventive Medicine,
University of Ottawa, Ottawa, ON, Canada
(Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute of St
Michael's Hospital, Toronto, ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Mazer, Connelly) Department of Physiology, University of Toronto,
Toronto, ON, Canada
(Rumman, Leong-Poi, Connelly) Division of Cardiology, Li Ka Shing
Knowledge Institute of St Michael's Hospital, Toronto, ON, Canada
(Bonneau) Division of Cardiac Surgery, McGill University, Montreal, QC,
Canada
(Verma) Royal College of Surgeons in Ireland, Dublin, Ireland
(Yokoyama) Department of Surgery, St Luke's University Health Network,
Bethlehem, Pennsylvania, United States
(Teoh) Division of Endocrinology and Metabolism, Li Ka Shing Knowledge
Institute of St Michael's Hospital, Toronto, ON, Canada
(Cheema) Division of Cardiology, Southlake Regional Health Centre,
Newmarket, ON, Canada
(de Varennes) Division of Cardiac Surgery, Royal Victoria Hospital, McGill
University Health Center, Montreal, QC, Canada
(Leong-Poi, Connelly) Department of Medicine, University of Toronto,
Toronto, ON, Canada
(Verma) Department of Pharmacology and Toxicology, University of Toronto,
Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Predischarge elevated mean mitral gradients (>5 mm Hg) may
occur after repair for degenerative mitral regurgitation. We sought to
identify risk factors associated with elevated gradients and to evaluate
its impact on functional outcomes at 12 months in this subanalysis of the
Canadian Mitral Research Alliance CardioLink-2 trial. Method(s): One
hundred four patients with degenerative mitral regurgitation undergoing
mitral repair were randomized to either a leaflet resection or
preservation strategy. Logistic regression was used to identify risk
factors associated with an elevated gradient. Functional outcomes at 12
months were compared between participants with and without elevated
gradients. Result(s): Elevated gradients was identified in 15
participants (14.4%), which was not significantly different based on
allocation to each repair strategy (P = .10). Patients with elevated
gradients were more likely to be women (odds ratio [OR], 4.28; 95%
confidence interval [CI], 1.29-14.19; P = .02) and to have a lower
preoperative hemoglobin level (OR, 0.93; 95% CI, 0.89-0.98; P = .01) and
smaller intercommissural diameter (OR, 0.86; 95% CI, 0.76-0.97; P = .02)
and mitral annuloplasty size (OR, 0.71; 95% CI, 0.57-0.87; P = .001). The
ratio of intercommissural diameter-to-annuloplasty size was similar
between those with and without elevated gradients (both 0.8 +/- 0.1, P =
.69). At 12 months those with elevated gradients had a worse New York
Heart Association functional status (P = .0001), lower peak oxygen
saturation in exercise test (P = .01), smaller body weight-walk distance
product (P = .02), and higher Borg scale (P = .01) in the 6-minute walk
test. Conclusion(s): Female gender, smaller mitral anatomy sizes, and
lower preoperative hemoglobin levels were associated with postoperative
elevated mitral gradients, which was in turn were associated with reduced
functional status. Further research is warranted to investigate these
potential risk factors. Copyright © 2023

<3>
Accession Number
2022013500
Title
Perioperative care bundles for the prevention of surgical-site infections:
Meta-analysis.
Source
British Journal of Surgery. 109(10) (pp 933-942), 2022. Date of
Publication: 01 Oct 2022.
Author
Wolfhagen N.; Boldingh Q.J.J.; Boermeester M.A.; De Jonge S.W.
Institution
(Wolfhagen, Boldingh, Boermeester, De Jonge) Amsterdam UMC Location
University of Amsterdam, Department of Surgery, Meibergdreef 9, Amsterdam,
Netherlands
(Wolfhagen, Boldingh, Boermeester, De Jonge) Amsterdam Gastroenterology
Endocrinology & Metabolism (AGEM), Amsterdam, Netherlands
Publisher
Oxford University Press
Abstract
Background: Care bundles are used widely to prevent surgical-site
infections (SSIs). Recent systematic reviews suggested larger effects from
bundles with more interventions. These reviews were largely based on
uncontrolled before-after studies and did not consider their biases. The
aim of this meta-analysis was to determine the effectiveness of care
bundles to prevent SSIs and explore characteristics of effective care
bundles. Method(s): A systematic review, reanalysis, and
meta-analysis of available evidence were undertaken. RCTs, controlled
before-after studies, and uncontrolled before-after studies with
sufficient data for reanalysis as interrupted time series studies (ITS)
were eligible. Studies investigating the use of a care bundle, with at
least one intraoperative intervention, compared with standard care were
included. Result(s): Four RCTs, 1 controlled before-after study, and
13 ITS were included. Pooled data from RCTs were heterogeneous.
Meta-analysis of ITS resulted in a level change of -1.16 (95 per cent
c.i.-1.78 to -0.53), indicating a reduction in SSI. The effect was larger
when the care bundle comprised a higher proportion of evidence-based
interventions. Meta-regression analyses did not show statistically
significant associations between effect estimates and number of
interventions, number of evidence-based interventions, or proportion of
evidence-based interventions. Conclusion(s): Meta-analysis of ITS
indicated that perioperative care bundles prevent SSI. This effect is
inconsistent across RCTs. Larger bundles were not associated with a larger
effect, but the effect may be larger if the care bundle contains a high
proportion of evidence-based interventions. No strong evidence for
characteristics of effective care bundles was identified. Copyright
© 2022 The Author(s). Published by Oxford University Press on behalf
of BJS Society Ltd.

<4>
Accession Number
2016163062
Title
A Japanese Dose of Prasugrel versus a Standard Dose of Clopidogrel in
Patients with Acute Myocardial Infarction from the K-ACTIVE Registry.
Source
Journal of Clinical Medicine. 11(7) (no pagination), 2022. Article Number:
2016. Date of Publication: April-1 2022.
Author
Mori H.; Mizukami T.; Maeda A.; Fukui K.; Akashi Y.; Ako J.; Ikari Y.;
Ebina T.; Tamura K.; Namiki A.; Michishita I.; Kimura K.; Suzuki H.
Institution
(Mori, Mizukami, Maeda, Suzuki) Department of Cardiology, Showa University
Fujigaoka Hospital, Yokohama 227-8501, Japan
(Fukui) Kanagawa Cardiovascular and Respiratory Center, Department of
Cardiology, Yokohama 236-0051, Japan
(Akashi) Department of Cardiology, St. Marianna University School of
Medicine, Kawasaki 216-8511, Japan
(Ako) Department of Cardiology, Kitasato University School of Medicine,
Sagamihiara 252-0375, Japan
(Ikari) Department of Cardiology, Tokai University School of Medicine,
Isehara 259-1193, Japan
(Ebina) Department of Laboratory Medicine, Yokohama City University
Medical Center, Yokohama 232-0024, Japan
(Tamura) Department of Cardiology, Yokohama City University Graduate
School of Medicine, Yokohama 236-0004, Japan
(Namiki) Department of Cardiology, Kanto Rosai Hospital, Kawasaki
211-8510, Japan
(Michishita) Department of Cardiology, Yokohama Sakae Kyosai Hospital,
Yokohama 247-8581, Japan
(Kimura) Department of Cardiology, Yokohama City University Medical
Center, Yokohama 232-0024, Japan
Publisher
MDPI
Abstract
Background: Dual antiplatelet therapy (DAPT) with aspirin plus P2Y12
inhibitor is used as a standard therapy for patients with acute myocardial
infarction (AMI) treated with drug-eluting stents (DESs). In Japan,
clopidogrel was the major P2Y12 inhibitor used for a decade until the new
P2Y12 inhibitor, prasugrel, was introduced. Based on clinical studies
considering Japanese features, the set dose for prasugrel was reduced to
20 mg as a loading dose (LD) and 3.75 mg as a maintenance dose (MD); these
values are 60 and 10 mg, respectively, globally. Despite this dose
discrepancy, little real-world clinical data regarding its efficacy and
safety exist. Method(s): From the K-ACTIVE registry, based on the
DAPT regimen, patients were divided into a prasugrel group and a
clopidogrel group. The ischemic event was a composite of cardiovascular
death, non-fatal MI, and non-fatal stroke. The bleeding event was type 3
or 5 bleeding based on the Bleeding Academic Research Consortium (BARC)
criteria. Result(s): Substantially more patients were prescribed
prasugrel (n = 2786) than clopidogrel (n = 890). Clopidogrel tended to be
selected over prasugrel in older patients with numerous comorbidities.
Before adjustments were made, the cumulative incidence of ischemic events
at 1 year was significantly greater in the clopidogrel group than in the
prasugrel group (p = 0.007), while the cumulative incidence of bleeding
events at 1 year was comparable between the groups (p = 0.131). After
adjustments were made for the age, sex, body weight, creatine level, type
of AMI, history of MI, approach site, oral anticoagulation therapy,
presence of multivessel disease, Killip classification, and presence of
intra-aortic balloon pumping, both ischemic and bleeding events became
comparable between the groups. Conclusion(s): A Japanese dose of
prasugrel was commonly used in AMI patients in the real-world database.
Both the prasugrel and clopidogrel groups showed comparable rates of 1
year ischemic and bleeding events. Copyright © 2022 by the
authors. Licensee MDPI, Basel, Switzerland.

<5>
Accession Number
640025346
Title
Effects of early mobilization on pulmonary parameters and complications
post coronary artery bypass graft surgery.
Source
Applied nursing research : ANR. 69 (pp 151653), 2023. Date of Publication:
01 Feb 2023.
Author
Esmealy L.; Allahbakhshian A.; Gholizadeh L.; Khalili A.F.; Sarbakhsh P.
Institution
(Esmealy) Faculty of Nursing and Midwifery, Tabriz University of Medical
Sciences, Tabriz, East Azerbaijan, Iran, Islamic Republic of
(Allahbakhshian, Khalili) Faculty of Nursing and Midwifery, Tabriz
University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Gholizadeh) Faculty of Health, University of Technology Sydney, Sydney,
Australia
(Sarbakhsh) Department of Statistics and Epidemiology, School of Public
Health, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic
Republic of
Publisher
NLM (Medline)
Abstract
This study compared the effects of a four-phase and a three-phase early
mobilization protocol on respiratory parameters and complications in
patients following coronary artery bypass graft surgery. This is a
three-arm, parallel-group, randomized controlled clinical trial with 120
candidates for coronary artery bypass graft surgery. Participants were
randomly allocated to three groups: four-phase early mobilization
protocol, three-phase early mobilization protocol, and control. Arterial
blood gases, oxygen saturation, and incidence of pulmonary complications
were compared among the groups. Mean arterial blood gases and oxygen
saturation improved significantly over time in both four-phase early
mobilization protocol and three-phase early mobilization protocol groups
compared to control (p < 0.05). There were observed trends for greater
improvements in the study outcomes with three-phase early mobilization
protocol than four-phase early mobilization protocol; however, did not
reach statistically significant levels. The incidence of pulmonary
complications was significantly in both intervention groups compared to
control (odds ratio: 0.48, 95 % CI 0.007-0.537; p < 0.001). Both
four-phase early mobilization and the three-phase early mobilization
protocols improved respiratory parameters and reduced pulmonary
complications. Statistically insignificant trends were found trends in the
three-phase early mobilization protocol, focusing on chest physiotherapy
and breathing exercises. Copyright © 2022. Published by Elsevier
Inc.

<6>
Accession Number
639819276
Title
The effect of applying telehealth education to home care of infants after
congenital heart disease surgery.
Source
International journal for quality in health care : journal of the
International Society for Quality in Health Care. 35(1) (no pagination),
2023. Date of Publication: 14 Jan 2023.
Author
Zhang Q.-L.; Lin S.-H.; Lin W.-H.; Chen Q.; Cao H.
Institution
(Zhang, Lin, Lin, Chen, Cao) Department of Cardiac Surgery, Fujian
Children's Hospital (Fujian Branch of Shanghai Children's Medical Center),
College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics,
Fujian Medical University, No. 966 of Hengyu Road, Fuzhou, Fujian 350001,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The purpose of this study was to investigate the effect of
applying telehealth education to home care of infants after congenital
heart disease (CHD) surgery. METHOD(S): A prospective randomized
controlled study was conducted from July 2020 to February 2021 in Fujian
Children's Hospital to compare the home care condition of infants after
CHD surgery between the intervention group and the control group.
 RESULT(S): At 3months after discharge, parents' caring ability and
CHD knowledge in the intervention group were significantly better than
those in the control group and were significantly improved compared with
those at discharge time (P<0.05). The parental care burden in the
intervention group was significantly lower than that in the control group
and was significantly lower than that at discharge time (P<0.05). During
the follow-up period, the rate of loss of follow-up and complications in
the intervention group were significantly lower than those in the control
group (P<0.05). CONCLUSION(S): Telehealth education via WeChat can
effectively improve the knowledge of disease and home care ability of
parents of infants after CHD surgery and reduce their home care burden,
which can effectively reduce the incidence of complications and lost to
follow-up rate after discharge. Copyright © The Author(s) 2023.
Published by Oxford University Press on behalf of International Society
for Quality in Health Care. All rights reserved. For permissions, please
e-mail: journals.permissions@oup.com.

<7>
Accession Number
637710069
Title
Cold application for pain and anxiety reduction following chest tube
removal: A systematic review and meta-analysis.
Source
Journal of clinical nursing. 32(3-4) (pp 574-583), 2023. Date of
Publication: 01 Feb 2023.
Author
Chen C.-T.; Tung H.-H.; Chen Y.-C.; Wang J.-L.; Tsai S.-H.; Huang Y.-T.;
Hsu T.-F.
Institution
(Chen, Tung, Hsu) College of Nursing, National Yang Ming Chiao Tung
University, Taipei, Taiwan (Republic of China)
(Chen, Chen) Department of Nursing, College of Medicine, National Cheng
Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
(Republic of China)
(Chen) Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan (Republic of China)
(Wang, Tsai) Department of Internal Medicine, College of Medicine,
National Cheng Kung University Hospital, National Cheng Kung University,
Tainan, Taiwan (Republic of China)
(Huang) Department of Surgery, College of Medicine, National Cheng Kung
University Hospital, National Cheng Kung University, Tainan, Taiwan
(Republic of China)
(Hsu) Department of Emergency Medicine, Taipei Veterans General Hospital,
Taipei, Taiwan (Republic of China)
(Hsu) Center for Evidence-Based Medicine, Taipei Veterans General
Hospital, Taipei, Taiwan (Republic of China)
Publisher
NLM (Medline)
Abstract
AIM AND OBJECTIVES: To conduct a systematic review and meta-analysis to
evaluate the effects of cold application on pain and anxiety reduction
after chest tube removal (CTR). BACKGROUND: The act of removing the chest
tube often causes pain among cardiothoracic surgery patients. Most
guidelines regarding CTR do not mention pain management. The effects of
cold application on reducing pain and anxiety after CTR are inconsistent.
DESIGN: Systematic review and meta-analysis. METHOD(S): We searched
six databases, including Embase, Ovid Medline, Cochrane Library, Scopus,
the Index to Taiwan Periodical Literature System and Airiti Library, to
identify relevant articles up to the end of February 2021. We limited the
language to English and Chinese and the design to randomised controlled
trials (RCTs). All studies were reviewed by two independent investigators.
The Cochrane Collaboration's tool was used to assess the risk of bias,
Review Manager 5.4 was used to conduct the meta-analysis. The Grading of
Recommendations, Assessment, Development and Evaluation (GRADE)
methodology was used for assessing certainty of evidence (CoE).
 RESULT(S): Ten RCTs with 683 participants were included in the
meta-analysis. The use of cold application could effectively reduce pain
and anxiety after CTR. The subgroup showed that a skin temperature drops
to 13degreeC of cold application was significantly more effective for the
immediate reduction in pain intensity after CTR compared with control
group. The GRADE methodology demonstrated that CoE was very low level.
 CONCLUSION(S): Cold application is a safe and easy-to-administer
nonpharmacological method with immediate and persistent effects on pain
and anxiety relief after CTR. Skin temperature drops to 13degreeC or lasts
20 min of cold application were more effective for immediate reduction of
pain intensity following CTR. RELEVANCE TO CLINICAL PRACTICE: In addition
to pharmacological strategy, cold application could be used as evidence
for reducing pain intensity and anxiety level after CTR. Copyright
© 2022 John Wiley & Sons Ltd.

<8>
Accession Number
2013157768
Title
Del Nido cardioplegia for myocardial protection in adult cardiac surgery:
a systematic review and update meta-analysis.
Source
Perfusion (United Kingdom). 38(1) (pp 6-17), 2023. Date of Publication:
January 2023.
Author
Zhai K.; Cheng X.; Zhang P.; Wei S.; Huang J.; Wu X.; Gao B.; Li Y.
Institution
(Zhai, Cheng, Zhang, Wei, Huang, Wu, Gao, Li) Department of Cardiac
Surgery, Lanzhou University Second Hospital, Lanzhou University, Lanzhou,
China
(Zhai, Cheng, Zhang, Wei, Huang, Li) Laboratory of Extracorporeal Life
Support, Lanzhou University Second Hospital, Lanzhou University, Lanzhou,
China
Publisher
SAGE Publications Ltd
Abstract
Objective: Although the application of del Nido cardioplegia solution
(DNC) in adult cardiac surgery is accumulating, the feasibility and safety
of this myocardial protection strategy in adults remains controversial. We
aimed to update our previous meta-analysis to determine the myocardial
protective effect of DNC versus conventional cardioplegia (CC) in adult
cardiac surgery. Method(s): A comprehensive literature search was
performed using PubMed, EMBASE, the Cochrane Library, and International
Clinical Trials Registry Platform databases through November 2020.
 Result(s): Thirty-seven observational studies and four randomized
controlled trials (RCTs) including 21,779 patients were identified. The
DNC group was associated with decreased postoperative cardiac enzymes
[troponin T (cTnT) and creatine kinase-MB (CK-MB)] [standardized mean
differences (SMD): -0.59, 95% confidence interval (CI): -0.99 to -0.19, p
= 0.004], cardiopulmonary bypass (CPB) time (MD: -9.31, 95% CI: -13.10 to
-5.51, p < 0.00001), aortic cross-clamp (ACC) time (MD: -7.20, 95% CI:
-10.31 to -4.09, p < 0.00001), and cardioplegia volume (SMD: -1.95, 95%
CI: -2.46 to -1.44, p < 0.00001). Intraoperative defibrillation
requirement was less in the DNC group [relative risk (RR): 0.50, 95% CI:
0.33 to 0.75, p = 0.0007]. The pooled analysis revealed no significant
difference in operative mortality among the patients assigned to DNC and
those undergoing CC. Conclusion(s): In adult cardiac surgery,
compared to CC, myocardial protection used with DNC yield similar or
better short-term clinical outcomes. More high-quality trials and RCTs
reflecting long-term follow-up morbidity and mortality are required in the
future to confirm these findings. Copyright © The Author(s) 2021.

<9>
Accession Number
640026850
Title
Effects of different doses of glucocorticoids on postoperative atrial
fibrillation: a meta-analysis.
Source
BMC cardiovascular disorders. 23(1) (pp 16), 2023. Date of Publication: 12
Jan 2023.
Author
Zhou Z.; Long Y.; He X.; Li Y.
Institution
(Zhou, He, Li) Department of Cardiology, Chongqing Traditional Chinese
Medicine Hospital, Chongqing 400025, China
(Long) Department of Cardiology, Chongqing Traditional Chinese Medicine
Hospital, Chongqing 400025, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) is the most common
arrhythmia after cardiac surgery, and its occurrence is closely related to
inflammation. This paper intends to apply meta-analysis to investigate the
effect of glucocorticoids on POAF. METHOD(S): PubMed, Embase, Web of
Science, and Cochrane Library were searched using the internationally
recognized systematic evaluation and retrieval strategy. Two review
authors independently selected relevant studies and extracted data based
on the Cochrane handbook for systematic reviews of interventions approach.
Stata 17 was used for data analysis. In the subgroup analysis, we grouped
the participant data according to differences in glucocorticoids dose and
type of surgery. At the same time, we also conducted a meta-analysis on
the possible infection and gastrointestinal injury caused by
glucocorticoids use. RESULT(S): 27 studies and 14,442 patients were
finally included. Results from the random-effects model indicated that the
incidence of POAF was lower in glucocorticoid group (RR 0.80, 95% CI
0.71-0.92, P=0.001). According to the subgroup analysis result, low doses
of glucocorticoids reduced the incidence of POAF (RR 0.81, 95% CI
0.71-0.92, P=0.001). The effect of high doses glucocorticoids on the POAF
was not statistically significant (RR 0.81, 95% CI 0.56-1.19, P=0.286). In
the coronary artery bypass grafting (CABG) subgroup, the glucocorticoids
reduced the incidence of POAF (RR 0.71, 95% CI 0.58-0.87, P=0.001). In the
CABG OR Valvular Surgery group, the effect of glucocorticoids on POAF was
not statistically significant (RR 0.88, 95% CI 0.75-1.03, P=0.108). 15
studies documented postoperative complications of infection, two studies
were excluded from the system because the end point event was 0, and
meta-analysis showed no increased risk of infection from glucocorticoid
use (RR 0.85, 95% CI 0.68-1.06, P=0.158). Eight studies documented the
effects of glucocorticoids on gastrointestinal diseases, and meta-analysis
showed no differences between the two groups (RR 1.12, 95% CI 0.83-1.50,
P=0.450). CONCLUSION(S): The use of glucocorticoids can reduce the
incidence of POAF. The subgroup analysis result showed that low-dose
glucocorticoids were more effective than high-dose glucocorticoids in
inhibiting POAF. The use of glucocorticoids in CABG alone can better
inhibit the occurrence of POAF. The effects of glucocorticoids on
infection and gastrointestinal injury were not statistically significant.
REVIEW REGISTRATION: PROSPERO, CRD42022304521. Copyright © 2023.
The Author(s).

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

<11>
Accession Number
2022248353
Title
Comparison of Mixed Venous saturation in Patients Undergoing Coronary
Artery Bypass Graft Surgery with High Thoracic Epidural versus
Conventional Opioids Anaesthesia: A Randomized Control Study.
Source
European Journal of Molecular and Clinical Medicine. 10(1) (pp 2356-2366),
2023. Date of Publication: December 2023.
Author
Juneja A.; Sharma V.; Joey A.
Institution
(Juneja, Sharma, Joey) Dr. D. Y. Patil Medical College and Hospital,
Pimpri, Pune 411018, India
Publisher
EJMCM, International House
Abstract
Background: In coronary artery disease (CAD) a mismatch exists between
myocardial oxygen consumption and supply. Anesthetic goal targets balance
between this supply and demand perioperatively for improved tissue
perfusion. Studies show high thoracic epidural anesthesia (HTEA) helps to
achieve this goal. Aims and Objective: To find out the effectiveness of
HTEA in achieving improved tissue perfusion as measured by mixed venous
oxygen saturation (SvO2) in patients undergoing coronary artery bypass
grafting (CABG). Design of Study: Randomized control study
 Material(s) and Method(s): Prospective randomized control study,
where patients undergoing CABG were randomized into 2 groups; Group A:
general anesthesia with HTEA and Group B: general anesthesia with
conventional opioids. The objectives were to compare SvO2, heart rate
(HR), blood pressure [systolic blood pressure (SBP), diastolic blood
pressure (DBP), mean arterial pressure (MAP)], pulmonary artery wedge
pressure (PWAP) and blood lactate levels. Sample size: Sample size was
calculated to be 14, seven in each group using WinPepi software. For
better evaluation of results, we have taken 28 patients, 14 in each group.
 Result(s): Parameters like SvO2, HR, SBP, DBP, MAP, PAWP, blood
lactate levels were better controlled in Group A than B intraoperatively
as well as postoperatively. Conclusion(s): We conclude that there is
better myocardial consumption and supply balance and improved tissue
perfusion as measured by SvO2 in patients receiving HTEA in conjunction
with general anesthesia as compared in general anesthesia with
conventional opioids. Copyright © 2023 Ubiquity Press. All rights
reserved.

<12>
Accession Number
2022161468
Title
Comparison between dexmedetomidine and fentanyl for sedation efficacy
during mechanical ventilation and time taken for in post-operative adult
cardiac surgical patients.
Source
European Journal of Molecular and Clinical Medicine. 9(7) (pp 9197-9206),
2022. Date of Publication: June 2022.
Author
Behera A.; Brahma P.K.; Singh J.
Institution
(Behera, Singh) Department of Anesthesia, IMS and SUM Hospital, Siksha 'O'
Anusandhan Deemed to be University, K8, Kalinga Nagar, Odisha, Bhubaneswar
751003, India
(Brahma) Department of Community Medicine, IMS and SUM Hospital, Siksha
'O' Anusandhan Deemed to be University, K8, Kalinga Nagar, Odisha,
Bhubaneswar 751003, India
Publisher
EJMCM, International House
Abstract
Aims and Objectives: To compare the efficacy of sedation and time taken
for extubation using dexmedetomidine and fentanyl sedation in
post-operative adult cardiac surgical patients. Method(s): A
prospective randomized double-blind study involving 60 patients undergoing
open heart surgery was conducted. The patients were divided into two
groups, each involving 30 patients. One group received fentanyl at 1
microg/kg/h (Group A) and the other received dexmedetomidine at 0.5
microg/kg/h (Group B) for post-operative sedation with intermittent rescue
dose of fentanyl 0.5 microg/kg bolus in either group as per requirement.
The efficacy of sedation was assessed using the Ramsay sedation score. The
time taken for extubation from the stoppage of infusion was noted. An open
heart surgery prospective randomized double-blind trial including 60
patients was carried out. Two groups of 30 patients each were formed from
the patients. With occasional rescue doses of fentanyl 0.5 g/kg bolus in
either group as needed, one group (Group A) received fentanyl at 1 g/kg/h
and the other (Group B) received dexmedetomidine at 0.5 g/kg/h for
postoperative sedation. The Ramsay sedation score was used to evaluate the
effectiveness of the sedation. It was noticed how long it took to extubate
once the infusion was stopped. Result(s): Haemodynamic parameters
between the two groups were comparable. Sedation scores between fentanyl
and dexmedetomidine groups were comparable. Average time (in minutes)
required for extubation was 140.04 (+/-43.6 SD) in the dexmedetomidine
group compared with 359.4 (+/-93.3 SD) in the fentanyl group. The
difference in mean time for extubation was statistically significant.
 Conclusion(s): As compare to fentanyl Dexmedetomidine facilitates
adequate sedation for mechanical ventilation and also early
extubation. Copyright © 2022 Authors. All rights reserved.

<13>
Accession Number
2022205975
Title
Impact of coronary-subclavian steal after surgical myocardial
revascularization with internal thoracic artery in chronic hemodialysis
patients: A meta-analysis.
Source
Trends in Cardiovascular Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Baudo M.; Torregrossa G.; Dokollari A.; Bisleri G.; Bacco L.D.; Benussi
S.; Muneretto C.; Rosati F.
Institution
(Baudo, Bacco, Benussi, Muneretto, Rosati) Division of Cardiac Surgery,
Spedali Civili di Brescia, University of Brescia, Piazza Spedali Civili,
1, Brescia 25123, Italy
(Torregrossa, Dokollari) Division of Cardiac Surgery, Main Line Health -
Lankenau Heart Institute, Wynnewood, PA, United States
(Bisleri) Division of Cardiac Surgery, St Michael's Hospital, University
of Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Patients in hemodialysis with an arm arteriovenous fistula undergoing
coronary artery bypass grafting (CABG) with an internal thoracic artery
have been reported to suffer from coronary-subclavian steal (CSS) during
dialysis session. However, its occurrence is still debated. A systematic
literature review was performed to identify all studies investigating the
occurrence of a CSS event in this subset of patients. The primary endpoint
was the analysis of CSS and the following early and late survival
outcomes. Independent determinants of CSS and the impact of the distance
between the arteriovenous fistula (upper arm vs forearm) and the
ipsilateral internal thoracic artery graft on CSS events and mortality
were studied. Early and late survival outcomes were analyzed by comparing
ipsilateral versus contralateral arteriovenous fistula. Of the 1,383
retrieved articles, 10 were included (n = 643 patients). The pooled event
rate of CSS was 6.46% [95%CI=2.10-18.15], while of symptomatic CSS
incidence was 3.99% [95%CI=0.95-15.25]. No survival differences were noted
when comparing ipsilateral to contralateral arteriovenous fistula-internal
thoracic artery combinations. On meta-regression, the upper arm was
associated with more CSS events, while the forearm to lower late mortality
rates. Independently from arteriovenous fistula-internal thoracic artery
combination, CSS was not associated to higher mortality rates. Particular
attention is warranted when selecting the type of conduits for CABG in
patients with an arteriovenous fistula or if highly expected to need one
in the near future after surgery. A contralateral arteriovenous
fistula-internal thoracic artery combination is preferable. If this is not
possible, a forearm arteriovenous fistula position should be
preferred. Copyright © 2023 Elsevier Inc.

<14>
Accession Number
637880009
Title
CT or Invasive Coronary Angiography in Stable Chest Pain.
Source
New England Journal of Medicine. 386(17) (pp 1591-1602), 2022. Date of
Publication: 28 Apr 2022.
Author
Maurovich-Horvat P.; Bosserdt M.; Kofoed K.F.; Rieckmann N.; Benedek T.;
Donnelly P.; Rodriguez-Palomares J.; Erglis A.; Stechovsky C.; Sakalyte
G.; Adic N.C.; Gutberlet M.; Dodd J.D.; Diez I.; Davis G.; Zimmermann E.;
Kepka C.; Vidakovic R.; Francone M.; Ilnicka-Suckiel M.; Plank F.; Knuuti
J.; Faria R.; Schroder S.; Berry C.; Saba L.; Ruzsics B.; Kubiak C.;
Gutierrez-Ibarluzea I.; Hansen K.S.; Muller-Nordhorn J.; Merkely B.;
Knudsen A.D.; Benedek I.; Orr C.; Valente F.X.; Zvaigzne L.; Suchanek V.;
Zajanckauskiene L.; Adic F.; Woinke M.; Hensey M.; Lecumberri I.; Thwaite
E.; Laule M.; Kruk M.; Neskovic A.N.; Mancone M.; Kusmierz D.; Feuchtner
G.; Pietila M.; Ribeiro V.G.; Drosch T.; Delles C.; Matta G.; Fisher M.;
Szilveszter B.; Larsen L.; Ratiu M.; Kelly S.; Del Blanco B.G.; Rubio A.;
Drobni Z.D.; Jurlander B.; Rodean I.; Regan S.; Calabria H.C.; Boussoussou
M.; Engstrom T.; Hodas R.; Napp A.E.; Haase R.; Feger S.; Serna-Higuita
L.M.; Neumann K.; Dreger H.; Rief M.; Wieske V.; Estrella M.; Martus P.;
Dewey M.
Institution
(Maurovich-Horvat, Merkely, Szilveszter, Drobni, Boussoussou) The Heart
and Vascular Center, Semmelweis University, Budapest, Hungary
(Maurovich-Horvat) The Department of Radiology, Medical Imaging Center,
Semmelweis University, Budapest, Hungary
(Bosserdt, Zimmermann, Napp, Haase, Feger, Rief, Wieske, Estrella, Dewey)
The Department of Radiology, Charite-Universitatsmedizin Berlin, Freie
Universitat, Berlin, Germany
(Laule, Dreger) The Department of Cardiology and Angiology,
Charite-Universitatsmedizin Berlin, Freie Universitat, Berlin, Germany
(Rieckmann, Muller-Nordhorn) The Institute of Public Health,
Charite-Universitatsmedizin Berlin, Freie Universitat, Berlin, Germany
(Neumann) The Institute of Biometry and Clinical Epidemiology,
Charite-Universitatsmedizin Berlin, Freie Universitat, Berlin, Germany
(Dreger, Dewey) Humboldt-Universitat zu Berlin, DZHK (German Center for
Cardiovascular Research) Partner Site Berlin, Berlin, Germany
(Dewey) Berlin Institute of Health, Berlin University Alliance, Berlin,
Germany
(Gutberlet) The Department of Radiology, University of Leipzig Heart
Center, Leipzig, Germany
(Schroder, Drosch) The Department of Cardiology, Alb Fils Kliniken,
Goppingen, Germany
(Muller-Nordhorn) The Bavarian Cancer Registry, Bavarian Health and Food
Safety Authority, Munich, Germany
(Serna-Higuita, Martus) The Department of Clinical Epidemiology and
Applied Biostatistics, Universitatsklinikum Tubingen, Tubingen, Germany
(Kofoed, Knudsen, Engstrom) The Department of Cardiology, Rigshospitalet,
University of Copenhagen, Copenhagen, Denmark
(Kofoed, Knudsen) The Department of Radiology, Rigshospitalet, University
of Copenhagen, Copenhagen, Denmark
(Kofoed, Knudsen, Larsen, Jurlander, Engstrom) The Department of Clinical
Medicine, Faculty of Health and Medical Sciences, University of
Copenhagen, Copenhagen, Denmark
(Hansen) The Department of Public Health, Section for Health Services
Research, University of Copenhagen, Copenhagen, Denmark
(Larsen) The Department of Cardiology, Herlev-Gentofte Hospital, Hellerup,
Denmark
(Jurlander) The Department of Cardiology, Nordsjaellands Hospital,
Hillerod, Denmark
(Benedek, Hodas) The Department of Internal Medicine, Clinic of
Cardiology, Targu Mures, Romania
(Ratiu) The Department of Radiology and Medical Imaging, Targu Mures,
Romania
(Benedek) George Emil Palade University of Medicine, Pharmacy, Science,
and Technology, County Clinical Emergency Hospital Targu Mures, Targu
Mures, Romania
(Benedek, Rodean) The Center of Advanced Research in Multimodality Cardiac
Imaging, CardioMed Medical Center, Targu Mures, Romania
(Donnelly, Orr, Kelly, Regan) The Department of Cardiology, Southeastern
Health and Social Care Trust, Belfast, United Kingdom
(Davis) The Department of Cardiology, Aintree University Hospital, United
Kingdom
(Thwaite) The Department of Radiology, Aintree University Hospital, United
Kingdom
(Ruzsics, Fisher) The Department of Cardiology, Royal Liverpool University
Hospital, Institute for Cardiovascular Medicine and Science, Liverpool
Heart and Chest Hospital, United Kingdom
(Fisher) The Faculty of Health and Life Sciences, University of Liverpool,
Liverpool, United Kingdom
(Davis) Edge Hill University, Ormskirk, United Kingdom
(Berry, Delles) The Institute of Cardiovascular and Medical Sciences,
University of Glasgow, Glasgow, United Kingdom
(Berry) Golden Jubilee National Hospital, Clydebank, United Kingdom
(Rodriguez-Palomares, Valente, Del Blanco) The Department of Cardiology,
Hospital Universitario Vall d'Hebron, Institut de Recerca, Universitat
Autonoma de Barcelona, Barcelona, Spain
(Calabria) The Department of Radiology, Hospital Universitario Vall
d'Hebron, Institut de Recerca, Universitat Autonoma de Barcelona,
Barcelona, Spain
(Rodriguez-Palomares, Valente, Del Blanco) Centro de Investigacion
Biomedica en Red, Madrid, Spain
(Diez, Lecumberri, Rubio) The Department of Cardiology, Spain
(Diez, Lecumberri, Rubio) The Department of Radiology, Spain
(Gutierrez-Ibarluzea) Basurto Hospital, Bilbao, Basque Foundation for
Health Innovation and Research, Barakaldo, Basque Office for Health
Technology Assessment, Vitoria-Gasteiz, Spain
(Erglis) The Department of Cardiology, Riga, Latvia
(Stechovsky) The Department of Cardiology, Motol University Hospital,
Prague, Czechia
(Sakalyte, Zajanckauskiene) The Department of Cardiology, Medical Academy,
Lithuanian University of Health Sciences, Kaunas, Lithuania
(Sakalyte, Zajanckauskiene) The Department of Cardiology, Hospital of
Lithuanian University of Health Sciences, Kaunas, Lithuania
(Adic, Adic) The Faculty of Medicine, University of Novi Sad, Department
of Cardiology, Institute for Cardiovascular Diseases of Vojvodina, Novi
Sad, Serbia
(Vidakovic, Neskovic) The Department of Cardiology, Internal Medicine
Clinic, Clinical Hospital Center Zemun, Faculty of Medicine, University of
Belgrade, Belgrade, Serbia
(Dodd) The Department of Radiology, Dublin, Ireland
(Hensey) The Department of Cardiology, Dublin, Ireland
(Dodd) St. Vincent's University Hospital and School of Medicine,
University College Dublin, Dublin, Ireland
(Kepka, Kruk) The National Institute of Cardiology, Warsaw, Poland
(Ilnicka-Suckiel) The Department of Cardiology, Provincial Specialist
Hospital in Wroclaw, Wroclaw, Poland
(Kusmierz) The Department of Radiology, Provincial Specialist Hospital in
Wroclaw, Wroclaw, Poland
(Mancone) The Department of Clinical Internal, Anesthesiologic, and
Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
(Francone) The Department of Biomedical Sciences, Humanitas University,
IRCCS Humanitas Research Hospital, Milan, Italy
(Saba) The Department of Radiology, University of Cagliari, Cagliari,
Italy
(Matta) The Department of Radiology, Azienda Ospedaliera Brotzu, Cagliari,
Italy
(Plank) The Department of Internal Medicine III, The Department of
Cardiology, Innsbruck Medical University, Innsbruck, Austria
(Feuchtner) The Department of Radiology, Innsbruck Medical University,
Innsbruck, Austria
(Knuuti) The Turku PET Center, Turku, Finland
(Pietila) Heart Center, Turku University Hospital, University of Turku,
Turku, Finland
(Pietila) The Administrative Center, Health Care District of Southwestern
Finland, Turku, Finland
(Faria, Ribeiro) The Department of Cardiology, Centro Hospitalar de Vila
Nova de Gaia-Espinho, Vila Nova de Gaia, Portugal
(Kubiak) The European Clinical Research Infrastructure Network-European
Research Infrastructure Consortium, Paris, France
(Zvaigzne) Department Radiology, Riga, Latvia
(Erglis) Paul Stradins Clinical University Hospital, University of Latvia,
Riga, Latvia
(Suchanek, Woinke) The Department of Imaging Methods, Motol University
Hospital, Prague, Czechia
(Suchanek, Woinke) The Department Cardiology, University of Leipzig Heart
Center, Leipzig, Germany
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND In the diagnosis of obstructive coronary artery disease (CAD),
computed tomography (CT) is an accurate, noninvasive alternative to
invasive coronary angiography (ICA). However, the comparative
effectiveness of CT and ICA in the management of CAD to reduce the
frequency of major adverse cardiovascular events is uncertain. METHODS We
conducted a pragmatic, randomized trial comparing CT with ICA as initial
diagnostic imaging strategies for guiding the treatment of patients with
stable chest pain who had an intermediate pretest probability of
obstructive CAD and were referred for ICA at one of 26 European centers.
The primary outcome was major adverse cardiovascular events
(cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke)
over 3.5 years. Key secondary outcomes were procedure-related
complications and angina pectoris. RESULTS Among 3561 patients (56.2% of
whom were women), follow-up was complete for 3523 (98.9%). Major adverse
cardiovascular events occurred in 38 of 1808 patients (2.1%) in the CT
group and in 52 of 1753 (3.0%) in the ICA group (hazard ratio, 0.70; 95%
confidence interval [CI], 0.46 to 1.07; P=0.10). Major procedure-related
complications occurred in 9 patients (0.5%) in the CT group and in 33
(1.9%) in the ICA group (hazard ratio, 0.26; 95% CI, 0.13 to 0.55). Angina
during the final 4 weeks of follow-up was reported in 8.8% of the patients
in the CT group and in 7.5% of those in the ICA group (odds ratio, 1.17;
95% CI, 0.92 to 1.48). CONCLUSIONS Among patients referred for ICA because
of stable chest pain and intermediate pretest probability of CAD, the risk
of major adverse cardiovascular events was similar in the CT group and the
ICA group. The frequency of major procedure-related complications was
lower with an initial CT strategy. Copyright © 2022 Massachusetts
Medical Society.

<15>
Accession Number
2022142529
Title
Racial Disparity Among the Clinical Outcomes Post-Myocardial Infarction
Patients: A Systematic Review and Meta-analysis.
Source
Current Problems in Cardiology. 48(4) (no pagination), 2023. Article
Number: 101528. Date of Publication: April 2023.
Author
Jaiswal V.; Hanif M.; Ang S.P.; Mehta A.; Ishak A.; Song D.; Daneshvar F.;
Butey S.; Gera A.; Aujla S.; Raj N.; Iqbal A.; Kumar V.; Huang H.;
Mukherjee D.; Jaiswal A.; Wajid Z.
Institution
(Jaiswal, Ishak, Gera, Raj, Mukherjee, Jaiswal) JCCR Cardiology Research,
Varanasi, India
(Hanif) Department of Internal Medicine, SUNY Upstate Medical University,
NY, United States
(Ang) Department of Internal medicine, Rutgers Health/Community Medical
Center, NJ
(Mehta) University of Debrecen, Faculty of Medicine, Debrecen, Hungary
(Song) Department of Internal Medicine, Icahn School of Medicine at Mount
Sinai, NY, United States
(Daneshvar) Department of Cardiology, AdventHealth, FL
(Butey) Department of Medicine, Indira Gandhi Government Medical College,
Nagpur, India
(Aujla) Department of Medicine, Government Medical College, Punjab,
Amritsar, India
(Iqbal) Saidu Group of Teaching Hospital Swat, Dublin, Ireland
(Kumar) Department of Medicine, The Brooklyn Hospital Center, NY, United
States
(Huang) Royal College of Surgeons in Ireland, Dublin, Ireland
(Wajid) Department of Internal Medicine, Wayne State University School of
Medicine, MI
Publisher
Elsevier Inc.
Abstract
The clinical outcomes post-Myocardial Infarction (MI) between Black and
White patients have not been well studied, with limited literature
available. We conducted a meta-analysis to estimate the clinical outcomes
between Black and White patients post-MI.We systematically searched the
PubMed, Embase, and Scopus databases from inception until September 26,
2022. A total of 6 studies with 220,984 patients have been included in the
analysis. The mean age of patients with White and Black race was 68.46 and
65.14 years, respectively. The most common comorbidity among White and
Black patients was hypertension (53% vs 87.73%). Our analysis showed that
the likelihood of all-cause mortality (OR, 0.71[95%CI: 0.56-0.91]),
P=0.01] and stroke (OR, 0.74[95%CI: 0.67-0.81]), P<0.001] were
significantly lower in white patients compared with black patients.
However, Black patients had fewer utilization of CABG (OR, 1.38[95%CI:
1.19-1.62], P<0.001]) and PCI (OR, 1.31[95%CI: 1.101-1.68]), P=0.04]
compared with White patients, while 30-day mortality was comparable
between both the groups. To our knowledge, this is the first meta-analysis
with the largest sample size thus far, highlighting that Black patients
are at increased risk for all-cause mortality and stroke but have lower
utilization of revascularization among MI patients than White
patients. Copyright © 2022 Elsevier Inc.

<16>
Accession Number
2022006965
Title
Volatile Versus Total Intravenous Anesthesia on Postoperative Delirium in
Adult Patients Undergoing Cardiac Valve Surgery: A Randomized Clinical
Trial.
Source
Anesthesia and Analgesia. 136(1) (pp 60-69), 2023. Date of Publication: 01
Jan 2023.
Author
Jiang J.-L.; Zhang L.; He L.-L.; Li X.-F.; Dai S.-H.; Yu H.
Institution
(Jiang, Zhang, Yu, Li, Dai, Yu) Department of Anesthesiology, West China
Hospital, Sichuan University, Chengdu, China
(He) Department of Anesthesiology, Sichuan Jinxin Women and Children's
Hospital, Sichuan, Chengdu, China
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The effect of anesthesia regimens on postoperative delirium
after on-pump cardiac valve surgery is yet undetermined. This study aimed
to evaluate the effect of volatile anesthesia compared with propofol-based
total intravenous anesthesia (TIVA) on the occurrence of delirium after
on-pump cardiac valve surgery. METHOD(S): This randomized clinical
trial was conducted at a university academic hospital in China, from
February 2019 to January 2021. Patients scheduled for on-pump cardiac
valve surgery or combined valve with coronary artery bypass grafting
(CABG) surgeries were randomly assigned to receive anesthesia maintenance
with either a volatile anesthetic (sevoflurane or desflurane) or
propofol-based TIVA. The primary outcome was the incidence of delirium
during the first 7 days after surgery, assessed using the confusion
assessment method for the intensive care unit (ICU). The secondary
outcomes included duration of delirium, subtypes of delirium, 30-day
mortality, pain score, major morbidity (including cerebral infarction,
respiratory failure, and pneumonia), duration of mechanical ventilation,
and lengths of ICU and hospital stay. The statistical analysis of the
primary outcome variable was by Pearson's chi2test.
 RESULT(S): Among the 684 patients analyzed (mean age, 53.8 years; 381
[55.7%] women), 676 were assessed for the primary outcome. Postoperative
delirium occurred in 63 of 337 (18.7%) patients receiving volatile
anesthesia versus 76 of 339 (22.4%) patients receiving propofol-based TIVA
(relative risk, 0.80; 95% confidence interval [CI], 0.55-1.16; P =.231).
There were no significant differences between the groups in any of the
secondary outcomes. CONCLUSION(S): Among patients undergoing on-pump
cardiac valve surgery, anesthesia maintenance with a volatile agent did
not result in significantly fewer occurrences of postoperative delirium
than propofol-based TIVA. Copyright © 2023 Lippincott Williams
and Wilkins. All rights reserved.

<17>
Accession Number
2016041488
Title
Infective Endocarditis by Moraxella Species: A Systematic Review.
Source
Journal of Clinical Medicine. 11(7) (no pagination), 2022. Article Number:
1854. Date of Publication: April-1 2022.
Author
Ioannou P.; Alexakis K.; Baliou S.; Kofteridis D.P.
Institution
(Ioannou, Alexakis, Baliou, Kofteridis) Department of Internal Medicine &
Infectious Diseases, University Hospital of Heraklion, Heraklion 71110,
Greece
Publisher
MDPI
Abstract
Moraxella catarrhalis is the most clinically relevant species among
Moraxella spp. For decades, it was considered to be part of the normal
human flora in the upper respiratory tract. However, since the late 1970s,
considerable evidence has proposed that M. catarrhalis is an important
pathogen in the human respiratory tract. Even though Infective
Endocarditis (IE) is rarely caused by Moraxella spp., these infections can
be problematic due to the lack of experience in their management. The aim
of this study was to systematically review all published cases of IE by
Moraxella spp. A systematic review of PubMed, Scopus and Cochrane library
(through 8 December 2021) for studies providing epidemiological, clinical,
microbiological data as well as treatment data and outcomes of IE by
Moraxella spp. was performed. A total of 27 studies, containing data for
31 patients, were included. A prosthetic valve was present in 25.8%.
Mitral valve was the most commonly infected site. Fever, sepsis and
embolic phenomena were the most common clinical presentations.
Cephalosporins, aminoglycosides, aminopenicillins and penicillin were the
most commonly used antimicrobials. Overall mortality was
12.9%. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<18>
Accession Number
2016009877
Title
Remote Ischaemic Preconditioning in Intra-Abdominal Cancer Surgery
(RIPCa): A Pilot Randomised Controlled Trial.
Source
Journal of Clinical Medicine. 11(7) (no pagination), 2022. Article Number:
1770. Date of Publication: April-1 2022.
Author
Papadopoulou A.; Dickinson M.; Samuels T.L.; Heiss C.; Hunt J.; Forni L.;
Creagh-Brown B.C.
Institution
(Papadopoulou) Department of Anaesthesia, King's College Hospital, London
SE5 9RS, United Kingdom
(Papadopoulou, Heiss, Hunt, Forni, Creagh-Brown) Department of Clinical
and Experimental Medicine, Faculty of Health and Medical Sciences,
University of Surrey, Guildford GU2 7XH, United Kingdom
(Dickinson) Department of Anaesthesia, Royal Surrey County Hospital,
Guildford GU2 7XX, United Kingdom
(Samuels) Department of Critical Care, Surrey and Sussex Healthcare NHS
Trust, Redhill RH2 5RH, United Kingdom
(Heiss) Vascular Department, Surrey and Sussex Healthcare NHS Trust,
Redhill RH2 5RH, United Kingdom
(Forni, Creagh-Brown) Department of Critical Care, Royal Surrey County
Hospital, Guildford GU2 7XX, United Kingdom
Publisher
MDPI
Abstract
There is limited evidence on the effect of remote ischaemic
preconditioning (RIPC) following non-cardiac surgery. The aim of this
study was to investigate the effect of RIPC on morbidity following
intra-abdominal cancer surgery. We conducted a double blinded pilot
randomised controlled trial that included 47 patients undergoing surgery
for gynaecological, pancreatic and colorectal malignancies. The patients
were randomized into an intervention (RIPC) or control group. RIPC was
provided by intermittent inflations of an upper limb tourniquet. The
primary outcome was feasibility of the study, and the main secondary
outcome was postoperative morbidity including perioperative troponin
change and the urinary biomarkers tissue inhibitor of metalloproteinases-2
and insulin-like growth factor-binding protein 7 (TIMP-2*IGFBP-7). The
recruitment target was reached, and the protocol procedures were followed.
The intervention group developed fewer surgical complications at 30 days
(4.5% vs. 33%), 90 days (9.5% vs. 35%) and 6 months (11% vs. 41%)
(adjusted p 0.033, 0.044 and 0.044, respectively). RIPC was a significant
independent variable for lower overall postoperative morbidity survey
(POMS) score, OR 0.79 (95% CI 0.63 to 0.99) and fewer complications at 6
months including pulmonary OR 0.2 (95% CI 0.03 to 0.92), surgical OR 0.12
(95% CI 0.007 to 0.89) and overall complications, OR 0.18 (95% CI 0.03 to
0.74). There was no difference in perioperative troponin change or
TIMP2*IGFBP-7. Our pilot study suggests that RIPC may improve outcomes
following intra-abdominal cancer surgery and that a larger trial would be
feasible. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<19>
Accession Number
2015752913
Title
Efficacy of Levobupivacaine Alone Versus Levobupivacaine with Ketamine in
Subcutaneous Infiltration for Postoperative Analgesia in Lower Segment
Cesarean Section.
Source
International Journal of Pharmaceutical and Clinical Research. 14(2) (pp
92-99), 2022. Date of Publication: 2022.
Author
Verma R.
Institution
(Verma) Department of Anaesthesiology, Patna Medical College and Hospital,
Bihar, Patna, India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Aim: The aim of the present study to comparison of levobupivacaine alone
versus levobupivacaine with ketamine in subcutaneous infiltration for
postoperative analgesia in lower segment cesarean section.
 Material(s) and Method(s): A randomized double blind controlled study
conducted in the Department of Anaesthesiology, Patna Medical College and
Hospital, Patna, Bihar, India for 1 year. A total of 30 parturients were
randomly assigned to two groups (each with 15) based on computer-generated
random numbers kept in sealed and numbered envelopes. Parturients in Group
A received a subcutaneous surgical wound infiltration with a 0.5 percent
levobupivacaine solution diluted with normal saline to a total of 32 ml at
2 mg/kg body weight to a maximum of 150 mg. Parturients in Group B
received a subcutaneous surgical wound infiltration with a solution of 0.5
percent levobupivacaine 2 mg/kg body weight diluted with normal saline to
a total volume of 32 ml, plus ketamine 1 mg/kg body weight diluted with
normal saline to a total volume of 150 mg. The VAS scale and total
analgesic use throughout the 24-hour postoperative period were used to
assess the primary outcome, postoperative pain alleviation.
 Result(s): The mean heart rates at zero hour (baseline) were
comparable in groups A and B (P=0.871). Except at the 4th and 6th hour
post-operative, the mean heart rate of group A was greater than that of
group B, which was statistically insignificant at the majority of time
periods. Conclusion(s): In terms of greater pain relief, reduced need
for rescue opioid analgesia, and no serious side effects, the study
concluded that ketamine is a viable adjunct modality to levobupivacaine
for local wound infiltration. Copyright © 2022, Dr Yashwant
Research Labs Pvt Ltd. All rights reserved.

<20>
Accession Number
2015418115
Title
Red Flags, Prognostic Impact, and Management of Patients With Cardiac
Amyloidosis and Aortic Valve Stenosis: A Systematic Review and
Meta-Analysis.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 858281.
Date of Publication: 09 Mar 2022.
Author
Myasoedova V.A.; Conte M.; Valerio V.; Moschetta D.; Massaiu I.; Petraglia
L.; Leosco D.; Poggio P.; Parisi V.
Institution
(Myasoedova, Valerio, Moschetta, Massaiu, Poggio) Centro Cardiologico
Monzino Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS),
Milan, Italy
(Conte, Petraglia, Leosco, Parisi) Dipartimento di Scienze Mediche
Traslazionali, Universita degli Studi di Napoli Federico II, Naples, Italy
(Conte) Casa di Cura San Michele, Maddaloni, Italy
(Moschetta) Dipartimento di Scienze farmacologiche e biomolecolari,
Universita degli Studi di Milano, Milano, Italy
(Massaiu) Developmental Biology of the Immune System, Life and Medical
Sciences Institute, University of Bonn, Bonn, Germany
Publisher
Frontiers Media S.A.
Abstract
Background: Cardiac amyloidosis (CA) has been recently recognized as a
condition frequently associated with aortic stenosis (AS). The aim of this
study was to evaluate: the main characteristics of patients with AS with
and without CA, the impact of CA on patients with AS mortality, and the
effect of different treatment strategies on outcomes of patients with AS
with concomitant CA. Material(s) and Method(s): A detailed search
related to CA in patients with AS and outcomes was conducted according to
the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guidelines. Seventeen studies enrolling 1,988 subjects (1,658 AS
alone and 330 AS with CA) were included in the qualitative and
quantitative analysis of main patients with AS characteristics with and
without CA, difference in mortality, and treatment strategy.
 Result(s): The prevalence of CA resulted in a mean of 15.4% and it
was even higher in patients with AS over 80 years old (18.2%). Patients
with the dual diagnosis were more often males, had lower body mass index
(BMI), were more prone to have low flow, low gradient with reduced left
ventricular ejection fraction AS phenotype, had higher E/A and E/e', and
greater interventricular septum hypertrophy. Lower Sokolow-Lyon index,
higher QRS duration, higher prevalence of right bundle branch block,
higher levels of N-terminal pro-brain natriuretic peptide, and
high-sensitivity troponin T were significantly associated with CA in
patients with AS. Higher overall mortality in the 178 patients with AS +
CA in comparison to 1,220 patients with AS alone was observed [odds ratio
(OR) 2.25, p = 0.004]. Meta-regression analysis showed that younger age
and diabetes were associated with overall mortality in patients with CS
with CA (Z-value -3.0, p = 0.003 and Z-value 2.5, p = 0.013,
respectively). Finally, patients who underwent surgical aortic valve
replacement (SAVR) or transcatheter aortic valve implantation (TAVI) had a
similar overall mortality risk, but lower than medication-treated only
patients. Conclusion(s): Results from our meta-analysis suggest that
several specific clinical, electrocardiographic, and echocardiographic
features can be considered "red flags" of CA in patients with AS. CA
negatively affects the outcome of patients with AS. Patients with
concomitant CA and AS benefit from SAVR or TAVI. Copyright © 2022
Myasoedova, Conte, Valerio, Moschetta, Massaiu, Petraglia, Leosco, Poggio
and Parisi.

<21>
Accession Number
2021973543
Title
Deconstructing the Dogma: Systematic Literature Review and Meta-analysis
of Adjunctive Gentamicin and Rifampin in Staphylococcal Prosthetic Valve
Endocarditis.
Source
Open Forum Infectious Diseases. 9(11) (no pagination), 2022. Article
Number: ofac583. Date of Publication: 01 Nov 2022.
Author
Ryder J.H.; Tong S.Y.C.; Gallagher J.C.; Mcdonald E.G.; Thevarajan I.; Lee
T.C.; Cortes-Penfield N.W.
Institution
(Ryder, Cortes-Penfield) Department of Internal Medicine, Division of
Infectious Diseases, University of Nebraska Medical Center, Omaha, NE,
United States
(Tong, Thevarajan) Victorian Infectious Diseases Service, Royal Melbourne
Hospital, Peter Doherty Institute for Infection and Immunity, Melbourne,
Australia
(Tong, Thevarajan) Department of Infectious Diseases, University of
Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne,
Australia
(Gallagher) Department of Pharmacy Practice, Temple University,
Philadelphia, PA, United States
(Mcdonald, Lee) Clinical Practice Assessment Unit, Department of Medicine,
McGill University, Montreal, QC, Canada
Publisher
Oxford University Press
Abstract
Background: Based primarily on in vitro and animal models, with little
data directly addressing patient outcomes, current guidelines recommend
treating staphylococcal prosthetic valve endocarditis (PVE) with
antibiotic combinations including gentamicin and rifampin. Here, we
synthesize the clinical data on adjunctive rifampin and gentamicin in
staphylococcal PVE. Method(s): We conducted a systematic review and
meta-analysis of PubMed- and Cochrane-indexed studies reporting outcomes
of staphylococcal PVE treated with adjunctive rifampin, gentamicin, both
agents, or neither (ie, glycopeptide or beta-lactam monotherapy). We
recorded outcomes including mortality, relapsed infection, length of stay,
nephrotoxicity, hepatotoxicity, and important drug-drug interactions
(DDIs). Result(s): Four relevant studies were identified. Two studies
(n = 117) suggested that adding gentamicin to rifampin-containing regimens
did not reduce clinical failure (odds ratio [OR], 0.98 [95% confidence
interval {CI},. 39-2.46]), and 2 studies (n = 201) suggested that adding
rifampin to gentamicin-containing regimens did not reduce clinical failure
(OR, 1.29 [95% CI,. 71-2.33]). Neither gentamicin nor rifampin was
associated with reduced infection relapse; 1 study found that rifampin
treatment was associated with longer hospitalizations (mean, 31.3 vs 42.3
days; P <. 001). Comparative safety outcomes were rarely reported, but 1
study found rifampin to be associated with hepatoxicity, nephrotoxicity,
and DDIs, leading to treatment discontinuation in 31% of patients.
 Conclusion(s): The existing clinical data do not suggest a benefit of
either adjunctive gentamicin or rifampin in staphylococcal PVE. Given that
other studies also suggest these agents add nephrotoxicity, hepatoxicity,
and risk of DDIs without benefit in staphylococcal endovascular
infections, we suggest that recommendations for gentamicin and rifampin in
PVE be downgraded and primarily be used within the context of clinical
trials. Copyright © 2022 The Author(s). Published by Oxford
University Press on behalf of Infectious Diseases Society of America.

<22>
Accession Number
638966697
Title
The effect of non-pharmacologic strategies on prevention or management of
intensive care unit delirium: A systematic review.
Source
F1000Research. 9 (no pagination), 2022. Article Number: 1178. Date of
Publication: 2022.
Author
Bihorac A.; Cupka J.S.; Hashemighouchani H.; Lipori J.; Ruppert M.M.;
Bhaskar R.; Ozrazgat-Baslanti T.; Rashidi P.
Institution
(Bihorac, Cupka, Hashemighouchani, Lipori, Ruppert, Bhaskar,
Ozrazgat-Baslanti) Department of Medicine, University of Florida,
Gainesville, FL 32608, United States
(Bihorac, Cupka, Hashemighouchani, Lipori, Ruppert, Bhaskar,
Ozrazgat-Baslanti, Rashidi) Intelligent Critical Care Center (IC3),
University of Florida, Gainesville, FL 32608, United States
(Rashidi) Department of Biomedical Engineering, University of Florida,
Gainesville, FL 32608, United States
Publisher
F1000 Research Ltd
Abstract
Background: Post-operative delirium is a common complication among adult
patients in the intensive care unit. Current literature does not support
the use of pharmacologic measures to manage this condition, and several
studies explore the potential for the use of non-pharmacologic methods
such as early mobility plans or environmental modifications. The aim of
this systematic review is to examine and report on recently available
literature evaluating the relationship between non-pharmacologic
management strategies and the reduction of delirium in the intensive care
unit. Method(s): Six major research databases were systematically
searched for articles analyzing the efficacy of non-pharmacologic delirium
interventions in the past five years. Search results were restricted to
adult human patients aged 18 years or older in the intensive care unit
setting, excluding terminally ill subjects and withdrawal-related
delirium. Following title, abstract, and full text review, 27 articles
fulfilled the inclusion criteria and are included in this report.
 Result(s): The 27 reviewed articles consist of 12 interventions with
a single-component investigational approach, and 15 with multi-component
bundled protocols. Delirium incidence was the most commonly assessed
outcome followed by duration. Family visitation was the most effective
individual intervention while mobility interventions were the least
effective. Two of the three family studies significantly reduced delirium
incidence, while one in five mobility studies did the same.
Multi-component bundle approaches were the most effective of all; of the
reviewed studies, eight of 11 bundles significantly improved delirium
incidence and seven of eight bundles decreased the duration of delirium.
 Conclusion(s): Multi-component, bundled interventions were more
effective at managing intensive care unit delirium than those utilizing an
approach with a single interventional element. Although better management
of this condition suggests a decrease in resource burden and improvement
in patient outcomes, comparative research should be performed to identify
the importance of specific bundle elements. Copyright © 2022
Cupka JS et al.

<23>
Accession Number
2020843991
Title
Effect of cardiac shock wave therapy plus optimal medical therapy on
rehospitalization in patients with severe coronary artery disease: A
meta-analysis and trial sequential analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 1010342. Date of Publication: 12 Dec 2022.
Author
Li P.; Jia N.; Liu B.; He Q.
Institution
(Li) The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics,
Institute of Geriatric Medicine, Chinese Academy of Medical Sciences,
Beijing Hospital/National Center of Gerontology of National Health
Commission, Beijing, China
(Jia, Liu, He) Department of Cardiology, Beijing Hospital, National Center
of Gerontology, Institute of Geriatric Medicine, Chinese Academy of
Medical Sciences, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Objective: Several small sample-sized clinical studies have demonstrated
that cardiac shock wave therapy (CSWT) might reduce the risk of
rehospitalization in patients with severe coronary artery disease (CAD).
However, other observational studies did not reported that clinical
benefit of CSWT. Therefore, the effect of CSWT plus optimal medical
therapy (OMT) on rehospitalization is still controversial. Method(s):
We performed an updated meta-analysis and systematic review of randomized
clinical trials (RCTs) and prospective cohort studies identified in
systematic searches of Pubmed, Embase, the Cochrane library, the
ClinicalTrials.gov website and Chinese SinoMed Database (up to December
2021). Primary endpoint was the rate of major adverse cardiac events
(MACEs, the composite outcome of mortality, coronary artery
revascularization, and rehospitalization). Meta-regression and subgroup
analyses were used to identify possible contributors to between-study
variances in the HDRS. Required information size (RIS) was calculated with
trial sequential analysis (TSA). Result(s): A total of 11 RCTs and 5
prospective cohort studies involving 1,149 patients with a mean follow-up
of 10.3 months (range 3-72) months were included. Overall, CSWT plus OMT
significantly decreased the rate of MACEs compared with the OMT group (RR,
0.39; 95% CI, 0.29-0.53), which was mainly attributed to markedly lower
risk of rehospitalization (RR, 0.37; 95% CI, 0.27-0.51). Subgroup analysis
showed that the pooled RRs for MACEs was significantly lower in studies
enrolling patients with higher baseline Canadian Cardiovascular Society
angina class (>=2.2) (RR, 0.36; 95% CI, 0.26-0.50) or studies with short
follow-up period (followed <= 6 months, RR, 0.39; 95% CI, 0.24-0.64;
followed 7-12 months, RR, 0.38; 95% CI, 0.26-0.54) or studies with HF with
reduced ejection fraction (RR, 0.31; 95% CI, 0.13-0.72) or with preserved
ejection fraction (RR, 0.40; 95% CI, 0.29-0.56). TSA showed that The RIS
for MACE was 935, and the accrued information size was 577.
 Conclusion(s): Cardiac shock wave therapy plus OMT could decrease the
rate of rehospitalization among patients with severe CAD. However, this
result must be interpreted with caution, for the evidence supporting the
use of CSWT for severe CAD is limited by the small sample size and short
follow-up period of previous studies. Larger RCTs with longer follow-up
are warranted to confirm these findings. Systematic review registration:
[https://inplasy.com/], identifier [INPLASY202210103]. Copyright
© 2022 Li, Jia, Liu and He.

<24>
Accession Number
2018944491
Title
Effect of Magnesium Sulfate in Prevention of Postoperative Atrial
Fibrillation Arrhythmia among Candidates of CABG Surgery with Abnormal
P-wave Duration.
Source
Journal of Kerman University of Medical Sciences. 29(6) (pp 542-546),
2022. Date of Publication: November and December 2022.
Author
Payami B.; Assareh A.R.; Adel S.M.H.; Bahrami H.
Institution
(Payami, Assareh) Atherosclerosis Research Center, Ahvaz Jundishapur
University of Medical Sciences, Ahvaz, Iran, Islamic Republic of
(Adel, Bahrami) Department of Cardiology, School of Medicine, Ahvaz
Jundishapur University of Medical Sciences, Ahvaz, Iran, Islamic Republic
of
Publisher
Kerman University of Medical Sciences
Abstract
Background: Cardiac arrhythmias, especially atrial fibrillation, are among
the most common early complications of open-heart surgery. Hypomagnesemia
is one of the clinical mechanisms associated with the pathogenesis of
postoperative atrial fibrillation. This study aimed to evaluate the effect
of magnesium sulfate on the prevention of atrial fibrillation in patients
with abnormal P-wave duration who underwent coronary artery bypass graft
(CABG)surgery. Method(s): In this clinical trial, 150 patients
participated who had undergone CABG surgery at Imam Khomeini hospital in
Ahvaz in 2014. According to the inclusion criteria, the intervention and
control groups were randomly matched. The intervention group, consisting
of 57 patients, received 2.4 g of magnesium sulfate daily for three days
and 75 patients of the control group received a placebo. Prevention of
postoperative atrial fibrillation by magnesium sulfate was evaluated in
patients and data were analyzed using SPSS software. Result(s): The
two groups did not have a significant difference in terms of gender,
diabetes, hyperlipidemia, and hypertension. Also, mean P-wave duration,
length of intensive care unit stay, the total length of hospitalization,
left ventricular ejection fraction (LVEF), distribution of creatinine,
atrial fibrillation, and aortic clamp time in intervention and control
groups were not statistically significant. Only, the total pump duration
difference was reported to be statistically significant between groups.
 Conclusion(s): The results of our study showed that the
administration of magnesium sulfate alone cannot be helpful in the
prevention of atrial fibrillation among patients with long P-wave
duration. Trial Registration: https://www.irct.ir/, Identifier:
IRCT2015092814190N9. Copyright © 2022 The Author(s).

<25>
Accession Number
640018873
Title
The efficacy of intravenous iron for treatment of anemia before cardiac
surgery: An updated systematic review and meta-analysis with trial
sequential analysis.
Source
Journal of cardiothoracic surgery. 18(1) (pp 16), 2023. Date of
Publication: 11 Jan 2023.
Author
Liu H.-M.; Tang X.-S.; Yu H.
Institution
(Liu, Tang, Yu, Yu) Department of Anesthesiology, West China Hospital,
Sichuan University, Chengdu 610041, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Preoperative anemia is common in patients undergoing cardiac
surgery with various etiologies, among which iron deficiency is the
leading cause. However, the benefit of intravenous (IV) iron for the
treatment of anemia before cardiac surgery is uncertain. This updated
meta-analysis aimed to evaluate the efficacy of IV iron in adult cardiac
surgery patients with preoperative anemia. METHOD(S): This review was
conducted according to Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) guidelines. We searched Embase, PubMed and the
Cochrane Central Register of Controlled Trials to identify eligible
randomized controlled trials (RCTs) and observational studies. Quality was
assessed using the Cochrane Collaboration risk of bias tool and
Newcastle-Ottawa scale, and the strength of evidence was assessed using
the Grading of Recommendations, Assessment, Development and Evaluations
(GRADE) criteria. Trial sequential analysis was performed on the primary
outcome (transfusion rate) to confirm whether firm evidence was reached.
 RESULT(S): Six RCTs (936 patients) and 5 observational studies (1350
patients) were included in this meta-analysis. The IV iron group and the
control group were comparable in terms of transfusion rate [55.1% vs
60.9%, risk ratio (RR)=0.91, 95% confidence interval (CI) 0.81-1.03,
P=0.13, low quality]. There were no significant differences in units
transfused per patient, ICU stay and hospital length of stay between the
two groups. And pooled data showed a benefit of IV iron compared to the
control group on mortality (2.76% vs 3.75%, RR=0.58, 95% CI 0.36-0.95,
P=0.03, moderate quality) and no mortality reduction existed when
including only RCTs. CONCLUSION(S): This meta-analysis suggested that
IV iron treatment for patients with anemia before cardiac surgery did not
reduce the transfusion requirement (low quality), but it was associated
with decreased mortality (moderate quality). More large-scale,
high-quality randomized clinical trials are warranted to confirm or refute
our findings. PROSPERO registry reference: CRD42022331875. Copyright
© 2023. The Author(s).

<26>
Accession Number
2021158825
Title
Late outcomes of valve-in-valve transcatheter aortic valve implantation
versus re-replacement: Meta-analysis of reconstructed time-to-event data.
Source
International Journal of Cardiology. 370 (pp 112-121), 2023. Date of
Publication: 01 Jan 2023.
Author
Sa M.P.; Van den Eynde J.; Simonato M.; Hirji S.; Erten O.; Jacquemyn X.;
Tasoudis P.; Dokollari A.; Sicouri S.; Weymann A.; Ruhparwar A.; Arora R.;
Clavel M.-A.; Pibarot P.; Ramlawi B.
Institution
(Sa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau Heart
Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Sa, Erten, Tasoudis, Dokollari, Sicouri, Ramlawi) Department of
Cardiothoracic Surgery Research, Lankenau Institute for Medical Research,
PA, United States
(Van den Eynde, Jacquemyn) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Simonato) Yale School of Medicine, New Haven, CT, United States
(Hirji) Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Weymann, Ruhparwar) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University of Duisburg-Essen, Essen, Germany
(Arora) Department of Surgery, Section of Cardiac Surgery, Max Rady
College of Medicine, University of Manitoba, Winnipeg, MB, Canada
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Faculty of Medicine, Universite
Laval, Quebec City, Quebec, Canada
Publisher
Elsevier Ireland Ltd
Abstract
Aims: To evaluate all-cause mortality in ViV-TAVI versus redo SAVR in
patients with failed bioprostheses. Method(s): Study-level
meta-analysis of reconstructed time-to-event data from Kaplan-Meier curves
of non-randomized studies published by September 30, 2021. Result(s):
Ten studies met our eligibility criteria and included a total of 3345
patients (1676 patients underwent ViV-TAVI and 1669 patients underwent
redo SAVR). Pooling all the studies, ViV-TAVI showed a lower risk of
all-cause mortality in the first 44 days [hazard ratio (HR) 0.67, 95%
confidence interval (CI) 0.49-0.93, P = 0.017], with an HR reversal after
197 days favoring redo SAVR (HR 1.53; 95% CI 1.22-1.93; P < 0.001).
Pooling only the matched populations (1143 pairs), ViV-TAVI showed a lower
risk of all-cause mortality in the first 55 days [hazard ratio (HR) 0.63,
95% confidence interval (CI) 0.45-0.89, P < 0.001], with a reversal HR
after 212 days favoring redo SAVR (HR 1.57; 95% CI 1.22-2.03; P < 0.001).
The Cox regression model showed a statistically significant association of
prosthesis-patient mismatch (PPM) with all-cause mortality during
follow-up for ViV-TAVI (HR 1.03 per percentage increase in the study- and
treatment arm-level proportion of PPM, 95% 1.02-1.05, P < 0.001).
 Conclusion(s): ViV-TAVI is associated with a strong protective effect
immediately after the procedure in comparison with redo SAVR, however,
this initial advantage reverses over time and redo SAVR seems to be a
protective factor for all-cause mortality after 6 months. Considering that
these results are the fruit of pooling data from observational studies,
they should be interpreted with caution and trials are
warranted. Copyright © 2022 Elsevier B.V.

<27>
Accession Number
2020858600
Title
Conventional aortic root vs valve-sparing root replacement surgery in
aortic dilatation syndromes: a comparison of mortality and postoperative
complications.
Source
Expert Review of Cardiovascular Therapy. 21(1) (pp 57-65), 2023. Date of
Publication: 2023.
Author
Rashid H.N.; Chehab O.; Hurrell H.; Androshchuk V.; Sularz A.; Patterson
T.; Lucchese G.; Redwood S.
Institution
(Rashid, Chehab, Hurrell, Androshchuk, Sularz, Patterson, Lucchese,
Redwood) Department of Cardiology and Cardiac Surgery, Guy's & St. Thomas'
Hospital, London, United Kingdom
(Rashid, Chehab, Hurrell, Androshchuk, Patterson, Redwood) School of
Cardiovascular Medicine & Sciences, King's College London, London, United
Kingdom
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Conventional aortic root and valve-sparing root replacement
surgery are two current surgical treatments for aortic dilatation
syndromes. This review article aims to review the current literature
surrounding these two established techniques. Areas covered: This review
article will address the current indications for valve-sparing root
replacement surgery, technical considerations in surgical planning and a
comparison of clinical outcomes between these two surgical techniques.
Expert opinion: Valve-sparing root replacement surgery is a safe and
established treatment for aortic syndromes. Valve-sparing surgery
procedure avoids the inherent risk of prosthetic valve dysfunction and
prosthesis infection by preserving the native aortic valve compared to
conventional aortic root surgery. This has been demonstrated in various
observational studies and should be considered in clinically and
anatomically appropriate patients. Other technical considerations, such as
reimplantation versus remodeling technique and aortic cusp repair in
select patients, may impact in short-term procedural and long-term
clinical success with valve-sparing surgery. Copyright © 2022
Informa UK Limited, trading as Taylor & Francis Group.

<28>
Accession Number
2022183172
Title
The prognostic impacts of frailty on clinical and patient-reported
outcomes in patients undergoing coronary artery or valvular
surgeries/procedures: A systematic review and meta-analysis.
Source
Ageing Research Reviews. 85 (no pagination), 2023. Article Number: 101850.
Date of Publication: March 2023.
Author
Wong C.W.Y.; Yu D.S.F.; Li P.W.C.; Chan B.S.
Institution
(Wong, Chan) School of Nursing, Li Ka Shing Faculty of Medicine, The
University of Hong Kong, Room 543, 5/Academic Building, 3 Sassoon Road,
Pokfulam, Hong Kong
(Yu) School of Nursing, Li Ka Shing Faculty of Medicine, The University of
Hong Kong, Room 521, 5/Academic Building, 3 Sassoon Road, Pokfulam, Hong
Kong
(Li) School of Nursing, Li Ka Shing Faculty of Medicine, The University of
Hong Kong, Room 523, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong
Kong
Publisher
Elsevier Ireland Ltd
Abstract
Background: Frailty is emerging as an important prognostic indicator for
patients undergoing cardiac surgeries/procedures. We sought to evaluate
the prognostic and differential impacts of frailty on patients undergoing
coronary artery or valvular surgical procedures of different levels of
invasiveness, and to explore the differential predictability of various
frailty measurement models. Method(s): Eight databases were searched
for prospective cohort studies that have adopted validated measure(s) of
frailty and reported clinical, healthcare service utilization, or
patient-reported outcomes in patients undergoing coronary artery or
valvular surgeries/procedures. Result(s): Sixty-two articles were
included (N = 16,679). Frailty significantly predicted mortality
(short-term [<= 30 days]: odds ratio [OR]: 2.33, 95% confidence interval
[CI]: 1.28-4.26; midterm [6 months to 1 year]: OR: 3.93, 95%CI: 2.65-5.83;
long-term [>1 year]: HR: 2.23, 95%CI: 1.60-3.11), postoperative
complications (ORs: 2.54-3.57), discharge to care facilities (OR: 5.52,
95%CI: 3.84-7.94), hospital readmission (OR: 2.00, 95%CI: 1.15-3.50), and
reduced health-related quality of life (HRQoL; standardized mean
difference: -0.74, 95%CI: -1.30 to -0.18). Subgroup analyses showed that
frailty exerted a greater impact on short-term mortality in patients
undergoing open-heart surgeries than those receiving transcatheter
procedures. Multidimensional and physical-aspect-focused frailty
measurements performed equally in predicting mortality, but
multidimensional measurements were more predictive of hospital readmission
than physical-aspect-focused measurements. Conclusion(s): Frailty was
predictive of postoperative mortality, complications, increased healthcare
service utilization, and reduced HRQoL. The impact of frailty on
short-term mortality was more prominent in patients undergoing open-heart
surgeries than those receiving transcatheter procedures. Multidimensional
measures of frailty enhanced prognostic risk estimation, especially for
hospital readmission. Copyright © 2023 Elsevier B.V.

<29>
Accession Number
2021929825
Title
Percutaneous coronary intervention of native coronary artery versus
saphenous vein graft in patients with prior coronary artery bypass graft
surgery: Rationale and design of the multicenter, randomized PROCTOR
trial.
Source
American Heart Journal. 257 (pp 20-29), 2023. Date of Publication: March
2023.
Author
de Winter R.W.; Walsh S.J.; Hanratty C.G.; Spratt J.C.; Sprengers R.W.;
Twisk J.W.; Vegting I.; Schumacher S.P.; Bom M.J.; Hoek R.; Verouden N.J.;
Delewi R.; Nap A.; Knaapen P.
Institution
(de Winter, Vegting, Schumacher, Bom, Hoek, Verouden, Delewi, Nap,
Knaapen) Department of Cardiology, Heart Center Amsterdam, Amsterdam UMC,
Amsterdam, Netherlands
(Walsh) Department of Cardiology, Belfast Health and Social Care Trust,
Royal Victoria Hospital, Belfast, United Kingdom
(Hanratty) Heart & Vascular Centre, Mater Private Day Hospital, Dublin,
Ireland
(Spratt) Department of Cardiology, St George's University Hospital NHS
Trust, London, United Kingdom
(Sprengers) Department of Radiology & Nuclear Medicine, Amsterdam UMC,
Amsterdam, Netherlands
(Twisk) Department of Epidemiology & Data Science, Amsterdam UMC,
Amsterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Patients with prior coronary artery bypass grafting (CABG)
frequently require repeat percutaneous revascularization due to advanced
age, progressive coronary artery disease and bypass graft failure.
Percutaneous coronary intervention (PCI) of either the bypass graft or the
native coronary artery may be performed. Randomized trials comparing
native vessel PCI with bypass graft PCI are lacking and long-term outcomes
have not been reported. Method(s): PROCTOR (NCT03805048) is a
prospective, multicenter, randomized controlled trial, that will include
584 patients presenting with saphenous vein graft (SVG) failure and a
clinical indication for revascularization, as determined by the local
Heart Team. The trial is designed to compare the clinical and angiographic
outcomes in patients randomly allocated in a 1:1 fashion to either a
strategy of native vessel PCI or SVG PCI. The primary study endpoint is a
3-year composite of major adverse cardiac events (MACE: all-cause
mortality, non-fatal target coronary territory myocardial infarction [MI],
or clinically driven target coronary territory revascularization). At
3-years, after evaluation of the primary endpoint, follow-up invasive
coronary angiography will be performed. Secondary endpoints comprise
individual components of MACE at 1, 3 and 5 years follow-up, PCI-related
MI, MI >48 hours after index PCI, target vessel failure, target lesion
revascularization, renal failure requiring renal-replacement therapy,
angiographic outcomes at 3-years and quality of life (delta Seattle Angina
Questionnaire, Canadian Cardiovascular Society Grading Scale and Rose
Dyspnea Scale). Conclusion(s): PROCTOR is the first randomized trial
comparing an invasive strategy of native coronary artery PCI with SVG PCI
in post-CABG patients presenting with SVG failure. Copyright ©
2022 The Author(s)

<30>
Accession Number
640027615
Title
Effects of high-intensity inspiratory muscle training on systemic
inflammatory response in cardiac surgery - A randomized clinical trial.
Source
Physiotherapy theory and practice. (pp 1-11), 2023. Date of Publication:
13 Jan 2023.
Author
Furon Y.; Dang Van S.; Blanchard S.; Saulnier P.; Baufreton C.
Institution
(Furon) Department of Physical and Rehabilitation Medicine, University
Hospital of Angers, Angers, France
(Dang Van, Baufreton) Department of Cardiac Surgery, University Hospital
of Angers, Angers, France
(Blanchard) Laboratory of Immunology and Allergology, University Hospital
of Angers, Angers, France
(Saulnier) Research Department Unit, University Hospital of Angers,
Angers, France
Publisher
NLM (Medline)
Abstract
PURPOSE: Preoperative inspiratory muscle training reduces the incidence of
postoperative pulmonary complications after cardiac surgery, but training
protocols vary widely in terms of intensity. Currently, the mechanisms
underlying the effectiveness of this practice are not known. The purpose
of the present study is to determine whether preoperative high-intensity
inspiratory muscle training (HI-IMT) modulates the perioperative systemic
inflammatory response in cardiac surgery patients. METHOD(S):
Participants awaiting surgical aortic valve replacement were randomized to
3 to 6 weeks preoperative home-based HI-IMT or same duration low-intensity
inspiratory muscle training (LI-IMT). The primary outcome was the
preoperative value of the soluble tumor necrosis factor receptor 1
(sTNFR1). Secondary outcomes assessed perioperative evolution of the
cytokines: sTNFR1, Tumor necrosis factor-alpha, Interleukin (IL)-6, IL-8,
IL10, IL1beta, and their combined z-score; reflecting post-training and
postoperative inflammatory response. Perioperative pulmonary function and
postoperative clinical outcomes were collected. RESULT(S): Between
February 2018 and March 30, 2019 patients were randomized, to HI-IMT or
LI-IMT. There were no differences between the groups in terms of baseline
characteristics. The median (IQR) training duration was 34 (28-44) days.
After training, the median (IQR) predicted maximal inspiratory pressure
was higher in the HI-IMT vs LI-IMT group (119 (96-142%) vs 97 (81-107%); p
= .04) Levels of the sTNFR1 cytokine increased during training in the
HI-IMT group, pre vs post training (Median (IQR) 1073 (920; 1219) vs 1172
(965; 1368) ng/L; p = .03). The 24-h postoperative global inflammatory
score was lower in the HI-IMT than in the LI-IMT group (Median (IQR),
-0.37 (-0.62, 0.03) vs -0.10 (-0.17, 0.49), p = .04). Global inflammatory
scores were not different at other time points. There were no significant
differences between the groups in post-operative pulmonary function and
postoperative clinical outcome. CONCLUSION(S): High intensity
inspiratory muscle training shows immunomodulatory properties. These
properties could explain why preoperative inspiratory muscle training can
lead to lung protection after cardiac surgery.

<31>
Accession Number
640028565
Title
Robotic vs Other Surgery Techniques for Mitral Valve Repair and/or
Replacement: A Systematic Review and Meta-analysis.
Source
Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese.
(no pagination), 2023. Date of Publication: 10 Jan 2023.
Author
Husen T.F.; Kohar K.; Angelica R.; Laviashna Saputro B.I.
Institution
(Husen) Faculty of Medicine, University of Indonesia, Pondok Cina, West
Java 16424, Indonesia
(Kohar, Angelica, Laviashna Saputro) Faculty of Medicine, University of
Indonesia, Pondok Cina, West Java 16424, Indonesia
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Mitral valve repair or replacement (MVr/R) are procedures
that aim to correct mitral regurgitation. The three techniques, namely
conventional, minimally invasive, and robotic each present their
advantages and setbacks. Previous studies had compared each technique with
the other but mostly focused on two techniques. In this systematic review
and meta-analysis, we attempt to compare all three techniques, to provide
a reference for the clinical selection of the best surgical scheme.
 METHOD(S): Registered to PROSPERO, and following PRISMA guidelines.
The literature search was performed in databases including PubMed, Scopus,
Google Scholar, EBSCOHost, Wiley, ProQuest, and Embase, up to June 1st,
2022. Critical appraisal of studies was performed using Newcastle Ottawa
Scale converted by Agency for Healthcare Research and Quality (AHRQ). We
used bayesian network meta-analysis and conventional meta-analysis (random
effects model) to rank and analyze pooled odds ratio (OR), mean difference
(MD), and the p-value of each intervention. RESULT(S): A total of 18
studies with 60,331 patients were included in this systematic review and
meta-analysis. Hospital stay was significantly better in the robotic group
compared to other interventions in terms of ICU stay and overall length of
stay. In the operative procedure, patients in the robotic group were
correlated with longer cross-clamp (XC) and cardiopulmonary bypass (CPB)
times. Besides, robotic procedures also correlated with a lower
complication rate. CONCLUSION(S): Robotic surgery showed better
surgery outcomes, including hospital stay and post-operational
complications, although it was correlated with longer cross-clamp time and
CPB time compared to other interventions. However, its high cost may
become a tough consideration for both clinicians and
patients. Copyright © 2022 Hellenic Society of Cardiology.
Published by Elsevier B.V. All rights reserved.

<32>
Accession Number
640028544
Title
Comparison of Bretschneider HTK and Blood Cardioplegia (4:1): A
Prospective Randomized Study.
Source
The Thoracic and cardiovascular surgeon. (no pagination), 2023. Date of
Publication: 13 Jan 2023.
Author
Ak K.; Dericioglu O.; Midi A.; Kararmaz A.; Er Z.; Dogusan Z.; Arsan S.
Institution
(Ak) Department of Cardiovascular Surgery, Marmara University School of
Medicine, Marmara Uninersitesi Hastanesi Mimar Sinan Cad. Fevzi Cakmak
Mah. Ust Kaynarca Kalp ve Damar Cerrahisi Bolumu Pendik, Istanbul, Turkey
(Dericioglu, Arsan) Department of Cardiovascular Surgery, Marmara
University School of Medicine, Istanbul, Turkey
(Midi) Department of Pathology, Bahcesehir University, School of Medicine,
Istanbul, Turkey
(Kararmaz) Department of Anesthesiology and Reanimation, Marmara
University School of Medicine, Istanbul, Turkey
(Er) Department of Cardiovascular Surgery, Bozok University Faculty of
Medicine Ringgold Standard Institution, Yozgat, Turkey
(Dogusan) Department of Pathology, Bone Marrow Transplantation Unite, Yeni
Yuzyil University School of Medicine, Istanbul, Turkey
Publisher
NLM (Medline)
Abstract
BACKGROUND: We compared the effect of intermittent blood and
histidine-tryptophan-ketoglutarate (HTK) solution of Bretschneider on
myocardial histopathology and perioperative outcome. METHOD(S):
Forty adult cardiac surgery patients were grouped into two (n=20 for
each): (1) Intermittent blood cardioplegia (IBC): had repeated cold 4:1
blood cardioplegia and (2) HTK: had a single dose of cold HTK for
cardioprotection. Creatine kinase (CK)-MB, Troponin-I (cTn-I), pH, and
lactate were studied in coronary sinus blood before and after aortic
cross-clamping (AXC) and systemic blood at postoperative 6th, 24th, and
48th hours. Myocardial biopsy was performed before and after AXC for light
microscopy. Vacuolation, inflammation, edema, and glycogen were graded
semiquantitatively (from 0 to 3). The myocardial apoptotic index was
evaluated via the terminal deoxynucleotidyl transferase dUTP nick end
labeling. RESULT(S): There were no differences in perioperative
clinical outcomes between the groups. The coronary sinus samples after AXC
were more acidotic (7.15+/-0.14 vs. 7.32+/-0.07, p=0.001) and revealed
higher CK-MB (21.0+/-12.81 vs. 12.60+/-11.80, p=0.008) in HTK compared
with IBC. The HTK had significantly a higher amount of erythrocyte
suspension intraoperatively compared with IBC (0.21+/-0.53 vs. 1.68+/-0.93
U, p=0.001). Microscopically, myocardial edema was more pronounced in HTK
compared with IBC after AXC (2.25+/-0.91 vs. 1.50+/-0.04, p=0.013). While
a significant increase in the apoptotic index was seen after AXC in both
groups (p=0.001), no difference was detected between the groups (p=0.417).
 CONCLUSION(S): IBC and HTK have a similar clinical outcome and
protective effect, except for more pronounced myocardial edema and
increased need for intraoperative transfusion with HTK. Copyright
Thieme. All rights reserved.

<33>
Accession Number
640030326
Title
Clinical Outcomes of MANTA vs Suture-Based Vascular Closure Devices After
Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis.
Source
Indian heart journal. (no pagination), 2023. Date of Publication: 11 Jan
2023.
Author
Doshi R.; Vasudev R.; Guragai N.; Patel K.N.; Kumar A.; Majmundar M.;
Doshi P.; Patel P.; Shah K.; Santana M.; Roman S.; Vallabhajosyula S.;
Virk H.; Bikkina M.; Shamoon F.
Institution
(Doshi) Department of Cardiology, St Joseph University Medical Center,
Paterson, NJ, United States
(Vasudev, Guragai, Patel, Shah, Santana, Roman, Virk, Bikkina, Shamoon)
Department of Cardiology, St Joseph University Medical Center, Paterson,
NJ, United States
(Patel) Department of Internal Medicine, Saint Peter's University
Hospital, New Brunswick, NJ, USA
(Kumar) Department of Internal Medicine Cleveland Clinic Akron General
Akron OH, United States
(Majmundar) Department of Cardiology, University of Kansas Medical Center,
Kansas City, KS, United States
(Doshi) Department of Medicine, MS Ramaiah Medical College, Bengaluru,
India
(Vallabhajosyula) Section of Cardiovascular Medicine, Department of
Medicine, Wake Forest University School of Medicine, Winston-Salem, NC,
United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: A recently published randomized control trial showed different
results with suture-based vascular closure device (VCD) than plug-based
VCD in patients undergoing transfemoral transcatheter aortic valve
replacement (TAVR). The learning curve for MANTA device is steep, while
the learning curve for suture based VCD is shallow as the devices are
quite different. In this meta-analysis, we have compared suture-based
(ProGlide and Prostar XL) vs plug-based VCDs (MANTA). METHOD(S): We
performed a meta-analysis of all published studies (using PubMed/Medline
and Cochrane databases) reporting the clinical outcome of plug-based vs
suture-based VCDs in transfemoral TAVR patients. RESULT(S): We
included nine studies with a total of 2,865 patients (plug-based n= 1631,
suture-based n= 1234). There was no significant difference in primary
outcome of all bleeding when using plug-based as opposed to suture-based
VCDs (RR 1.14 [0.62-2.06] I2 = 72%). There was no significant difference
in the incidence of secondary outcomes between two groups including major
life threatening bleeding (RR 1.16 [0.38-3.58] I2=65%), major vascular
complications (RR 0.84 [0.35-2.00] I2= 55%), minor vascular complications
(RR 1.05 [0.56-1.95] I2= 42%), pseudo aneurysm (RR 1.84 [0.11-29.98] I2=
44%), stenosis-dissection (RR 0.98 [0.66-1.47] I2=0%), VCD failure (RR
1.71 [0.96-3.04] I2= 0%), and blood transfusion (RR 1.01 [0.38-2.71], I2 =
61%). CONCLUSION(S): Large bore arteriotomy closure with plug-based
VCD was not superior to suture-based VCDs in this transfemoral TAVR
population. There was very frequent use of secondary VCDs in suture-based
VCD group which is not practical when using MANTA. Additional high-powered
studies are required to determine the safety and efficacy of MANTA
device. Copyright © 2023 Cardiological Society of India.
Published by Elsevier, a division of RELX India, Pvt. Ltd. All rights
reserved.

<34>
Accession Number
640029948
Title
Type D personality as a risk factor for adverse outcome in patients with
cardiovascular disease: an individual patient data meta-analysis.
Source
Psychosomatic medicine. (no pagination), 2023. Date of Publication: 16
Jan 2023.
Author
Lodder P.; Wicherts J.M.; Antens M.; Albus C.; Bessonov I.S.; Conden E.;
Dulfer K.; Gostoli S.; Grande G.; Hedberg P.; Herrmann-Lingen C.; Jaarsma
T.; Koo M.; Lin P.; Lin T.-K.; Meyer T.; Pushkarev G.; Rafanelli C.; Raykh
O.I.; de Quadros A.S.; Schmidt M.; Sumin A.N.; Utens E.M.W.J.; van
Veldhuisen D.J.; Wang Y.; Kupper N.
Institution
(Wicherts) Department of Methodology and Statistics, Tilburg University,
Netherlands
(Antens, Kupper) Center of Research on Psychology in Somatic diseases
(CoRPS), Department of Medical and Clinical Psychology, Tilburg
University, Netherlands
(Albus) Department of Psychosomatics and Psychotherapy, University of
Cologne, Medical Faculty and University Hospital, Cologne, Germany
(Bessonov, Pushkarev, Raykh, Sumin) Laboratory of Comorbidity in
Cardiovascular Diseases, Federal State Budgetary Scientific Institution
"Research Institute for Complex Issues of Cardiovascular Diseases",
Russian Federation
(Conden) Uppsala University, Centre for Clinical Research, Hospital of
Vastmanland, Sweden
(Dulfer) Intensive Care Unit, Department of Pediatrics and Pediatric
Surgery, Erasmus Medical Centre - Sophia Children's Hospital, Netherlands
(Gostoli, Rafanelli) Department of Psychology, University of Bologna,
Italy
(Grande) Brandenburgische Technische Universitat Cottbus-Senftenberg,
Germany
(Hedberg) Department of Clinical Physiology and Centre for Clinical
Research, Uppsala University, Vastmanland County Hospital, Vasteras,
Sweden
(Herrmann-Lingen, Meyer) Department of Psychosomatic Medicine and
Psychotherapy, University of Gottingen Medical Center and German Center
for Cardiovascular Research (DZHK), partner site Gottingen, Germany
(Jaarsma) Department of Health, Medicine and Caring Sciences, Linkoping
University, Linkoping, Sweden
(Lin) College of Nursing of Harbin Medical University, Second Affiliated
Hospital of Harbin Medical University, Harbin, China
(de Quadros, Schmidt) Institute of Cardiology, University Foundation of
Cardiology, Brazil
(Utens) Research Institute of Child Development and Education, Amsterdam,
Netherlands
(van Veldhuisen) Department of Cardiology, University of Groningen,
University Medical Center Groningen, Groningen, Netherlands
(Wang) Department of Cardiology, Second Affiliated Hospital of Harbin
Medical University, Harbin, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Type D personality, a joint tendency toward negative
affectivity (NA) and social inhibition (SI), has been linked to adverse
events in patients with heart disease, though with inconsistent findings.
Here, we apply an individual patient-data meta-analysis to data from 19
prospective cohort studies (N = 11151), to investigate the prediction of
adverse outcomes by Type D personality in acquired cardiovascular disease
(CVD) patients. METHOD(S): For each outcome (all-cause mortality,
cardiac mortality, myocardial infarction (MI), coronary artery bypass
grafting, percutaneous coronary intervention, major adverse cardiac event
(MACE), any adverse event), we estimated Type D's prognostic influence and
the moderation by age, sex, and disease type. RESULT(S): In CVD
patients, evidence for a Type D effect in terms of the Bayes factor (BF)
was strong for MACE (BF = 42.5; OR = 1.14) and any adverse event (BF =
129.4; OR = 1.15). Evidence for the null hypothesis was found for
all-cause mortality (BF = 45.9; OR = 1.03), cardiac mortality (BF = 23.7;
OR = 0.99) and MI (BF = 16.9; OR = 1.12), suggesting Type D had no effect
on these outcomes. This evidence was similar in the subset of coronary
artery disease (CAD) patients, but inconclusive for heart failure (HF)
patients. Positive effects were found for NA on cardiac- and all-cause
mortality, the latter being more pronounced in males than females.
 CONCLUSION(S): Across 19 prospective cohort studies, Type D predicts
adverse events in CAD patients, while evidence in HF patients was
inconclusive. In both CAD and HF patients, we found evidence for a null
effect of Type D on cardiac- and all-cause mortality. Copyright ©
2023 by the American Psychosomatic Society.

<35>
Accession Number
640029767
Title
Antithrombotic Therapy and Cardiovascular Outcomes After Transcatheter
Aortic Valve Implantation in Patients Without Indications for Chronic Oral
Anticoagulation: A systematic review and network meta-analysis of
randomized controlled trials.
Source
European heart journal. Cardiovascular pharmacotherapy. (no pagination),
2023. Date of Publication: 14 Jan 2023.
Author
Guedeney P.; Roule V.; Mesnier J.; Chapelle C.; Portal J.-J.; Laporte S.;
Ollier E.; Zeitouni M.; Kerneis M.; Procopi N.; Barthelemy O.; Sorrentino
S.; Mihalovic M.; Silvain J.; Vicaut E.; Montalescot G.; Collet J.-P.
Institution
(Guedeney, Zeitouni, Kerneis, Procopi, Barthelemy, Silvain, Montalescot,
Collet) Sorbonne Universite, ACTION study group, Institut de Cardiologie,
Pitie Salpetriere Hospital (AP-HP), Paris, France
(Roule) Service de Cardiologie, Centre Hospitalier Universitaire (CHU) de
Caen Normandie, Normandie Univ, Caen, France
(Mesnier) French Alliance for Cardiovascular Trials (FACT); Universite de
Paris, INSERM Unite-1148, and Hopital Bichat, Assistance Publique-Hopitaux
de Paris, Paris, France
(Chapelle, Laporte, Ollier) Unite de Recherche Clinique Innovation et
Pharmacologie CHU de Saint-Etienne, Saint-Etienne, France
(Portal, Vicaut) Unite de Recherche Clinique, Lariboisiere Hospital
(AP-HP), ACTION Study Group, Paris, France
(Sorrentino) Division of cardiology, Department of Medical and Surgical
Science, Magna Graecia University, Catanzaro, Italy
(Mihalovic) Cardiocenter, Third Faculty of Medicine, Charles University,
University Hospital Kralovske Vinohrady, Prague, Czechia
Publisher
NLM (Medline)
Abstract
AIMS: As the antithrombotic regimen which may best prevent ischemic
complications along with the lowest bleeding risk offset following
transcatheter aortic valve implantation (TAVI) remains unclear, we aimed
to compare the safety and efficacy of antithrombotic regimens in patients
without having an indication for chronic oral anticoagulation. METHODS AND
RESULTS: We conducted a Prospero-registered (CRD42021247924) systematic
review and network meta-analysis of randomized controlled trials
evaluating post-TAVI antithrombotic regimens up to April 2022. We
estimated the relative risk (RR) and 95% confidence intervals (95%CI)
using a random-effects model in a frequentist pairwise and network
metanalytic approach. We included 7 studies comprising of 4 006 patients
with a mean weighted follow-up of 12.9 months. Risk of all-cause death was
significantly reduced with dual antiplatelet therapy (DAPT) compared to
low-dose rivaroxaban + 3-month single antiplatelet therapy (SAPT) (RR
0.60, 95%CI 0.41-0.88) while no significant reduction was observed with
SAPT versus DAPT (RR 1.02 95%CI 0.67-1.58) and SAPT and DAPT compared to
apixaban or edoxaban (RR:0.60 95%CI:0.32-1.14 and RR:0.59 95%CI 0.34-1.02,
respectively). SAPT was associated with a significant reduction of
life-threatening, disabling, or major bleeding compared to DAPT (RR 0.45
95%CI 0.29-0.70), apixaban or edoxaban alone (RR 0.45, 95%CI 0.25-0.79)
and low-dose rivaroxaban + 3-month SAPT (RR 0.30, 95%CI 0.16-0.57). There
were no differences between the various regimens with respect to
myocardial infarction, stroke, or systemic embolism. CONCLUSION(S):
Following TAVI in patients without an indication for chronic oral
anticoagulant, SAPT more than halved the risk of bleeding compared to DAPT
and direct oral anticoagulant-based regimens without significant ischemic
offset. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<36>
Accession Number
640030818
Title
Heparin Rebound: An In-Depth Review.
Source
Journal of cardiothoracic and vascular anesthesia. (no pagination), 2022.
Date of Publication: 24 Dec 2022.
Author
Stone M.E.; Vespe M.W.
Institution
(Stone, Vespe) Icahn School of Medicine at Mount Sinai, New York, NY
Publisher
NLM (Medline)
Abstract
The common conception of "heparin rebound" invokes heparin returning to
circulation in the postoperative period after apparently adequate
intraoperative reversal with protamine. This is believed to portend
increased postoperative bleeding and provides the rationale for
administering additional empiric doses of protamine in response to
prolonged coagulation tests and/or bleeding. However, the relevant
literature of the last 60+ years provides only a weak level of evidence
that "rebounded" heparin itself is a significant etiology of postoperative
bleeding after cardiac surgery with cardiopulmonary bypass. Notably, many
of the most frequently cited heparin rebound investigators ultimately
concluded that although exceedingly low levels of heparin activity could
be detected by anti-Xa assay in some (but not all) patients
postoperatively, there was no correlation with actual bleeding. An
understanding of the literature requires a careful reading of the details
because the investigators lacked standardized definitions for "heparin
rebound" and "adequate reversal" while studying the phenomenon with
significantly different experimental methodologies and laboratory tests.
This review was undertaken to provide a modern understanding of the
"heparin rebound" phenomenon to encourage an evidence-based approach to
postoperative bleeding. Literature searches were conducted via PubMed
using the following MeSH terms: heparin rebound, heparin reversal,
protamine, platelet factor 4, and polybrene. Relevant English language
articles were reviewed, with subsequent references obtained from the
internal citations. Perspective is provided for both those who use
HepCon-guided management and those who do not, as are practical
recommendations for the modern era based on the published data and
conclusions of the various investigators. Copyright © 2022
Elsevier Inc. All rights reserved.

<37>
Accession Number
2021079245
Title
Fate of iatrogenic atrial septal defects following mitral transcatheter
edge-to-edge repair - a subanalysis of the MITHRAS trial.
Source
International Journal of Cardiovascular Imaging. (no pagination), 2022.
Date of Publication: 2022.
Author
Blazek S.; Unterhuber M.; Rommel K.-P.; Kresoja K.-P.; Kister T.; Besler
C.; Fengler K.; Rosch S.; Daehnert I.; Thiele H.; Lurz P.; von Roeder M.
Institution
(Blazek, Unterhuber, Rommel, Kresoja, Kister, Besler, Fengler, Rosch,
Thiele, Lurz, von Roeder) Department of Internal Medicine/Cardiology,
Heart Center Leipzig at Leipzig University, Struempellstrasse 39, Leipzig
04289, Germany
(Rosch, Thiele, Lurz) Leipzig Heart Institute, Leipzig, Germany
(Daehnert) Department of Pediatric Cardiology, Heart Center Leipzig at
Leipzig University, Leipzig, Germany
Publisher
Springer Science and Business Media B.V.
Abstract
Persisting iatrogenic atrial septal defects (iASD) after transcatheter
mitral edge-to-edge repair (M-TEER) are associated with impaired outcomes.
We investigated the natural history of relevant iASDs with left-to-right
shunting post-M-TEER, predictors of spontaneous closure of iASD between 1
and 6 months post-M-TEER, and outcomes (heart failure [HF]
hospitalization) in patients with spontaneous closure versus those with
persistent iASD 6 months post-M-TEER. Patients with a relevant iASD
1-month post-M-TEER, who were treated conservatively in the randomized
controlled MITHRAS trial, underwent clinical follow-up including
transesophageal echocardiography 6 months post-M-TEER. Overall, 36
patients (median 77 [interquartile range 65-81] years; 36% women)
completed the 6-months follow-up. Six (17%) patients had a spontaneous
closure of the iASD. The eccentricity index of the iASD 1-month after
M-TEER was the strongest predictor for spontaneous closure (Odds ratio
3.78; 95% confidence interval 1.26-11.33, p = 0.01) and an eccentricity
index of < 1.9 provided a sensitivity of 77% at a specificity of 83% for
iASD persistence (Area under the curve 0.83, p < 0.001) within 6-months
post M-TEER. At follow-up, a numerical difference in the endpoint of HF
hospitalization between the spontaneous closure and the residual shunt
group (0% vs. 20%, p = 0.25) was observed. The eccentricity of the iASD
was the strongest predictor for spontaneous closure at 1-months and an
eccentricity index of < 1.9 is associated with a high persistence rate for
6 month after M-TEER. Clinical Trial Registration ClinicalTrials.gov
https://clinicaltrials.gov/ct2/show/NCT03024268 Identifier: NCT03024268.
Graphical Abstract: a (red) is reflecting the mayor lengthwise dimension
and b (blue) the mayor oblique dimension. The eccentricity index is
calculated by dividing a through b. (Open circle) is depicting an example
for a round iASD and (Open rhombus) an example for an eccentric iASD 1
month after M-TEER.[Figure not available: see fulltext.]. Copyright
© 2022, The Author(s).

<38>
Accession Number
640026253
Title
The Prognostic Significance of Red Cell Distribution Width in Cardiac
Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of cardiothoracic and vascular anesthesia. (no pagination), 2022.
Date of Publication: 20 Nov 2022.
Author
Frentiu A.A.; Mao K.; Caruana C.B.; Raveendran D.; Perry L.A.; Penny-Dimri
J.C.; Ramson D.M.; Segal R.; Bellomo R.; Smith J.A.; Liu Z.
Institution
(Frentiu, Penny-Dimri, Ramson) Department of Surgery (School of Clinical
Sciences at Monash Health), Monash University, Clayton, Australia
(Mao, Raveendran) Department of Critical Care, Melbourne Medical School,
Faculty of Medicine, Dentistry and Health Sciences, University of
Melbourne, Parkville, Australia
(Caruana) Department of Intensive Care, Austin Hospital, 145 Studley Road,
Heidelberg, VIC, Australia
(Perry, Segal, Liu) Department of Critical Care, Melbourne Medical School,
Faculty of Medicine, Dentistry and Health Sciences, The University of
Melbourne, Parkville, Australia; Department of Anaesthesia and Pain
Management, Royal Melbourne Hospital, Parkville, Australia
(Bellomo) Department of Critical Care, Melbourne Medical School, Faculty
of Medicine, Dentistry and Health Sciences, The University of Melbourne,
Parkville, Australia; Department of Intensive Care, Austin Hospital, 145
Studley Road, Heidelberg, Victoria, Australia; Department of Intensive
Care, Austin Hospital, Heidelberg, Australia; Australian and New Zealand
Intensive Care Research Centre, Melbourne, Australia; Monash University
School and Public Health and Preventive Medicine, Monash University,
Clayton, Australia; Data Analytics Research and Evaluation (DARE) Centre,
Austin Hospital, Heidelberg, Australia
(Smith) Department of Surgery (School of Clinical Sciences at Monash
Health), Monash University, Clayton, Australia; Department of
Cardiothoracic Surgery, Monash Health, Clayton, Australia
Publisher
NLM (Medline)
Abstract
RED CELL DISTRIBUTION WIDTH (RDW) is a routinely available biomarker of
likely erythropoietic dysfunction, which may be associated with adverse
outcomes after cardiac surgery. This systematic review and meta-analysis
aimed to clarify the prognostic value of RDW in patients undergoing
cardiac surgery. The authors searched MEDLINE, Embase, and the Cochrane
Library from inception to May 10, 2022 for studies investigating the
association between elevated RDW (as defined by the authors of included
studies) and adverse outcomes after cardiac surgery. Herein, the authors
extracted maximally adjusted hazard ratios (HRs) and odds ratios (ORs)
with associated CIs, and pooled them using random-effects inverse-
variance modeling. The authors explored interstudy heterogeneity using
metaregression. The authors included 26 studies involving 48,092 patients
who had undergone cardiac surgery. Elevated preoperative RDW was
associated with long-term mortality (pooled HR 1.63, 95% CI 1.05-2.52),
short-term mortality (pooled OR 2.16, 95% CI 1.21-3.87), acute kidney
injury (AKI; pooled OR 1.30, 95% CI 1.19-1.41) and postoperative atrial
fibrillation (POAF; pooled OR 1.44, 95% CI 1.05-1.96). Some studies
suggested a significant association between preoperative RDW elevation and
neurologic complications; however, their number was insufficient for
meta-analysis. The postoperative RDW levels were less consistently
reported and could not be meta-analyzed. In conclusion, the authors found
that elevated preoperative RDW was associated with increased short- and
long-term mortality, POAF, and AKI after cardiac surgery. Further research
is needed to investigate its role in the risk stratification of patients
undergoing cardiac surgery. Copyright © 2022. Published by
Elsevier Inc.

<39>
Accession Number
2022039238
Title
Mitral Annular Calcification Related Infective Endocarditis: A
Contemporary Systematic Review.
Source
Current Problems in Cardiology. 48(3) (no pagination), 2023. Article
Number: 101558. Date of Publication: March 2023.
Author
Kumar A.; Samra G.; Kaur S.; Ogunnowo G.; Kocyigit D.; Xu B.
Institution
(Kumar, Kocyigit, Xu) Section of Cardiovascular Imaging, Robert and
Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold
Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Kumar) Department of Internal Medicine, MedStar Georgetown University
Hospital, Washington, DC, United States
(Samra) Department of Internal Medicine, Cleveland Clinic, Cleveland, OH,
United States
(Kaur, Ogunnowo) Robert and Suzanne Tomsich Department of Cardiovascular
Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic
Institute, Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Mitral annular calcification (MAC) is a chronic degenerative process often
found incidentally on imaging. MAC is associated with elevated risk of
atherosclerosis and stroke. The association between MAC and the risk of
infective endocarditis (IE) is less well known. Therefore, we conducted
this systematic review in order to understand the diagnosis, clinical
outcomes, and management of IE associated with MAC. We conducted a
systematic review of published data regarding MAC related IE in various
databases until November 20, 2019. Case series and cohort studies were
included. A total of 8 studies with a cohort of 113 patients were
included. Mean age was 69 years with equal gender distribution (50%
female). Hypertension (55.8%) was the most common comorbidity seen in this
patient population. IE was diagnosed by either antemortem trans esophageal
echocardiographic examination (76%) or post-mortem autopsy (24%).
Staphylococcus aureus (47%) was the most common pathogen identified. MAC
was adjudicated to be moderate-to-severe in 100% of identified cases, with
77.9% of cases presenting with distinct vegetation's. Twenty-six percent
of patients (n = 29) underwent surgery. MAC may be associated with
development of IE. Echocardiography is the most common non-invasive
technique for diagnosis. Due to the difficulties associated with
antemortem diagnosis, diagnosis is occasionally made on post-mortem
examination. Neurologic complications are frequently encountered, and
reported mortality is high in MAC associated IE. Copyright © 2022
Elsevier Inc.

<40>
Accession Number
2018935445
Title
A Comparative Study of the Clinical Implications of Cardioplegia Infusion
Between the Microplegia Technique and Del Nido Cardioplegia Among Patients
Undergoing Coronary Artery Bypass Surgery.
Source
Iranian Heart Journal. 24(1) (pp 31-38), 2023. Date of Publication:
January 2023.
Author
Baharestani B.; Nazari S.; Ashrafi M.M.; Nejatollahi M.; Ghanbari A.;
Azarfarin R.; Behjati M.; Hesari F.
Institution
(Baharestani, Nejatollahi, Ghanbari, Azarfarin, Behjati, Hesari) Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Nazari, Ashrafi) Young Researchers and Elites Club, Faculty of Medicine,
Islamic Azad University, Yazd Branch, Yazd, Iran, Islamic Republic of
Publisher
Iranian Heart Association
Abstract
Background: Cardioplegia is used to protect the heart from ischemic injury
during cardiovascular bypass. We randomly selected candidates for coronary
artery bypass surgery undergoing either microplegia or del Nido
cardioplegia. Method(s): We performed a controlled randomized
double-blind study to evaluate 60 patients undergoing coronary artery
bypass surgery in Rajaie Cardiovascular Medical and Research Center during
a 3-month period. During surgery, the case group received microplegia, and
the control group received del Nido cardioplegia. Preoperative,
intraoperative, and postoperative personal information was collected from
the patients' records, and the data were analyzed using the SPSS software,
version 22, using appropriate statistical tests. Result(s): Out of 60
patients under study, 28 patients underwent microplegia, and 32 patients
received del Nido cardioplegia. The patients, randomly assigned to the
groups, did not significantly differ concerning height, weight, and body
surface area. No significant differences existed between the 2 groups. The
levels of postoperative decreases in hemoglobin and hematocrit were
significant in the microplegia group and led to an increase in the number
of blood transfusions in the intensive care unit. A significant increase
in CK-MB was observed in the del Nido group 24 hours after surgery.
 Conclusion(s): Microplegia, compared with del Nido cardioplegia,
conferred proper myocardial protection. However, the use of the
microplegia technique was associated with more significant decreases in
hemoglobin and hematocrit postoperatively, and the beneficial effects of
microplegia in reducing hemodilution were not
well-reflected. Copyright © 2023, Iranian Heart Association. All
rights reserved.

<41>
Accession Number
2018935444
Title
Comparison Between Beating and Non-Beating-Heart Pump Approaches Among
Patients Undergoing Pulmonary Valvar Surgery: A Randomized Clinical Trial.
Source
Iranian Heart Journal. 24(1) (pp 22-30), 2023. Date of Publication:
January 2023.
Author
Tabaei A.S.; Khorrami Z.; Ghanbarlou A.; Kalan M.E.; Daneshmandi M.;
Miraki S.
Institution
(Tabaei, Daneshmandi) Rajaie Cardiovascular Medical and Research Center,
Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Khorrami) HIV/STI Surveillance Research Center, WHO Collaborating Center
for HIV Surveillance, Institute for Futures Studies in Health, Kerman
University of Medical Sciences, Kerman, Iran, Islamic Republic of
(Ghanbarlou) Taleghani Hospital, Shahid Beheshti University, Tehran, Iran,
Islamic Republic of
(Kalan) Department of Epidemiology, Robert Stempel College of Public
Health, Florida International University, Miami, FL, United States
(Miraki) Department of Emergencies, School of Nursing and Midwifery,
Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Iranian Heart Association
Abstract
Background: Open-heart surgery is usually done in 2 ways. The first and
most common method is done with cardiac arrest after aortic clamping and
the perfusion of the cardioplegic solution into the coronary arteries. The
second method is the on-pump beating heart, done usually for the
right-heart chambers. In this study, we sought to compare these 2 methods
concerning cardiac muscle damage, kidney and liver parameters, and
clinical outcomes in patients with isolated pulmonary valve repair.
 Method(s): Forty-three patients that underwent cardiopulmonary bypass
were randomly assigned to 2 on-pump non-beating (n=20) and beating (n=23)
heart groups. We assessed between-group hemodynamics and arterial blood
gasses. Result(s): The operation time was shorter in the
beating-heart group than in the non-beating heart group (P=0.003). The
ejection fraction (EF) at discharge in the non-beating group was
significantly lower than that in the beating-heart group (44.25+/-6.12 vs
50.00+/-5.56). Cardiac troponin I and creatine phosphokinase levels showed
significant decreases at the preoperative time in both groups; the levels
were better in the beating-heart group. No changes were observed in
arterial blood gasses before surgery, postoperatively, at intensive care
unit admission, and 24 hours after surgery in the 2 groups. The potassium
level after the operation was significantly lower in the beating-heart
group (4.18 [+/- 0.85]). Conclusion(s): The beating-heart surgical
procedure conferred a better EF at discharge. Additionally, cardiac
troponin I and creatine phosphokinase levels decreased after the
preoperative time. Copyright © 2023, Iranian Heart Association.
All rights reserved.

<42>
Accession Number
2018935437
Title
Effects of Remote Ischemic Preconditioning on Antioxidant Capacity and
Lipid Peroxidation in Patients Undergoing Coronary Artery Bypass Grafting
in Tehran Heart Center.
Source
Iranian Heart Journal. 24(1) (pp 15-21), 2023. Date of Publication: 2023.
Author
Mehrabanian M.; Firoozabadi M.D.; Gorjipour F.; Soltaninia H.;
Nooralishahi B.; Rahab M.; Mohseni M.
Institution
(Mehrabanian, Firoozabadi, Soltaninia, Nooralishahi) Tehran Heart Center,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Gorjipour) Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Rahab) Rasool Akram Hospital, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Mohseni) Department of Anesthesiology, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Iranian Heart Association
Abstract
Background: Remote ischemic preconditioning (RIPC) may improve outcomes in
ischemia/reperfusion injury (IRI) by improving antioxidant defense. We
investigated total antioxidant capacity (TAC) and malondialdehyde (MDA)
content as markers of lipid peroxidation. Method(s): The present
randomized clinical trial allocated 50 coronary artery bypass graft (CABG)
patients with cardiopulmonary bypass at Tehran Heart Center to 2 groups:
RIPC and control (25 patients each). Clinical biochemistry parameters,
TAC, and MDA were measured at 3 time points: post-anesthesia induction
(before skin incision), immediately post-CPB, and 24 hours post-ICU
admission. Result(s): Increased transfusions of packed cells in the
ICU and higher plasma MDA levels at post-CPB were observed in the control
group. Additionally, significantly higher plasma TAC levels were observed
at 24 hours post-ICU in the RIPC group. Conclusion(s): RIPC protects
against IRI in CABG on CPB by reducing lipid peroxidation and elevating
antioxidant defense. RIPC could be integrated into CABG to reduce IRI
adverse outcomes. Copyright © 2023, Iranian Heart Association.
All rights reserved.

<43>
Accession Number
2016352586
Title
Postoperative prophylactic intermittent noninvasive ventilation versus
usual postoperative care for patients at high risk of pulmonary
complications: a multicentre randomised trial.
Source
British Journal of Anaesthesia. 130(1) (pp e160-e168), 2023. Date of
Publication: January 2023.
Author
Abrard S.; Rineau E.; Seegers V.; Lebrec N.; Sargentini C.; Jeanneteau A.;
Longeau E.; Caron S.; Callahan J.-C.; Chudeau N.; Beloncle F.; Lasocki S.;
Dupoiron D.
Institution
(Abrard, Rineau, Sargentini, Jeanneteau, Longeau, Lasocki) Department of
Anesthesiology and Intensive Care, University Hospital of Angers, Angers,
France
(Abrard, Rineau) MITOVASC Institute, INSERM 1083, CNRS 6015, University of
Angers, Angers, France
(Abrard) Department of Anesthesiology and Critical Care Medicine, Edouard
Herriot Hospital, Hospices Civils de Lyon, Lyon, France
(Seegers) Department of Clinical Research, Integrated Center for Oncology
Paul Papin, Angers, France
(Lebrec, Dupoiron) Anesthesiology and Pain Medicine Department, Integrated
Center for Oncology Paul Papin, Angers, France
(Caron) Department of Anesthesiology, Le Mans Hospital, Le Mans, France
(Callahan, Chudeau) Department of Intensive Care, Le Mans Hospital, Le
Mans, France
(Beloncle) Medical Intensive Care Department, University Hospital of
Angers, Angers, France
Publisher
Elsevier Ltd
Abstract
Background: Pulmonary complications are an important cause of morbidity
and mortality after surgery. We evaluated the clinical effectiveness of
noninvasive ventilation (NIV) in preventing postoperative acute
respiratory failure. Method(s): This is an open, multicentre
randomised trial that included patients at high risk of postoperative
pulmonary complications after elective or semi-urgent surgery with an
Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score
>=45. Patients were randomly assigned to intermittent prophylactic
face-mask NIV for 6-8 h day-1 or usual postoperative care. The
primary outcome was in-hospital acute respiratory failure within 7 days
after surgery. Patients who underwent surgery and postoperative extubation
were included in the modified intended-to-treat analysis. Results are
presented as n (%) and odds ratios (ORs) with 95% confidence intervals.
 Result(s): Between November 2017 and October 2019, 266 patients were
randomised and 253 included in the main analysis. Of these, 203 (80.2%)
were male with a mean age of 68 (11) yr and an ARISCAT score of 53 (6);
237 subjects (93.7%) underwent cardiac or thoracic surgery. There were 125
patients allocated to prophylactic NIV and 128 to usual care. Unplanned
treatment termination occurred in 58 subjects in the NIV group, which was
linked to NIV discomfort for 36 subjects. There was no difference in the
incidence of the primary outcome of postoperative acute respiratory
failure between treatment groups (NIV: 30 of 125 subjects [24.0%] vs usual
care: 35 of 128 subjects [27.3%]; OR 0.97 [0.90-1.04]; P=0.54).
 Conclusion(s): Prophylactic NIV was difficult to implement after
high-risk surgery because of low patient compliance. Prophylactic NIV did
not prevent acute respiratory failure. Clinical trial registration: NCT
03629431 and EudraCT 2017-001011-36. Copyright © 2021 British
Journal of Anaesthesia

<44>
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.
 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. 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). 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. Type of
Study: Treatment study, Randomized controlled trial. Level of
Evidence: Level 1. Copyright © 2022

<45>
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.
 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. 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. 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. Copyright © 2022 Soletti,
Perezgrovas-Olaria, Harik, Rahouma, Dimagli, Alzghari, Demetres, Bratton,
Yaghmour, Satija, Lau, Girardi, Salemo and Gaudino.

<46>
Accession Number
2022068706
Title
Drug-Coated versus Uncoated Balloon for Side Branch Protection in Coronary
Bifurcation Lesions Treated with Provisional Stenting Using Drug-Eluting
Stents: A Meta-analysis.
Source
International Journal of Clinical Practice. 2022 (no pagination), 2022.
Article Number: 5892589. Date of Publication: 2022.
Author
Jiang Z.-M.; Liu L.
Institution
(Jiang) Department of Cardiology, The Fourth Hospital of Changsha,
Changsha, China
(Liu) Department of Cardiology, The Eighth Hospital of Changsha, Changsha,
China
Publisher
Hindawi Limited
Abstract
Background. Provisional stenting using drug-eluting stents (DES) has
become the preferred treatment for coronary bifurcation lesions (CBLs). We
performed a meta-analysis to compare the effects of side branch (SB)
protection using a drug-coated balloon (DCB) versus an uncoated balloon
(UCB) during the procedure. Methods. Relevant randomized and nonrandomized
studies were identified by searching the Medline, Embase, Web of Science,
Wanfang, and CNKI databases. We used a random-effect model to pool the
data by incorporating the heterogeneity between the included studies.
Results. Overall, 803 patients with CBLs treated with provisional stenting
using DES were included from seven studies. With a follow-up duration of 6
to 12 months, SB protection with DCB was associated with a lower degree of
postoperative diameter stenosis (mean difference (MD): -11.35%, 95%
confidence interval (CI): -14.17 to-8.53, p<0.001; I2 = 0%) and less late
lumen loss (MD: -0.19 mm, 95% CI:-0.28 to-0.10, p<0.001; I2 = 69%) of SB
compared to those with UCB. Moreover, SB protection with DCB was
associated with reduced risks of target lesion revascularization (risk
ratio [RR]: 0.49, 95% CI: 0.27 to 0.88, p=0.02; I2 = 0%) and major adverse
cardiovascular events (RR: 0.42, 95% CI: 0.27 to 0.66, p<0.01; I2 = 0%).
Subgroup analysis according to the study design showed similar results.
Conclusions. For patients with CBL treated with provisional stenting using
DES, SB protection with DCB was associated with better angiographic and
clinical outcomes than those with UCB. Copyright © 2022 Zhi-Ming
Jiang and Le Liu.

<47>
Accession Number
2013979152
Title
SARS-CoV-2 infection in heart transplant recipients: a systematic
literature review of clinical outcomes and immunosuppression strategies.
Source
Heart Failure Reviews. 27(5) (pp 1653-1663), 2022. Date of Publication:
September 2022.
Author
Ilonze O.J.; Ballut K.; Rao R.S.; Jones M.A.; Guglin M.
Institution
(Ilonze, Ballut, Rao, Jones, Guglin) Krannert Institute of Cardiology,
Section of Advanced Heart Failure and Transplant Cardiology, Division of
Cardiology, Indiana University School of Medicine, Indianapolis, United
States
(Ilonze) IndianapolisUnited States
Publisher
Springer
Abstract
The impact of SARS-CoV-2 infection on heart transplant recipients is
unknown. Literature is limited to case reports and series. The purpose of
this study is to identify the clinical features, outcomes, and
immunosuppression strategies of heart transplant recipients with COVID-19
infection. A systematic review was conducted using the search term
"Coronavirus" or COVID," "SARS-CoV-2," "cardiac transplantation," and
"heart transplant." Case reports and retrospective studies were gathered
by searching Medline/PubMed, Google Scholar, CINAHL, Cochrane CENTRAL, and
Web of Science. Thirty-three articles were selected for review. We
identified 74 cases of SARS-CoV-2 infection in heart transplant and
heart-kidney transplant recipients. The mean age was 60.5 +/- 15.8 years,
and 82.4% were males with median time from transplant of 6.5 years.
Commonest symptoms were fever, cough, and dyspnea, but new left
ventricular (LV) dysfunction was rare. Leukocytosis, lymphopenia, elevated
inflammatory markers, and bilateral ground-glass opacities were common.
Mortality was high, with particularly poor survival in patients who
required intensive care unit (ICU) admission and older patients.
Immunosuppression involved discontinuation of antimetabolites and
steroids. COVID-19 infection in heart transplant (HT) recipients presents
similarly to the general population, but new onset of LV dysfunction is
uncommon. Immunosuppression strategies include increase in corticosteroids
and discontinuation of antimetabolites. Copyright © 2021, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<48>
Accession Number
2018935314
Title
Effects of Verapamil on the Reduction of Radial Artery Thrombosis after
Coronary Angiography: A Randomized Clinical Trial.
Source
Journal of Tehran University Heart Center. 17(4) (pp 180-185), 2022. Date
of Publication: 2022.
Author
Beyranvand M.; Mohammadi Z.; Piranfar M.A.; Gachkar L.
Institution
(Beyranvand, Mohammadi, Piranfar) Department of Cardiology, Taleghani
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Gachkar) Infectious Diseases and Tropical Medicine Research Center,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Tehran Heart Center
Abstract
Background: The trans-radial approach significantly reduces access
bleeding and underlying vascular complications and is associated with
lower health care costs than the transfemoral approach. One of the most
common complications, however, is radial artery occlusion (RAO).
 Method(s): This study investigates the effects of verapamil on radial
artery thrombosis in patients referred to Taleghani Hospital in Tehran
between 2020 and 2021. Patients were randomized into 2 groups: the first
group received verapamil, nitroglycerin, and heparin and the second group
nitroglycerin and heparin. To randomly assign 100 cases to the 2
experimental and control groups, we first formed a framework for sampling
100 people (from 1 to 100); then, based on the table of random numbers, we
assigned the first 50 numbers to the experimental group and the remainder
to the control group. The 2 groups were compared for radial artery
thrombosis. Result(s): This study evaluated 100 candidates for
coronary angiography in 2 groups of 50 with and without verapamil. The
mean age was 58.6+/-11.2 years in the group with verapamil and 58.1+/-12.7
years in the group without verapamil (P=0.84). The difference between the
2 groups in terms of heart failure was statistically significant
(P<0.028). The prevalence of clinical thrombosis was 2.0% in the group
with verapamil and 22.0% in the group without verapamil (P<0.004). The
prevalence of ultrasound-confirmed thrombosis was 4.0% in the group with
verapamil and 36.0% in the group without verapamil (P<0.001).
 Conclusion(s): Intra-arterial injection of verapamil added to heparin
and nitroglycerine during trans-radial angiography could significantly
reduce RAO. Copyright © 2022 Tehran University of Medical
Sciences..

<49>
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.
 Objective(s): To explore the opioid-sparing effect of different doses
of esketamine infusion during thoracic surgery and its impact on patient
recovery. Study Design: Randomized controlled study. Setting(s):
A single-center study with a total of 120 patients. 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. 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. Limitation(s): The sample size
calculation was based mainly on the index of hydromorphone consumption.
 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. Copyright © 2022, American Society of
Interventional Pain Physicians. All rights reserved.

<50>
Accession Number
2013619342
Title
Impact of minimal invasive extracorporeal circulation on perioperative
intravenous fluid management in coronary artery bypass surgery.
Source
Perfusion (United Kingdom). 38(1) (pp 135-141), 2023. Date of Publication:
January 2023.
Author
Ellam S.; Rasanen J.; Hartikainen J.; Selander T.; Juutilainen A.; Halonen
J.
Institution
(Ellam) Department of Anesthesiology and Operative Services, Kuopio
University Hospital, Kuopio, Finland
(Rasanen, Hartikainen, Juutilainen, Halonen) School of Medicine,
University of Eastern Finland, Kuopio, Finland
(Hartikainen, Halonen) Heart Center, Kuopio University Hospital, Kuopio,
Finland
(Selander) Research Support Services, Kuopio University Hospital, Kuopio,
Finland
Publisher
SAGE Publications Ltd
Abstract
Objective: Compare the use of blood products and intravenous fluid
management in patients scheduled for coronary artery bypass surgery and
randomized to minimal invasive extracorporeal circulation (MiECC) and
conventional extracorporeal circulation (CECC). Method(s): A total of
240 patients who were scheduled for their first on-pump CABG, were
randomized to MiECC or CECC groups. The study period was the first 84
hours after surgery. Hemoglobin <80 g/l was used as transfusion trigger.
 Result(s): Red blood cell transfusions intraoperatively were given
less often in the MiECC group (23.3% vs 9.2%, p = 0.005) and the total
intravenous fluid intake was significantly lower in the MiECC group (3300
ml [2950-4000] vs 4800 ml [4000-5500], p < 0.001). Hemoglobin drop also
was lower in the MiECC group (35.5 +/- 8.9 g/l vs 50.7 +/- 9 g/l, p <
0.001) as was hemoglobin drop percent (25.3 +/- 6% vs 35.3 +/- 5.9%, p <
0.001). Chest tube drainage output was higher in the MiECC group (645 ml
[500-917.5] vs 550 ml [412.5-750], p = 0.001). Particularly, chest tube
drainage in up to 600 ml category, was in benefit of CECC group (59.1% vs
40.8%, p = 0.003). ROC curve analysis showed that patients with hemoglobin
level below 95 g/l upon arrival to intensive care unit was associated with
increased risk of developing postoperative atrial fibrillation (POAF) (p =
0.002, auc = 0.61, cutoff <95, sensitivity = 0.47, positive predictive
value = 0.64). Conclusion(s): MiECC reduced the intraoperative need
for RBC transfusion and intravenous fluids compared to the CECC group,
also reducing hemoglobin drop compared to the CECC group in CABG surgery
patients. Postoperative hemoglobin drop was a predictor of
POAF. Copyright © The Author(s) 2021.

<51>
Accession Number
2013496714
Title
Predicting atrial fibrillation after cardiac surgery: a scoping review of
associated factors and systematic review of existing prediction models.
Source
Perfusion (United Kingdom). 38(1) (pp 92-108), 2023. Date of Publication:
January 2023.
Author
Fleet H.; Pilcher D.; Bellomo R.; Coulson T.G.
Institution
(Fleet) Melbourne Medical School, The University of Melbourne, Melbourne,
VIC, Australia
(Pilcher, Coulson) Department of Epidemiology and Preventative Medicine,
Monash University, Melbourne, VIC, Australia
(Bellomo, Coulson) Centre for Integrated Critical Care, The University of
Melbourne, Parkville, VIC, Australia
(Coulson) Department of Anaesthesia, Austin Hospital, Melbourne, VIC,
Australia
Publisher
SAGE Publications Ltd
Abstract
Introduction: Postoperative atrial fibrillation (POAF) is common after
cardiac surgery and associated with increased hospital length of stay,
patient morbidity and mortality. We aimed to identify factors associated
with POAF and evaluate the accuracy of available POAF prediction models.
 Method(s): We screened articles from Ovid MEDLINE and
PubMed Central (PMC) and included studies that evaluated risk
factors associated with POAF or studies that designed or validated POAF
prediction models. We only included studies in cardiac surgical patients
with sample size n 50 and a POAF outcome group 20. We summarised factors
that were associated with POAF and assessed prediction model performance
by reviewing reported calibration and discriminative ability.
 Result(s): We reviewed 232 studies. Of these, 142 fulfilled the
inclusion criteria. Age was frequently found to be associated with POAF,
while most other variables showed contradictory findings, or were assessed
in few studies. Overall, 15 studies specifically developed and/or
validated 12 prediction models. Of these, all showed poor discrimination
or absent calibration in predicting POAF in externally validated cohorts.
 Conclusion(s): Except for age, reporting of factors associated with
POAF is inconsistent and often contradictory. Prediction models have low
discrimination, missing calibration statistics, are at risk of bias and
show limited clinical applicability. This suggests the need for studies
that prospectively collect AF relevant data in large cohorts and then
proceed to validate findings in external data sets. Copyright ©
The Author(s) 2021.

<52>
Accession Number
2013279605
Title
Comparative clinical efficacy of novel bidirectional cannula in cardiac
surgery via peripheral cannulation for cardiopulmonary bypass.
Source
Perfusion (United Kingdom). 38(1) (pp 44-50), 2023. Date of Publication:
January 2023.
Author
Gunaydin S.; Babaroglu S.; Budak A.B.; Sayin B.; Cayhan V.; Ozisik K.
Institution
(Gunaydin, Babaroglu, Budak, Ozisik) Department of Cardiovascular Surgery,
Ankara City Hospital, University of Health Sciences, Ankara, Turkey
(Sayin, Cayhan) Department of Radiology, Ankara City Hospital, University
of Health Sciences, Ankara, Turkey
Publisher
SAGE Publications Ltd
Abstract
Objectives: The aim of this study is to evaluate the safety and efficacy
of the novel bidirectional cannula that ensures stable distal perfusion
compared to conventional cannula in patients undergoing femoral arterial
cannulation for cardiopulmonary bypass (CPB). Method(s): During a
1-year period, 64 patients undergoing surgery via peripheral cannulation
were prospectively randomized to receive 19 F bidirectional (BiflowTM,
LivaNova, Italy) or 19 F conventional (HLS Peripheral cannula, Getinge
GroupTM, Germany) cannula with 6 F downstream line (BicakcilarTM, Turkey)
for femoral artery cannulation. The primary outcome included the efficacy
(adequacy of antegrade/retrograde comparative flow via cannula measured by
doppler ultrasonography) and the secondary outcome was the safety
(early/late complications and adverse events). Result(s): Percent
flow (distal/proximal) after cannulation measured by doppler
ultrasonography was significantly better in study group (33.1 +/- 5
ml/min) versus downstream cannula (16.1 +/- 4, p = 0.012). SpO<inf>2</inf>
measured by near infrared spectroscopy (NIRS) also demonstrated
significantly better saturation in distal calf of the cannulated leg in
bidirectional cannula group (67.5% +/- 10% vs 52.5 +/- 8, p = 0.04). The
incidence of serious adverse events was seroma on femoral region (one
patient), superficial wound infection (one patient), pseudo-hematoma (two
patients) in bidirectional cannula group and in-hospital femoral
embolectomy/artery repair (two patients), superficial wound infection
(three patients), cannulation site hematoma (three patients) in
conventional cannula group. Conclusion(s): This study demonstrates
that in patients undergoing femoral arterial cannulation for CPB during
cardiac surgery, the use of a novel bidirectional cannula is safe and easy
to insert and provides stable distal perfusion of the cannulated
limb. Copyright © The Author(s) 2021.

<53>
Accession Number
640021170
Title
Matters of the Heart: A Scoping Review Toward Better Management of
Nontuberculous Mycobacterial Infections of Cardiac Devices.
Source
Open Forum Infectious Diseases. Conference: Infectious Diseases Week,
IDWeek 2022. Washington, DC United States. 9(Supplement 2) (pp S613-S614),
2022. Date of Publication: December 2022.
Author
Mahatanan R.; Ovalle A.; Lee D.; Alkozah M.; Talbot E.
Institution
(Mahatanan, Ovalle, Lee, Alkozah, Talbot) Dartmouth-Hitchcock Medical
Center, Lebanon, NH, United States
Publisher
Oxford University Press
Abstract
Background. Medical device infections caused by nontuberculous
mycobacteria (NTM) are increasingly reported in the literature. Management
is complex and often guided by expert opinion, in the absence of
evidence-based guidelines. Methods. We searched available databases for
reports of implantable cardiac device-related (ICDR) infections with NTM.
We collected patient-level characteristics, microbiological, and treatment
data, and used univariate analysis to correlate with reported outcome,
which we defined as death, treatment failure, relapse after treatment
completion, cure, and treatment completion. Results. Of 2573 potential
eligible articles, 68 articles were included, representing 112 patients.
The average patient age was 61 years, and 6% of patients were
immunocompromised. Of 12 species reported, 65% were rapid growers, with M.
fortuitum most common. Prosthetic heart valves and pacemaker/automatic
implantable cardiac devices (AICD) were the most commonly reported
infected devices (45% and 37%, respectively). Diagnosis was often delayed,
and confirmed with culture (62%, 41% blood cultures) and 16s ribosomal RNA
gene sequencing data (14%) of cases. Antimicrobial susceptibility was
available in 55% of cases. 70% of patients received >2 antibiotics and, of
these, 41% included a macrolide. Devices were removed for 65% of patients,
more commonly if the infected deice was a pacemaker or AICD than another
type of cardiac device (86% vs 56%, p=0.02). 67% of patients with
prosthetic valves underwent valve replacement. Compared with those who did
not have their device removed, patients who underwent device removal were
less likely to die (23% vs 48%, p=0.02) and more likely to have favorable
outcomes (68% vs 28%, p=0.002). Conclusion. Reports of ICRD NTM infections
were common, and suspicion should be high even for those without
immunocompromising condition. Determining outcome was challenging and
should be standardized to provide an evidence base for better management.
In our analysis, patients who underwent device removal had improved
survival, suggesting either that comorbidity precluded device removal
and/or that removal may be an essential part of the management.

<54>
Accession Number
640016019
Title
Outcomes of percutaneous PFO closure: Single centre experience.
Source
Anatolian Journal of Cardiology. Conference: 38th Turkish Cardiology
Congress. Antalya Turkey. 26(Supplement 1) (pp S122), 2022. Date of
Publication: December 2022.
Author
Coteli C.; Yetkin A.; Sener Y.Z.; Karakulak U.N.; Sahiner L.; Kaya B.;
Ates A.H.; Yorgun H.; Aytemir K.
Institution
(Coteli, Yetkin, Sener, Karakulak, Sahiner, Kaya, Ates, Yorgun, Aytemir)
Department of Cardiology, Hacettepe University, Faculty of Medicine,
Ankara, Turkey
Publisher
Turkish Society of Cardiology
Abstract
Background and Aim: Patent foramen ovale closure aims to reduce recurrent
stroke risk in a specific group of patients. On the other hand, absolute
risk reduction with PFO closure compared to antiplatelet treatment is
still under investigation due to procedural complication risks.
 Method(s): The objective of this trial is to report short and
long-term results of PFO closure in our center. Result(s): In our
study group (mean age 43.7, SD: 11.12), 217 (58.8%) of them were female,
the most common comorbidity was hypertension (in 87 pts, 23.6%), atrial
fibrillation was present in 9 patients (2.4%), and 46 pts (12.5%) had
migraine. The median rope score of patients was 6 (2-9). The percutaneous
PFO closure was performed without complications in 352 patients (95.4%).
Pericardial effusion, access-related bleeding, dislocation, and
supraventricular arrhythmia were observed in 5, 9.1, and 2 patients,
respectively. Pericardiocentesis, urgent surgery, and blood transfusion
were not needed in any patient. The device migrated after releasing in one
patient and was collected with a snare catheter. The transseptal atrial
septal puncture was required in 15 (4.1%) patients. 327 patients (88.6%)
used DAPT, and 42 patients (11.4%) used SAPT (ASA or clopidogrel) or oral
anticoagulant after procedure. The median follow-up duration was 12.7
months (3-147 months). Mortality was not observed in the study group, but
18 patients (5.7%) presented with recurrent stroke during follow- up.
Clinically disabling stroke was present in 3 patients (0.81%). Device
malposition or thrombus formation on the closure device were not observed
at the third-month transthoracic echocardiography. Conclusion(s): PFO
closure is a safe, feasible, and effective therapeutic option for
thromboembolic risk reduction in selected patients. Procedure-related
complication risk and postprocedural recurrent stroke are low. Further
randomized controlled trials and cost-effectivity analysis are needed to
understand the absolute outcomes of the procedure. (Table Presented).

<55>
Accession Number
640016375
Title
Comprehensive Evaluation Of A Technology With Expanding Indications.
Source
International Journal of Technology Assessment in Health Care. Conference:
Annual Meeting of the Health Technology Assessment International, HTAi
2018. Vancouver, BC Canada. 34(Supplement 1) (pp 72), 2018. Date of
Publication: December 2018.
Author
Lambert L.; Desy F.; Azzi L.; Vutcovici M.; Briere A.; Boothroyd L.;
Bogaty P.; Racine N.; De Guise M.
Publisher
Cambridge University Press
Abstract
INTRODUCTION: The use of transcatheter aortic valve implantation (TAVI) is
evolving. Our Cardiovascular Evaluation Unit is implementing a
comprehensive approach to inform decision-makers on optimal use of TAVI,
including the development of quality standards. We are implementing a
multifaceted evaluation framework in collaboration with clinical
stakeholders. METHOD(S): Our unit has carried out a continuous field
evaluation in collaboration with the clinical teams at all six TAVI
centers in Quebec for the past four years (1 April 2013-31 March 2017),
with regular feedback to the teams and sharing of results with each
individual center. Hospital documentation was reviewed according to
established national quality indicator definitions. Field evaluation data
were combined with the results of systematic literature review to
establish provincial standards for practice, through a deliberation
process by an interdisciplinary committee of clinical experts from each
center. Systematic surveillance of the literature is ongoing.
 RESULT(S): In the period 2013-2017, use of TAVI in Quebec was limited
to very elderly patients with significant comorbidities at high risk of
operative mortality. We observed improvements in both processes of care
(e.g. documentation of risk scores) and clinical outcomes (e.g. 30-day and
1-year mortality) over time. Our consensus standards recognize the
potential value of TAVI for patients at moderate operative risk, identify
uncertainties and recommend best practices for patient evaluation and
clinical decision-making about choice of treatment. CONCLUSION(S): A
comprehensive, long-term evaluation process of TAVI with feedback to
centers is associated with improvements in processes of care and outcomes.
In the present context of expanding clinical indications, we will continue
to evaluate patient selection, processes and outcomes according to the
newly-established provincial quality standards. This iterative approach
facilitates continued evidence generation and decisionmaking for optimal
use of an evolving intervention. We acknowledge the contribution of the
members of the expert clinical committee.

<56>
Accession Number
2022217304
Title
Gender Bias in the Evaluation of Surgical Performance: Results of a
Prospective Randomized Trial.
Source
Annals of Surgery. 277(2) (pp 206-213), 2023. Date of Publication: 01 Feb
2023.
Author
Antonoff M.B.; Feldman H.; Luc J.G.Y.; Iaeger P.I.; Rubin M.L.; Li L.;
Vaporciyan A.A.
Institution
(Antonoff, Feldman, Vaporciyan) Department of Thoracic and Cardiovascular
Surgery, University of Texas Md Anderson Cancer Center, Houston, TX,
United States
(Luc) Division of Cardiovascular Surgery, Department of Surgery,
University of British Columbia, Vancouver, BC, Canada
(Iaeger) Department of Academic Analytics and Technology, University of
Texas Md Anderson Cancer Center, Houston, TX, United States
(Rubin, Li) Department of Biostatistics, University of Texas Md Anderson
Cancer Center, Houston, TX, United States
Publisher
Wolters Kluwer Health
Abstract
Objective: The study aims to determine the influence of trainee gender on
assessments of coronary anastomosis performance. Summary of Background
Data: Understanding the impact of gender bias on the evaluation of
trainees may enable us to identify and utilize assessment tools that are
less susceptible to potential bias. Method(s): Cardiothoracic
surgeons were randomized to review the video performance of trainees who
were described by either male or female pronouns. All participants viewed
the same video of a coronary anastomosis and were asked to grade technique
using either a Checklist or Global Rating Scale (GRS). Effect of trainee
gender on scores by respondent demographic was evaluated using regression
analyses. Inter-rater reliability was assessed using the Cronbach's alpha.
 Result(s): 103 cardiothoracic surgeons completed the Checklist
(trainee gender: male n=50, female n=53) and 112 completed the GRS
(trainee gender: male n=56, female n=56). For the Checklist, male
cardiothoracic surgeons who were in practice <10 years (P = 0.036) and
involved in training residents (P = 0.049) were more likely to score male
trainees higher than female trainees. The GRS demonstrated high
inter-rater reliability across male and female trainees by years and scope
of practice for the respondent (alpha >0.900) when compared to the
Checklist assessment tool. Conclusion(s): Early career male surgeons
may exhibit gender bias against women when evaluating trainee performance
of coronary anastomoses. The GRS demonstrates higher interrater
reliability and robustness against gender bias in the assessment of
technical performance than the Checklist, and such scales should be
emphasized in educational evaluations. Copyright © 2021 Wolters
Kluwer Health, Inc. All rights reserved.

<57>
[Use Link to view the full text]
Accession Number
2022080804
Title
Survival after Invasive or Conservative Management of Stable Coronary
Disease.
Source
Circulation. 147(1) (pp 8-19), 2023. Date of Publication: 03 Jan 2023.
Author
O'Brien S.M.; Rosenberg Y.; Kirby R.; Newman J.D.; Berger J.S.; Sidhu
M.S.; Harrington R.A.; Boden W.E.; Stone G.W.; Mark D.B.; Spertus J.A.;
Hochman J.S.; Maron D.J.; Reynolds H.R.; Bangalore S.; Mavromichalis S.;
Chang M.; Contreras A.; Esquenazi-Karonika S.; Gilsenan M.; Gwiszcz E.;
Mathews P.; Mohamed S.; Naumova A.; Roberts A.; Vanloo K.; Anthopolos R.;
Xu Y.; Troxel A.B.; Lu Y.; Huang Z.; Broderick S.; Selvanayagam J.; Lopes
R.D.; Goodman S.G.; Steg G.; Juliard J.-M.; Doerr R.; Keltai M.; Bhargava
B.; Thomas B.; Sharir T.; Nikolsky E.; Maggioni A.P.; Kohsaka S.; Escobedo
J.; White H.D.; Pracon R.; Bockeria O.; Senior R.; Banfield A.; Shaw L.J.;
Phillips L.; Berman D.; Kwong R.Y.; Picard M.H.; Chaitman B.R.; Ali Z.;
Min J.; Mancini G.B.J.; Leipsic J.; Guzman L.; Hillis G.; Thambar S.;
Joseph M.; Selvnayagam J.; Beltrame J.; Lang I.; Schuchlenz H.; Huber K.;
Goetschalckx K.; Hueb W.; Caramori P.R.; De Quadros A.; Smanio P.;
Mesquita C.; Lopas R.D.; Vitola J.; Marin-Neto J.; Da Silva E.R.; Tumelero
R.; Andrade M.; Alves A.R.; Dall'Orto F.; Polanczyk C.; Figueiredo E.;
Howarth A.; Gosselin G.; Cheema A.; Bainey K.; Phaneuf D.; Diaz A.; Garg
P.; Mehta S.; Wong G.; Lam A.; Cha J.; Galiwango P.; Uxa A.; Chow B.;
Hameed A.; Udell J.; Chema A.; Hamid M.; Hauguel-Moreau M.; Furber A.;
Goube P.; Steg P.-G.; Barone-Rochette G.; Thuaire C.; Slama M.; Doer R.;
Nickenig G.; Bekeredjian R.; Schulze P.C.; Merkely B.; Fontos G.; Vertes
A.; Varga A.; Bhargva B.; Kumar A.; Nair R.G.; Grant P.; Manjunath C.;
Moorthy N.; Satheesh S.; Nath R.K.; Wander G.; Christopher J.; Dwivedi S.;
Oomman A.; Mathur A.; Gadkari M.; Naik S.; Punnoose E.; Kachru R.;
Christophar J.; Kaul U.; Sharer T.; Kerner A.; Tarantini G.; Perna G.P.;
Racca E.; Mortara A.; Monti L.; Briguori C.; Leone G.; Amati R.; Salvatori
M.; Di Chiara A.; Calabro P.; Galvani M.; Provasoli S.; Fukuda K.; Koshaka
S.; Nakano S.; Laucevicius A.; Kedev S.; Khairuddin A.; Escobdo J.;
Riezebos R.; Timmer J.; Heald S.; Stewart R.; Ramos W.M.; Demkow M.;
Mazurek T.; Drozdz J.; Szwed H.; Witkowski A.; Ferreira N.; Pinto F.;
Ramos R.; Popescu B.; Pop C.; Bockeria L.; Bockerya O.; Demchenko E.;
Romanov A.; Bershtein L.; Jizeeri A.; Stankovic G.; Apostolovic S.; Adjic
N.C.; Zdravkovic M.; Beleslin B.; Dekleva M.; Davidovic G.; Chua T.; Foo
D.; Poh K.K.; Ntsekhe M.; Sionis A.; Marin F.; Miro V.; Lopez-Sendon J.;
Blancas M.G.; Gonzalez-Juanatey J.; Fernandez-Aviles F.; Peteiro J.; Luena
J.E.C.; Held C.; Aspberg J.; Rossi M.; Kuanprasert S.; Yamwong S.;
Johnston N.; Donnelly P.; Moriarty A.; Roxy R.; Elghamaz A.; Gurunathan
S.; Karogiannis N.; Shah B.N.; Trimlett R.H.J.; Rubens M.B.; Nicol E.D.;
Mittal T.K.; Hampson R.; Gamma R.; De Belder M.; Nageh T.; Lindsay S.;
Mavromatis K.; Miller T.; Banerjee S.; Reynolds H.; Nour K.; Stone P.
Institution
(Hochman, Anthopolos, Reynolds, Bangalore, Xu, Mavromichalis, Chang,
Contreras, Newman, Berger, Troxel) NYU Grossman School of Medicine, New
York, NY, United States
(O'Brien, Lopes, Mark) Duke Clinical Research Institute, Durham, NC,
United States
(Rosenberg, Kirby) National Institutes of Health, Bethesda, MD, United
States
(Bhargava) All India Institute of Medical Sciences, New Delhi, India
(Senior, Banfield) Northwick Park Hospital, London, United Kingdom
(Senior) Imperial College London, Royal Brompton Hospital, United Kingdom
(Goodman) St Michael's Hospital, University of Toronto, Canada
(Pracon) Department of Coronary and Structural Heart Diseases, National
Institute of Cardiology, Warsaw, Poland
(Lopez-Sendon) IdiPaz Research Institute and Hospital, Universitario la
Paz, Madrid, Spain
(Maggioni) Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO)
Research Center, Florence, Italy
(Sidhu) Albany Medical College, NY, United States
(White) Te Whatu Ora Health New Zealand, Te Toki Tumai, Green Lane
Cardiovascular Services, University of Auckland, New Zealand
(Harrington, Maron) Stanford University, Department of Medicine, CA,
United States
(Boden) Veterans Affairs New England Healthcare System, Boston University
School of Medicine, MA, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri, Kansas City, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The ISCHEMIA trial (International Study of Comparative Health
Effectiveness With Medical and Invasive Approaches) compared an initial
invasive versus an initial conservative management strategy for patients
with chronic coronary disease and moderate or severe ischemia, with no
major difference in most outcomes during a median of 3.2 years. Extended
follow-up for mortality is ongoing. Method(s): ISCHEMIA participants
were randomized to an initial invasive strategy added to
guideline-directed medical therapy or a conservative strategy. Patients
with moderate or severe ischemia, ejection fraction >=35%, and no recent
acute coronary syndromes were included. Those with an unacceptable level
of angina were excluded. Extended follow-up for vital status is being
conducted by sites or through central death index search. Data obtained
through December 2021 are included in this interim report. We analyzed
all-cause, cardiovascular, and noncardiovascular mortality by randomized
strategy, using nonparametric cumulative incidence estimators, Cox
regression models, and Bayesian methods. Undetermined deaths were
classified as cardiovascular as prespecified in the trial protocol.
 Result(s): Baseline characteristics for 5179 original ISCHEMIA trial
participants included median age 65 years, 23% women, 16% Hispanic, 4%
Black, 42% with diabetes, and median ejection fraction 0.60. A total of
557 deaths accrued during a median follow-up of 5.7 years, with 268 of
these added in the extended follow-up phase. This included a total of 343
cardiovascular deaths, 192 noncardiovascular deaths, and 22 unclassified
deaths. All-cause mortality was not different between randomized treatment
groups (7-year rate, 12.7% in invasive strategy, 13.4% in conservative
strategy; adjusted hazard ratio, 1.00 [95% CI, 0.85-1.18]). There was a
lower 7-year rate cardiovascular mortality (6.4% versus 8.6%; adjusted
hazard ratio, 0.78 [95% CI, 0.63-0.96]) with an initial invasive strategy
but a higher 7-year rate of noncardiovascular mortality (5.6% versus 4.4%;
adjusted hazard ratio, 1.44 [95% CI, 1.08-1.91]) compared with the
conservative strategy. No heterogeneity of treatment effect was evident in
prespecified subgroups, including multivessel coronary disease.
 Conclusion(s): There was no difference in all-cause mortality with an
initial invasive strategy compared with an initial conservative strategy,
but there was lower risk of cardiovascular mortality and higher risk of
noncardiovascular mortality with an initial invasive strategy during a
median follow-up of 5.7 years. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT04894877. Copyright © 2023 Lippincott Williams and Wilkins.
All rights reserved.

<58>
Accession Number
2022081440
Title
Chlorthalidone vs. Hydrochlorothiazide for Hypertension-Cardiovascular
Events.
Source
New England Journal of Medicine. 387(26) (pp 2401-2410), 2022. Date of
Publication: 29 Dec 2022.
Author
Ishani A.; Cushman W.C.; Leatherman S.M.; Lew R.A.; Woods P.; Glassman
P.A.; Taylor A.A.; Hau C.; Klint A.; Huang G.D.; Brophy M.T.; Fiore L.D.;
Ferguson R.E.
Institution
(Ishani) Minneapolis Veterans Affairs (VA), Health Care System, Department
of Medicine, University of Minnesota, Minneapolis, United States
(Cushman) Medical Service, Memphis VA Medical Center, Department of
Preventive Medicine, University of Tennessee, Health Science Center,
Memphis, United States
(Leatherman, Lew, Woods, Hau, Klint, Brophy, Fiore, Ferguson) Cooperative
Studies Program Coordinating Center, VA Boston Healthcare System, United
States
(Leatherman, Lew) Department of Biostatistics, Boston University, School
of Public Health, United States
(Brophy, Ferguson) Department of Medicine, Boston University, School of
Medicine, Boston, United States
(Glassman) Pharmacy Benefits Management Services
(Huang) Office of Research and Development, Department of Veterans
Affairs, Washington, DC, United States
(Glassman) VA Greater Los Angeles Healthcare System, David Geffen School
of Medicine, University of California, Los Angeles, United States
(Taylor) Michael E. DeBakey VA Medical Center, Department of Medicine,
Baylor College of Medicine, Houston, United States
Publisher
Massachussetts Medical Society
Abstract
Background Whether chlorthalidone is superior to hydrochlorothiazide for
preventing major adverse cardiovascular events in patients with
hypertension is unclear. Methods In a pragmatic trial, we randomly
assigned adults 65 years of age or older who were patients in the
Department of Veterans Affairs health system and had been receiving
hydrochlorothiazide at a daily dose of 25 or 50 mg to continue therapy
with hydrochlorothiazide or to switch to chlorthalidone at a daily dose of
12.5 or 25 mg. The primary outcome was a composite of nonfatal myocardial
infarction, stroke, heart failure resulting in hospitalization, urgent
coronary revascularization for unstable angina, and non-cancer-related
death. Safety was also assessed. Results A total of 13,523 patients
underwent randomization. The mean age was 72 years. At baseline,
hydrochlorothiazide at a dose of 25 mg per day had been prescribed in
12,781 patients (94.5%). The mean baseline systolic blood pressure in each
group was 139 mm Hg. At a median follow-up of 2.4 years, there was little
difference in the occurrence of primary-outcome events between the
chlorthalidone group (702 patients [10.4%]) and the hydrochlorothiazide
group (675 patients [10.0%]) (hazard ratio, 1.04; 95% confidence interval,
0.94 to 1.16; P=0.45). There were no between-group differences in the
occurrence of any of the components of the primary outcome. The incidence
of hypokalemia was higher in the chlorthalidone group than in the
hydrochlorothiazide group (6.0% vs. 4.4%, P<0.001). Conclusions In this
large pragmatic trial of thiazide diuretics at doses commonly used in
clinical practice, patients who received chlorthalidone did not have a
lower occurrence of major cardiovascular outcome events or
non-cancer-related deaths than patients who received hydrochlorothiazide.
(Funded by the Veterans Affairs Cooperative Studies Program;
ClinicalTrials.gov number, NCT02185417.) Copyright © 2022
Massachusetts Medical Society.

<59>
Accession Number
640019108
Title
Pectoral Nerve Blocks for Transvenous Subpectoral pacemaker insertion in
Children: Randomized Controlled Trial.
Source
Korean journal of anesthesiology. (no pagination), 2023. Date of
Publication: 12 Jan 2023.
Author
Elhaddad A.M.; Hefnawy S.M.; El-Aziz M.A.; Ebraheem M.M.; Mohamed A.K.
Institution
(Elhaddad, Hefnawy, Mohamed) Department of Anesthesia, Kasr Alainy ,Cairo
University / Abo Elreesh Children's Hospital ,via Al Kasr Al Aini, Cairo
Governorate, Egypt
(El-Aziz, Ebraheem) Department of Anesthesia, Faculty of Medicine, Misr
University for science and technology
Publisher
NLM (Medline)
Abstract
Background: Postoperative pain management after pacemaker insertion
routinely uses either opioid agents, nonsteroid anti-inflammatory drugs,
or paracetamol. There has been increased interest in opioid-sparing
multimodal pain management to minimize postoperative narcotic use. This
study aims to assess postoperative pain control and opioid consumption
provided by pectoral nerve blocks (PECs) versus standard postoperative
pain control in pediatric patients after transvenous subpectoral pacemaker
insertion. Method(s): in this randomized controlled study, forty
pediatric patients presented for transvenous subpectoral pacemaker
insertion, with either congenital or post-operative complete heart
block(CHB). : Patients were randomly assigned into two groups according to
the method of perioperative pain management, Group C (control) received
conventional analgesic care without any block and Group P (pectoral)
received PECs. Demographics, procedural variables, postoperative pain, and
postoperative opioid usage were compared between the two groups.
 Result(s): Intra-procedure, pectoral nerve blocks reduced cumulative
dose of fentanyl and atracurium with better hemodynamic profile and longer
procedure time. Post-procedure, pectoral nerve blocks reduced
postprocedural pain scores, which was reflected in later first call for
rescue analgesia, and lower postoperative morphine consumption, and did
not increase rates of complications in children who underwent transvenous
subpectoral pacemaker insertion. Conclusion(s): Ultrasound guided
PECs have a good intraoperative hemodynamic profile, reduce postoperative
pain scores, and lower total opioid usage in children who underwent
transvenous subpectoral pacemaker placement.

<60>
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. 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. 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. 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. Copyright © 2021 Sociedade Brasileira de Anestesiologia

<61>
Accession Number
2011342120
Title
Efficacy and safety of edoxaban in patients early after surgical
bioprosthetic valve implantation or valve repair: A randomized clinical
trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(1) (pp 58-67.e4),
2023. Date of Publication: January 2023.
Author
Shim C.Y.; Seo J.; Kim Y.J.; Lee S.H.; De Caterina R.; Lee S.; Hong G.-R.;
Lee C.J.; Shin D.-H.; Ha J.-W.; Suh Y.J.; Choi J.Y.; Cho I.-J.; Roh Y.H.
Institution
(Shim, Seo, Hong) Division of Cardiology, Severance Cardiovascular
Hospital, Yonsei University College of Medicine, Seoul, South Korea
(Kim) Department of Radiology, Research Institute of Radiological Science,
Severance Hospital, Yonsei University College of Medicine, Seoul, South
Korea
(Lee, Lee) Division of Cardiovascular Surgery, Department of Thoracic and
Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei
University College of Medicine, Seoul, South Korea
(De Caterina) Cardio-Thoracic and Vascular Department, Pisa University
Hospital and University of Pisa, Pisa, Italy
Publisher
Elsevier Inc.
Abstract
Objective: Early warfarin anticoagulation is recommended in patients
undergoing surgical bioprosthetic valve implantation or valve repair. It
is unclear whether non-vitamin K antagonist oral anticoagulants can be a
full alternative to warfarin. This study aimed to compare efficacy and
safety of edoxaban with warfarin in patients early after surgical
bioprosthetic valve implantation or valve repair. Method(s): The
Explore the Efficacy and Safety of Edoxaban in Patients after Heart Valve
Repair or Bioprosthetic Valve Replacement study was a prospective,
randomized (1:1), open-label, clinical trial conducted from December 2017
to September 2019. Patients were randomly assigned to receive edoxaban (60
mg or 30 mg once daily) or warfarin for the first 3 months after surgical
bioprosthetic valve implantation or valve repair. The primary efficacy
outcome was a composite of death, clinical thromboembolic events, or
asymptomatic intracardiac thrombosis. The primary safety outcome was the
occurrence of major bleeding. Result(s): Of 220 participants, 218
(109 per group) were included in the modified intention-to-treat analysis.
The primary efficacy outcome occurred in 4 patients (3.7%) taking warfarin
and none taking edoxaban (risk difference, -0.0367; 95% confidence
interval, -0.0720 to -0.0014; P < .001 for noninferiority). The primary
safety outcome occurred in 1 patient (0.9%) taking warfarin and 3 patients
(2.8%) taking edoxaban (risk difference, 0.0183; 95% confidence interval,
-0.0172 to 0.0539; P = .013 for noninferiority). Conclusion(s):
Edoxaban is noninferior to warfarin for preventing thromboembolism and is
potentially comparable for risk of major bleeding during the first 3
months after surgical bioprosthetic valve implantation or valve
repair. Copyright © 2021 The American Association for Thoracic
Surgery

<62>
Accession Number
637423324
Title
Use of Electronic Auscultation in Full Personal Protective Equipment to
Detect Ventilation Status in Selective Lung Ventilation: A Randomized
Controlled Trial.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 851395.
Date of Publication: 21 Feb 2022.
Author
Wei T.-J.; Hsiung P.-Y.; Liu J.-H.; Lin T.-C.; Kuo F.-T.; Wu C.-Y.
Institution
(Wei, Hsiung, Liu, Lin, Kuo, Wu) Department of Anesthesiology, National
Taiwan University Hospital, Taipei, Taiwan (Republic of China)
Publisher
Frontiers Media S.A.
Abstract
Chest auscultation is the first procedure performed to detect endotracheal
tube malpositioning but conventional stethoscopes do not conform to the
personal protective equipment (PPE) protocol during the COVID-19 pandemic.
This double-blinded randomized controlled trial evaluated the feasibility
of using ear-contactless electronic stethoscope to identify endobronchial
blocker established selective lung ventilation, simulating endobronchial
intubation during thoracic surgery with full PPE. Conventional and
electronic auscultation was performed without and with full PPE,
respectively, of 50 patients with selective lung ventilation. The rates of
correct ventilation status detection were 86 and 88% in the conventional
and electronic auscultation groups (p = 1.00). Electronic auscultation
revealed a positive predictive value of 87% (95% CI 77 to 93%), and a
negative predictive value of 91% (95% CI 58 to 99%), comparable to the
results for conventional auscultation. For detection of the true
unilateral lung ventilation, the F1 score and the phi were 0.904 and
0.654, respectively for conventional auscultation; were 0.919 and 0.706,
respectively for electronic auscultation. Furthermore, the user experience
questionnaire revealed that the majority of participant anesthesiologists
(90.5%) rated the audio quality of electronic lung sounds as comparable or
superior to that of conventional acoustic lung sounds. In conclusion,
electronic auscultation assessments of ventilation status as examined
during thoracic surgery in full PPE were comparable in accuracy to
corresponding conventional auscultation assessments made without PPE.
Users reported satisfactory experience with the electronic
stethoscope. Copyright © 2022 Wei, Hsiung, Liu, Lin, Kuo and Wu.

<63>
Accession Number
2021796896
Title
Minimally invasive techniques in benign and malignant adrenal tumors.
Source
World Journal of Clinical Cases. 10(35) (pp 12812-12821), 2022. Date of
Publication: 16 Dec 2022.
Author
Dogrul A.B.; Cennet O.; Dincer A.H.
Institution
(Dogrul, Cennet, Dincer) Department of General Surgery, Hacettepe
University Faculty of Medicine, Hacettepe University, Ankara 06100, Turkey
Publisher
Baishideng Publishing Group Inc
Abstract
Minimally invasive adrenalectomy has become the main treatment modality
for most adrenal lesions. Both laparoscopic transabdominal and
retroperitoneoscopic approaches are safe and feasible options, each with
respective advantages, including better surgical outcomes, fewer
complications, and faster recovery over open adrenalectomy. While open
surgery remains a valid modality in treatment of adrenocortical cancer in
the presence of some findings such as invasion, robotic platforms, and
minimally invasive surgery have gained popularity as technology continues
to evolve. Organ preservation during adrenalectomy is feasible in some
conditions to prevent adrenal insufficiency. Ablative technologies are
increasingly utilized in benign and malignant tumors, including the
adrenal gland, with various outcomes. A multidisciplinary team, an
experienced surgeon, and a highvolume center are recommended for any
surgical approaches and management of adrenal lesions. This review article
evaluated recent findings and current evidence on minimally invasive
adrenalectomy. Copyright © The Author(s) 2022. Published by
Baishideng Publishing Group Inc. All rights reserved.

<64>
Accession Number
2021796777
Title
Planning issues on linac-based stereotactic radiotherapy.
Source
World Journal of Clinical Cases. 10(35) (pp 12822-12836), 2022. Date of
Publication: 16 Dec 2022.
Author
Huang Y.-Y.; Yang J.; Liu Y.-B.
Institution
(Huang, Liu) School of Nuclear Science and Engineering, East China
University of Technology, Jiangxi, Nanchang 330013, China
(Huang) Department of Radiotherapy, The Second Affiliated Hospital of
Zhengzhou University, Henan, Zhengzhou 450014, China
(Yang) Department of Radiotherapy, The Third Affiliated Hospital of
Zhengzhou University, Henan, Zhengzhou 450052, China
Publisher
Baishideng Publishing Group Inc
Abstract
This work aims to summarize and evaluate the current planning progress
based on the linear accelerator in stereotactic radiotherapy (SRT). The
specific techniques include 3-dimensional conformal radiotherapy, dynamic
conformal arc therapy, intensity-modulated radiotherapy, and
volumetric-modulated arc therapy (VMAT). They are all designed to deliver
higher doses to the target volume while reducing damage to normal tissues;
among them, VMAT shows better prospects for application. This paper
reviews and summarizes several issues on the planning of SRT to provide a
reference for clinical application. Copyright © The Author(s)
2022. Published by Baishideng Publishing Group Inc. All rights reserved.

<65>
Accession Number
2021977399
Title
Association of preoperative pain-related education with postoperative
patient care among in-hospital cardiac patients.
Source
Anaesthesia, Pain and Intensive Care. 26(6) (pp 757-767), 2022. Date of
Publication: 01 Dec 2022.
Author
Khalid A.; Sadiqa A.; Rehman N.A.; Bilal M.; Inayat T.
Institution
(Khalid) Lahore Institute of Nursing & Allied Health Sciences, Lahore,
Pakistan
(Sadiqa) Department of Physiology, Institute of Dentistry, CMH Lahore
Medical College, Lahore, Pakistan
(Rehman) Saeed Afridi College of Nursing & Allied Health Sciences,
Pakistan
(Bilal) Rehman College of Nursing, Khanewal, Pakistan
(Inayat) Postgraduate College of Nursing, Pakistan
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background: The present study evaluated the association of pre-operative
pain education with the postoperative pain perception among the patients
undergoing coronary artery bypass grafting (CABG). Methodology: This
randomized controlled trial was performed with cardiac patients undergoing
CABG at Punjab Institute of Cardiology (PIC), Lahore. Eighty patients (47
males and 33 females) were selected and randomly assigned, either to the
interventional group (40 patients) or the control group (40 patients).
Those with any psychiatric disorder, past pain history, and those addicted
to the opioids were excluded. The interventional group received
preoperative pain education (booklet by Canadian Pain Society).
Pre-operative and post-operative pain questionnaires including Brief Pain
Inventory (BPI) scales were study tools. Chi-square and independent
t-test, were used for association and comparison respectively.
 Result(s): No significant difference was found between comparative
groups regarding pre-operative pain perception, while significant
difference was noted between the two groups regarding post-operative
clarification of pain management (P < 0.001), preparedness for stronger
analgesics (P < 0.001), risk of analgesia dependence (P < 0.001), fear of
nausea related to pain-killers (P < 0.001), and threat of constipation
with use of analgesics (P < 0.001). BPI scale showed that the average pain
score of interventional and control groups were 17.25 +/- 5.26 and 32.17
+/- 2.51 respectively. Conclusion(s): CABG patients who received
preoperative pain education reported significantly less postoperative pain
after the CABG, compared to the controls. Abbreviations: BPI: Brief Pain
Inventory; CABG: Coronary artery bypass grafting; ICU: Intensive care
unit; POPM: Postoperative pain management Copyright © 2022
Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights
reserved.

<66>
Accession Number
2020834942
Title
A family-tailored early motor intervention (EMI-Heart) for infants with
complex congenital heart disease: study protocol for a feasibility RCT.
Source
Pilot and Feasibility Studies. 8(1) (no pagination), 2022. Article Number:
263. Date of Publication: December 2022.
Author
Mitteregger E.; Dirks T.; Theiler M.; Kretschmar O.; Latal B.
Institution
(Mitteregger, Latal) Child Development Center, University Children's
Hospital Zurich, Zurich, Switzerland
(Mitteregger, Latal) Children's Research Center, University Children's
Hospital Zurich, Zurich, Switzerland
(Mitteregger, Kretschmar, Latal) University of Zurich, Zurich, Switzerland
(Dirks) Paediatric Physiotherapy, Groningen, Netherlands
(Theiler) Swiss Parents' Association for the Child With Heart Disease
(Elternvereinigung Fur das Herzkranke Kind), Aarau, Switzerland
(Kretschmar) Department of Pediatric Cardiology, University Children's
Hospital Zurich, Zurich, Switzerland
Publisher
BioMed Central Ltd
Abstract
Background: Children with congenital heart disease (CHD) undergoing
open-heart surgery are at risk for developmental impairments with motor
delay manifesting first and contributing to parental concerns. Only a few
interventional studies aim to improve neuromotor development in infants
with CHD with inconclusive results. We thus developed a family-tailored
early motor intervention (EMI-Heart), which aims to promote motor
development and family well-being in the first year of life after
open-heart surgery. The primary aim described in this protocol is to
evaluate feasibility of EMI-Heart. The secondary aim is to describe the
difference between the intervention and control group in motor outcomes
and family well-being at baseline, post-treatment, and follow-up.
 Method(s): This prospective, parallel single-center feasibility
randomized controlled trial (RCT) will compare EMI-Heart with standard of
care in infants with complex CHD. Sixteen infants and their families,
randomly allocated to EMI-Heart or the control group, will participate
within the first 5 months of life. Infants assigned to EMI-Heart will
receive early motor intervention for 3 months. The intervention's key is
to promote infants' postural control to enhance motor development and
partnering with parents to encourage family well-being. Feasibility
outcomes will be (a) clinical recruitment rate and percentage of families
completing EMI-Heart, (b) average duration and number of sessions, and (c)
acceptability of EMI-Heart using a parental questionnaire post-treatment,
and descriptive acceptability of EMI-Heart to the pediatric
physiotherapist. Secondary outcomes of the intervention and control group
will be infants' motor outcomes and questionnaires assessing family
well-being at 3-5 months (baseline), at 6-8 months (post-treatment), and
at 12 months of age (follow-up). We will evaluate feasibility using
descriptive statistics. Non-parametric statistical analysis of secondary
outcomes will assess differences between the groups at baseline,
post-treatment, and follow-up. Discussion(s): This feasibility RCT
will provide information about a newly developed family-tailored early
motor intervention in infants with complex CHD. The RCT design will
provide a foundation for a future large-scale interventional trial for
infants with CHD after open-heart surgery. Trial registration: This study
protocol (version 1.3, 01.02.2022) was approved by the Cantonal Ethics
Commission Zurich (BASEC-Nr. 2019-01,787) and is registered by
Clinicaltrials.gov (NCTT04666857). Copyright © 2022, The
Author(s).

<67>
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. Copyright © 2022
Massachusetts Medical Society.

<68>
Accession Number
2015418012
Title
Risk Factors for Post-operative Planned Reintubation in Patients After
General Anesthesia: A Systematic Review and Meta-Analysis.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 839070.
Date of Publication: 09 Mar 2022.
Author
Xie Z.; Liu J.; Yang Z.; Tang L.; Wang S.; Du Y.; Yang L.
Institution
(Xie, Yang, Tang, Wang) Department of Nursing, First Affiliated Hospital
of Nanchang University, Nanchang, China
(Xie, Liu, Du, Yang) School of Nursing, Nanchang University, Nanchang,
China
Publisher
Frontiers Media S.A.
Abstract
Background: The occurrence of postoperative reintubation (POR) in patients
after general anesthesia (GA) is often synonymous with a poor prognosis in
patients. This is the first review analyzing scientific literature to
identify risk factors of POR after general anesthesia. The purpose of this
study was to collect currently published studies to determine the most
common and consistent risk factors associated with POR after GA.
 Method(s): We have retrieved all relevant research published before
April 2021 from PubMed, Embase, Web of Science, and the Cochrane Library
electronic databases. These studies were selected according to the
inclusion and exclusion criteria. The Z test determined the combined odds
ratio (OR) of risk factors. We used OR and its corresponding 95%
confidence interval (CI) to identify significant differences in risk
factors. The quality of the study was evaluated with the NOS scale, and
meta-analysis was carried out with Cochrane Collaboration's Revman 5.0
software. Result(s): A total of 10 studies were included, with a
total of 7,789 recipients of POR. We identified 7 risk factors related to
POR after GA: ASA >= 3 (OR = 3.58), COPD (OR = 2.09), thoracic surgery (OR
= 17.09), airway surgery (OR = 9.93), head-and-neck surgery (OR = 3.49),
sepsis (OR = 3.50), DVT (OR = 4.94). Conclusion(s): Our meta-analysis
showed that ASA >= 3, COPD, thoracic surgery, airway surgery,
head-and-neck surgery, sepsis and DVT were associated with POR after GA.
Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?, Identifier:
CRD42021252466. Copyright © 2022 Xie, Liu, Yang, Tang, Wang, Du
and Yang.

<69>
Accession Number
2015120015
Title
Clinical outcomes of patients with hepatic insufficiency undergoing
transcatheter aortic valve implantation: a systematic review and
meta-analysis.
Source
BMC Cardiovascular Disorders. 22(1) (no pagination), 2022. Article Number:
67. Date of Publication: December 2022.
Author
Jiang W.; Cheng Z.; Tu S.; Wang X.; Xiang C.; Zhou W.; Chen L.
Institution
(Jiang, Tu, Wang) The First Clinical Medical College of Lanzhou
University, No.222, Tianshui Road (South), Chengguan District, Gansu
Province, Lanzhou City 730000, China
(Cheng) Department of Cardiac Surgery, Ruijin Hospital affiliated to
School of Medicine, Shanghai Jiao Tong University, No.197, Ruijin Road
(Second), Shanghai City 200025, China
(Xiang) The Second Clinical Medical College of Lanzhou University, No.222,
Tianshui Road (South), Chengguan District, Gansu Province, Lanzhou City
730000, China
(Zhou) Department of General Surgery, The First Hospital of Lanzhou
University, No. 1, Donggangxi Road, Chengguan District, Gansu Province,
Lanzhou City 730000, China
(Chen) Department of Infectious Diseases, The First Hospital of Lanzhou
University, No. 1, Donggangxi Road, Chengguan District, Gansu Province,
Lanzhou City 730000, China
Publisher
BioMed Central Ltd
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is currently a
common treatment in high-risk aortic stenosis patients, but the impact of
hepatic insufficiency on prognosis after TAVI is debatable and whether
TAVI is superior to surgical aortic valve replacement (SAVR) in patients
with hepatic insufficiency is uncertain. Objective(s): To investigate
the effect of abnormal liver function on the outcome and safety after TAVI
and whether TAVI is superior to SAVR in patients with hepatic
insufficiency. Method(s): PubMed, Embase, the Cochrane Library and
Web of Science were systematically searched from inception up to 26
November 2021. Studies were eligible if mortality and complications after
TAVI in patients with and without hepatic insufficiency, or mortality and
complications for TAVI versus SAVR in patients with hepatic insufficiency
were reported. The Newcastle-Ottawa scale (NOS) was used to evaluate the
quality of each study. This meta-analysis was registered with PROSPERO
(CRD42021253423) and was carried out by using RevMan 5.3 and Stata 14.0.
 Result(s): This meta-analysis of 21 studies assessed a total of
222,694 patients. Hepatic insufficiency was associated with higher
short-term (in-hospital or 30-day) mortality [OR = 1.62, 95% CI (1.18 to
2.21), P = 0.003] and 1-2 years mortality [HR = 1.64, 95% CI (1.42 to
1.89), P < 0.00001] after TAVI. Between TAVI and SAVR in patients with
hepatic insufficiency, there was a statistically significant difference in
in-hospital mortality [OR = 0.46, 95% CI (0.27 to 0.81), P = 0.007], the
occurrence rate of blood transfusions [OR = 0.29, 95% CI (0.22 to 0.38), P
< 0.00001] and the occurrence rate of acute kidney injury [OR = 0.55, 95%
CI (0.33 to 0.91), P = 0.02]. Conclusion(s): TAVI patients with
hepatic insufficiency may have negative impact both on short-term
(in-hospital or 30-day) and 1-2-years mortality. For patients with hepatic
insufficiency, TAVI could be a better option than SAVR. Copyright
© 2022, The Author(s).

<70>
Accession Number
2015119868
Title
CABG in patients with liver cirrhosis: to pump or not to pump?.
Source
Expert Review of Cardiovascular Therapy. 20(2) (pp 95-99), 2022. Date of
Publication: 2022.
Author
Jiang S.M.; Liblik K.; Baranchuk A.; Payne D.; El-Diasty M.
Institution
(Jiang, Payne, El-Diasty) Division of Cardiac Surgery, Queen's University,
Kingston, ON, Canada
(Liblik, Baranchuk) Department of Cardiology, Queen's University,
Kingston, ON, Canada
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Coronary artery bypass grafting in patients with established
liver cirrhosis is generally associated with poor outcomes. Avoiding
cardiopulmonary bypass (CPB) in these patients has not demonstrated any
advantage over the use of CPB. We review the current available literature
that compared the outcome of both on-pump (ONCABG) and off-pump (OPCAB)
techniques in cirrhotic patients in terms of morbidity and mortality.
Areas covered: A comprehensive search was conducted in the PubMed/MEDLINE
and EMBASE databases in January 2021. Articles that reported outcomes of
OPCAB and/or ONCABG in cirrhotic patients with no concomitant surgical
procedures were included. 829 unique abstracts were retrieved with title
and abstract screening completed independently by two reviewers. Two case
studies and six retrospective cohort studies were included. The largest
study comprised more than 98% of the total population, showing some
survival benefit for OPCAB over ONCABG. However, it was population-based
and did not report the severity of liver. The remaining studies reported
no clear difference in outcome between the two techniques. Expert opinion:
Surgical myocardial revascularisation carries high perioperative risk in
patients with liver cirrhosis irrespective of the surgical technique.
There is a lack of evidence to suggest that avoiding CPB in these patients
may be beneficial. Copyright © 2022 Informa UK Limited, trading
as Taylor & Francis Group.

<71>
Accession Number
2015242471
Title
Fractional Flow Reserve to Guide Treatment of Patients With Multivessel
Coronary Artery Disease.
Source
Journal of the American College of Cardiology. 78(19) (pp 1875-1885),
2021. Date of Publication: 09 Nov 2021.
Author
Rioufol G.; Roubille F.; Perret T.; Motreff P.; Angoulvant D.; Cottin Y.;
Meunier L.; Cetran L.; Cayla G.; Harbaoui B.; Wiedemann J.-Y.; Van Belle
E.; Pouillot C.; Noirclerc N.; Soto F.-X.; Caussin C.; Bertrand B.;
Lefevre T.; Dupouy P.; Lesault P.-F.; Albert F.; Koning R.; Leborgne L.;
Barnay P.; Chapon P.; Lafont A.; Piot C.; Amaz C.; Vaz B.; Benyahya L.;
Varillon Y.; Ovize M.; Mewton N.; Finet G.; Fournier A.; Jarry G.; Leleu
F.; Malaquin D.; Mirode A.; Belle L.; Mangin L.; Hirsch J.-L.; Metge M.;
Pansiery M.; Soto F.; Boge A.; HadjHamou K.; Miliani I.; Molins G.; Mourot
S.; Pelletier M.; Ressencourt O.; Schaad F.; Coste P.; Chasseriaud W.;
Poustis P.; Morelle J.-F.; Demicheli T.; Range G.; Thuaire C.;
Barber-Chamoux N.; Combaret N.; Malcles G.; Souteyrand G.; Buffet P.;
Gudjonvick A.; L'Huillier I.; Lorgis L.; Richard C.; Baronne-Rochette G.;
Bouvaist H.; Marliere S.; Ormezzano O.; Vanzetto G.; Trouillet C.; Valy
Y.; VanBelle E.; Bauters C.; Delhaye C.; Lemesle G.; Rihani R.; Graux P.;
Lemahieu J.-M.; Besnard C.; Courand P.-Y.; Dauphin R.; Lantelme P.;
Caignault J.-R.; Dubreuil O.; Ranc S.; Ritz B.; Bergerot C.; Bochaton T.;
Bonnefoy-Cudraz E.; Bresson D.; Dementhon J.; Derimay F.; Green L.; Prieur
C.; Sanchez I.; Zouaghi O.; Armero S.; Ben-Amer H.; Chevalier B.; Garot
P.; Hovasse T.; Louvard Y.; Morice M.-C.; Tavolaro O.; Unterseeh T.; Cung
D.; Macia J.-C.; Levy G.; Roth O.; Jacquemin L.; Cornillet L.; Ledermann
B.; Schmutz L.; Karam N.; Rahal S.; Amabile N.; Girard P.; Veugeois A.;
Barthelemy O.; Collet J.-P.; Montalescot G.; Berland J.; Godin M.;
Landolff Q.; Zoghlami B.; Bougrini K.; Geyer C.; Glanenapp J.; Mascarel
P.; Rambaud G.; ViFane R.; Desveaux B.; Ivanes F.; Pacouret G.; Quilliet
L.-E.; SaintEtienne C.; Bretelle C.; Champin S.
Institution
(Rioufol, Derimay, Finet) Hopital Cardiologique et Pneumologique Louis
Pradel, Hospices Civils de Lyon, Bron, France
(Roubille) Hopital Arnaud de Villeneuve, Montpellier, France
(Perret) Centre Hospitalier Saint Joseph-Saint Luc, Lyon, France
(Motreff) Hopital Gabriel Montpied, Clermont-Ferrand, France
(Angoulvant) EA4245 T2i, Hopital Trousseau, CHRU de Tours, Universite de
Tours, Tours, France
(Cottin) Hopital du Bocage Central, Dijon, France
(Meunier) Centre Hospitalier de La Rochelle, La Rochelle, France
(Cetran) Hopital Cardiologique, Centre Hospitalo-Universitaire de
Bordeaux, Universite de Bordeaux, Bordeaux, France
(Cayla) Service de cardiologie, Hopital Caremeau, Universite de
Montpellier, Nimes, France
(Harbaoui) Hopital de la Croix-Rousse, Hospices Civils de Lyon, Lyon,
France
(Wiedemann) Centre Hospitalier de Mulhouse, Mulhouse, France
(Van Belle) Hopital Cardiologique Calmette, Lille, France
(Pouillot) Clinique Sainte Clotilde, La Reunion, France
(Noirclerc) Centre Hospitalier Annecy-Genevois, Annecy, France
(Morelle) Clinique Saint Martin, Caen, France
(Soto) Centre Hospitalier d'Auxerre, Auxerre, France
(Caussin) Institut Mutualiste de Montsouris, Paris, France
(Bertrand) Hopital Michallon, Grenoble, France
(Lefevre) Institut Hospitalier Jacques Cartier, Massy, France
(Dupouy) Clinique Les Fontaines, Melun, France
(Lesault) Hopital Prive de l'Estuaire, Le Havre, France
(Albert) Centre Hospitalier General, Chartres, France
(Barthelemy) Hopital de La Pitie-Salpetriere, Assistance Publique-Hopitaux
de Paris, Paris, France
(Koning) Clinique Saint Hilaire, Rouen, France
(Leborgne) Centre Hospitalier Amiens-Picardie, Hopital Sud, Amiens, France
(Barnay) Hopital Henri Duffaut, Avignon, France
(Chapon) Centre Hospitalier de Valence, Valence, France
(Armero) Hopital Europeen, Marseille, France
(Lafont) Hopital Europeen George Pompidou, Assistance Publique-Hopitaux de
Paris, Paris, France
(Piot) Clinique Le Millenaire, Montpellier, France
(Amaz, Vaz, Benyahya, Varillon, Ovize, Mewton) Centre d'investigation
clinique de Lyon, INSERM 1407, Hopital Cardiologique et Pneumologique
Louis Pradel, Hospices Civils de Lyon, Bron, France
Publisher
Elsevier Inc.
Abstract
Background: There is limited evidence that fractional flow reserve (FFR)
is effective in guiding therapeutic strategy in multivessel coronary
artery disease (CAD) beyond prespecified percutaneous coronary
intervention or coronary graft surgery candidates. Objective(s): The
FUTURE (FUnctional Testing Underlying coronary REvascularization) trial
aimed to evaluate whether a treatment strategy based on FFR was superior
to a traditional strategy without FFR in the treatment of multivessel CAD.
 Method(s): The FUTURE trial is a prospective, randomized, open-label
superiority trial. Multivessel CAD candidates were randomly assigned (1:1)
to treatment strategy based on FFR in all stenotic (>=50%) coronary
arteries or to a traditional strategy without FFR. In the FFR group,
revascularization (percutaneous coronary intervention or surgery) was
indicated for FFR <=0.80 lesions. The primary endpoint was a composite of
major adverse cardiac or cerebrovascular events at 1 year. Result(s):
The trial was stopped prematurely by the data safety and monitoring board
after a safety analysis and 927 patients were enrolled. At 1-year
follow-up, by intention to treat, there were no significant differences in
major adverse cardiac or cerebrovascular events rates between groups
(14.6% in the FFR group vs 14.4% in the control group; hazard ratio: 0.97;
95% confidence interval: 0.69-1.36; P = 0.85). The difference in all-cause
mortality was nonsignificant, 3.7% in the FFR group versus 1.5% in the
control group (hazard ratio: 2.34; 95% confidence interval: 0.97-5.18; P =
0.06), and this was confirmed with a 24 months' extended follow-up. FFR
significantly reduced the proportion of revascularized patients, with more
patients referred to exclusively medical treatment (P = 0.02).
 Conclusion(s): In patients with multivessel CAD, we did not find
evidence that an FFR-guided treatment strategy reduced the risk of
ischemic cardiovascular events or death at 1-year follow-up. (Functional
Testing Underlying Coronary Revascularisation; NCT01881555) Copyright
© 2021 American College of Cardiology Foundation

<72>
Accession Number
2021704282
Title
Supplemental Regional Block Anesthesia Reduces Opioid Utilization
Following Free Flap Reconstruction of the Oral Cavity: A Prospective,
Randomized Clinical Trial.
Source
Journal of Oral and Maxillofacial Surgery. 81(2) (pp 140-149), 2023. Date
of Publication: February 2023.
Author
Le J.M.; Gigliotti J.; Sayre K.S.; Morlandt A.B.; Ying Y.P.
Institution
(Le) Resident, Department of Oral and Maxillofacial Surgery, University of
Alabama at Birmingham, Birmingham, AL
(Gigliotti) Assistant Professor, Faculty of Dental Medicine and Oral
Health Sciences, McGill University, Montreal, QC, Canada
(Sayre) Assistant Professor, Department of Oral and Maxillofacial Surgery,
Boston University School of Dental Medicine, Boston, MA
(Morlandt) Professor, Section of Oral Oncology, Department of Oral and
Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL
(Ying) Associate Professor, Section of Oral Oncology, Department of Oral
and Maxillofacial Surgery, University of Alabama at Birmingham,
Birmingham, AL
Publisher
W.B. Saunders
Abstract
Purpose: Regional anesthesia has been shown to effectively manage acute
pain and reduce opioid utilization in the early postoperative period
following colorectal, orthopedic, and thoracic surgeries. The same effect,
however, has not been demonstrated in major head and neck surgery. The
purpose of this study is to determine whether supplemental regional
anesthesia reduces opioid utilization following microvascular free flap
reconstruction of the oral cavity. Method(s): A prospective,
randomized clinical trial was conducted for patients undergoing oral
cavity reconstruction using microvascular free tissue transfer between
January 2020 and March 2022. The predictor variable was a regional
anesthetic nerve block, delivered preoperatively, at the flap donor site.
The primary and secondary outcomes were opioid utilization, measured in
oral morphine equivalent (OME), from postoperative day 1 to 5, and
hospital length of stay (LOS), respectively. Covariates included age, sex,
tobacco and alcohol history, prior radiation therapy, pathology, oral
site, flap type, tracheostomy, and neck dissection. Student's t test,
chi2 test, and linear regression models were computed using
correlations with 95% confidence intervals (CIs). For all statistical
tests, P values of <.05 were regarded as statistically significant.
 Result(s): Ninety-eight participants completed the study. The mean
age was 56 years with 55% male. Forty-eight patients received a
presurgical regional anesthesia block, and 50 patients served as control
subjects. Bivariate analysis demonstrated an even distribution of all
study variables. Total OME utilization was significantly less in the
treatment group compared to the control group, (166.32 vs 118.43 OME; 95%
CI, 1.32 to 94.45; P = .04). The LOS was comparable (6.60 vs 6.48 days;
95% CI, -0.53 to 0.77; P = .71). Tobacco use had a positive effect (B =
0.28; 95% CI, 21.63 to 115.31; P = .005) while the block had a negative
effect with total OME, (B = -0.19; 95% CI, -90.39 to -0.59; P = .047). The
extent of the neck dissection (B = 0.207; 95% CI, 0.026 to 1.403; P =
.042) was a positive predictor for LOS. Overall, there were no adverse
events associated with the regional block throughout the study period.
 Conclusion(s): Supplemental regional anesthesia is safe and
associated with reduced opioid utilization in patients undergoing
vascularized free flap reconstruction of composite oral cavity defects and
does not prolong the length of hospitalization. Copyright © 2022

<73>
Accession Number
2021324792
Title
Effect of the Paravertebral Block on Chronic Postsurgical Pain After
Thoracic Surgery: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(2) (pp 252-260),
2023. Date of Publication: February 2023.
Author
Na H.-S.; Koo C.-H.; Koo B.-W.; Ryu J.-H.; Jo H.; Shin H.-J.
Institution
(Na, Koo, Koo, Ryu, Jo, Shin) Department of Anesthesiology and Pain
Medicine, Seoul National University Bundang Hospital, Gyeonggi, Seongnam,
South Korea
(Na, Koo, Koo, Ryu, Shin) Department of Anesthesiology and Pain Medicine,
Seoul National University College of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objective: This study aimed to identify the benefits of thoracic
paravertebral block (PVB) by focusing on its role in reducing chronic
postsurgical pain (CPSP) after thoracic surgery. Design(s): A
systematic review and meta-analysis of randomized controlled trials
(RCTs). Setting(s): Electronic databases, including PubMed, EMBASE,
CENTRAL, Scopus, and Web of Science, were searched to identify studies.
 Participant(s): Patients undergoing thoracic surgeries.
 Intervention(s): Paravertebral block for postoperative analgesia.
Measurement and Main Results: A total of 1,028 adult patients from 10 RCTs
were included in the final analysis. The incidence of CPSP at 3 months
after surgery was not reduced in the PVB group compared with the no-block
(odds ratio [OR] 0.59, 95% CI 0.34-1.04; p = 0.07; I2 = 6.96%)
and other-block (OR 1.39, 95% CI 0.30-6.42; p = 0.67; I2 =
77.75%) groups. The PVB did not significantly reduce the incidence of CPSP
after 6 months from surgery when compared with no block (OR 0.44, 95% CI
0.08-2.53; p = 0.36; I2 = 87.53%) and other blocks (OR 1.17,
95% CI 0.71-1.95; p = 0.93; I2 = 45.75%). The PVB significantly
decreased postoperative pain at 24 and 48 hours at rest compared with the
no- block group. The pain score was higher in the PVB group than in the
other block groups 48 hours after surgery at rest. Conclusion(s):
Thoracic PVB does not prevent CPSP after thoracic surgery. Further large
RCTs are required to confirm and validate the authors'
results. Copyright © 2022 Elsevier Inc.

<74>
Accession Number
640006267
Title
PHASE 2 STUDY INTERIM RESULTS OF RBT- 1 EFFECT ON POSTOPERATIVE COURSE IN
ELECTIVE CABG/VALVE SURGERY.
Source
Critical Care Medicine. Conference: 52nd Society of Critical Care Medicine
Critical Care Congress, SCCM 2023. San Francisco, CA United States. 51(1
Supplement) (pp 2), 2023. Date of Publication: January 2023.
Author
Lamy A.; Assi R.; Brown C.; Arghami A.; Mack C.; Jessen M.; Smith J.;
Marzouk M.; Washburn T.B.; Savage D.; Collar A.; Scavo V.; Bennetts J.;
Zager R.; Wang C.; Lavin P.; Ruiz S.; Singh B.
Institution
(Lamy) Hamilton General Hospital, Hamilton, ON, Canada
(Assi) Yale University, New Haven, CT, United States
(Brown) Saint John Regional Hospital, Saint John, NB, Canada
(Arghami) Mayo Clinic, Rochester, MN, United States
(Mack) New York Presbyterian Hospital, Weill-Cornell Medicine, Flushing,
NY, United States
(Jessen) University of Texas, Southwestern Medical Center, Dallas, TX,
United States
(Smith) Monash Health, Clayton, VIC, Australia
(Marzouk) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec, QC, Canada
(Washburn) Heart Center Research, LLC, Huntsville, AL, United States
(Savage) Southern Indiana Physicians Cardiothoracic Surgery, Bloomington,
IN, United States
(Collar) MyMichigan Health, East Lansing, MI, United States
(Scavo) Indiana / Ohio Heart Cardiothoracic and Vascular Surgeons, Fort
Wayne, IN, United States
(Bennetts) Flinders Medical Centre, Bedford Park, SA, Australia
(Zager, Ruiz, Singh) Renibus Therapeutics, Southlake, TX, United States
(Wang) Pharma Data Associates, LLC, Piscataway, NJ, United States
(Lavin) Lavin Consulting, LLC, Framingham, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
INTRODUCTION: Patients undergoing cardiac surgery are at risk of
postoperative complications. RBT-1 is a novel drug with anti-inflammatory
and antioxidant activity, which has shown broad organ protective activity
in preclinical models. A Phase 2 randomized, double-blind,
placebo-controlled study assessed the efficacy of RBT-1, as measured by
cytoprotective preconditioning biomarkers, hospital course, and
readmission rates. METHOD(S): Eligible subjects undergoing elective
coronary artery bypass graft and/or valve surgery on cardiopulmonary
bypass were randomized 1:1:1 to receive placebo, low dose RBT-1, or high
dose RBT-1 as preconditioning 24-48 hours before surgery. An interim
analysis was performed once 60 subjects had completed 30 day follow up.
The primary endpoint was to assess the efficacy of RBT-1 in generating a
cytoprotective biomarker response. Key secondary/exploratory endpoints
included ventilator and ICU days, incidence of acute kidney injury (AKI),
hospital length of stay (LOS), and readmission rates. RESULT(S): The
cytoprotective biomarker composite was significantly increased in response
to both RBT-1 dose groups compared to placebo (p < 0.0001). Mean
ventilator days in the placebo and combined RBT-1 groups were 3.2 and 1.2,
respectively (p=0.03). Mean ICU days in the placebo and RBT-1 groups were
7.0 and 2.7, respectively (p=0.0375). AKI incidence was decreased by 52%,
with a 27% and 13% incidence in the placebo and RBT-1 groups,
respectively. Mean LOS in the placebo and RBT-1 groups were 10.9 and 8.9
days, respectively, resulting in a 2-day reduction. Hospital readmission
at 30 days was reduced by 91%, with rates of 31.8% and 2.6% in the placebo
and RBT-1 groups, respectively (p=0.0027). Treatment with RBT-1 was
generally well tolerated. The most common treatment-related adverse event
was photosensitivity. CONCLUSION(S): RBT-1 is a novel drug with
cytoprotective preconditioning activity. Interim Phase 2 results suggest
RBT-1 protects against postoperative complications of cardiac surgery. The
improvements in renal complications, hospital course, and readmission
rates are expected given the broad organ protective mechanism of RBT-1.
Final results of this study are expected in 2023.

<75>
Accession Number
640006359
Title
THIRTY YEARS OF SOLVENT/DETERGENTTREATED PLASMA FOR TRANSFUSION IN
CRITICALLY ILL PATIENTS.
Source
Critical Care Medicine. Conference: 52nd Society of Critical Care Medicine
Critical Care Congress, SCCM 2023. San Francisco, CA United States. 51(1
Supplement) (pp 158), 2023. Date of Publication: January 2023.
Author
Gareis M.; Heger A.; Shah T.M.
Institution
(Gareis, Heger) Octapharma Pharmazeutika Produktionsges.mb.H, Vienna,
Austria
(Shah) Octapharma USA., Paramus, NJ, United States
Publisher
Lippincott Williams and Wilkins
Abstract
INTRODUCTION: OctaplasLG (Octapharma AG, Switzerland) is a
solvent/detergent (S/D)-treated plasma preparation made from pooled fresh
frozen plasma (FFP). First used in 1989 as an FFP alternative, S/D plasma
was developed to increase pathogen safety in treating acquired coagulation
factor deficiencies during active bleeding, bleeding prevention, and
therapeutic plasma exchange (TPE). Here, we review published literature on
the efficacy, safety, and cost effectiveness of S/D plasma.
 METHOD(S): Medline (PubMed) and Google Scholar were searched for
articles reporting "octaplas" or "octaplasLG" efficacy and/or safety in
clinical settings. RESULT(S): Efficacy/safety was shown for multiple
indications in different patient groups, such as cardiac surgery
(n=125/117 adult/pediatric patients receiving S/D plasma), liver disease
(n=30/20), liver transplantation (n=269/5), hemodilution/blood loss (n=47
adults), obstetrics/gynecology (n=38 adults), and TPE (n=167/41), as well
as in 162 critically ill neonates/pediatric patients. Studies demonstrated
S/D plasma could improve standard coagulation markers comparable with FFP
and was also associated with greater endothelial protection. S/D plasma
had lower incidences of allergic and febrile non-hemolytic transfusion
reactions, and transfusion-associated circulatory overload compared with
FFP, and almost no confirmed cases of transfusion-related acute lung
injury reported after >13 million units transfused. Studies suggested S/D
plasma was more cost-effective than FFP due to lower risk of
transfusion-related complications. Literature results showed some
countries have replaced FFP with S/D plasma to improve plasma safety. A
new freeze-dried form has been recently developed with similar biochemical
quality to S/D plasma, and is of particular interest for pre-hospital
settings, e.g., trauma, where rapid reconstitution/flexible storage
improves logistics/utilization. CONCLUSION(S): Available evidence
from 30 years of global use indicates that S/D plasma is an efficacious
alternative to FFP in adult/pediatric patients for multiple indications,
with a favorable safety profile. The clinical utility of S/D plasma is
also expanding, with the freeze-dried form having the potential to further
improve patient outcomes and reduce costs.

<76>
Accession Number
640006754
Title
PNEUMOPERICARDIUM IN COVID-19: A SYSTEMATIC REVIEW.
Source
Critical Care Medicine. Conference: 52nd Society of Critical Care Medicine
Critical Care Congress, SCCM 2023. San Francisco, CA United States. 51(1
Supplement) (pp 86), 2023. Date of Publication: January 2023.
Author
Figueras R.A.; Yang K.; Schurman A.; Albini P.; Mittal A.
Institution
(Figueras, Yang) University of California, Riverside School of Medicine,
United States
(Schurman, Albini, Mittal) Riverside University, Health Systems Medical
Center, United States
Publisher
Lippincott Williams and Wilkins
Abstract
INTRODUCTION: COVID-19 can manifest in the lungs as acute respiratory
distress syndrome leading to poor lung compliance and increasing
susceptibility to barotrauma, which is hypothesized to cause an airleak
resulting in pneumomediastinum (PM) and pneumothorax (PTX).
Pneumopericardium (PP), a more rare complication, has been documented in
relatively few cases to date. This study sought to review the relationship
between positive pressure ventilation (PPV) and development of PP and to
survey treatment options for COVID-19 patients with PP. METHOD(S): A
systematic search was conducted on full text articles, including case
reports and case series, for COVID-19 patients with comorbid PP from
January 1st, 2019 to April 12th, 2022. Demographic data, presence of PM,
PTX, PP and subcutaneous emphysema (SE), treatment information regarding
respiratory support, use of steroids and other medications were recorded
along with in-hospital mortality. RESULT(S): 51 articles met final
inclusion criteria, reporting 76 cases of COVID-19 patients with PP. The
average age was 54.5 years with a range of 17-82. Fifty-eight (76.3%)
patients were male. 27 (35.5%) patients with PP died. PP occurred in
isolation in 5 (6.6%) patients. PP was most comorbid with PM (n=65,
85.5%). SE occurred in 44 (57.9%) patients and PTX in 25 (32.9%) patients.
18 (23.7%) patients developed all of the sequalae of airleak. 64 (84.2%)
patients received some degree of respiratory support: 35 (46.1%) patient's
maximum support was supplemental oxygen, six (7.9%) were on non-invasive
PPV, and 22 (28.9%) required mechanical ventilation. 29 (38.2%) patients
with PP were given steroids. Only 1 patient received pericardiocentesis
for presumed tamponade physiology. CONCLUSION(S): There was a high
mortality in COVID-19 patients with PP. Previous reports hypothesized that
PPV may be the etiology of PP in COVID-19 patients; however, only 36.8% of
patients with PP in this review received PPV. It is unclear if the
COVID-19 patients with PP not receiving PPV had tachypnea causing air
trapping thus leading to self-induced barotrauma. Decompressive maneuvers
have been studied in PTX and PM, however only one patient in this review
received pericardiocentesis. Further research is needed to provide further
etiology and treatment guidelines as this pandemic continues.

<77>
Accession Number
640005719
Title
EVALUATION OF LIPOSOMAL BUPIVACAINE VERSUS USUAL CARE AND ITS EFFECT ON
PAIN FOR CARDIAC SURGERY.
Source
Critical Care Medicine. Conference: 52nd Society of Critical Care Medicine
Critical Care Congress, SCCM 2023. San Francisco, CA United States. 51(1
Supplement) (pp 550), 2023. Date of Publication: January 2023.
Author
Klodell C.; Hall A.; Antigua A.
Institution
(Klodell, Hall, Antigua) HCA Florida North Florida Hospital, FL, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
INTRODUCTION: The objective of this study is to compare clinical effects
of standard of care and liposomal bupivacaine. The primary outcome of this
study will be to compare the pain scores associated with liposomal
bupivacaine compared to standard of care of standard bupivacaine.
 METHOD(S): A prospective, randomized, single-blinded,
active-controlled, parallel group trial was conducted on cardiac surgery
evaluating opioid analgesic consumption and effectiveness of pain control
in patients who received liposomal bupivacaine vs.
bupivacaine/epinephrine. The study was conducted at a 503-bed tertiary
care community hospital. Participants included patients of at least 18
years of age undergoing a cardiac surgical procedure at the study
institution. The standard of care group received 0.25% bupivacaine with
epinephrine at 1 mL/kg total dose and the treatment arm received liposomal
bupivacaine 266 mg/20 ml added to 40 ml 0.25% bupivacaine with
epinephrine. Both treatment arms received either therapy as a single-dose
infiltration from the first to the 8th intercostal space. RESULT(S):
A total of 43 patients received liposomal bupivacaine and 44 patients
received bupivacaine/ epinephrine. The difference in average opioid
(morphine equivalent) usage between liposomal bupivacaine and
bupivacaine/epinephrine on post-operative (POD) day 1 was 11 mg (IQR
5.25-24.3 mg) and 14 mg (IQR 5-26.175 mg) and on POD 4, the difference was
1.5 mg (IQR 0-4.875) and 0 mg (IQR 0-3). There was no difference in
average pain scores and adverse effects between the two groups.
 CONCLUSION(S): The results of this current study found that the
administration of liposomal bupivacaine intra-operatively cardiac surgery
show less opioid use as compared to the standard of care. The study is
ongoing and enrolling more patients.

<78>
Accession Number
2022160813
Title
The racial disparity among post transcatheter aortic valve replacement
outcomes: A meta-analysis.
Source
IJC Heart and Vasculature. 44 (no pagination), 2023. Article Number:
101170. Date of Publication: February 2023.
Author
Jaiswal V.; Peng Ang S.; Hanif M.; Savaliya M.; Vadhera A.; Raj N.; Gera
A.; Aujla S.; Daneshvar F.; Ishak A.; Subhan Waleed M.; Hugo
Aguilera-Alvarez V.; Naz S.; Hameed M.; Wajid Z.
Institution
(Jaiswal) JCCR Cardiology, Varanasi, India
(Jaiswal, Savaliya, Raj, Gera, Ishak, Subhan Waleed, Hameed) Department of
Cardiovascular Research, Larkin Community Hospital, South Miami, FL,
United States
(Peng Ang) Division of Internal Medicine, Rutgers Health/Community Medical
Center, NJ, United States
(Hanif) Department of Internal Medicine, SUNY Upstate Medical University,
United States
(Vadhera) Department of Medicine, Maulana Azad Medical College, New Delhi,
India
(Aujla) Department of Medicine, Government Medical College Amritsar,
Punjab, India
(Daneshvar) Department of Cardiology, AdventHealth, FL, United States
(Hugo Aguilera-Alvarez) Universidad Autonoma de Baja, CA, United States
(Naz) The University of Texas, MD Anderson Cancer Center, TX, United
States
(Wajid) Department of Internal Medicine, Wayne State University School of
Medicine, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Racial disparities have been well described in cardiovascular
disease. However, the impact of race on the outcomes post - Transcatheter
aortic valve replacement (TAVR) remains unknown. Objective(s): We aim
to evaluate the disparity among the race (black and white) post - TAVR.
 Method(s): We systematically searched all electronic databases from
inception until September 26, 2022. The primary outcome was in-hospital
all-cause mortality, and secondary outcomes was myocardial infarction
(MI), acute kidney injury (AKI), permanent pacemaker implantation (PPI) or
ICD, stroke, vascular complications, and major bleeding. Result(s): A
total of three studies with 1,02,009 patients were included in the final
analysis. The mean age of patients with white and black patients was 82.65
and 80.45 years, respectively. The likelihood of in-hospital all-cause
mortality (OR, 1.01(95 %CI: 0.86-1.19), P = 0.93), stroke (OR, 0.83(95
%CI:0.61-1.13), P = 0.23, I2 = 46.57 %], major bleeding [OR, 1.05(95
%CI:0.92-1.20), P = 0.46), and vascular complications [OR, 0.92(95
%CI:0.81-1.06), P = 0.26), was comparable between white and black
patients. However, patients with white race have lower odds of MI (OR,
0.65(95 %CI:0.50-0.84), P < 0.001), and AKI (OR, 0.84(95 %CI:0.74-0.95), P
= 0.01) and higher odds of PPI or ICD (OR, 1.16(95 %CI: 1.06-1.27), P <
0.001, I2 = 0 %) compared with black race patients. Conclusion(s):
Our findings suggest disparity post - TAVR outcomes existed, and black
patients are at higher risk of MI and AKI than white patients. Key
Clinical Message: * What is already known on this topic: Disparity has
been witnessed among patients with cardiovascular disease. However, no
studies have drawn a significant association among post-TAVR patients'
outcomes * What this study adds: Among patients who underwent TAVR, there
is a difference in the adverse outcomes between black and white race
patients. White patients have a lower risk of post-procedure MI and AKI
compared with Black patients. * How this study might affect research,
practice, or policy: These disparities need to be addressed, and proper
guidelines need to be made along with engaging patients with better
medical infrastructure and treatment options. Copyright © 2023
The Author(s)

<79>
Accession Number
640014353
Title
Sex Differences in Type A Acute Aortic Dissection: A Systematic Review and
Meta-Analysis.
Source
European journal of preventive cardiology. (no pagination), 2023. Date of
Publication: 11 Jan 2023.
Author
Carbone A.; Ranieri B.; Castaldo R.; Franzese M.; Rega S.; Cittadini A.;
Czerny M.; Bossone E.
Institution
(Carbone) Unit of Cardiology, University of Campania "Luigi Vanvitelli" -
80138, Naples, Italy
(Ranieri, Castaldo, Franzese) Via Emanuele Gianturco, Naples, Italy
(Rega, Bossone) Department of Public Health, University of Naples
"Federico II", Via Pansini, Naples 5-80131, Italy
(Cittadini) Department of Translational Medical Sciences, University of
Naples "Federico II", Via S Pansini, Naples 5 - 80131, Italy
(Cittadini) Italian Clinical Outcome Research and Reporting Program
(I-CORRP) - 80131, Naples, Italy
(Czerny) University Heart Center Freiburg . Bad Krozingen, University
Hospital Freiburg, 15 - 79189 Bad Krozingen, Germany
(Czerny) Faculty of Medicine, Albert-Ludwigs University Freiburg, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: In acute aortic dissection (AAD) sex heterogeneity reports are
not exhaustive and in part even conflicting. AIM: To explore sex
differences in clinical features, management and outcomes among patients
with type A AAD. METHOD(S): A systematic review and meta-analysis of
literature were conducted for studies (2004-2022) reporting type A AAD sex
differences. Among the 1938 studies retrieved, 16 (16069 patients, 7142
women and 8927 men) fulfilled all eligibility criteria. Data were
aggregated used random effects model as pooled risk ratio and mean
difference. RESULT(S): Due to information reported by considered
manuscripts, analysis were performed only among surgically treated type A
AAD patients. At the time of hospital presentation type A AAD women were
older than men but had lower BMI, BSA and creatinine plasma levels. Active
smoking, bicuspid aortic valve and previous cardiac surgery were less
common in women while diabetes mellitus was more frequent. Furthermore
women experienced more frequently pericardial effusion/cardiac tamponade
than men. Interestingly, in-hospital surgical mortality did not differ
between sexes (RR, 1.02; 95% CI, 0.53-1.99; p=0.95), whereas 5 (RR 0.94;
95% CI: 0.92-0.97; p<0.001) and 10-year survival (RR 0.82; 95% CI:
0.74-0.92; p=0.004) was higher among men. A descriptive analysis of
in-hospital outcomes among medically treated type A AAD patients confirmed
prohibitive high mortality for both sexes (men 58.6% vs women 53.8%,
p=0.59). CONCLUSION(S): A female sex phenotype appears to be evident
in type A AAD implying the need for a personalized management patient
approach along with tailored preventive strategies. PROSPERO registry ID:
CRD42022359072. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<80>
Accession Number
640014319
Title
Effect of High-Dose Selenium on Postoperative Organ Dysfunction and
Mortality in Cardiac Surgery Patients: The SUSTAIN CSX Randomized Clinical
Trial.
Source
JAMA surgery. (no pagination), 2023. Date of Publication: 11 Jan 2023.
Author
Stoppe C.; McDonald B.; Meybohm P.; Christopher K.B.; Fremes S.; Whitlock
R.; Mohammadi S.; Kalavrouziotis D.; Elke G.; Rossaint R.; Helmer P.;
Zacharowski K.; Gunther U.; Parotto M.; Niemann B.; Boning A.; Mazer C.D.;
Jones P.M.; Ferner M.; Lamarche Y.; Lamontagne F.; Liakopoulos O.J.;
Cameron M.; Muller M.; Zarbock A.; Wittmann M.; Goetzenich A.; Kilger E.;
Schomburg L.; Day A.G.; Heyland D.K.
Institution
(Stoppe, McDonald) University of Ottawa Heart Institute, Ottawa, ON,
Canada
(Meybohm, Helmer) Department of Anaesthesiology, Intensive Care,
Emergency, Pain Medicine, University Hospital Wuerzburg, Wuerzburg,
Germany
(Christopher) Division of Renal Medicine, Brigham and Women's Hospital,
Boston, MA, United States
(Fremes) Sunnybrook Research Institute, Toronto, ON, Canada
(Whitlock) Hamilton Health Sciences, Hamilton, Ontario, Canada
(Mohammadi, Kalavrouziotis) Quebec Heart and Lung Institute, Laval
University, Quebec City, QC, Canada
(Elke) University Hospital Schleswig-Holstein, Kiel, Germany
(Rossaint, Goetzenich) University Hospital Aachen, Aachen, Germany
(Zacharowski) University Hospital Frankfurt, Frankfurt, Germany
(Gunther) Oldenburg Clinic, University of Oldenburg, Oldenburg, Germany
(Parotto) Department of Anesthesiology and Pain Medicine, Toronto General
Hospital, Toronto, ON, Canada
(Parotto) Division of Critical Care Medicine, Department of Anesthesia and
Interdepartmental University of Toronto, Toronto, ON, Canada
(Niemann, Boning) University Hospital of Giessen, Giessen, Germany
(Mazer) Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto,
ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, Department of
Physiology, University of Toronto, Toronto, ON, Canada
(Jones) London Health Sciences Centre, London, ON, Canada
(Ferner) University Medical Center of the Johannes Gutenberg-University
Mainz, Mainz, Germany
(Lamarche) Hopital du Sacre-Coeur de Montreal, Montreal, QC, Canada
(Lamarche) Montreal Heart Institute, Montreal, QC, Canada
(Lamontagne) Hopital Fleurimont (CHUS), Sherbrooke, QC, Canada
(Liakopoulos) Department of Cardiothoracic Surgery, Heart Center,
University Hospital of Cologne, Cologne, Germany
(Cameron) Jewish General Hospital, Montreal, QC, Canada
(Muller) University Heart Center Freiburg Bad Krozingen, Bad Krozingen,
Germany
(Zarbock) University Hospital Munster, Munster, Germany
(Wittmann) University Hospital Bonn, Bonn, Germany
(Goetzenich) now with Abiomed Europe GmbH, Aachen, Germany
(Kilger) Ludwig Maximilian University of Munich, Munich, Germany
(Schomburg) Institute for Experimental Endocrinology,
Charite-Universitatsmedizin Berlin, Berlin, Germany
(Day, Heyland) Clinical Evaluation Research Unit, Queen's University,
Kingston, Ontario, Canada
(Heyland) Department of Critical Care Medicine, Queen's University,
Kingston, Ontario, Canada
Publisher
NLM (Medline)
Abstract
Importance: Selenium contributes to antioxidative, anti-inflammatory, and
immunomodulatory pathways, which may improve outcomes in patients at high
risk of organ dysfunctions after cardiac surgery. Objective(s): To
assess the ability of high-dose intravenous sodium selenite treatment to
reduce postoperative organ dysfunction and mortality in cardiac surgery
patients. Design, Setting, and Participant(s): This multicenter,
randomized, double-blind, placebo-controlled trial took place at 23 sites
in Germany and Canada from January 2015 to January 2021. Adult cardiac
surgery patients with a European System for Cardiac Operative Risk
Evaluation II score-predicted mortality of 5% or more or planned combined
surgical procedures were randomized. Intervention(s): Patients were
randomly assigned (1:1) by a web-based system to receive either
perioperative intravenous high-dose selenium supplementation of 2000 mug/L
of sodium selenite prior to cardiopulmonary bypass, 2000 mug/L immediately
postoperatively, and 1000 mug/L each day in intensive care for a maximum
of 10 days or placebo. Main Outcomes and Measures: The primary end
point was a composite of the numbers of days alive and free from organ
dysfunction during the first 30 days following cardiac surgery.
 Result(s): A total of 1416 adult cardiac surgery patients were
analyzed (mean [SD] age, 68.2 [10.4] years; 1043 [74.8%] male). The median
(IQR) predicted 30-day mortality by European System for Cardiac Operative
Risk Evaluation II score was 8.7% (5.6%-14.9%), and most patients had
combined coronary revascularization and valvular procedures. Selenium did
not increase the number of persistent organ dysfunction-free and alive
days over the first 30 postoperative days (median [IQR], 29 [28-30] vs 29
[28-30]; P=.45). The 30-day mortality rates were 4.2% in the selenium and
5.0% in the placebo group (odds ratio, 0.82; 95% CI, 0.50-1.36; P=.44).
Safety outcomes did not differ between the groups. Conclusions and
Relevance: In high-risk cardiac surgery patients, perioperative
administration of high-dose intravenous sodium selenite did not reduce
morbidity or mortality. The present data do not support the routine
perioperative use of selenium for patients undergoing cardiac surgery.
Trial Registration: ClinicalTrials.gov Identifier: NCT02002247.

<81>
Accession Number
2022076783
Title
Extracorporeal Membrane Oxygenation for Graft Dysfunction Early After
Heart Transplantation: A Systematic Review and Meta-analysis.
Source
Journal of Cardiac Failure. (no pagination), 2023. Date of Publication:
2023.
Author
Aleksova N.; BUCHAN T.A.; FOROUTAN F.; ZHU A.; CONTE S.E.A.N.; MACDONALD
P.; NOLY P.-E.; CARRIER M.; MARASCO S.F.; TAKEDA K.O.J.I.; POZZI M.;
BAUDRY G.; ATIK F.A.; LEHMANN S.V.E.N.; JAWAD K.; HICKEY G.W.; DEFONTAINE
A.; BARON O.; LOFORTE A.; CAVALLI G.G.; ABSI D.O.; KAWABORI M.;
MASTROIANNI M.A.; SIMONENKO M.; SPONGA S.; MOAYEDI Y.; ORCHANIAN-CHEFF
A.N.I.; ROSS H.J.; RAO V.; GUYATT G.; BILLIA F.; ALBA A.C.
Institution
(Aleksova, BUCHAN, FOROUTAN, MOAYEDI, ROSS, RAO, BILLIA, ALBA) Peter Munk
Cardiac Centre, Toronto General Hospital, Toronto, ON, Canada
(ZHU) Faculty of Medicine, University of Toronto, Toronto, ON, Canada
(CONTE, MACDONALD) Heart Transplant Unit, St Vincent's Hospital, Sydney,
NSW, Australia
(NOLY, CARRIER) Department of Cardiac Surgery, Montreal Heart Institute,
University of Montreal, Montreal, Canada
(MARASCO) Department of Cardiothoracic Surgery, The Alfred Hospital,
Melbourne, Australia
(TAKEDA) Department of Surgery, Division of Cardiac, Thoracic & Vascular
Surgery, Columbia University, New York, New York
(POZZI, BAUDRY) Service de Chirurgie Cardiaque et Cardiologie, Hospices
Civils de Lyon, Hopital Louis Pradel, Lyon, France
(ATIK) Instituto de Cardiologia e Transplantes do Distrito Federal (ICDF),
Brasilia, Brazil
(LEHMANN, JAWAD) Clinic of Cardiac Surgery, Heart Center, University of
Leipzig, Leipzig, Germany
(HICKEY) UPMC Heart and Vascular Institute, University of Pittsburgh,
Pittsburgh, PA, United States
(DEFONTAINE, BARON) Centre Hospitalier Universitaire de Nantes, Nantes,
France
(LOFORTE, CAVALLI) Division of Cardiac Surgery, S. Orsola University
Hospital, IRCCS Bologna, Bologna, Italy
(ABSI) Cardiovascular and Intrathoracic Transplant Department, Favaloro
Foundation University Hospital, Buenos Aires, Argentina
(KAWABORI, MASTROIANNI) Department of Cardiovascular Surgery, Tufts
Medical Center, Boston, MA, United States
(SIMONENKO) Almazov National Medical Research Centre, St. Petersburg,
Russian Federation
(SPONGA) Cardiothoracic Department, University Hospital of Udine, Udine,
Italy
(ORCHANIAN-CHEFF) Library and Information Services, University Health
Network, Toronto, ON, Canada
(GUYATT) Department of Health Research Methods, Evidence and Impact,
McMaster University, Hamilton, ON, Canada
Publisher
Elsevier B.V.
Abstract
Introduction: Venoarterial extracorporeal membrane oxygenation (VA-ECMO)
is a prevailing option for the management of severe early graft
dysfunction. This systematic review and individual patient data (IPD)
meta-analysis aims to evaluate (1) mortality, (2) rates of major
complications, (3) prognostic factors, and (4) the effect of different
VA-ECMO strategies on outcomes in adult heart transplant (HT) recipients
supported with VA-ECMO. Methods and Results: We conducted a
systematic search and included studies of adults (>=18 years) who received
VA-ECMO during their index hospitalization after HT and reported on
mortality at any timepoint. We pooled data using random effects models. To
identify prognostic factors, we analysed IPD using mixed effects logistic
regression. We assessed the certainty in the evidence using the GRADE
framework. We included 49 observational studies of 1477 patients who
received VA-ECMO after HT, of which 15 studies provided IPD for 448
patients. There were no differences in mortality estimates between IPD and
non-IPD studies. The short-term (30-day/in-hospital) mortality estimate
was 33% (moderate certainty, 95% confidence interval [CI] 28%-39%) and
1-year mortality estimate 50% (moderate certainty, 95% CI 43%-57%).
Recipient age (odds ratio 1.02, 95% CI 1.01-1.04) and prior sternotomy (OR
1.57, 95% CI 0.99-2.49) are associated with increased short-term
mortality. There is low certainty evidence that early intraoperative
cannulation and peripheral cannulation reduce the risk of short-term
death. Conclusion(s): One-third of patients who receive VA-ECMO for
early graft dysfunction do not survive 30 days or to hospital discharge,
and one-half do not survive to 1 year after HT. Improving outcomes will
require ongoing research focused on optimizing VA-ECMO strategies and care
in the first year after HT. Copyright © 2022 The Author(s)

<82>
Accession Number
640012602
Title
Coronary Revascularization in Patients With Diabetes: A Meta-analysis of
Randomized Controlled Trials and Propensity-Matched Studies.
Source
Innovations (Philadelphia, Pa.). (pp 15569845221143420), 2023. Date of
Publication: 11 Jan 2023.
Author
Ahmed A.; Varghese K.S.; Fusco P.J.; Mathew D.M.; Mathew S.M.; Ahmed S.;
Rogando D.O.; Salazar S.A.; Pandey R.; Awad A.K.; Levy K.H.; Hernandez M.;
Calixte R.
Institution
(Ahmed, Varghese, Fusco, Mathew, Mathew, Ahmed, Rogando, Salazar, Pandey,
Awad, Levy, Hernandez) City University of New York School of Medicine, New
York, NY, USA
(Calixte) Epidemiology and Biostatistics, SUNY Downstate Health Sciences
University, Brooklyn, NY, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Patients with diabetes have poorer outcomes with coronary
artery disease (CAD) and pose a unique clinical population for
revascularization. We performed a pairwise meta-analysis of randomized
trials (RCTs) and propensity-matched observational studies (PMS) to
compare the clinical outcomes of coronary artery bypass grafting (CABG)
and percutaneous coronary intervention (PCI) in patients with diabetes.
 METHOD(S): A comprehensive literature search was performed to
identify RCT and PMS studies comparing CABG with PCI in patients with
diabetes with concurrent CAD. Studies were pooled using the random-effects
model to perform a pairwise meta-analysis. Primary outcomes included
long-term all-cause mortality, cardiac mortality, myocardial infarction
(MI), major adverse cardiac and cerebrovascular events (MACCE), and repeat
revascularization. Meta-regression was used to explore the effects of
baseline risk factors on primary outcomes with moderate to high
heterogeneity. RESULT(S): A total of 18 RCTs and 9 PMS with 28,846
patients were included. PCI was associated with increased long-term
all-cause mortality (risk ratio [RR] = 1.34, P < 0.001), cardiac mortality
(RR = 1.52, P < 0.001), MI (RR = 1.51, P = 0.009), MACCE (RR = 1.65, P <
0.001), and repeat revascularization (RR = 2.48, P < 0.001) compared with
CABG. There was no difference in long-term stroke between the 2 groups (RR
= 0.95, P = 0.82). At meta-regression, a greater proportion of female
patients in studies was associated with a decreased protective benefit for
CABG for long-term all-cause mortality but an increased protective benefit
for long-term MI and repeat revascularization. CONCLUSION(S):
Revascularization of patients with diabetes using CABG is associated with
significantly reduced long-term mortality, MI, MACCE, and repeat
revascularizations. Future studies exploring the influence of gender on
revascularization outcomes are necessary to elucidate the ideal treatment
modality in patients with diabetes.

<83>
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.
 Design(s): A randomized controlled trial. Setting(s): Department
of Anesthesiology, Children's Hospital of Chongqing Medical University.
 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.
 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. 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.
 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. Copyright © 2022 Elsevier
Inc.

<84>
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. 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. 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). 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. Copyright © 2022 The Author(s)

<85>
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. 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.
 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. 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. Copyright
© 2022 Authors. All rights reserved.

<86>
Accession Number
2015983045
Title
Effect of Music Intervention on Lung Expansion Exercises after
Cardiothoracic Surgery.
Source
Journal of Clinical Medicine. 11(6) (no pagination), 2022. Article Number:
1589. Date of Publication: March-2 2022.
Author
Chen G.-Y.; Guo L.-Y.; Chuang I.-C.; Kuo H.-C.; Tsai Y.-C.; Liu S.-F.
Institution
(Chen, Kuo, Tsai, Liu) Department of Respiratory Therapy, Kaohsiung Chang
Gung Memorial Hospital, Kaohsiung 833, Taiwan (Republic of China)
(Guo) Department of Sports Medicine, College of Medicine, Kaohsiung
Medical University, Kaohsiung 807, Taiwan (Republic of China)
(Guo) Department of Medical Research, Kaohsiung Medical University
Hospital, Kaohsiung 807, Taiwan (Republic of China)
(Guo) College of Humanities and Social Sciences, National Pingtung
University of Science and Technology, Pingtung 912, Taiwan (Republic of
China)
(Chuang) Department of Respiratory Therapy, Kaohsiung Medical University,
Kaohsiung 807, Taiwan (Republic of China)
(Kuo) Department of Paediatrics, Kaohsiung Chang Gung Memorial Hospital,
Kaohsiung 833, Taiwan (Republic of China)
(Kuo, Liu) Medical Department, College of Medicine, Chang Gung University,
Taoyuan 333, Taiwan (Republic of China)
(Liu) Division of Pulmonary and Critical Care Medicine, Department of
Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833,
Taiwan (Republic of China)
Publisher
MDPI
Abstract
Background: Music intervention can reduce anxiety. This study analyzed the
physiological changes from using music intervention after cardiothoracic
surgery. Method(s): Subjects were randomly assigned to the music
group or the control group. The maximal inspiratory pressure/maximal
expiratory pressure (MIP/MEP), pulse oximeter oxygen saturation (SpO2),
visual analogue scale (VAS) for pain, and State-Trait Anxiety Inventory
(STAI) were compared. Result(s): Compared to the control group (n =
9), the music group (n = 9) had higher MIP and MEP during the overall test
(p < 0.05), with significant differences in the changes and time (p <
0.001). However, only MEP was significant in terms of the interaction
between music intervention and time (p < 0.001). In terms of the groups,
SpO2 and VAS were significant (p < 0.05). SBP, SpO2, and VAS over time
showed significant differences between the two groups (p < 0.05). In terms
of the interaction between music intervention and time, only SpO2 was
significant (p < 0.05). The STAI-S scale decreased by -5.7 +/- 5.8 in the
music group vs. -0.47 +/- 9.37 in control group and the STAI-T scale
increased by 4.17 +/- 12.31 in the music group vs. 1.9 +/- 9.29 in the
control group, but showed no significance. Conclusion(s): Music
intervention with nature sounds has a positive physiological impact and
can reduce postoperative pain and anxiety in cardiothoracic surgery
patients. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<87>
Accession Number
2015982964
Title
Spectral Entropy Monitoring Accelerates the Emergence from Sevoflurane
Anesthesia in Thoracic Surgery: A Randomized Controlled Trial.
Source
Journal of Clinical Medicine. 11(6) (no pagination), 2022. Article Number:
1631. Date of Publication: March-2 2022.
Author
Chen J.-T.; Wu Y.-M.; Tiong T.-Y.; Cata J.P.; Kuo K.-T.; Li C.-C.; Liu
H.-Y.; Cherng Y.-G.; Wu H.-L.; Tai Y.-H.
Institution
(Chen, Wu, Li, Liu, Cherng, Tai) Department of Anesthesiology, Shuang Ho
Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
(Republic of China)
(Chen, Wu, Li, Liu, Cherng, Tai) Department of Anesthesiology, School of
Medicine, College of Medicine, Taipei Medical University, Taipei 11031,
Taiwan (Republic of China)
(Tiong, Kuo) Division of Thoracic Surgery, Department of Surgery, Shuang
Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
(Republic of China)
(Tiong, Kuo) Division of Thoracic Surgery, Department of Surgery, School
of Medicine, College of Medicine, Taipei Medical University, Taipei 11031,
Taiwan (Republic of China)
(Cata) Department of Anesthesiology and Perioperative Medicine, The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit
409, Houston, TX 77030, United States
(Wu) Department of Anesthesiology, Taipei Veterans General Hospital,
Taipei 11217, Taiwan (Republic of China)
(Wu) School of Medicine, National Yang Ming Chiao Tung University, Taipei
11221, Taiwan (Republic of China)
Publisher
MDPI
Abstract
The clinical efficacy of spectral entropy monitoring in improving
postoperative recovery remains unclear. This trial aimed to investigate
the impact of M-Entropy (GE Healthcare, Helsinki, Finland) guidance on
emergence from anesthesia and postoperative delirium in thoracic surgery.
Adult patients undergoing video-assisted thoracoscopic surgery for lung
resection at a medical center were randomly allocated into the M-Entropy
guidance group (n = 39) and the control group (n = 37). In the M-Entropy
guidance group, sevoflurane anesthesia was titrated to maintain response
and state entropy values between 40 and 60 intraoperatively. In the
control group, the dosing of sevoflurane was adjusted based on clinical
judgment and vital signs. The primary outcome was time to spontaneous eye
opening. M-Entropy guidance significantly reduced the time proportion of
deep anesthesia (entropy value <40) during surgery, mean difference:
-21.5% (95% confidence interval (CI): -32.7 to -10.3) for response entropy
and -24.2% (-36.3 to -12.2) for state entropy. M-Entropy guidance
significantly shortened time to spontaneous eye opening compared to
clinical signs, mean difference: -154 s (95% CI: -259 to -49). In
addition, patients of the M-Entropy group had a lower rate of emergence
agitation (absolute risk reduction: 0.166, 95% CI: 0.005-0.328) and
delirium (0.245, 0.093-0.396) at the postanesthesia care unit.
M-Entropy-guided anesthesia hastened awakening and potentially prevented
emergence agitation and delirium after thoracic surgery. These results may
provide an implication for facilitating postoperative recovery and
reducing the complications associated with delayed emergence and
delirium. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<88>
Accession Number
2015794811
Title
Monitoring of Unfractionated Heparin Therapy in the Intensive Care Unit
Using a Point-of-Care aPTT: A Comparative, Longitudinal Observational
Study with Laboratory-Based aPTT and Anti-Xa Activity Measurement.
Source
Journal of Clinical Medicine. 11(5) (no pagination), 2022. Article Number:
1338. Date of Publication: March-1 2022.
Author
Lardinois B.; Hardy M.; Michaux I.; Horlait G.; Rotens T.; Jacqmin H.;
Lessire S.; Bulpa P.; Dive A.; Mullier F.
Institution
(Lardinois, Hardy, Jacqmin, Mullier) Hematology Laboratory, Namur
Thrombosis and Hemostasis Center, CHU UCL Namur, Universite Catholique de
Louvain, Yvoir 5530, Belgium
(Hardy, Lessire) Anesthesiology Department, Namur Thrombosis and
Hemostasis Center, CHU UCL Namur, Universite Catholique de Louvain, Yvoir
5530, Belgium
(Michaux, Horlait, Rotens, Bulpa, Dive) Department of Intensive Care,
Namur Thrombosis and Hemostasis Center, CHU UCL Namur, Universite
Catholique de Louvain, Yvoir 5530, Belgium
Publisher
MDPI
Abstract
Continuous intravenous unfractionated heparin (UFH) is administered
routinely in the intensive care unit (ICU) for the anticoagulation of
patients, and monitoring is performed by the activated partial
thromboplastin time (APTT) or anti-Xa activity. However, these strategies
are associated with potentially large time intervals before dose
adjustments, which could be detrimental to the patient. The aim of the
study was to compare a point-of-care (POCT) version of the APTT to (i)
laboratory-based APTT and (ii) measurements of anti-Xa activity in terms
of correlation, agreement and turnaround time (TAT). Thirty-five ICU
patients requiring UFH therapy were prospectively included and followed
longitudinally for a maximum duration of 15 days. UFH was administered
according to a local adaptation of Raschke and Amanzadeh's aPTT nomograms.
Simultaneous measurements of POCT-APTT (CoaguCheck aPTT Test, Roche
Diagnostics) on a drop of fresh whole blood, laboratory-based APTT (C.K.
Prest, Stago) and anti-Xa activity (STA Liquid anti-Xa, Stago) were
systematically performed two to six times a day. Antithrombin, C-reactive
protein, fibrinogen, factor VIII and lupus anticoagulant were measured.
The time tracking of sampling and analysis was recorded. The overall
correlation between POCT-APTT and laboratory APTT (n = 795 pairs) was
strongly positive (rs = 0.77, p < 0.0001), and between POCT-APTT and
anti-Xa activity (n = 729 pairs) was weakly positive (rs = 0.46, p <
0.0001). Inter-method agreement (Cohen's kappa (k)) between POCT and
laboratory APTT was 0.27, and between POCT and anti-Xa activity was 0.30.
The median TATs from sample collection to the lab delivery of results for
lab-APTT and anti-Xa were 50.9 min (interquartile range (IQR), 38.4-69.1)
and 66.3 min (IQR, 49.0-91.8), respectively, while the POCT delivered
results in less than 5 min (p < 0.0001). Although the use of the POCT-APTT
device significantly reduced the time to results, the results obtained
were poorly consistent with those obtained by lab-APTT or anti-Xa
activity, and therefore it should not be used with the nomograms developed
for lab-APTT. Copyright © 2022 by the authors. Licensee MDPI,
Basel, Switzerland.

<89>
Accession Number
2020783325
Title
Postoperative pain and pain management and neurocognitive outcomes after
non-cardiac surgery: a protocol for a series of systematic reviews.
Source
Systematic Reviews. 11(1) (no pagination), 2022. Article Number: 280. Date
of Publication: December 2022.
Author
Khaled M.; Sabac D.; Marcucci M.
Institution
(Khaled, Marcucci) Department of Health Research Methods, Evidence and
Impact, McMaster University, 1280 Main Street W, Hamilton, ON L8S4L8,
Canada
(Khaled, Marcucci) Perioperative and Surgery Research Program, Population
Health Research Institute, Hamilton, ON, Canada
(Sabac) Bachelor of Health Sciences, McMaster University, Hamilton, ON,
Canada
(Marcucci) Department of Medicine, McMaster University, Hamilton, ON,
Canada
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative delirium (POD) is common after non-cardiac
surgery in older adults and can result in increased risk of adverse
outcomes including postoperative cognitive dysfunction (POCD). Pain after
surgery is also frequent and can persist as chronic postsurgical pain
(CPSP). Evidence is inconsistent and controversial on whether acute and
chronic postsurgical pain, and different postoperative pain management
strategies (including opioid versus opioid-sparing strategies), is
associated with the occurrence of POD and POCD. In this protocol, we
propose a series of systematic reviews to answer the following research
questions: In adults undergoing non-cardiac surgery, (1) is acute
postsurgical pain associated with POD and/or POCD? (2) Are
opioid-sparing/avoidance strategies of acute postoperative pain management
associated with lower incidence and/or severity of POD and POCD, compared
to predominantly opioid-based strategies? (3) Is CPSP associated with
POCD? (4) Are opioid-sparing management strategies of CPSP associated with
lower incidence and/or severity of POCD compared to standard of care or
strategies not aiming at reduced opioid use? Methods: We will search
MEDLINE, EMBASE, Cochrane (CENTRAL), CINAHL, and PSYCHINFO. According to
the research question, we will include cohort and case-control studies
(questions 1 and 3) or randomized controlled trials and non-randomized
studies (questions 2 and 4). The risk of bias will be assessed
independently and in duplicate using the revised Cochrane risk-of-bias
tool, the Newcastle-Ottawa Scale, and the Joanna-Briggs Institute critical
appraisal checklist. Disagreements will be resolved by a third reviewer.
Findings will be reported narratively, and where possible and appropriate,
meta-analyses will be performed. Certainty of evidence will be assessed
using the Grading of Recommendations Assessment, Development, and
Evaluation approach. We will conduct the reviews in accordance with the
guideline of the Preferred Reporting Items for Systematic Review and
Meta-Analyses Protocols. Discussion(s): Our systematic reviews will
summarize available evidence to date on the association of postoperative
pain and its management strategies with the incidence of POD and POCD in
non-cardiac surgery. We will evaluate the existing evidence and its
limitations and inform the design of future interventional studies
comparing the effects of different pain management strategies on
postoperative neurocognitive outcomes. Systematic review registration:
PROSPERO CRD42021192105. Copyright © 2022, The Author(s).

<90>
Accession Number
2017791462
Title
Intraoperative transesophageal echocardiography following mitral valve
repair: a systematic review.
Source
Brazilian Journal of Anesthesiology (English Edition). 72(3) (pp 379-397),
2022. Date of Publication: 01 May 2022.
Author
Zamper R.; Prempeh A.; Iglesias I.; Fayad A.
Institution
(Zamper, Prempeh, Iglesias, Fayad) Western University, Schulich School of
Medicine and Dentistry, Department of Anesthesia and Perioperative
Medicine, London, Canada
Publisher
Elsevier Editora Ltda
Abstract
Objective: We aimed to examine the recent evidence and search for novel
assessments on intraoperative TEE following mitral valve repair that can
impact short and long-term outcomes. Method(s): The Ovid MEDLINE,
PubMed, and EMBASE databases were searched from January 1, 2008, until
January 27, 2021, for studies on patients with severe Mitral Valve
Regurgitation (MR) undergoing Mitral Valve (MV) repair surgery with
intraoperative Transesophageal Echocardiography (TEE) performed after the
repair. Additional searches were conducted using Google search engine, Web
of Science, and Cochrane Library. Result(s): After reviewing 302
records, 8 retrospective and 22 prospective studies were included (n =
30). Due to clinical and methodological diversity, these studies are
noncomparable and data were not amenable to quantitative synthesis.
 Conclusion(s): Although technological advances allowed the objective
assessment of geometric and dynamic alterations of the MV, the impact of
the use of these technologies on short- or long-term outcomes was not
studied. There is uncertainty and conflicting evidence on the ideal method
and metrics to evaluate MV patency post-repair. Few isolated studies
validated methods to assess coaptation surface and LV function
post-repair. Copyright © 2022 Sociedade Brasileira de
Anestesiologia

<91>
Accession Number
2021923738
Title
A Meta-Analysis of the Effect of Serratus Anterior Plane Block after
Thoracic Surgery.
Source
Iranian Red Crescent Medical Journal. 24(9) (no pagination), 2022. Article
Number: e2076. Date of Publication: 30 Oct 2022.
Author
Xia S.; Zhu X.; Xiong J.
Institution
(Xia, Zhu, Xiong) Department of Cardiothoracic Surgery, The First People's
Hospital of Jiujiang City, Jiangxi, Jiujiang, China
Publisher
ZamenPub
Abstract
Background: As one of the new regional nerve block techniques, the
serratus anterior plane block (SAPB) has demonstrated high potential in
thoracic surgery. Objective(s): The present study aimed to analyze
the effect of SAPB following thoracic surgery. Method(s): Chinese and
English databases were retrieved to collect clinical randomized controlled
studies (RCTs) on SAPB for postoperative analgesia in thoracic surgery.
Both study and control groups were operated under general anesthesia, the
SAPB was performed in the study group, and the rest of the postoperative
analgesic regimen was the same as that of the control group. The following
indicators were evaluated: (1) resting visual analogue scale (VAS) score
(4, 12, and 24 h after the surgery), (2) active VAS score (4, 12, and 24 h
after the surgery), (3) postoperative nausea and vomiting (PONV), (4)
Postoperative Ramsay score (4-6 hours after operation), (5) Number of
patient-controlled intravenous analgesia (PCIA) compressions, and (6)
Postoperative sufentanil consumption. Stata software (version 15) was used
for meta-analysis. Result(s): The resting and active VAS scores at 4,
12, and 24 h postoperatively were lower in the study group than in the
control group (P< 0.05), and there was no significant difference between
the two groups in Ramsay scores at 4-6 h postoperatively (P >0.05). The
incidence of PONV was significantly lower in the study group than in the
control group (P< 0.05), and the number of postoperative PCIA compressions
and sufentanil consumption were significantly less in the study group than
in the control group (P< 0.05). Conclusion(s): As evidenced by the
obtained results, the SAPB can enhance the postoperative analgesic effect
in thoracic surgery, reduce the incidence of PONV, and decrease opioid
consumption. Copyright © 2022, Author(s).

<92>
Accession Number
2019734786
Title
Selection of Vascular Closure Devices in Transcatheter Aortic Valve
Replacement: Systematic Review and Network Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 46 (pp 78-84), 2023. Date of
Publication: January 2023.
Author
Sakata T.; Kuno T.; Fujisaki T.; Yokoyama Y.; Misumida N.; Sugiura T.;
Latib A.
Institution
(Sakata) Cardiovascular Research Institute, Icahn School of Medicine at
Mount Sinai, New York, United States
(Kuno, Latib) Division of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, New York, United States
(Fujisaki) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Morningside and West, New York, United States
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
PA, United States
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, United States
(Sugiura) Department of Cardiothoracic & Vascular Surgery, Montefiore
Medical Center, Albert Einstein College of Medicine, New York, United
States
Publisher
Elsevier Inc.
Abstract
Various vascular closure devices (VCDs) are commonly used for percutaneous
transcatheter aortic valve replacement (TAVR). However, superiority and
safety profile among them remain unclear. We compared periprocedural
complications among various VCDs in patients undergoing TAVR. PubMed and
EMBASE were searched through January 2022 to identify clinical studies
comparing any 2 VCDs of Prostar, Proglide and MANTA in patients who
underwent TAVR. Studies using surgical cut-down or alternative access
other than transfemoral approach were excluded. We analyzed the odds
ratios (ORs) of vascular complications (VC), bleeding, acute kidney injury
and all-cause mortality using a network meta-analysis. All outcomes were
defined by Valve Academic Research Consortium 2 criteria. Two randomized
controlled trials and 15 observational studies were identified, yielding a
total of 11,344 patients including Prostar (n = 4499), Proglide (n =
5705), or MANTA group (n = 1140). The rates of major VC and
life-threatening and major bleeding were significantly lower in Proglide
compared to Prostar (OR [95 % CI] = 0.54 [0.32-0.89], 0.68 [0.52-0.90],
and 0.49 [0.26-0.95], respectively). There was no significant difference
in major VC and bleeding between Proglide and MANTA groups. Proglide was
associated with a lower rate of acute kidney injury (0.56 [0.34-0.92]) and
red blood cell transfusion (0.39 [0.16-0.98]) compared to Prostar. There
was no significant difference in additional interventions and 30-day
overall mortality among three groups. In this network meta-analysis of VCD
in patients undergoing TAVR, MANTA and Proglide had comparable outcomes
while Proglide appears superior to Prostar in terms of major VC and
bleeding. Copyright © 2022 Elsevier Inc.

<93>
Accession Number
2018735405
Title
Leadless pacemaker implantation in dextrocardia with situs viscerum
inversus: A case report and literature review.
Source
PACE - Pacing and Clinical Electrophysiology. 46(1) (pp 39-43), 2023. Date
of Publication: January 2023.
Author
Bontempi L.; Fundaliotis A.; Moretti M.; Sammartino A.M.; Saino A.T.;
Arabia G.; Piti A.; Curnis A.; Dell'Aquila A.
Institution
(Bontempi, Fundaliotis, Moretti, Sammartino, Saino, Piti, Dell'Aquila)
Unit of Cardiology, Cardiac Electrophysiology and, Electrostimulation
Laboratory, "Bolognini" Hospital of Seriate - ASST Bergamo Est, Bergamo,
Italy
(Bontempi, Sammartino, Arabia, Curnis, Dell'Aquila) Department of Medical
and Surgical Specialties, Radiological Sciences, and Public Health,
Institute of Cardiology, ASST Spedali Civili Hospital of Brescia and
University of Brescia, Brescia, Italy
Publisher
John Wiley and Sons Inc
Abstract
Leadless pacemaker implantation (LPI) has fewer device complications and
reduced chance of infection compared to conventional pacemakers.
Dextrocardia with situs viscerum inversus (DC+SVI) is a rare condition,
which seldom leads to cardiac complications. However, its presence poses a
challenge to operators in cardiac procedures. LPI reports in DC patients
are scarce. We report a case of LPI in a DC+SVI patient, followed by a
brief but comprehensive literature review. Copyright © 2022 Wiley
Periodicals LLC.

<94>
Accession Number
2020454564
Title
The Impact of Bariatric Surgery on Cardiac Structure, and Systolic and
Diastolic Function in Patients with Obesity: A Systematic Review and
Meta-analysis.
Source
Obesity Surgery. 33(1) (pp 345-361), 2023. Date of Publication: January
2023.
Author
Esparham A.; Shoar S.; Kheradmand H.R.; Ahmadyar S.; Dalili A.; Rezapanah
A.; Zandbaf T.; Khorgami Z.
Institution
(Esparham, Kheradmand, Ahmadyar) Student Research Committee, College of
Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Shoar) Department of Clinical Research, ScientificWriting Corp, Houston,
TX, United States
(Dalili, Rezapanah) Department of Surgery, School of Medicine, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Dalili, Rezapanah) Surgical Oncology Research Center, Imam Reza Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Zandbaf) Department of Surgery, School of Medicine, Islamic Azad
University, Mashhad, Iran, Islamic Republic of
(Khorgami) Department of Surgery, University of Oklahoma College of
Community Medicine, Tulsa, OK, United States
(Khorgami) Harold Hamm Diabetes Center, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, United States
Publisher
Springer
Abstract
The purpose of this study was to provide pooled data from all studies on
the impact of bariatric surgery on cardiac structure, and systolic and
diastolic function evaluated by either echocardiography or cardiac
magnetic resonance. PubMed, Web of Science, Embase, and Scopus databases
were searched. Almost all of cardiac left-side structural indices improved
significantly after bariatric surgery. However, right-side structural
indices did not change significantly. Left ventricular ejection fraction
and most of the diastolic function indices improved significantly after
the bariatric surgery. The subgroup analysis showed that the left
ventricular mass index decreased more in long-term follow-up (>= 12
months). In addition, subgroup analysis of studies based on surgery type
did not reveal any difference in outcomes between gastric bypass and
sleeve gastrectomy groups. Copyright © 2022, The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<95>
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. Copyright © 2023, Springer Nature B.V.

<96>
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.
 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. 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. 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. Copyright
© The Author(s) 2022. Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery. All rights
reserved.

<97>
Accession Number
2018982139
Title
Ross Procedure Versus Mechanical Versus Bioprosthetic Aortic Valve
Replacement: A Network Meta-Analysis.
Source
Journal of the American Heart Association. 12(1) (no pagination), 2023.
Article Number: e8066. Date of Publication: 16 Aug 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, United States
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, New York, NY, United States
(Toyoda, Itagaki, El-Hamamsy) Department of Cardiovascular Surgery, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Fujisaki) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Morningside and West, New York, NY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Ibrahim) Division of Cardiovascular Surgery, Hospital of the University
of Pennsylvania, Philadelphia, PA, United States
(Ouzounian) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
Toronto General Hospital and the University of Toronto, Toronto, ON,
Canada
(Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
Publisher
American Heart Association Inc.
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 >=16 years undergoing
the Ross proce-dure, 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.
 CONCLUSION(S): 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. Copyright © 2022 The Authors.

<98>
Accession Number
2022161412
Title
Comparison of Haemodynamic Changes of Dexmedetomidine with That of Saline
Infusion for Spine Surgery in Prone Position under General Anaesthesia.
Source
European Journal of Molecular and Clinical Medicine. 9(7) (pp 8784-8792),
2022. Date of Publication: June 2022.
Author
Helawar S.; Shree S.P.; Prakash K.S.; Faiaz A.F.
Institution
(Helawar, Shree, Prakash, Faiaz) Department of Anaesthesia, Kanachur
Institute of Medical Sciences, Karnataka, Mangalore, India
Publisher
EJMCM, International House
Abstract
Background: In this study, we wanted to compare hemodynamic changes in
patients receiving dexmedetomidine with those of patients receiving
placebo. Material(s) and Method(s): This was a hospital based
randomized prospective comparative study conducted among 60 patients who
presented to the Department of General Anaesthesia in Seth G S Medical
College, KEM Hospital Mumbai from 2013 to 2014 after obtaining clearance
from Institutional Ethics Committee and written informed consent from the
study participants. Result(s): The mean pre-operative heart rate in
Group D was 79.83 +/- 8.92 beats per minute (bpm) and in group C it was
76.97 +/- 8.97 bpm and the difference was not statistically significant (p
= 0.208). Immediately after turning the patient prone, the mean heart rate
in group D was 79.83 +/- 6.28 bpm and that in group C was 90. 25 +/- 12.32
bpm and the difference was not statistically significant (p value = 0
784). The mean heart rate was significantly lower in group D compared to
group C during rest of the intra operative period. At the time of
reversal, the mean heart rate was 88.73 +/- 6.24 bpm and 94.31 +/- 6.21
bpm in group D and group C respectively. There is significant difference
in the mean heart rate with p value 0.001. The pre-operative mean SBP in
group D was 123.33 +/- 14.15 and that in group C was 125.94 +/- 11.45; the
difference was not statistically significant with p value 0.244. In
comparison of diastolic blood pressure (DBP) at various intervals between
Group D and Group C, all the p values were statistically significant.
Whereas the pre-operative mean DBP was 82.10 +/- 2.11 mm of Hg and 82.63
+/- 3.86 mm of Hg in Group D and Group C respectively. The difference was
not statistically significant (p value 0.513). In Comparison of MAP at
various intervals between Group D and Group C, all the p values were
statistically significant. Whereas the pre-operative mean arterial
pressure (MAP) in group D patients was 95.73 +/- 2.60 mm of Hg and that in
group C patients was 97 50 +/- 6.53 mm of Hg there is no significant
difference in mean MAP between two groups p value 0.172.
 Conclusion(s): Dexmedetomidine provides good intra-operative
hemodynamic stability in spine surgeries. The incidence of bradycardia and
hypotension were less with the dexmedetomidine in prone
position. Copyright © 2022 Ubiquity Press. All rights reserved.

<99>
[Use Link to view the full text]
Accession Number
2022126009
Title
Association of smoking with postoperative atrial fibrillation in patients
with cardiac surgery: A PRISMA-compliant article.
Source
Medicine (United States). 100(23) (pp E26179), 2021. Date of Publication:
11 Jun 2021.
Author
Wan Q.; Li S.; Hu J.
Institution
(Wan, Hu) Jiangxi Provincial People's Hospital Affiliated to Nanchang
University, Nanchang of Jiangxi, China
(Li) Grade 2017, The Second Clinical Medical College of Nanchang
University, Nanchang, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Cigarette smoking is an important modifiable risk factor for
incident atrial fibrillation. However, the impact of smoking on
postoperative atrial fibrillation in patients undergoing cardiac surgery
remains controversial. We performed this meta-analysis to explore the
association of smoking with postoperative atrial fibrillation in patients
with cardiac surgery. Method(s):We systematically searched 2
computer-based databases (PubMed and EMBASE) up to July 2019 for all
relevant studies. A random-effects model was selected to pool the odds
ratios (ORs) and 95% confidence intervals (CIs). In this meta-analysis,
the protocol and reporting of the results were based on the Preferred
Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)
statement. Result(s):A total of 36 studies were included in this
meta-analysis. Overall, smoking was not associated with an increased risk
of postoperative atrial fibrillation in patients undergoing cardiac
surgery (odds ratio [OR] = 0.89; 95% confidence interval [CI] 0.79-1.02).
The corresponding results were stable in the subgroup analyses.
Specifically, smoking was not associated with an increased risk of
postoperative atrial fibrillation regardless of the type of cardiac
surgery: coronary artery bypass grafting (OR = 0.91; 95% CI 0.77-1.07),
valve surgery (OR = 0.15; 95% CI 0.01-1.56), and coronary artery bypass
grafting+valve surgery (OR = 0.91; 95% CI 0.70-1.18).
 Conclusion(s):Based on currently published studies, smoking was not
associated with an increased risk of postoperative atrial fibrillation in
patients undergoing cardiac surgery. Copyright © 2021 the
Author(s). Published by Wolters Kluwer Health, Inc.

<100>
[Use Link to view the full text]
Accession Number
2022120221
Title
Comparison of results of transcatheter femoral aortic valve replacement
under local and general anesthesia: A protocol for systematic review and
meta-analysis.
Source
Medicine (United States). 100(34) (pp E27085), 2021. Date of Publication:
27 Aug 2021.
Author
Han X.; Liu S.; Wang J.; Chen H.; Chen Y.; Song B.
Institution
(Han, Wang, Chen, Chen) The First Clinical Medical College of Lanzhou
University, First Hospital of Lanzhou University, Lanzhou, China
(Liu, Song) Department of Cardiovascular Surgery, First Hospital of
Lanzhou University, Lanzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Traditionally, TAVR (Transcatheter Aortic Valve Replacement)
has been performed under general anesthesia (GA). Thus GA facilitates the
use of TEE (Transesophageal echocardiography), and the use of TEE is an
important means to improve the quality of cardiac surgery and reduce
postoperative complications. However, GA was also associated with
prolonged mechanical ventilation, longer hospitalization and intensive
care unit hours, and the need for positive inotropic agents. With
increasing clinical experience and advances in transcatheter techniques,
transfemoral TAVR may also be feasible under local anesthesia (LA).
Studies have shown that LA can avoid hemodynamic fluctuations caused by
general anesthesia and lung damage caused by positive pressure
ventilation, and can also reduce medical costs. Method(s):Two
researchers independently read the titles and abstracts of the literature
obtained. After excluding the studies that did not meet the inclusion
criteria, they read through the full text of the remaining literatures to
determine whether they truly met the inclusion criteria. When two
researchers disagree on the included literature, the third researcher
decides whether to include it or not. For literature with incomplete data,
contact the author via email for unpublished data. The included studies
were assessed by two researchers for the risk of bias, and cross-checked.
Stata16.0 was used for meta-analysis. Heterogeneity was assessed by chi2
test and I2 quantification. Pooled analysis was performed by random
effects model. Sensitivity analysis was performed by excluding references
one by one. We will perform subgroup analysis based on data conditions.
 Result(s):In this study, high quality evidence was provided by
selecting local anesthesia and general anesthesia during transfemoral
transcatheter aortic valve replacement for patients with primary arterial
stenosis. Conclusion(s):Local anesthesia provides anaesthetic-guided
sedation that does not require intubation and is safe and effective. Local
anesthesia may be a better alternative to TAVR under general
anesthesia.Ethics and dissemination:The study does not require ethical
approval. Copyright © 2021 the Author(s). Published by Wolters
Kluwer Health, Inc.

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