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<1>
Accession Number
2020645167
Title
Efficacy and Safety of NOACs Compared With VKAs for Patients With Atrial
Fibrillation After Transcatheter Aortic Valve Implantation: A System
Review and Meta-Analysis.
Source
Clinical and Applied Thrombosis/Hemostasis. 28 (no pagination), 2022. Date
of Publication: January-December 2022.
Author
Ge J.; Han W.; Ma C.; Maduray K.; Chen T.; Zhong J.
Institution
(Ge, Han, Ma, Maduray, Chen, Zhong) The Key Laboratory of Cardiovascular
Remodeling and Function Research, Chinese Ministry of Education, Chinese
National Health Commission and Chinese Academy of Medical Sciences, The
State and Shandong Province Joint Key Laboratory of Translational
Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo
College of Medicine, Shandong University, Jinan, China
(Zhong) Department of Cardiology, Qilu Hospital (Qingdao), Cheeloo College
of Medicine, Shandong University, Qingdao, China
Publisher
SAGE Publications Inc.
Abstract
Novel oral anticoagulants (NOACs) are preferentially recommended in
patients with nonvalvular atrial fibrillation (AF) for stroke prevention
over vitamin K antagonists (VKAs). However, the evidence regarding the
efficacy and safety of NOACs versus VKAs after transcatheter aortic valve
implantation (TAVI) in patients with AF is very rare. Pubmed, Embase, Web
of science, and Cochrane Databases were searched for eligible studies
published before May 19, 2022. A total of 11 studies were included in this
meta-analysis involving 27 107 patients. Regarding primary outcomes, there
were no differences between NOACs and VKAs in all-cause mortality (RR:
0.84, 95% CI: (0.69, 1.02)) and stroke (RR: 1.00, 95% CI: (0.85, 1.19)).
With respect to secondary outcomes, NOACs were associated with reduced
incidence of bleeding (RR: 0.77, 95% CI: (0.71, 0.83)) and intracranial
bleeding (RR: 0.57, 95% CI: (0.39, 0.83)), whereas no significant
differences were found in major or life-threatening bleeding (RR: 0.98,
95% CI: (0.82, 1.17)) and myocardial infarction (RR: 1.37, 95% CI: (0.83,
2.26)). Our meta-analysis revealed the safety and efficacy of NOACs may be
superior to VKAs in AF patients undergoing TAVI.<br/>Copyright &#xa9; The
Author(s) 2022.

<2>
Accession Number
2021878793
Title
Thai Guidelines for Transcatheter Aortic Valve Implantation, TAVI 2021.
Source
Journal of the Medical Association of Thailand. 105(12) (pp 1296-1303),
2022. Date of Publication: December 2022.
Author
Chandavimol M.; Buddhari W.; Sakiyalak P.; Cheewatankornkul S.;
Lertsuwunseri V.; Taksaudom N.; Kittayarak C.; Chunhamaneewat N.;
Srimahachota S.
Institution
(Chandavimol) Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
(Buddhari, Lertsuwunseri, Kittayarak, Srimahachota) King Chulalongkorn
Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
(Sakiyalak, Chunhamaneewat) Siriraj Hospital, Mahidol University, Bangkok,
Thailand
(Cheewatankornkul) Songklanagarind Hospital, Prince of Songkla University,
Songkhla, Thailand
(Taksaudom) Chaing Mai University Hospital, Chiang Mai University, Chiang
Mai, Thailand
Publisher
Medical Association of Thailand
Abstract
Thai Guidelines for Transcatheter Aortic Valve Implantation (TAVI) were
initiated by the Thai Heart Association, Society of Thoracic Surgeons of
Thailand, and Cardiovascular Intervention Association of Thailand. There
are several factors in Thailand that differ from western countries, such
as patient life expectancy, the types of available TAVI valves,
socio-economic status, and experiences in TAVI. Therefore,
Thailand-specific guidelines would be of great benefit for Thai patients.
The objectives of the guidelines are to provide update recommendations
regarding best practice in patients undergoing TAVI in Thailand, to
emphasize the importance of a multidisciplinary heart valve team, and to
emphasize the importance of data collection and follow up in patients
undergoing TAVI for quality improvement. Classes of recommendation were
based on standard classification and level of evidence. Recommendations
were categorized into recommendation for multidisciplinary heart valve
team, for perioperative risk assessment, for patient selection, for
antithrombotic treatment after TAVI, for hospital and operator
requirement, and for TAVI data collection.<br/>Copyright &#xa9; 2022
JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND.

<3>
Accession Number
2019685108
Title
Biomarker Prediction of Complex Coronary Revascularization Procedures in
the FOURIER Trial.
Source
Journal of the American College of Cardiology. 80(9) (pp 887-897), 2022.
Date of Publication: 30 Aug 2022.
Author
Fagundes A.; Morrow D.A.; Oyama K.; Furtado R.H.M.; Zelniker T.A.; Tang
M.; Kuder J.F.; Murphy S.A.; Hamer A.; Keech A.C.; Sever P.; Giugliano
R.P.; Sabatine M.S.; Bergmark B.A.
Institution
(Fagundes) IDOR -D'Or Institute for Research and Education, Sao Paolo,
Brazil, Brazil
(Fagundes, Morrow, Oyama, Furtado, Zelniker, Tang, Kuder, Murphy,
Giugliano, Sabatine, Bergmark) Thrombolysis in Myocardial Infarction
(TIMI) Study Group, Division of Cardiovascular Medicine, Brigham and
Women's Hospital, Harvard Medical School, Boston, Massachusetts, United
States
(Oyama) Department of Cardiovascular Medicine, Tohoku University Graduate
School of Medicine, Sendai, Japan
(Furtado) Hospital Israelita Albert Einstein and Instituto do Coracao da
Faculdade de Medicina da U.S.P., Sao Paulo, Brazil
(Zelniker) Division of Cardiology, Vienna General Hospital and Medical
University of Vienna, Vienna, Austria
(Hamer) Cardiol Therapeutics, Oakville, ON, Canada
(Keech) National Health and Medical Research Council Clinical Trials
Centre, Sydney Medical School, University of Sydney, Sydney, NSW,
Australia
(Sever) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Biomarkers are known to predict major adverse cardiovascular
events. However, the association of biomarkers with complex coronary
revascularization procedures or high-risk coronary anatomy at the time of
revascularization is not understood. <br/>Objective(s): We examined the
associations between baseline biomarkers and major coronary events (MCE)
and complex revascularization procedures. <br/>Method(s): FOURIER was a
randomized trial of the proprotein convertase subtilisin-kexin type 9
inhibitor evolocumab vs placebo in 27,564 patients with stable
atherosclerosis. We analyzed adjusted associations among the biomarkers,
MCE (coronary death, myocardial infarction, or revascularization), and
complex revascularization (coronary artery bypass graft or complex
percutaneous coronary intervention) using a multimarker score with 1 point
assigned for each elevated biomarker (high-sensitivity C-reactive protein
>=2 mg/L; N-terminal pro-B-type natriuretic peptide >=450 pg/mL;
high-sensitivity troponin I >=6 ng/L; growth-differentiation factor-15
>=1,800 pg/mL). <br/>Result(s): When patients were grouped by the number
of elevated biomarkers (0 biomarkers, n = 6,444; 1-2 biomarkers, n =
12,439; >=3 biomarkers, n = 2,761), there was a significant graded
association between biomarker score and the risk of MCE (intermediate
score: HR<inf>adj</inf>: 1.57 [95% CI: 1.38-1.78]; high score:
HR<inf>adj</inf>: 2.90 [95% CI: 2.47-3.40]), and for complex
revascularization (intermediate: HR<inf>adj</inf>: 1.33 [95% CI:
1.06-1.67]; high score: HR<inf>adj</inf>: 2.07 [95% CI: 1.52-2.83]) and
its components (P<inf>trend</inf> <0.05 for each). The number of elevated
biomarkers also correlated with the presence of left main disease,
multivessel disease, or chronic total occlusion at the time of
revascularization (P < 0.05 for each). <br/>Conclusion(s): A
biomarker-based strategy identifies stable patients at risk for coronary
events, including coronary artery bypass graft surgery and complex
percutaneous coronary intervention, and predicts high-risk coronary
anatomy at the time of revascularization. These findings provide insight
into the relationships between cardiovascular biomarkers, coronary
anatomical complexity, and incident clinical events. (Further
Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With
Elevated Risk [FOURIER]; NCT01764633)<br/>Copyright &#xa9; 2022 American
College of Cardiology Foundation

<4>
Accession Number
2019380957
Title
Cochrane corner: Biomarkers to improve preoperative prediction of major
cardiac outcomes after non-cardiac surgery.
Source
Heart. 108(16) (pp 1257-1259), 2022. Date of Publication: 05 Jul 2022.
Author
Vernooij L.M.; Van Klei W.A.; Moons K.G.M.; Van Waes J.A.R.; Damen
J.A.A.G.
Institution
(Vernooij, Van Klei, Van Waes) Anesthesiology Intensive Care and Emergency
Medicine, Umc Utrecht, Utrecht, Netherlands
(Van Klei) Anesthesia and Pain Management, University Health Network,
Toronto, ON, Canada
(Moons, Damen) Julius Center for Health Sciences and Primary Care, Umc
Utrecht, Utrecht, Netherlands
(Moons, Damen) Cochrane Netherlands, Umc Utrecht, Utrecht, Netherlands
Publisher
BMJ Publishing Group

<5>
[Use Link to view the full text]
Accession Number
2017127097
Title
The role of lipoprotein (a) in primary and secondary cardiovascular
disease prevention: a systematic review of epidemiological studies.
Source
Current Opinion in Cardiology. 34(4) (pp 424-434), 2019. Date of
Publication: 01 Jul 2019.
Author
Kouvari M.; Panagiotakos D.B.
Institution
(Kouvari, Panagiotakos) Department of Nutrition-Dietetics, School of
Health Science and Education, Harokopio University, Athens, Greece
(Panagiotakos) Faculty of Health, University of Canberra, Canberra,
Australia
(Panagiotakos) School of Allied Health, College of Science, Health and
Engineering, La Trobe University, Melbourne, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Lipoprotein (a) [Lp(a)] is highly suggested as an
emerging risk factor in cardiovascular disease (CVD) prevention. However,
there remains controversy regarding the shape of Lp(a) risk curve and the
extent to which Lp(a) confers risk for CVD, independently of conventional
lipid markers. This systematic review outlines the current state of
knowledge regarding the role of Lp(a) in primary and secondary CVD
prevention. Recent findings Searches resulted in the selection of n1/419
studies. In the context of primary CVD prevention, n1/49 cohorts, n1/42
case-cohorts, and n1/42 retrospective studies were identified, the
majority of which suggested a significant positive association between
Lp(a) and CVD onset. In terms of secondary CVD prevention, n1/45 cohorts
and n1/41 case-cohort were considered as eligible highlighting from a
positive to a neutral association between Lp(a) and CVD progression.
Summary A positive association between Lp(a) and CVD seems to be supported
by a large body of evidence yet it is comparatively moderate in magnitude
and differentiates according to study population and the examined
endpoints. This fact along with the lack of a definitive functional
mechanism limits the potential connotation of Lp(a) in daily clinical
practice.<br/>Copyright &#xa9; 2019 Wolters Kluwer Health, Inc. All rights
reserved

<6>
Accession Number
2017140132
Title
Influence of practice patterns on outcome among countries enrolled in the
SYNTAX trial: 5-year results between percutaneous coronary intervention
and coronary artery bypass grafting+.
Source
European Journal of Cardio-thoracic Surgery. 52(3) (pp 445-453), 2017.
Date of Publication: 01 Sep 2017.
Author
Milojevic M.; Head S.J.; Mack M.J.; Mohr F.W.; Morice M.-C.; Dawkins K.D.;
Holmes D.R.; Serruys P.W.; Kappetein A.P.
Institution
(Milojevic, Head, Kappetein) Department of Cardiothoracic Surgery, Erasmus
University Medical Center, Rotterdam, Netherlands
(Mack) Department of Cardiovascular Surgery, Heart Hospital Baylor Plano,
Baylor Healthcare System, Plano, TX, United States
(Mohr) Department of Cardiovascular Surgery, Herzzentrum Universitat
Leipzig, Leipzig, Germany
(Morice) Department of Cardiology, Institut Hospitalier Jacques Cartier,
Massy, France
(Dawkins) Boston Scientific Corporation, Natick, MA, United States
(Holmes) Division of Cardiovascular Disease and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Serruys) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: To examine differences among participating countries in
baseline characteristics, clinical practice, medication strategies and
outcomes of patients randomized to coronary artery bypass grafting and
percutaneous coronary intervention in the SYNTAX trial. <br/>METHOD(S): In
SYNTAX, centres in 18 different countries enrolled 1800 patients, of which
8 countries enrolled >_80 patients, what was projected to be a large
enough sample size to be included in the analysis. Baseline
characteristics, practice patterns and clinical outcomes were compared
between the USA (n = 245), the UK (n = 267), Italy (n = 197), France (n =
208), Germany (n = 179), Netherlands (n = 148), Belgium (n = 91) and
Hungary (n = 83). The remaining patients from other participating
countries were pooled together (n = 382). <br/>RESULT(S): Five-year
results demonstrated significantly different outcomes between countries.
After adjustment, percutaneous coronary intervention patients in France
had lower rates of major adverse cardiac and cerebrovascular events
[hazard ratio (HR) = 0.60, 95% confidence interval (CI) 0.37-0.98], while
the incidence of repeat revascularization was higher in Hungary (HR =
1.89, 95% CI 1.14-3.42). Coronary artery bypass grafting showed the lowest
rate of repeat revascularization in the UK (HR = 0.32, 95% CI 0.12-0.85).
There were numerous differences in the risk profile of patients between
participating countries, as well as marked differences in surgical
practice across countries in the use of blood cardioplegia (range
3.1-89.0%; P < 0.001), bilateral internal mammary artery usage (range
7.8-68.2%; P < 0.001) and off-pump procedures (range 3.9-44.4%; P <
0.001). Variation was also found for percutaneous coronary intervention in
the number of implanted stents (range 4.0 +/- 2.3 to 6.1 +/- 2.6; P <
0.001) as well as for the entire stents length (range 69.0 +/- 45.1 to
124.1 +/- 60.9; P < 0.001). Remarkable differences were observed in the
prescription of post-coronary artery bypass grafting medication in terms
of acetylsalicylic acid (range 79.6-95.0%; P = 0.004), thienopyridine
(6.8-31.1%; P < 0.001) and statins (41.3-89.1%; P < 0.001).
<br/>CONCLUSION(S): Patient characteristics and clinical patterns are
significantly different between countries, resulting in significantly
different 5-year outcomes. This article presents specific data that can
further improve outcomes in each country.<br/>Copyright &#xa9; The Author
2017. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<7>
Accession Number
639930128
Title
The DANTON study: Discontinuation of antihypertensive treatment in OLder
people with dementia living in a nursing home-results of a randomized
controlled trial.
Source
European Geriatric Medicine. Conference: 18th Congress of the European
Geriatric Medicine Society. Online. 13(Supplement 1) (pp S27), 2022. Date
of Publication: December 2022.
Author
Bogaerts J.; Gussekloo J.; De Jong-Schmit B.; Le Cessie S.; Achterberg W.;
Poortvliet R.
Institution
(Bogaerts, De Jong-Schmit, Achterberg, Poortvliet) Leiden University
Medical Center, Departement of Public Health and Primary Care, Netherlands
(Gussekloo) Leiden University Medical Center, Department of Internal
Medicine, Section Gerontology and Geriatrics, Netherlands
(Le Cessie) Leiden University Medical Center, Departement of Statistics
and Biomedical Datasciences, Netherlands
Publisher
Springer
Abstract
Introduction: Neuropsychiatric symptoms (NPS), such as apathy and
agitation, are highly prevalent in nursing home (NH) residents with
dementia. Literature suggests an association of both cerebral
hypoperfusion and antihypertensive treatment (AHT) with NPS in patients
with dementia. Therefore, we investigated whether discontinuation of AHT
in NH residents with dementia reduces NPS and improves quality of life
(QoL). <br/>Method(s): Randomized, single-blinded trial conducted in 26
Dutch NH organisations. Residents with moderate-severe dementia and a
systolic blood pressure <= 160 mmHg during AHT were randomized in an
intervention (semi-protocolized discontinuation) and control
(continuation) group during an 8-month period. Exclusion criteria were
heart failure NYHA-class-III/IV, angina pectoris, recent cardiovascular
event/procedure, or life-expectancy<4 months. Coprimary endpoints were NPS
(Neuropsychiatric Inventory-NH) and QoL (Qualidem) at 4 months. Secondary
endpoints included psychotropic medication use, care dependency and falls.
<br/>Result(s): Between December 2018 and May 2021, 205 NH residents (mean
age 84.7 years-79.5% women) were randomized. On advice of the Data Safety
Monitoring Board, the study was preliminary finished due to futility on
the co-primary endpoints. While no differences between randomization
groups were found on the NPI-NH (adjusted mean difference 1.6 [-2.3 to
5.6]; p = 0.417) and the Qualidem (adjusted mean difference -1.4 [-3.2 to
0.5]; p = 0.154) at 4 months, serious adverse events occurred more
frequently in the intervention group (HR 1.65 [0.98-2.78]). Key
conclusions: Based on preliminary study results, the benefits of
deprescribing AHT in NH residents with dementia for reduction of NPS and
improvement of QoL, are unclear and may not be without any potential risk.

<8>
Accession Number
639929667
Title
Alpha-2-adrenergic Receptor Agonists for the Prevention of Delirium and
Cognitive Decline after Open Heart Surgery (ALPHA2PREVENT): Protocol for a
multicentre randomised controlled trial.
Source
European Geriatric Medicine. Conference: 18th Congress of the European
Geriatric Medicine Society. Online. 13(Supplement 1) (pp S205), 2022. Date
of Publication: December 2022.
Author
Neerland B.E.
Institution
(Neerland) Oslo Delirium Research Group, Dep of Geriatric Medicine, Oslo
University Hospital, Oslo, Norway
Publisher
Springer
Abstract
Introduction: Postoperative delirium is common in older cardiac surgery
patients and associated with negative short-term and longterm outcomes.
The alpha-2-adrenergic receptor agonist dexmedetomidine shows promise as
prophylaxis and treatment for delirium in intensive care units (ICU) and
postoperative settings. Clonidine has similar pharmacological properties.
We aim to study whether repurposing of clonidine can represent a novel
treatment option for delirium, and the possible effects of dexmedetomidine
and clonidine on long-term cognitive trajectories, motor activity patterns
and biomarkers of neuronal injury, and whether these effects are
associated with frailty status. <br/>Method(s): This five-centre, double
blind randomised controlled trial will include 900 cardiac surgery
patients aged 70 + Participants are randomized 1:1:1 to dexmedetomidine or
clonidine or placebo. The study drug is given as a continuous intravenous
infusion from the start of cardiopulmonary bypass, at a rate of 0.4
mug/kg/h. The infusion rate is decreased to 0.2 mug/kg/h postoperatively
and is continued until discharge from the ICU or 24 h postoperatively,
whichever happens first. <br/>Result(s): Inclusion started January 17,
2022. Primary endpoint is the 7-day cumulative incidence of postoperative
delirium (Diagnostic and Statistical Manual of Mental Disorders, 5th
edition). Secondary endpoints include the composite endpoint of coma,
delirium or death, in addition to delirium severity and motor activity
patterns, levels of circulating biomarkers of neuronal injury, cognitive
function and frailty status 1 and 6 months after surgery.
<br/>Conclusion(s): This trial will provide evidence for prophylactic
efficacy of dexmedetomidine and clonidine in reducing the incidence of
postoperative delirium as well as decline in cognitive function 1 and 6
months postoperatively in older cardiac surgical patients. Inclusion of
preoperative frailty assessments will provide evidence for frailty as a
predictive marker of treatment effect. The analysis of biomarkers will
provide insights into the neural mechanisms in postoperative delirium and
long-term cognitive dysfunction. The analysis of activity by
accelerometers will provide insight into motor activity patterns in
subtypes of delirium.

<9>
Accession Number
639929439
Title
TRANSIENT ISCHEMIC ATTACK AND MINOR STROKE AS "SURGERY STUFF": A REVIEW OF
LITERATURE.
Source
Neurological Sciences. Conference: 52nd Annual Conference of the Italian
Society of Neurology. Milano Italy. 43(Supplement 1) (pp S142-S143), 2022.
Date of Publication: December 2022.
Author
Caproni S.; Ottavi P.; Borghetti V.; Taddei G.; Conti C.; Riva A.; Di
Schino C.; Costantini F.; Colosimo C.
Institution
(Caproni) Neurology Division, "S. Maria" University Hospital, Terni, Italy
(Ottavi) Vascular Surgery, Cardio-Thoraco-Vascular Department, "S. Maria"
University Hospital, Terni, Italy
(Borghetti) Heart Surgery, Cardio-Thoraco-Vascular Department, "S. Maria"
University Hospital, Terni, Italy
(Taddei) Neurosurgery, Surgery Department, "S. Maria Goretti" Hospital,
Latina, Italy
(Conti) Neurosurgery, Neuroscience Department, "S. Maria" University
Hospital, Terni, Italy
(Riva) Neurology, Medicine Department, "Universita Politecnica delle
Marche", Ancona, Italy
(Di Schino, Costantini, Colosimo) Neurology and Stroke Unit, Neuroscience
Department, "S. Maria" University Hospital, Terni, Italy
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Objective: To review the subtypes of Transient ischemic attack (TIA) and
minor stroke (mS) in which a surgical treatment is needed, discussing the
importance and the timing of a multidisciplinary approach. <br/>Method(s):
Case series and review of literature of TIA and mS due to conditions at
high risk of early recurrence with potential surgical approach, even in
urgency. <br/>Result(s): Cases of patients suffering from symptomatic
carotid stenosis, hemodynamic stroke, bacterial endocarditis, atrial
myxoma, and Bow-Hunter disease. <br/>Discussion(s): Symptomatic carotid
stenosis, or particular cases of hemodynamic cerebrovascular events,
should be promptly referred to vascular surgeon, since increasing
evidences highlighted a benefit from an early artery revascularization. In
addition, beyond arrhythmic causes, cardioembolic events due to bacterial
endocarditis and atrial myxoma should be quickly diagnosed, possibly in
emergency department, because they are, as well as a concern of standard
acute and prophylactic treatments, a presumptive urgency for heart
surgery. In addition to the above mentioned conditions, in patients
suffering from vertebrobasilar TIA or mS, clinicians should keep in mind
Bow-Hunter disease (rotational vertebral artery occlusion), because
surgical artery decompression can represent the only suitable treatment in
selected cases. <br/>Conclusion(s): When a surgical treatment is needed,
it is fundamental the timing of a multidisciplinary approach, in order to
achieve an optimized management and prevent major strokes or other
critical complications.

<10>
Accession Number
639929066
Title
COGNITIVE OUTCOMES IN PATIENTS TREATED WITH POST-OPERATIVE ELECTRICAL
STIMULATION AFTER CORONARY ARTERY BYPASS GRAFT (CABG).
Source
Neurological Sciences. Conference: 52nd Annual Conference of the Italian
Society of Neurology. Milano Italy. 43(Supplement 1) (pp S423-S424), 2022.
Date of Publication: December 2022.
Author
Lo Re V.; Russelli G.; Bulati M.; Iannolo G.; Martucci G.; Panarello G.;
Lo Gerfo E.; Avorio F.; Sparacia G.; Parla G.; Terzo D.; Vizzini G.;
Ambrosio F.
Institution
(Lo Re) Neurology Service, Department of Diagnostic and Therapeutic
Services, Mediterranean Institute for Transplantation and Advanced
Specialized Therapies, IRCCS ISMETT, Palermo, Italy
(Russelli, Bulati, Iannolo, Lo Gerfo, Parla) Research Department, IRCCS
ISMETT, Palermo, Italy
(Martucci, Panarello) Department of Anesthesia and Intensive Care, IRCCS
ISMETT, Palermo, Italy
(Avorio) Neurology Service, IRCCS ISMETT, Palermo, Italy
(Sparacia) Radiology Service, IRCCS ISMETT, Palermo, Italy
(Terzo) Rehabilitation Service Coordinator, Istituto Mediterraneo per i
Trapianti e Terapie ad Alta Specializzazione IRCCS-ISMETT, Palermo, Italy
(Vizzini) Salvator Mundi International Hospital, UPMC, Roma, Italy
(Ambrosio) Department of Physical Medicine and Rehabilitation, University
of Pittsburgh, Pittsburgh, United States
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Objectives: Mechanisms of neurocognitive injury, such as postoperative
sequelae of cardiac surgery, are not fully understood. Postoperative bed
rest and systemic inflammation induced by surgical stress lead to skeletal
muscle impairment. In addition to the critical role of skeletal muscle
function for physical mobility, increasing attention has recently been
paid to the endocrine function of skeletal muscle as an important secretor
of circulating factors involved in cognitive health (myokines). In the
light of evidence supporting a link between muscle vitality and cognitive
function, there is a need to preserve skeletal muscle trophism and
strength during hospitalization for surgery, and this could be crucial to
preserve cognition postoperatively. <br/>Material(s) and Method(s):We
performed a single-center, pilot, randomized, two-arm, controlled trial to
test our central hypothesis that initiating an early rehabilitation
protocol, through neuromuscular electrical stimulation (NMES) + usual care
(UC) versus UC alone, preserves skeletal muscle mass in CABG patients and
promotes the secretion of neuroprotective myokines in the bloodstream
(i.e., Klotho and brain-derived neurotrophic factor). Primary outcome
variables included: circulating Klotho, fibroblast growth factor 23
(FGF-23), Interleukin 6 (IL-6), and brain-derived neurotrophic factor
(BDNF) values. Secondary outcomes variable included physical and cognitive
function: muscle strength measured using a hand-held dynamometer,
repeatable battery for the assessment of neuropsychological status
(RBANS), and mini-mental state examination (MMSE) test scores.
<br/>Result(s): The analysis only included patients who completed the
entire protocol (55 patients; NMES group: 23; UC group: 32). No
statistically significant differences were found between the two groups in
biomarkers levels assessed three months after hospital discharge, nor in
cognitive assessment and muscle strength performance. We then divided our
patients in two groups (responders and non-responders) based on Klotho's
increase three months after hospital discharge compared to baseline
values, regardless of the type of physical therapy. We found better
performances in delayed memory tasks in the responders group.
<br/>Discussion(s):While we cannot confirm the addition of NMES as
offering an added benefit for postoperative rehabilitation to prevent
postoperative cognitive impairment when compared to UC alone, our work
does demonstrate a link between increased Klotho protein levels and
improved memory test performance. These findings suggest that the Klotho
myokine could exert a neuroprotective role for individuals post-CABG.
<br/>Conclusion(s): There is the need to understand the mechanisms that
link Klotho levels with postoperative neuroprotection and, more
interestingly, comprehend why some individuals are responders while others
are not.

<11>
Accession Number
639935317
Title
Programmed intermittent bolus infusion vs. continuous infusion for erector
spinae plane block in video-assisted thoracoscopic surgery: A
double-blinded randomised controlled trial.
Source
European journal of anaesthesiology. 40(2) (pp 130-137), 2023. Date of
Publication: 01 Feb 2023.
Author
Taketa Y.; Takayanagi Y.; Irisawa Y.; Fujitani T.
Institution
(Taketa) From the Department of Anaesthesiology and Critical Care, Ehime
Prefectural Central Hospital, Japan (YT, YT
Publisher
NLM (Medline)
Abstract
BACKGROUND: The optimal form of administration for erector spinae plane
block has not been established. <br/>OBJECTIVE(S): To compare the efficacy
of programmed intermittent bolus infusion (PIB) and continuous infusion
for erector spinae plane block. DESIGN: A prospective, randomised,
double-blind study. SETTING: A single centre between June 2019 and March
2020. PATIENTS: Included patients had an American Society of
Anesthesiologists physical status 1 to 3 and were scheduled for
video-assisted thoracic surgery. INTERVENTIONS: Patients were randomised
to receive continuous infusion (0.2% ropivacaine 8 ml h-1; Group C) or PIB
(0.2% ropivacaine 8 ml every 2 h; Group P). MAIN OUTCOME MEASURES: The
primary outcome was the number of desensitised dermatomes in the
midclavicular line, measured 21 h after first bolus injection.
<br/>RESULT(S): Fifty patients were randomly assigned to each group;
finally, the data of 24 and 25 patients in Group C and P, respectively,
were analysed. The mean difference in the number of desensitised
dermatomes in the midclavicular line at 5 and 21 h after the initial bolus
administration was 1.0 [95% confidence interval (CI) 0.5 to 1.5] and 1.6
(95% CI 1.1 to 2.0), respectively, which was significantly higher in Group
P than in Group C (P < 0.001). The median difference in rescue morphine
consumption in the early postoperative period (0 to 24 h) was 4 (95% CI 1
to 8) mg, which was significantly lower in Group P (P = 0.035). No
significant difference in the postoperative numerical rating scale score
was found between the groups. <br/>CONCLUSION(S): PIB for erector spinae
plane block in video-assisted thoracic surgery resulted in a larger
anaesthetised area and required a lower anaesthetic dose to maintain the
analgesic effect. Therefore, it is more suitable for erector spinae plane
block than continuous infusion. TRIAL REGISTRATION: UMIN Clinical Trials
Registry (UMIN-CTR, ID: UMIN000036574, Principal investigator: Taro
Fujitani, 04/22/2019,
https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R0000416
71).<br/>Copyright &#xa9; 2022 European Society of Anaesthesiology and
Intensive Care. Unauthorized reproduction of this article is prohibited.

<12>
Accession Number
2021349065
Title
Effects of ferric carboxymaltose on hemoglobin level after cardiac
surgery: A randomized controlled trial.
Source
Anaesthesia Critical Care and Pain Medicine. 42(1) (no pagination), 2023.
Article Number: 101171. Date of Publication: February 2023.
Author
Houry M.; Tohme J.; Sleilaty G.; Jabbour K.; Bou Gebrael W.; Jebara V.;
Madi-Jebara S.
Institution
(Houry, Tohme, Jabbour, Bou Gebrael, Madi-Jebara) Department of Anesthesia
and Critical Care, Hotel-Dieu de France hospital, Universite Saint-Joseph,
Beirut, Lebanon
(Sleilaty, Jebara) Department of Cardiovascular and Thoracic Surgery,
Hotel-Dieu de France hospital, Universite Saint-Joseph, Beirut, Lebanon
(Sleilaty) Clinical Research Center, Faculty of Medicine, Universite
Saint-Joseph, Beirut, Lebanon
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Perioperative anemia is common in cardiac surgery. Few studies
investigated the effect of postoperative intravenous (IV) iron
supplementation and were mostly inconclusive. <br/>Method(s): Design: A
randomized single-center, double-blind, placebo-controlled, parallel-group
trial. <br/>Participant(s): 195 non-anemic patients were recruited from
December 2018 to December 2020: 97 patients received 1 g of ferric
carboxymaltose (FCM) and 98 patients received 100 mL of physiological
serum on postoperative day 1. Measurements: hemoglobin levels,
reticulocyte count, serum iron, serum ferritin, and transferrin saturation
were measured at induction of anesthesia, postoperative days 1, 5, and 30.
Transfusion rate, duration of mechanical ventilation, critical care unit
length of stay, and side effects associated with IV iron administration
were measured. The primary outcome was hemoglobin level on day 30.
Secondary outcomes included iron balance, transfused red cell packs, and
critical care unit length of stay. <br/>Result(s): At day 30, the
hemoglobine level was higher in the FCM group than in the placebo group
(mean 12.9 +/- 1.2 vs. 12.1 +/- 1.3 g/dL (95%CI 0.41-1.23, p-value
<0.001)). Patients in the FCM group received fewer blood units (median
1[0-2] unit vs. 2 [0-3] units, p-value = 0.037) and had significant
improvement in iron balance compared to the control group. No side effects
associated with FCM administration were reported. <br/>Conclusion(s): In
this randomized controlled trial, administration of FCM on postoperative
day 1 in non-anemic patients undergoing cardiac surgery increased
hemoglobin levels by 0.8 g/dL on postoperative day 30, leading to reduced
transfusion rate, and improved iron levels on postoperative day 5 and 30.
Clinical trial registry number: NCT03759964.<br/>Copyright &#xa9; 2022
Societe francaise d'anesthesie et de reanimation (Sfar)

<13>
Accession Number
2022034833
Title
Efficacy of Stroke Volume Variation-guided Fluid Management of Patients
undergoing Off-pump Coronary Artery Bypass Grafting: An Observational
Comparative Study between Open and Closed Chest.
Source
Journal of Clinical and Diagnostic Research. 16(12) (pp UC20-UC23), 2022.
Date of Publication: December 2022.
Author
Durge S.; Sayed N.I.; Basantwani S.
Institution
(Durge) Department of Anaesthesiology, Apollo Hospital, Chattisgarh,
Bilaspur, India
(Sayed, Basantwani) Department of Anaesthesiology, Lokmanya Tilak
Municipal Medical College and General Hospital, Maharashtra, Mumbai, India
Publisher
Journal of Clinical and Diagnostic Research
Abstract
Introduction: Functional haemodynamic monitoring using dynamic parameter
such as Stroke Volume Variation (SVV), based on pulse contour analysis,
helps in predicting fluid responsiveness in off pump Coronary Artery
Bypass Grafting (CABG) surgery. This allows adequate volume replacement to
achieve optimal cardiac performance. <br/>Aim(s): To evaluate the efficacy
of SVV in predicting volume responsiveness and effect on haemodynamic
variable in patients undergoing off pump CABG in both closed and open
chest. <br/>Material(s) and Method(s): This single-centre, non randomised
observational study was conducted at a tertiary medical college and
hospital (LokmanyaTilak Municipal Medical College and General Hospital)
Mumbai, Maharashtra, India, from December 2016 to December 2018. A total
of 34 patients undergoing elective off pump CABG were included.
Haemodynamic measurements Stroke Volume (SV), Cardiac Output (CO), Cardiac
Index (CI), and SVV, were recorded with the transducer positioned at the
level of midaxillary line. If the SVV was equal to or higher than 12, 100
mL fluid aliquot was given to patients. Endpoints for fluid aliquots was
increase in CO by 15%, decrease in SVV of less than 12 or an increase
Central Venous Pressure (CVP) upto 15 millimeter of mercury (mmHg). Number
of times SVV above 12 during the procedure was recorded. SVV was
considered as fluid responsive "if there was an increase in SV by 5%".
Statistical analysis was done using Student's t-test (two tailed,
dependent) on continuous parameters. The p-value <0.05, was considered
significant. <br/>Result(s): Out of 103 events of rise in SVV, 65 (63.1%)
occurred when chest was open and 38 (36.9%) while chest was closed. The
SVV-guided fluid response was 76.3% in closed chest and 75.4% in open
chest and there was no significant difference. (p-value=0.91). There was a
significant increase in SV (p-value<0.01), CO (p-value=0.04), and
significant decrease in SVV (p-value<0.01) and heart rate (p-value<0.01)
after fluid loading in the responsive group when compared with non
responsive group. There was no statistically significant difference
between percentage change in SV, CO, CI, SBP, DBP, MAP and CVP between
closed and open chest conditions after fluid replacement.
<br/>Conclusion(s): SVV is not affected by open or closed chest conditions
in mechanically ventilated patients undergoing CABG and can be used as a
guide for fluid replacement. Weather open or closed chest conditions, few
patients do not respond to fluid replacement when SVV are more than 12 by
an increase in SV, cardiac output or CI, the cause of which remains to be
determined.<br/>Copyright &#xa9; 2022 Journal of Clinical and Diagnostic
Research. All rights reserved.

<14>
Accession Number
2020866060
Title
Effects of ultrasound-guided regional anesthesia in cardiac surgery: a
systematic review and network meta-analysis.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 409. Date
of Publication: December 2022.
Author
Dost B.; De Cassai A.; Balzani E.; Tulgar S.; Ahiskalioglu A.
Institution
(Dost) Department of Anesthesiology and Reanimation, Faculty of Medicine,
Ondokuz Mayis University, Kurupelit, Samsun TR55139, Turkey
(De Cassai) UOC Anesthesia and Intensive Care Unit, University Hospital of
Padua, Padua, Italy
(Balzani) Department of Surgical Science, University of Turin, Turin,
Italy
(Tulgar) Department of Anesthesiology and Reanimation, Samsun Training and
Research Hospital, Samsun University Faculty of Medicine, Samsun, Turkey
(Ahiskalioglu) Department of Anesthesiology and Reanimation, Ataturk
University School of Medicine, Erzurum, Turkey
(Ahiskalioglu) Clinical Research, Development and Design Application and
Research Center, Ataturk University School of Medicine, Erzurum, Turkey
Publisher
BioMed Central Ltd
Abstract
Background: The objective of this systematic review and network
meta-analysis was to compare the effects of single-shot ultrasound-guided
regional anesthesia techniques on postoperative opioid consumption in
patients undergoing open cardiac surgery. <br/>Method(s): This systematic
review and network meta-analysis involved cardiac surgical patients (age >
18 y) requiring median sternotomy. We searched PubMed, EMBASE, The
Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web
of Science. The effects of the single-shot ultrasound-guided regional
anesthesia technique were compared with those of placebo and no
intervention. We conducted a risk assessment of bias for eligible studies
and assessed the overall quality of evidence for each outcome.
<br/>Result(s): The primary outcome was opioid consumption during the
first 24 h after surgery. The secondary outcomes were pain after
extubation at 12 and 24 h, postoperative nausea and vomiting, extubation
time, intensive care unit discharge time, and length of hospital stay.
Fifteen studies with 849 patients were included. The regional anesthesia
techniques included pecto-intercostal fascial block, transversus thoracis
muscle plane block, erector spinae plane (ESP) block, and pectoralis nerve
block I. All the regional anesthesia techniques included significantly
reduced postoperative opioid consumption at 24 h, expressed as morphine
milligram equivalents (MME). The ESP block was the most effective
treatment (-22.93 MME [-34.29;-11.56]). <br/>Conclusion(s): In this
meta-analysis, we concluded that fascial plane blocks were better than
placebo when evaluating 24 h MMEs. However, it is still challenging to
determine which is better, given the paucity of studies available in the
literature. More randomized controlled trials are required to determine
which regional anesthesia technique is better. Trial registration:
PROSPERO; CRD42022315497.<br/>Copyright &#xa9; 2022, The Author(s).

<15>
Accession Number
2020866041
Title
A randomized controlled trial (PAMI trial) on our new trend periareolar
minimally invasive (PAMI) technique versus inframammary approach for
minimally invasive cardiac surgery.
Source
Cardiothoracic Surgeon. 30(1) (no pagination), 2022. Article Number: 29.
Date of Publication: December 2022.
Author
El Adel M.; Nady M.A.; Amin A.; Khairy M.
Institution
(El Adel, Nady, Amin, Khairy) Cardiothoracic Surgery Departments, Faculty
of Medicine, Assiut University, Asyut, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: A minimally invasive approach has become standard for mitral
valve surgery. The periareolar approach has grown in popularity regarding
the cosmesis for patients. We have adopted a new modification to the
periareolar approach: the periareolar minimally invasive (PAMI) technique.
The objectives of the current study are to test the hypothesis that the
PAMI approach is more feasible and safer than the inframammary approach in
addition to identify risk factors and assess outcomes of both periareolar
and inframammary approach. <br/>Method(s): A randomized controlled trial
of 3 months compared the PAMI technique to the inframammary approach for
minimally invasive cardiac surgery. <br/>Result(s): A total of 102
patients were enrolled and randomized into two groups: 53 received
minimally invasive cardiac surgery through the periareolar approach, and
49 were the control group using the inframammary approach. Using
intention-to-treat analysis, the periareolar approach was superior to the
inframammary approach in surgical site infection (two cases in comparison
to 8 with P = 0.004), and the number needed to treat for effectiveness was
8. No early deaths occurred, 97 cases (95.1%) needed no reoperation, and 5
cases (4.9%) were reopened for bleeding. The primary endpoints compared
were the duration of procedure, duration of mechanical ventilation, amount
of bleeding, ICU stay, and hospital stay. We found no statistically
significant differences between the groups. At 3 months, the secondary
endpoints evaluated were the rate of surgical site infection, respiratory
complications, groin complications, pericardial effusion, breast hematoma,
and cosmoses using a Likert scale. We found no statistically significant
difference between the groups, except for surgical site infection (P =
0.004) and cosmesis (P< 0.001). <br/>Conclusion(s): The results of this
PAMI trial are suggestive that the PAMI technique is most probably
applicable for the right side of the heart, such as in atrial septal
defect closure, tricuspid disease, and mitral valve surgery. Trial
registration: PAMI Trial NCT04726488 Registered January 27,
2021.<br/>Copyright &#xa9; 2022, The Author(s).

<16>
Accession Number
639935173
Title
A Systematic Review of Benefits and Risks of Fetal Surgery for Congenital
Cardiac Defects Such as Pulmonary Valve Stenosis and Critical Aortic
Stenosis.
Source
Brazilian journal of cardiovascular surgery. (no pagination), 2022. Date
of Publication: 19 Dec 2022.
Author
Diniz A.M.B.; Manso P.H.; Santos M.V.; Rodrigues A.J.; Sbragia L.
Institution
(Diniz, Sbragia) Division of Pediatric Surgery, Department of Surgery and
Anatomy, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao
Paulo, Ribeirao Preto, Sao Paulo, Brazil
(Manso) Division of Pediatric Cardiology, Department of Pediatrics,
Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo,
Ribeirao Preto, Sao Paulo, Brazil
(Santos) Division of Pediatric Neurosurgery, Department of Surgery and
Anatomy, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao
Paulo, Ribeirao Preto, Sao Paulo, Brazil
(Rodrigues) Division of Cardiothoracic Surgery, Faculdade de Medicina de
Ribeirao Preto, Universidade de Sao Paulo, Ribeirao Preto, Sao Paulo,
Brazil
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Congenital heart diseases (CHDs) constitute the most
prevalent congenital pathology, and they are a consequence of structural
and functional abnormalities during fetal development. The etiology of CHD
involves the interaction of genetic and environmental factors. Fetal
cardiac surgery aims at preventing natural pathways of CHD in utero,
mitigating progression to more complex abnormalities. The goal of this
review was to demonstrate the benefits and risks of fetal interventions in
the two most prevalent CHDs, pulmonary stenosis and pulmonary atresia with
an intact ventricular septum, but also critical aortic stenosis and
hypoplastic left heart syndrome. <br/>METHOD(S): Original and relevant
articles were selected by meta-aggregation to perform a qualitative
analysis of fetal cardiac interventions for pulmonary stenosis and
critical aortic stenosis. The Joanna Briggs Institute's Qualitative
Assessment and Review Instrument (or JBI-QARI) was used for data quality
appraisal. <br/>RESULT(S): Of 61 potential articles, 13 were selected, and
nine were finally included. <br/>Discussion(s): The present review
demonstrated that fetal cardiac surgery increases right ventricular growth
and hemodynamic flow in pulmonary stenosis, whereas in critical aortic
stenosis it enables growth of the left ventricle and increases left
ventricular pressure. However, it has a high complication rate, along with
considerable morbidity and mortality. <br/>CONCLUSION(S): The benefits of
fetal cardiac surgery for pulmonary stenosis and critical aortic stenosis
are well-described in the literature; however, there is a significant risk
of complications which can be reduced by the surgeon's technical expertise
and well-structured hospital facilities.

<17>
Accession Number
639934956
Title
Effects of Remote Ischemic Preconditioning on Decreasing Troponin Release
in Patients Not Taking Sulfonylureas After Cardiac Surgery - A
Meta-Analysis.
Source
Brazilian journal of cardiovascular surgery. (no pagination), 2022. Date
of Publication: 19 Dec 2022.
Author
Wang X.; Xiao S.; Hu Y.; Guo M.; Liu A.; Huan C.; Xu T.; Yin J.; Pan D.;
Zhu H.
Institution
(Wang, Xiao, Hu, Guo, Liu, Huan, Xu, Pan, Zhu) Department of Cardiology,
Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
(Yin) Department of General Practice, Affiliated Hospital of Xuzhou
Medical University, Xuzhou, Jiangsu, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Remote ischemic preconditioning (RIPC) is a new noninvasive
myocardial protection strategy that uses blood pressure cuf inflation to
simulate transient non-fatal ischemia to protect the myocardium and reduce
ischemia-reperfusion injury. Sulfonylureas may mask the effects of RIPC
due to their cardioprotec-tive effect. This meta-analysis aimed to
evaluate whether RIPC, in the absence of sulfonylureas, reduces troponin
release in patients undergoing cardiac surgery. <br/>METHOD(S): We
conducted a meta-analysis of randomized controlled clinical trials to
determine whether RIPC can reduce postoperative troponin release in
cardiac surgery patients undergoing cardiopulmonary bypass without
treatment with sulfonylureas. The data were normalized to equivalent units
prior to the analysis. A random-effects model was used to provide more
conservative estimate of the effects in the presence of known or unknown
heterogeneity. <br/>RESULT(S): Six studies with a total of 570
participants were included. The analysis showed that troponin release was
lower in the RIPC group than in the control group at six hours (test of
standardized mean differences = 0, Z=3.64, P<0.001) and 48 hours (Z=2.72,
P=0.007) postoperatively. When the mean of cross-clamping time was > 60
minutes, RIPC reduced troponin release at six hours (Z=2.84, P=0.005), 24
hours (Z=2.64, P=0.008), and 48 hours (Z=2.87, P=0.004) postoperatively.
<br/>CONCLUSION(S): In cardiac surgery patients who are not taking
sulfonylureas, RIPC can reduce troponin release at six and 48 hours
postoperatively; hence, RIPC may serve significant benefits in certain
cardiac surgery patients.

<18>
Accession Number
639933703
Title
Chiari network for the interventional cardiologist: A hidden enemy at the
heart gate - A systematic review of the literature.
Source
International journal of cardiology. (no pagination), 2022. Date of
Publication: 29 Dec 2022.
Author
Ali H.; Lupo P.; Cristiano E.; Nicoli L.; Foresti S.; De Ambroggi G.;
Anderson R.H.; De Lucia C.; Turturiello D.; Paganini E.M.; Bessi R.;
Farghaly A.A.A.; Butera G.; Cappato R.
Institution
(Ali, Lupo, Cristiano, Nicoli, Foresti, De Ambroggi, De Lucia,
Turturiello, Paganini, Bessi, Cappato) Arrhythmia & Electrophysiology
Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
(Anderson) Institute of Genetic Medicine, Newcastle University, Newcastle
Upon Tyne, United Kingdom
(Farghaly) Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto
San Giovanni, Milan, Italy; Cardiovascular Department, Assiut University,
Assiut, Egypt
(Butera) Department of Paediatric Cardiology, Cardiac Surgery and Heart
Lung Transplantation, ERN GUARD HEART: Bambin Gesu Hospital and Research
Institute, IRCCS, Rome, Italy; Department of Paediatric and Adult
Congenital Heart Disease, Evelina London Children's Hospital, Guy's and
St. Thomas' NHS Foundation Trust, London, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: This study aimed to collect and analyze the literature data
regarding Chiari network (CN) and other right atrium (RA) remnants
comprising the Eustachian and Thebesian valves (EV, ThV) as a potential
entrapment site during different percutaneous cardiac procedures (PCP).
METHODS AND RESULTS: A systematic search was conducted using Pubmed and
Embase databases following the PRISMA guidelines to obtain available data
concerning PCP associated with entrapment of inserted materials within
CN-EV-ThV. The final analysis included 41 patients who underwent PCP with
reported material entrapment within these RA remnants. The PCP was atrial
septal defect (ASD)/patent foramen ovale (PFO) closure, catheter ablation,
and pacemaker/defibrillator implantation in 44%, 22%, and 17% of patients,
respectively. The entrapped materials were ASD/PFO devices, multipolar
electrophysiology catheters, passive-fixation pacing leads, and
J-guidewires in about 30%, 20%, 15%, and 10% of patients, respectively.
Intraprocedural transthoracic, transoesophageal and intracardiac
echocardiography showed sensitivity to reveal these structures of 20%,
~95%, and 100%, respectively. A percutaneous approach successfully managed
70% of patients, while cardiovascular surgery was required in 20% and
three patients died (7.3%). <br/>CONCLUSION(S): CN and other RA remnants
may cause entrapment of various devices or catheters during PCP requiring
right heart access. The percutaneous approach, guided by intraprocedural
imaging, appears safe and effective in managing most patients. Prevention
includes recognizing these anatomical structures at baseline cardiac
imaging and intraprocedural precautions. Further studies are needed to
analyze the actual incidence of this condition, its clinical impact and
appropriate management.<br/>Copyright &#xa9; 2022 Elsevier Ireland Ltd.
All rights reserved.

<19>
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. (no pagination), 2022. Date of
Publication: 2022.
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.<br/>Copyright &#xa9; 2022
Informa UK Limited, trading as Taylor & Francis Group.

<20>
Accession Number
2020023992
Title
A Meta-Analysis on the Impact of High BMI in Patients Undergoing
Transcatheter Aortic Valve Replacement.
Source
Journal of Cardiovascular Development and Disease. 9(11) (no pagination),
2022. Article Number: 386. Date of Publication: November 2022.
Author
Seo J.; Li W.; Safiriyu I.; Kharawala A.; Nagraj S.; Tahir A.;
Doundoulakis I.; Koliastasis L.; Rios S.; Palaiodimos L.; Kokkinidis D.G.
Institution
(Seo, Safiriyu, Kharawala, Nagraj, Tahir, Palaiodimos) Department of
Internal Medicine, Jacobi Medical Center/Albert Einstein College of
Medicine, The Bronx, NY 10461, United States
(Doundoulakis, Koliastasis) Department of Cardiology, Hippokration
Hospital, National and Kapodistrian University of Athens, Athens 10679,
Greece
(Rios) Montefiore Einstein Center for Heart & Vascular Care, Albert
Einstein College of Medicine, Montefiore Medical Center, The Bronx, NY
10467, United States
(Kokkinidis) Section of Cardiovascular Medicine, Yale New Haven Hospital,
Yale University School of Medicine, New Haven, CT 06510, United States
Publisher
MDPI
Abstract
Background: A paradoxical association of obesity with lower risk of
transcatheter aortic valve replacement (TAVR) outcomes has been reported.
We aimed to systematically review the literature and compare TAVR-related
morbidity and mortality among individuals with overweight or obesity and
their peers with normal body mass index (BMI). <br/>Method(s): PubMed and
Embase databases were systematically searched for studies reporting TAVR
outcomes in different BMI groups. Separate meta-analyses were conducted
for studies reporting hazard ratios (HR) and odds ratios/relative risks.
Short- and mid-/long-term outcomes were examined. <br/>Result(s): 26
studies with a total of 74,163 patients were included in our study.
Overweight was associated with lower risk of short-term mortality (HR:
0.77; 95% CI: 0.60-0.98) and mid-/long-term mortality (HR: 0.79; 95% CI:
0.70-0.89). Obesity was associated with lower risk for mid-/long-term
mortality (HR: 0.79; 95% CI: 0.73-0.86), but no difference was observed in
short-term mortality, although a trend was noted (HR: 0.87l 95% CI:
0.74-1.01). Individuals with obesity demonstrated an association with
higher odds of major vascular complications (OR: 1.33; 95% CI: 1.05-1.68).
Both overweight (OR: 1.16; 95% CI: 1.03-1.30) and obesity (OR: 1.26; 95%
CI: 1.06-1.50) were associated with higher likelihood for receiving
permanent pacemakers after TAVR. <br/>Conclusion(s): Individuals with
overweight and obesity were associated with lower mortality risk compared
to those with normal BMI but with higher likelihood of major vascular
complications and permanent pacemaker implantation after
TAVR.<br/>Copyright &#xa9; 2022 by the authors.

<21>
Accession Number
2013301210
Title
Safety of Direct Oral Anticoagulants Compared to Warfarin for Atrial
Fibrillation after Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. 34(3) (pp 947-957), 2022.
Date of Publication: Autumn 2022.
Author
Hage A.; Dolan D.P.; Nasr V.G.; Castelo-Branco L.; Motta-Calderon D.;
Ghandour H.; Hage F.; Papatheodorou S.; Chu M.W.A.
Institution
(Hage, Dolan, Nasr, Castelo-Branco, Motta-Calderon, Hage, Papatheodorou)
Epidemiology, Harvard T.H. Chan School of Public Health, Boston,
Massachusetts
(Hage, Hage, Chu) Division of Cardiac Surgery, Western University, London,
ON, Canada
(Dolan) Division of Thoracic Surgery, Brigham and Women's Hospital,
Boston, Massachusetts
(Nasr) Division of Cardiac Anesthesia, Department of Anesthesiology,
Critical Care and Pain Medicine, Boston Children's Hospital, Boston,
Massachusetts
(Castelo-Branco) Neuroscience, Neuromodulation Center, Spaulding
Rehabilitation Hospital, Boston, Massachusetts
(Motta-Calderon) Division of General Internal Medicine, Brigham and
Women's Hospital, Boston, Massachusetts
(Ghandour) Global Surgery, Harvard Medical School, Boston, Massachusetts
Publisher
W.B. Saunders
Abstract
The evidence for use of direct oral anticoagulants (DOACs) in the
management of post-operative cardiac surgery atrial fibrillation is
limited and mostly founded on clinical trials that excluded this patient
population. We performed a systematic review and meta-analysis of clinical
trials and observational studies to evaluate the hypothesis that DOACs are
safe compared to warfarin for the anticoagulation of patients with
post-operative cardiac surgery atrial fibrillation. We searched PubMed,
EMBASE, Web of Science, clinicaltrials.gov, and the Cochrane Library for
clinical trials and observational studies comparing DOAC with warfarin in
patients >=18 years old who had post-cardiac surgery atrial fibrillation.
Primary outcomes included stroke, systemic embolization, bleeding, and
mortality. We performed a random-effects meta-analysis of all outcomes.
The meta-analysis for the primary outcomes showed significantly lower risk
of stroke with DOAC use (6 studies, 7143 patients, RR 0.64; 95% CI
0.50-0.81, I²: 0.0%) compared to warfarin, a trend towards
lower risk of systemic embolization (4 studies, 7289 patients, RR 0.64,
95% CI 0.41-1.01, I²: 31.99%) and similar risks of bleeding (14
studies, 10182 patients, RR 0.91; 95% CI 0.74-1.10, I²: 26.6%)
and mortality (12 studies, 9843 patients, relative risk [RR] 1.01; 95% CI
0.74-1.37, I²: 26.5%). Current evidence suggests that DOACs,
compared to warfarin, in the management of atrial fibrillation after
cardiac surgery is associated with lower risk of stroke and a strong trend
for lower risk of systemic embolization, and no evidence of increased risk
for hospital readmission, bleeding and mortality.<br/>Copyright &#xa9;
2021 Elsevier Inc.

<22>
Accession Number
2018876990
Title
Transcatheter "edge-to-edge" mitral valve repair: influence of bias in
randomized trials.
Source
Gaceta Medica de Mexico. 158(5) (pp 323-327), 2022. Date of Publication:
November-December 2022.
Author
Garcia-Villarreal O.A.
Institution
(Garcia-Villarreal) Colegio Mexicano de Cirugia Cardiovascular y Toracica,
Mexico City, Mexico
Publisher
Academia Nacional de Medicina
Abstract
Functional mitral regurgitation (FMR) is the result of three-dimensional
structural disruption of the mitral valve due to left ventricular
dysfunction. The "edge-to-edge" surgical technique has given rise to the
percutaneous transcatheter edge-to-edge repair (TEER) technique to treat
FMR; however, the lack of a mitral annuloplasty ring makes TEER only
partially effective, with uncertain long-term results. The MITRA-FR and
COAPT trials, on which current TEER recommendations are based, show
conflicting results. COAPT results possible bias has influenced current
recommendations issued by clinical practice guidelines in favor of TEER in
FMR.<br/>Copyright &#xa9; 2022, Academia Nacional de Medicina. All rights
reserved.

<23>
Accession Number
2017140060
Title
Early, dedicated follow-up and treatment of pleural effusions enhance the
recovery rate after open cardiac surgery: Results from a randomized,
clinical trial.
Source
European Journal of Cardio-thoracic Surgery. 51(1) (pp 58-66), 2017. Date
of Publication: 01 Jan 2017.
Author
Hansen L.S.; Hjortdal V.E.; Jakobsen C.-J.; Heiberg J.; Maagaard M.; Sloth
E.
Institution
(Hansen, Hjortdal, Jakobsen, Heiberg, Maagaard, Sloth) Aarhus University
Hospital, Aarhus N, Denmark
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Recent studies conclude that cardiac surgery patients are
prone to both mortality and morbidity in the weeks after discharge.
Complications such as pleural and pericardial effusions may influence
physical recovery due to symptoms such as dyspnoea, chest pain and
fatigue. Dedicated follow-up and timely treatment of postoperative
complications are suggested. <br/>METHOD(S): A randomized, controlled
intervention trial including 76 patients, in the ratio of 1 : 1. Patients
scheduled for elective on-pump coronary artery bypass grafting and/or
aortic valve replacement were eligible for inclusion. Patients were
randomized to either standard postoperative care or complementary
follow-up visits with clinical examinations, focused chest sonography and
protocol-driven thoracentesis if applicable. Primary outcomes were the
mean change in walking distance, peak expiratory flow and EuroQOL from
baseline to 30 days after surgery. <br/>RESULT(S): The mean difference in
walking distance after 30 days was 15% (65 +/- 22 m) between groups, P =
0.017. No differences were found in the peak expiratory flow or EuroQOL.
In patients with pleural effusion, walking distance improved by 22% after
thoracentesis (81 +/- 42 m), P < 0.0001, and peak expiratory flow improved
by 26% (1.1 +/- 1.2 l/min), P < 0.001. <br/>CONCLUSION(S): Supplemental
dedicated follow-up and treatment of postoperative effusions enhance
recovery by 15% compared with standard care, measured by improvement in
the walking distance 1 month after cardiac surgery.<br/>Copyright &#xa9;
The Author 2016.

<24>
Accession Number
2017140054
Title
A pilot prospective randomized, controlled trial comparing LigaSureTM
tissue fusion technology with the ForceTriadTM energy platform to the
electrosurgical pencil on rates of atrial fibrillation after pulmonary
lobectomy and mediastinal lymphadenectomy.
Source
European Journal of Cardio-thoracic Surgery. 47(1) (pp E13-E18), 2015.
Date of Publication: 01 Jan 2015.
Author
Martucci N.; Tracey M.; Rocca A.L.; Manna C.L.; De Luca G.; Rocco G.
Institution
(Martucci, Tracey, Rocca, Manna, De Luca, Rocco) Division of Thoracic
Surgery, Department of Thoracic Surgery and Oncology, Istituto Nazionale
Tumori, Fondazione "G. Pascale" IRCCS, Naples, Italy
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The use of bipolar sealing devices during pulmonary resection
is particularly useful in thoracoscopic surgery. Theoretically, a bipolar
device, which contains the current in a smaller area and completes the
current cycle only through the tissue between the electrodes, may reduce
the proportion of patients experiencing atrial fibrillation compared with
monopolar devices such as the electrosurgical pencil using which the
current completes the cycle through the patient. We investigated the
impact of the LigaSureTM (LS) tissue fusion technology with the
ForceTriadTM energy platform device on the incidence of postoperative
atrial fibrillation and on the reduction of postoperative chest tube
output and hospital length of stay after open pulmonary lobectomy.
<br/>METHOD(S): A pilot prospective randomized, controlled trial comparing
LS tissue fusion technology with the ForceTriadTM energy platform to the
conventional electrosurgical pencil. Overall, 146 patients with resectable
lung cancer were recruited at the Division of Thoracic Surgery of the
Istituto Nazionale Tumori, Fondazione Pascale, IRCCS, between January 2011
and July 2013. Of these, 119 candidates to open lobectomy for
non-small-cell lung cancer were randomized to either LS tissue fusion
technology with the ForceTriadTM energy platform (LS: 57 patients) or
standard haemostatic procedure (standard treatment, ST: 62 patients) for
hilar and mediastinal nodal dissection. The primary end-point was to
compare the incidence of postoperative atrial fibrillation of LS compared
with ST. The secondary end-point was to compare the efficacy of LS
compared with ST in terms of total chest tube drainage, daily chest tube
drainage and chest tube duration. <br/>RESULT(S): There was no
statistically significant difference between LS and ST in terms of
postoperative atrial fibrillation (P = 0.31). However, LS was associated
to significant reduction of duration of both mediastinal nodal dissection
(P = 0.017) and the cumulative chest tube drainage (P = 0.025).
<br/>CONCLUSION(S): The incidence of atrial fibrillation with LS tissue
fusion technology with the ForceTriadTM energy platform is not reduced as
compared with conventional electrosurgical pencil. However, the use of LS
during mediastinal nodal dissection is associated to shorter duration of
lymphadenectomy and duration of chest tube drainage.<br/>Copyright &#xa9;
The Author 2014.

<25>
Accession Number
2020931239
Title
Impact of pharmacological interventions on intrapulmonary shunt during
one-lung ventilation in adult thoracic surgery: a systematic review and
component network meta-analysis.
Source
British Journal of Anaesthesia. 130(1) (pp e92-e105), 2023. Date of
Publication: January 2023.
Author
Schorer R.; Dombret A.-L.; Hagerman A.; Bedat B.; Putzu A.
Institution
(Schorer, Dombret, Hagerman, Putzu) Department of Acute Medicine, Geneva
University Hospitals, Geneva, Switzerland
(Bedat) Division of Thoracic and Endocrine Surgery, Geneva University
Hospitals, Geneva, Switzerland
Publisher
Elsevier Ltd
Abstract
Background: Intrapulmonary shunt is a major determinant of oxygenation in
thoracic surgery under one-lung ventilation. We reviewed the effects of
available treatments on shunt, PaO<inf>2</inf>/FiO<inf>2</inf> and
haemodynamics through systematic review and network meta-analysis.
<br/>Method(s): Online databases were searched for RCTs comparing
pharmacological interventions and intrapulmonary shunt in thoracic surgery
under one-lung ventilation up to March 30, 2022. Random-effects
(component) network meta-analysis compared 24 treatments and 19 treatment
components. The Confidence in Network Meta-Analysis (CINeMA) framework
assessed evidence certainty. The primary outcome was intrapulmonary shunt
fraction during one-lung ventilation. <br/>Result(s): A total of 55 RCTs
were eligible for systematic review (2788 participants). The addition of
N<inf>2</inf>O (mean difference [MD]=-15%; 95% confidence interval [CI],
-25 to -5; P=0.003) or almitrine (MD=-13%; 95% CI, -20 to -6; P<0.001) to
propofol anaesthesia were efficient at decreasing shunt. Combined epidural
anaesthesia (MD=3%; 95% CI, 1-5; P=0.005), sevoflurane (MD=5%; 95% CI,
2-8; P<0.001), isoflurane (MD=6%; 95% CI, 4-9; P<0.001), and desflurane
(MD=9%; 95% CI, 4-14; P=0.001) increased shunt vs propofol. Almitrine
(MD=147 mm Hg; 95% CI, 58-236; P=0.001), dopexamine (MD=88 mm Hg; 95% CI,
4-171; P=0.039), and iloprost (MD=81 mm Hg; 95% CI, 4-158; P=0.038)
improved PaO<inf>2</inf>/FiO<inf>2</inf>. Certainty of evidence ranged
from very low to moderate. <br/>Conclusion(s): Adding N<inf>2</inf>O or
almitrine to propofol anaesthesia reduced intrapulmonary shunt during
one-lung ventilation. Halogenated anaesthetics increased shunt in
comparison with propofol. The effects of N<inf>2</inf>O, iloprost, and
dexmedetomidine should be investigated in future research. N<inf>2</inf>O
results constitute a research hypothesis currently not backed by any
direct evidence. The clinical availability of almitrine is limited.
Systematic review protocol: PROSPERO CRD42022310313.<br/>Copyright &#xa9;
2022 British Journal of Anaesthesia

<26>
Accession Number
2019845710
Title
Driving pressure-guided ventilation and postoperative pulmonary
complications in thoracic surgery: a multicentre randomised clinical
trial.
Source
British Journal of Anaesthesia. 130(1) (pp e106-e118), 2023. Date of
Publication: January 2023.
Author
Park M.; Yoon S.; Nam J.-S.; Ahn H.J.; Kim H.; Kim H.J.; Choi H.; Kim
H.K.; Blank R.S.; Yun S.-C.; Lee D.K.; Yang M.; Kim J.A.; Song I.; Kim
B.R.; Bahk J.-H.; Kim J.; Lee S.; Choi I.-C.; Oh Y.J.; Hwang W.; Lim B.G.;
Heo B.Y.
Institution
(Park, Ahn, Yang, Kim, Heo) Department of Anaesthesiology and Pain
Medicine, Samsung Medical Centre, Sungkyunkwan University School of
Medicine, Seoul, South Korea
(Yoon, Song, Kim, Bahk) Department of Anaesthesiology and Pain Medicine,
Seoul National University Hospital, University of Seoul National College
of Medicine, Seoul, South Korea
(Nam, Kim, Lee, Choi) Department of Anaesthesiology and Pain Medicine,
Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South
Korea
(Kim, Lim) Department of Anaesthesiology and Pain Medicine, Korea
University Guro Hospital, Korea University College of Medicine, Seoul,
South Korea
(Kim, Oh) Department of Anaesthesiology and Pain Medicine, and Anaesthesia
and Pain Research Institute, Yonsei University College of Medicine, South
Korea
(Choi, Hwang) Department of Anaesthesiology and Pain Medicine, Seoul St.
Mary's Hospital, College of Medicine, The Catholic University of Korea,
Seoul, South Korea
(Kim) Department of Thoracic and Cardiovascular Surgery, Samsung Medical
Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Blank) Department of Anaesthesiology, University of Virginia Health
System, Charlottesville, VA, United States
(Yun) Department of Biostatistics, Asan Medical Centre, University of
Ulsan College of Medicine, Seoul, South Korea
(Lee) Department of Anaesthesiology and Pain Medicine, Dongguk University
Hospital, Goyang-si, South Korea
Publisher
Elsevier Ltd
Abstract
Background: Airway driving pressure, easily measured as plateau pressure
minus PEEP, is a surrogate for alveolar stress and strain. However, the
effect of its targeted reduction remains unclear. <br/>Method(s): In this
multicentre trial, patients undergoing lung resection surgery were
randomised to either a driving pressure group (n=650) receiving an
alveolar recruitment/individualised PEEP to deliver the lowest driving
pressure or to a conventional protective ventilation group (n=650) with
fixed PEEP of 5 cm H<inf>2</inf>O. The primary outcome was a composite of
pulmonary complications within 7 days postoperatively. <br/>Result(s): The
modified intention-to-treat analysis included 1170 patients (mean
[standard deviation, SD]; age, 63 [10] yr; 47% female). The mean driving
pressure was 7.1 cm H<inf>2</inf>O in the driving pressure group vs 9.2 cm
H<inf>2</inf>O in the protective ventilation group (mean difference [95%
confidence interval, CI]; -2.1 [-2.4 to -1.9] cm H<inf>2</inf>O; P<0.001).
The incidence of pulmonary complications was not different between the two
groups: driving pressure group (233/576, 40.5%) vs protective ventilation
group (254/594, 42.8%) (risk difference -2.3%; 95% CI, -8.0% to 3.3%;
P=0.42). Intraoperatively, lung compliance (mean [SD], 42.7 [12.4] vs 33.5
[11.1] ml cm H<inf>2</inf>O^-1; P<0.001) and Pa<inf>o2</inf>
(median [inter-quartile range], 21.5 [14.5 to 30.4] vs 19.5 [13.5 to 29.1]
kPa; P=0.03) were higher and the need for rescue ventilation was less
frequent (6.8% vs 10.8%; P=0.02) in the driving pressure group.
<br/>Conclusion(s): In lung resection surgery, a driving pressure-guided
ventilation improved pulmonary mechanics intraoperatively, but did not
reduce the incidence of postoperative pulmonary complications compared
with a conventional protective ventilation. Clinical trial registration:
NCT04260451.<br/>Copyright &#xa9; 2022 The Author(s)

<27>
Accession Number
2020189137
Title
Postoperative recovery with continuous erector spinae plane block or
video-assisted paravertebral block after minimally invasive thoracic
surgery: a prospective, randomised controlled trial.
Source
British Journal of Anaesthesia. 130(1) (pp e137-e147), 2023. Date of
Publication: January 2023.
Author
Moorthy A.; Ni Eochagain A.; Dempsey E.; Wall V.; Marsh H.; Murphy T.;
Fitzmaurice G.J.; Naughton R.A.; Buggy D.J.
Institution
(Moorthy, Wall, Murphy, Buggy) Division of Anaesthesiology, Mater
Misericordiae University Hospital, Dublin, Ireland
(Moorthy, Buggy) School of Medicine, University College, Dublin, Ireland
(Ni Eochagain, Dempsey, Marsh, Naughton) Department of Anaesthesiology, St
James's University Hospital, Dublin, Ireland
(Fitzmaurice) Department of Cardiothoracic Surgery, St James's University
Hospital, Dublin, Ireland
(Buggy) EuroPeriscope, ESA-IC Onco-Anaesthesiology Research Group,
Brussels, Belgium
(Buggy) Outcomes Research, Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Ltd
Abstract
Background: PROcedure SPECific Postoperative Pain ManagemenT (PROSPECT)
guidelines recommend erector spinae plane (ESP) block or paravertebral
block (PVB) for postoperative analgesia after video-assisted thoracoscopic
surgery (VATS). However, there are few trials comparing the effectiveness
of these techniques on patient-centric outcomes, and none evaluating
chronic postsurgical pain (CPSP). Furthermore, there are no available
trials comparing ultrasound-guided ESP with surgically placed PVB in this
patient cohort. <br/>Method(s): We conducted a two-centre, prospective,
randomised, double-blind, controlled trial, comparing
anaesthesiologist-administered, ultrasound-guided ESP catheter with
surgeon-administered, video-assisted PVB catheter analgesia among 80 adult
patients undergoing VATS. Participants received a 20 ml bolus of
levobupivacaine 0.375% followed by infusion of levobupivacaine 0.15%
(10-15 ml h^-1) for 48 h. Primary outcome was Quality of
Recovery-15 score (QoR-15) at 24 h. Secondary outcomes included QoR-15 at
48 h, peak inspiratory flow (ml s^-1) at 24 h and 48 h, area
under the pain verbal response score vs time curve (AUC), opioid
consumption, Comprehensive Complication Index, length of stay, and CPSP at
3 months after surgery. <br/>Result(s): Median (25-75%) QoR-15 at 24 h was
higher in ESP (n=37) compared with PVB (n=37): 118 (106-134) vs 110
(89-121) (P=0.03) and at 48 h: 131 (121-139) vs 120 (111-133) (P=0.03).
There were no differences in peak inspiratory flow, AUC, Comprehensive
Complication Index, length of hospital stay, and opioid consumption.
Incidence of CPSP at 3 months was 12 (34%) for ESP and 11 (31%) for PVB
(P=0.7). <br/>Conclusion(s): Compared with video-assisted, surgeon-placed
paravertebral catheter, erector spinae catheter improved overall QoR-15
scores at 24 h and 48 h but without differences in pain or opioid
consumption after minimally invasive thoracic surgery. Clinical trial
registration: NCT04729712.<br/>Copyright &#xa9; 2022 British Journal of
Anaesthesia

<28>
Accession Number
2020155055
Title
Pearls, pitfalls, and surgical indications of the Intuity TM heart valve:
A rapid deployment bioprosthesis. A systematic review of the literature.
Source
Journal of Cardiac Surgery. 37(12) (pp 5411-5417), 2022. Date of
Publication: December 2022.
Author
Dokollari A.; Torregrossa G.; Sicouri S.; Veshti A.; Margaryan R.; Cameli
M.; Mandoli G.E.; Maccherini M.; Montesi G.; Cabrucci F.; Coku L.; Arora
R.; Li Q.R.; Bonacchi M.; Gelsomino S.
Institution
(Dokollari, Torregrossa, Sicouri) Department of Cardiothoracic Surgery
Research, Lankenau Institute for Medical Research, Wynnewood, PA, United
States
(Dokollari, Torregrossa) Department of Cardiothoracic Surgery, Lankenau
Medical Center, Lankenau Heart Institute, Main Line Health, Wynnewood, PA,
United States
(Veshti) Department of Cardiac Surgery, Mother Teresa Hospital, University
of Tirana, Tirana, Albania
(Margaryan) Department of Adult Cardiac Surgery, G. Pasquinucci Heart
Hospital, Fondazione CNR-G. Monasterio, Massa, Italy
(Cameli, Mandoli, Maccherini, Montesi) Department of Experimental and
Clinical Medicine, Cardiac Surgery Unit, University of Florence, Firenze,
Italy
(Cabrucci, Bonacchi) Department of Cardiac Surgery/Cardiology, University
of Siena, Siena, Italy
(Coku) Department of Cardiac Surgery, Appalachian Regional Health,
University of Kentucky, Hazard, KY, United States
(Arora) Department of Surgery, Section of Cardiac Surgery, Max Rady
College of Medicine, University of Manitoba, Winnipeg, MB, Canada
(Li) 2010 Vision Associates, Toronto, ON, Canada
(Gelsomino) Department of Cardiac Surgery, CARIM Maastricht Medical
University, Maastricht, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To highlight short- and long-term clinical outcomes of the
Intuity TM rapid deployment prosthesis for surgical aortic valve
replacement. <br/>Method(s): We reviewed on PubMed/MEDLINE, Embase,
SciELO, LILACS, CCTR/CENTRAL, and Google Scholar for clinical trials,
retrospective clinical studies, meta-analysis, and gray literature.
<br/>Result(s): Fourty-five clinical studies with 12.714 patients were
included in the analysis. Thirty-day mortality ranged from 3.8% for
Intuity and 3.9% for transcatheter aortic valve replacement (TAVR). The
incidence of paravalvular leak (PVL) (Intuity 0% and TAVR 2.17%),
permanent pacemaker implantation (Intuity 11.11% and TAVR 12.5%), stroke
(Intuity 2.2% and TAVR 2.6%), myocardial infarction (MI) (Intuity 0% and
TAVR 1%), were all higher in the TAVR group. Compared to other sutured
bioprosthesis (SB), mortality ranged from 0% to 3.9% for Intuity and
0%-6.9% for SB. Long-term cardiac mortality ranged from 0.9% to 1.55% for
Intuity and 1.4%-3.3% for the Perceval valve. The incidence of PVL
(Intuity 0.24%-0.7% and Perceval 0%-1%), endocarditis (Intuity 0.2%-0.7%
and Perceval 1.6%-6.6%), stroke (Intuity 0.36%-1.4% and Perceval 0%-0.8%),
MI (Intuity 0.07%-0.26%), and SVD (Intuity 0.12%-0.7% and Perceval 0%)
were comparable. Compared to standard full sternotomy (SFS), minimally
invasive surgery (MINV) mortality ranged from 0% to 4.3% for MINV and
0%-2.1% for SFS. Hospital costs outcomes ranged from $37,187-$44,368 for
the Intuity, $69,389 for TAVR, and $13,543 for SB. Intuity short-term
mortality ranged between 0.9% and 12.4% while long-term mortality ranged
between 2.6% and 20%. <br/>Conclusion(s): This manuscript provides a
360degree overview of the current rapid deployments, sutureless, and TAVR
prosthesis.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<29>
Accession Number
2020154983
Title
Effectiveness of intra-operative topical amiodarone for prevention of
postcardiac surgery new-onset atrial fibrillation: A review of current
evidence.
Source
Journal of Cardiac Surgery. 37(12) (pp 5371-5378), 2022. Date of
Publication: December 2022.
Author
Chen X.; Sartor C.; Zhang S.; Baranchuk A.; Ross-White A.; Fernandez A.L.;
El-Diasty M.
Institution
(Chen, Sartor) School of Medicine, Queen's University, Kingston, ON,
Canada
(Zhang) Department of Biomedical and Molecular Sciences, Queen's
University, Kingston, ON, Canada
(Baranchuk) Department of Medicine, Division of Cardiology, Queen's
University, Kingston, ON, Canada
(Ross-White) Queen's University Library, Queen's University, Kingston, ON,
Canada
(Fernandez) Cardiac Surgery Department, University Hospital, Santiago de
Compostela, Spain
(El-Diasty) Cardiac Surgery Department, Queen's University, Kingston, ON,
Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Postoperative atrial fibrillation (POAF) is one of the most
common complications following cardiac surgery and is associated with
increased morbidity. Intraoperative topical amiodarone application on
epicardial tissue has been shown to reduce systemic concentrations while
maintaining therapeutic myocardial concentrations, thereby, lowering the
risk of extracardiac adverse effects associated with oral and intravenous
amiodarone therapy. However, the efficacy and safety of topical amiodarone
in preventing POAF is unclear. <br/>Objective(s): This study summarizes
the clinical studies to-date that have investigated the efficacy and
safety of topical amiodarone administration in preventing POAF following
cardiac surgery. <br/>Method(s): A database search was conducted using
Medline, Embase, and Cochrane Library to identify relevant studies.
Abstracts were screened and data were extracted from relevant full-text
articles that met the inclusion and exclusion criteria. <br/>Result(s):
The search returned four studies with variable findings on the effect of
topical amiodarone therapy on the incidence of POAF, cardiac effects,
extracardiac effects, and hospital length of stay. <br/>Conclusion(s):
Prophylactic topical application of amiodarone may be effective and safe
for preventing post-operative new-onset atrial fibrillation. Further
investigation is required to evaluate the efficacy and safety of topical
amiodadrone therapy before it can be widely integrated into current
practice.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<30>
Accession Number
2020154981
Title
Postoperative cardiac troponin I as an indicator of surgical outcomes: A
systematic review.
Source
Journal of Cardiac Surgery. 37(12) (pp 5351-5361), 2022. Date of
Publication: December 2022.
Author
Ahmed S.H.; Pervez N.; Rehan S.T.; Shaikh T.G.; Waseem S.
Institution
(Ahmed, Pervez, Rehan, Shaikh, Waseem) Dow University of Health Sciences,
Karachi, Pakistan
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Cardiac surgeries are generally associated with high
morbidity and mortality. To prevent any adverse outcomes, it is crucial to
identify patients at risk of developing postoperative complications and
initiate relevant therapeutic interventions. Several biomarkers are used
to determine postoperative myocardial injury but they either lack
sensitivity and specificity or are elevated for a short time. In this
systematic review, we evaluate postoperative troponin I as a predictor of
postoperative myocardial infarction, mortality, and hospital and Intensive
Care Unit stay. <br/>Method(s): This systematic review was conducted in
accordance with the Preferred Reporting Items for Systematic Review and
Meta-Analysis guidelines. A thorough literature search was conducted over
PubMed, clinicaltrials. gov, and the Cochrane library from inception till
May 24, 2022 using relevant keywords, and only articles that met the
pre-defined criteria were recruited. <br/>Result(s): Following a
comprehensive literature search, a total of 359 articles were obtained.
Following a rigid screening and full-length review, only 13 studies met
our inclusion criteria and were included. The recruited studies evaluated
data from a total of 12,483 individuals and assessed troponin I as a
predictor of at least one outcome. <br/>Conclusion(s): Troponin I has the
potential to be used as a stand-alone predictor of surgical outcomes
following coronary artery bypass grafting and valvular surgeries. However,
supplementing it with other markers and scores offers the best chance at
timely diagnosing any complications.<br/>Copyright &#xa9; 2022 Wiley
Periodicals LLC.

<31>
Accession Number
2020108152
Title
Surgical versus transcatheter aortic valve replacement: Impact of
patient-prosthesis mismatch on outcomes.
Source
Journal of Cardiac Surgery. 37(12) (pp 5388-5394), 2022. Date of
Publication: December 2022.
Author
Alnajar A.; Hamad N.; Azhar M.Z.; Mousa Y.; Arora Y.; Lamelas J.
Institution
(Alnajar, Hamad, Arora, Lamelas) Department of Surgery, Division of
Cardiothoracic Surgery, University of Miami Miller School of Medicine,
Miami, FL, United States
(Azhar) University of Kansas School of Medicine, Wichita, KS, United
States
(Mousa) Florida Atlantic University, Boca Raton, FL, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The hemodynamics of most prosthetic valves are often inferior
to that of the normal native valve, and a significant proportion of
patients undergoing surgical (SAVR) or transcatheter aortic valve
replacement (TAVR) have high residual transaortic pressure gradients due
to prosthesis-patient mismatch (PPM). As the experience with TAVR has
increased and long-term outcomes are reported, a close look at the PPM
literature is required in light of new evidence. <br/>Method(s): For this
review, we searched the Embase, Medline, and Cochrane databases from 2000
to 2022. Articles reporting PPM as an outcome following aortic valve
replacements were identified and reviewed. <br/>Result(s): The impact of
PPM on clinical outcomes in aortic valve replacement has not been clear as
multiple studies failed to report PPM incidence. However, the PPM outcomes
after SAVR vary more widely than after TAVR, ranging from 8% to 80% in
SAVR and from 24% to 35% in TAVR. Incidence of severe PPM following redo
SAVR ranges from 2% to 9% and following valve-in-valve TAVR is from 14% to
33%, however, while PPM is higher in valve-in-valve TAVR, patients had
better survival rates. <br/>Conclusion(s): The gap between valve
performance and clinical outcomes in SAVR and TAVR could be reduced by
carefully selecting patients for either treatment option. Understanding
predictors of PPM can add to the safety, effectiveness, and increased
survival benefit of both SAVR and TAVR.<br/>Copyright &#xa9; 2022 Wiley
Periodicals LLC.

<32>
Accession Number
2020108086
Title
Sex differences in saphenous vein graft patency: A systematic review and
meta-analysis.
Source
Journal of Cardiac Surgery. 37(12) (pp 4573-4578), 2022. Date of
Publication: December 2022.
Author
Lehtinen M.L.; Harik L.; Soletti G.; Rahouma M.; Dimagli A.;
Perezgrovas-Olaria R.; Audisio K.; Demetres M.; Gaudino M.
Institution
(Lehtinen) Department of Cardiac Surgery, Heart and Lung Center, Helsinki
University Hospital and University of Helsinki, Helsinki, Finland
(Harik, Soletti, Rahouma, Dimagli, Perezgrovas-Olaria, Audisio, Gaudino)
Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York,
NY, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell, Medicine, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Saphenous vein grafts (SVG) are the most commonly used
conduits in coronary artery bypass grafting (CABG). Graft failure is
observed in up to 50% of SVG at 10 years after surgery. Whether a
difference in SVG patency rates exists between men and women remains
unclear. <br/>Method(s): We performed a study-level meta-analysis to
evaluate sex-related differences in follow-up patency rates of SVG after
CABG. A systematic literature search was conducted to identify studies on
CABG that reported follow-up SVG patency rates in men and women. The
primary outcome was SVG patency rates by sex at follow-up. <br/>Result(s):
Seventeen studies totaling 8235 patients and 14,781 SVG grafts were
included. There was no significant difference in follow-up SVG patency
rates between men and women (incidence rate ratio 0.96, 95% confidence
interval 0.90-1.03, p =.24), with mean angiographic follow-up of 33.5
months (standard deviation 29.2). Leave-one-out and cumulative analysis
were consistent with the main analysis. We concluded that follow-up SVG
patency rate is similar between men and women undergoing
CABG.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<33>
Accession Number
2020107998
Title
Minimally invasive versus conventional aortic valve replacement: The
network meta-analysis.
Source
Journal of Cardiac Surgery. 37(12) (pp 4868-4874), 2022. Date of
Publication: December 2022.
Author
Ogami T.; Yokoyama Y.; Takagi H.; Serna-Gallegos D.; Ferdinand F.D.;
Sultan I.; Kuno T.
Institution
(Ogami, Serna-Gallegos, Ferdinand, Sultan) Department of Cardiothoracic
Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Fountain Hill, PA, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Serna-Gallegos, Ferdinand, Sultan) Department of Cardiothroacic Surgery,
Heart and Vascular Institute, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, New York City, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Outcome comparisons after surgical aortic valve replacement
(SAVR) with minimally invasive approaches including mini-sternotomy (MS)
and right mini-thoracotomy (RMT) and full sternotomy (FS) have been
conflicting. Furthermore, the synthesis of mid-term mortality has not been
performed. <br/>Method(s): MEDLINE and EMBASE were searched through April
2022 to identify propensity score matched (PSM) studies or randomized
controlled trial (RCT) which compared outcomes following SAVR among three
incisional approaches: FS, MS, or RMT. The network analysis was performed
to compare these approaches with random effects model. Mid-term mortality
was defined as 1-year mortality. <br/>Result(s): A total of 42 studies met
the inclusion criteria enrolling 14,925 patients. RCT and PSM were
performed in 13 and 29 studies, respectively. The operative mortality was
significantly lower with MS compared to FS (risk ratio [RR]: 0.60, 95%
confidence interval [CI]: 0.41-0.90, p =.01, I² = 25.8%) or RMT
(RR: 0.51, 95% CI: 0.27-0.97, p =.03, I² = 25.8%). RMT had
significantly higher risk of reoperation for bleeding compared to MS (RR:
1.65, 95% CI: 1.18-2.30, p =.003, I² = 0%). Hospital length of
stay was significantly shorter with MS compared to FS (mean difference:
-0.89 days, 95% CI: -1.58 to -0.2, p =.01, I² = 95.5%) while it
was equivocal between FS and RMT. The mid-term mortality was similar among
the three approaches. <br/>Conclusion(s): While mid-term mortality was
comparable among approaches, MS may be a safe and potentially more
effective approach than FS and RMT for SAVR in the short
term.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<34>
Accession Number
2020107997
Title
Pulmonary hypertension associated with cardiopulmonary bypass and cardiac
surgery.
Source
Journal of Cardiac Surgery. 37(12) (pp 5269-5287), 2022. Date of
Publication: December 2022.
Author
Fayad F.H.; Sellke F.W.; Feng J.
Institution
(Fayad, Sellke, Feng) The Warren Alpert Medical School of Brown
University, Providence, RI, United States
(Fayad) Program in Liberal Medical Education, Brown University,
Providence, RI, United States
(Sellke, Feng) Division of Cardiothoracic Surgery, Rhode Island Hospital,
Alpert Medical School of Brown University, Providence, RI, United States
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim: Pulmonary hypertension (PH) is frequently associated
with cardiovascular surgery and is a common complication that has been
observed after surgery utilizing cardiopulmonary bypass (CPB). The purpose
of this review is to explain the characteristics of PH, the mechanisms of
PH induced by cardiac surgery and CPB, treatments for postoperative PH,
and future directions in treating PH induced by cardiac surgery and CPB
using up-to-date findings. <br/>Method(s): The PubMed database was
utilized to find published articles. <br/>Result(s): There are many
mechanisms that contribute to PH after cardiac surgery and CPB which
involve pulmonary vasomotor dysfunction, cyclooxygenase, the thromboxane
A2 and prostacyclin pathway, the nitric oxide pathway, inflammation, and
oxidative stress. Furthermore, there are several effective treatments for
postoperative PH within different types of cardiac surgery.
<br/>Conclusion(s): By possessing a deep understanding of the mechanisms
that contribute to PH after cardiac surgery and CPB, researchers can
develop treatments for clinicians to use which target the mechanisms of PH
and ultimately reduce and/or eliminate postoperative PH. Additionally,
learning about the most up-to-date studies regarding treatments can allow
clinicians to choose the best treatments for patients who are undergoing
cardiac surgery and CPB.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<35>
Accession Number
2020010524
Title
Coronary artery bypass surgery for acute coronary syndrome: A network
meta-analysis of on-pump cardioplegic arrest, off-pump, and on-pump
beating heart strategies.
Source
Journal of Cardiac Surgery. 37(12) (pp 5290-5299), 2022. Date of
Publication: December 2022.
Author
Hwang B.; Williams M.L.; Tian D.H.; Yan T.D.; Misfeld M.
Institution
(Hwang) School of Medicine, University of New South Wales, Sydney,
Australia
(Hwang, Williams, Tian, Yan) The Collaborative Research (CORE) Group,
Macquarie University, Sydney, Australia
(Williams) Department of Cardiothoracic Surgery, Dunedin Hospital,
Dunedin, New Zealand
(Yan, Misfeld) Department of Cardiothoracic Surgery, Royal Prince Alfred
Hospital, Sydney, Australia
Publisher
John Wiley and Sons Inc
Abstract
Background: Coronary artery bypass grafting (CABG) in the setting of an
acute coronary syndrome is a high-risk procedure, and the best strategy
for myocardial revascularisation remains debated. This study compares the
30-day mortality benefit of on-pump CABG (ONCAB), off-pump CABG (OPCAB),
and on-pump beating heart CABG (OnBHCAB) strategies. <br/>Method(s): A
systematic search of three electronic databases was conducted for studies
comparing ONCAB with OPCAB or OnBHCAB in patients with acute coronary
syndrome (ACS). The primary outcome, 30-day mortality, was compared using
a Bayesian hierarchical network meta-analysis (NMA). A random effects
consistency model was applied, and direct and indirect comparisons were
made to determine the relative effectiveness of each strategy on
postoperative outcomes. <br/>Result(s): One randomised controlled trial
and eighteen observational studies fulfilling the inclusion criteria were
identified. A total of 4320, 5559, and 1962 patients underwent ONCAB,
OPCAB, and OnBHCAB respectively. NMA showed that OPCAB had the highest
probability of ranking as the most effective treatment in terms of 30-day
mortality (odds ratio [OR], 0.50; 95% credible interval [CrI], 0.23-1.00),
followed by OnBHCAB (OR, 0.62; 95% CrI, 0.20-1.57), however the 95% CrI
crossed or included unity. A subgroup NMA of nine studies assessing only
acute myocardial infarction (AMI) patients demonstrated a 72% reduction in
likelihood of 30-day mortality after OPCAB (CrI, 0.07-0.83). No
significant increase in rate of stroke, renal dysfunction or length of
intensive care unit stay was found for either strategy.
<br/>Conclusion(s): Although no single best surgical revascularisation
approach in ACS patients was identified, the significant mortality benefit
with OPCAB seen with AMI suggests high acuity patients may benefit most
from avoiding further myocardial injury associated with cardiopulmonary
bypass and cardioplegic arrest.<br/>Copyright &#xa9; 2022 The Authors.
Journal of Cardiac Surgery published by Wiley Periodicals LLC.

<36>
Accession Number
2019987069
Title
Furosemide does not reduce the incidence of postoperative acute kidney
injury in adult patients undergoing cardiac surgery: A PRISMA-compliant
systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 37(12) (pp 4850-4860), 2022. Date of
Publication: December 2022.
Author
Xie C.-M.; Yao Y.-T.; Yang K.; Shen M.-Q.; He L.-X.; Dai Z.
Institution
(Xie, Yang, Shen, He, Dai) Department of Anesthesiology, Fuwai Yunnan
Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming
Medical University, Kunming, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: Acute kidney injury (AKI) is a common complication of cardiac
surgical patients, the occurrence of which is multifactorial. Furosemide
is the most common loop diuretic and widely used in cardiac surgery to
reduce fluid overload, increase tubular flow and urine output. It remains
unknown whether furosemide affects the incidence or prognosis of cardiac
surgery-induced acute kidney injury (CS-AKI). Therefore, the current study
was performed to address this question. <br/>Method(s): PubMed, Embase,
Scopus, Cochrane Library, and Web of Science databases were searched for
relevant studies. Primary outcomes of interest included postoperative
CS-AKI incidence, need for renal replacement therapy (RRT) rate. Secondary
outcomes of interest included postoperative serum creatinine (Scr) and
blood urea nitrogen (BUN) levels, postoperative mechanical ventilation
duration (MVD), length of stay (LOS) in intensive care unit (ICU) and in
hospital, and mortality. The odds ratio (OR) and/or the weighted mean
difference (WMD) with 95% confidence interval (CI) were used to pool the
data. <br/>Result(s): Database search yielded six studies including 566
adult patients, and 283 patients were allocated into Group Furosemide and
283 into Group Control (Placebo). Heterogeneity between studies was deemed
acceptable, and the publication bias was low. Meta-analysis suggested that
furosemide administration in adult cardiac surgical patients had no effect
on CS-AKI incidence (n = 4 trials; OR = 0.92; 95% CI: 0.37-2.30; p =.86;
I² = 57%) and need for RRT rate (n = 2 trials; OR = 4.13; 95%
CI: 0.44-38.51; p =.21; I² = 0%). Diversely, furosemide
administration in adult cardiac surgical patients significantly decreased
postoperative BUN level (n = 3 trials; WMD = 0.71; 95% CI: 0.10-1.33; p
=.02; I² = 0%), postoperative MVD (n = 2 trials; WMD = -3.13;
95% CI: -3.78 to -2.49; p <.00001; I² = 0%) and postoperative
LOS in ICU (n = 3 trials; WMD = -0.47; 95% CI: -0.76 to -0.18; p =.001;
I² = 0%). However, it had no significant impact on
postoperative Scr level, postoperative LOS in hospital, and postoperative
mortality. <br/>Conclusion(s): This meta-analysis suggested that
furosemide administration in adult cardiac surgical patients had no
significant effect on CS-AKI incidence, need for RRT rate, postoperative
Scr level, LOS in hospital and mortality, but could reduce postoperative
BUN level, MVD, and LOS in ICU. As only a limited number of studies were
included, these results should be interpreted carefully and cautiously.
Future high-quality randomized controlled trials are needed to define the
role of furosemide in CS-AKI prevention and management.<br/>Copyright
&#xa9; 2022 Wiley Periodicals LLC.

<37>
Accession Number
2019974965
Title
Early surgery or conservative management for asymptomatic severe aortic
stenosis: Meta-analysis of RECOVERY and AVATAR.
Source
Journal of Cardiac Surgery. 37(12) (pp 5336-5340), 2022. Date of
Publication: December 2022.
Author
Changal K.; Devarasetty P.P.; Royfman R.; Veria S.; Yassen M.; Vyas R.;
Gossl M.
Institution
(Changal, Devarasetty, Royfman, Veria, Yassen, Vyas) Cardiovascular
Medicine, University of Toledo College of Medicine and Life Sciences, OH,
United States
(Gossl) Valve Science Center, Minneapolis Heart Institute, Abbott
Northwestern Hospital, part of Allina Health, Minneapolis, United States
Publisher
John Wiley and Sons Inc
Abstract
The standard practice for management for asymptomatic severe aortic
stenosis with a normal left ventricular systolic function is conservative
management with a few exceptions. This practice is challenged by two
recent randomized controlled trials (RCT). All the prior data is
observational. We performed a meta-analysis of these 2 RCTs to determine
if early surgical aortic valve replacement in this patient population is
beneficial compared with the standard conservative therapy.<br/>Copyright
&#xa9; 2022 Wiley Periodicals LLC.

<38>
Accession Number
2019974950
Title
Mitral valve surgery via repeat median sternotomy versus right
mini-thoracotomy: A systematic review and meta-analysis of clinical
outcomes.
Source
Journal of Cardiac Surgery. 37(12) (pp 4500-4509), 2022. Date of
Publication: December 2022.
Author
Shirke M.M.; Ravikumar N.; Shawn T.J.X.; Mutsonziwa N.; Soh V.; Harky A.
Institution
(Shirke, Ravikumar, Shawn, Mutsonziwa, Soh) Department of Medicine,
Queen's University Belfast, School of Medicine, Belfast, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest,
Liverpool, United Kingdom
(Harky) Department of Integrative Biology, Faculty of Life Science,
University of Liverpool, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Redo mitral valve surgeries have high mortality and morbidity
and can be physically demanding for patients. Median sternotomy remains
the gold standard for most cardiac surgeries. To tackle certain risks with
a re-sternotomy, alternative procedures such as the right anterolateral
minithoracotomy have been explored. This review aims to compare the
clinical outcomes of re-sternotomy (MS) versus right mini thoracotomy (MT)
in mitral valve surgery. <br/>Method(s): A systematic, electronic search
was performed according to Preferred Reporting items for Systematic
Reviews and Meta-analysis guidelines to identify relevant articles that
compared outcomes of the MS versus MT procedures in patients who have had
cardiac surgery via a MS approach. <br/>Result(s): Twelve studies were
identified, enrolling 4514 patients. Length of hospital stay(MD = -3.71,
95% confidence interval [CI] [-4.92, -2.49]), 30-day mortality(odds ratio
[OR] = 0.59, 95% CI [0.39, 0.90]), and new-onset renal failure(OR = 0.38,
95% CI [0.22, 0.65]) were statistically significant in favor of the MT
approach. Infection rates(OR = 0.56, 95% CI[0.25, 1.21]) and length of
intensive care unit (ICU) stay (MD = -0.55, 95% CI[-1.16, 0.06]) was lower
in the MT group; however, the difference was not significant. No
significant differences were observed in the CPB time(MD = -2.33, 95% CI
[-8.15, 3.50]), aortic cross-clamp time MD = -1.67, 95% CI[-17.07,
13.76]), and rates of stroke(OR = 1.03, 95% CI[0.55, 1.92]).
<br/>Conclusion(s): Right MT is a safe alternative to the traditional
re-sternotomy for patients who have had previous cardiac surgery. The
approach offers a reduced length of hospital stay, ICU stay, and a lower
risk of new-onset renal failure requiring dialysis. This review calls for
robust trials in the field to further strengthen the
evidence.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<39>
Accession Number
2019974948
Title
Efficacy of chest X-rays after drain removal in adult and pediatric
patients undergoing cardiac and thoracic surgery: A systematic review.
Source
Journal of Cardiac Surgery. 37(12) (pp 5320-5325), 2022. Date of
Publication: December 2022.
Author
Thet M.S.; Han K.P.P.; Hlwar K.E.; Thet K.S.; Oo A.Y.
Institution
(Thet) Department of Surgery & Cancer, Faculty of Medicine, Imperial
College London, London, United Kingdom
(Han, Hlwar, Thet) Mandalay General Hospital, University of Medicine,
Mandalay, Myanmar
(Oo) Department of Cardiothoracic Surgery, St Bartholomew's Hospital,
London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Chest X-rays are routinely obtained after the removal of chest
drains in patients undergoing cardiac and thoracic surgical procedures.
However, a lack of guidelines and evidence could question the practice.
Routine chest X-rays increase exposure to ionizing radiation, increase
health-care costs, and lead to overutilisation of available resources.
This review aims to explore the evidence in the literature regarding the
routine use of chest X-rays following the removal of chest drains.
<br/>Material(s) and Method(s): A systematic literature search was
conducted in PubMed, Medline via Ovid, Cochrane central register of
control trials (CENTRAL), and ClinicalTrials. gov without any limit on the
publication year. The references of the included studies are manually
screened to identify potentially eligible studies. <br/>Result(s): A total
of 375 studies were retrieved through the search and 18 studies were
included in the review. Incidence of pneumothorax remains less than 10%
across adult cardiac, and pediatric cardiac and thoracic surgical
populations. The incidence may be as high as 50% in adult thoracic
surgical patients. However, the reintervention rate remains less than 2%
across the populations. Development of respiratory and cardiovascular
symptoms can adequately guide for a chest X-ray following the drain
removal. As an alternative, bedside ultrasound can be used to detect
pneumothorax in the thorax after the removal of a chest drain without the
need for ionizing radiation. <br/>Conclusion(s): A routine chest X-ray
following chest drain removal in adult and pediatric patients undergoing
cardiac and thoracic surgery is not necessary. It can be omitted without
compromising patient safety. Obtaining a chest X-ray should be clinically
guided. Alternatively, bedside ultrasound can be used for the same purpose
without the need for radiation exposure.<br/>Copyright &#xa9; 2022 The
Authors. Journal of Cardiac Surgery published by Wiley Periodicals LLC.

<40>
Accession Number
2019935605
Title
Review of bioprosthetic structural valve deterioration: Patient or valve?.
Source
Journal of Cardiac Surgery. 37(12) (pp 5243-5253), 2022. Date of
Publication: December 2022.
Author
Tnay T.D.; Shell D.; Lui A.
Institution
(Tnay, Shell, Lui) Department of Cardiothoracic Surgery, St Vincent's
Hospital - Melbourne St Vincent's Health Australia, Melbourne, Australia
Publisher
John Wiley and Sons Inc
Abstract
Background: With guidelines progressively recommending bioprosthetic
aortic valves in younger patients, a greater emphasis is placed on
structural valve deterioration (SVD) as an important clinical endpoint for
both transcatheter and surgically implanted valves. However, SVD of
bioprosthetic valves is a complex entity with varying definitions in the
literature and a multifaceted pathogenesis. <br/>Aim(s): This review first
aims to establish the most updated definitions of SVD as per the
literature. We then explore the patient- and valve-related factors that
play the greatest roles in facilitating early SVD. <br/>Method(s): A
PubMed literature review was conducted to identify the relevant research
in this field within the past two decades. <br/>Conclusion(s): Increasing
rates of obesity and metabolic syndrome pose a significant risk to the
longevity of bioprosthetic valves. Additionally, externally mounted valves
have proven to sacrifice durability for superior haemodynamics.
Bioprosthetic SVD continues to be a multifactorial issue that will require
various patient- and valve-related factors to be addressed.<br/>Copyright
&#xa9; 2022 Wiley Periodicals LLC.

<41>
Accession Number
2019738017
Title
Comparing the efficacy of N-acetylcysteine plus carvedilol versus
carvedilol in the prevention of atrial fibrillation following coronary
artery bypass graft surgery.
Source
Journal of Cardiac Surgery. 37(12) (pp 4698-4704), 2022. Date of
Publication: December 2022.
Author
Jalalian R.; Maleki M.; Ghafari R.; Habibi V.; Heydari S.; Iranian M.
Institution
(Jalalian, Maleki) Department of Cardiology, Faculty of Medicine,
Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of
(Ghafari, Habibi) Department of Cardiac Surgery, Faculty of Medicine,
Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of
(Heydari) Faculty of Medicine, Guilan University of Medical Sciences,
Rasht, Iran, Islamic Republic of
(Iranian) Rajaie Cardiovascular Medical and Research Center, School of
Medicine, Iran University of Medical Science, Tehran, Iran, Islamic
Republic of
Publisher
John Wiley and Sons Inc
Abstract
Background: Atrial fibrillation (AF) is the most common arrhythmia
following open-heart surgery. Agents with antioxidant properties may
reduce postoperative complications like postoperative AF (POAF) in
patients undergoing open-heart surgery. This study was conducted to assess
the effect of N-acetylcysteine (NAC) in prevention of AF following
coronary artery bypass graft (CABG) surgery. <br/>Method(s): Three hundred
patients who underwent CABG surgery were entered in the study. Patients
with contraindications for beta-blockers and patients were simultaneously
replacing or repairing the valve with open-heart surgery were excluded.
The patients were randomly divided into two groups (n = 150) and they were
received NAC plus carvedilol or carvedilol. The patients were monitored
for 5 days after surgery and the incidence of AF during hospitalization
was recorded. <br/>Result(s): AF was detected in 14 patients in the NAC
with Carvedilol group (9.33%) and 23 patients in Carvedilol group
(15.33%). There was no significant difference in the incidence of POAF
between the two groups (p value = 0.112). The result of multivariable
regression model represented that although the incidence of POAF was lower
in NAC plus carvedilol group, it wasn't statistically significant (p value
= 0.10). <br/>Conclusion(s): NAC was not associated with a decreased
incidence of AF following CABG surgery.<br/>Copyright &#xa9; 2022 Wiley
Periodicals LLC.

<42>
Accession Number
2019702256
Title
Acute iatrogenic complications after mitral valve repair.
Source
Journal of Cardiac Surgery. 37(12) (pp 4088-4093), 2022. Date of
Publication: December 2022.
Author
Paparella D.; Squiccimarro E.; Di Mauro M.; Katsavrias K.; Calafiore A.M.
Institution
(Paparella, Squiccimarro) Department of Medical and Surgical Sciences,
Division of Cardiac Surgery, University of Foggia, Foggia, Italy
(Paparella) Division of Cardiac Surgery, Santa Maria Hospital, GVM Care &
Research, Bari, Italy
(Squiccimarro, Di Mauro) Cardio-Thoracic Surgery Department, Heart &
Vascular Centre, Maastricht University Medical Centre, Maastricht,
Netherlands
(Katsavrias) Division of Cardiac Surgery A, Henry Dunant Hospital, Athens,
Greece
(Calafiore) Department of Cardiovascular Diseases, Gemelli Molise,
Campobasso, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim of the Study: Mitral valve repair is the procedure of
choice to correct mitral regurgitation. However, some dangerous iatrogenic
complications can occur at the end of the procedure. Therefore, we sought
to review the most frequent and clinically relevant acute iatrogenic
complication following mitral valve repair. <br/>Method(s): A thorough
review of the literature has been performed. Criteria for considering
studies for this non-systematic review were as follows: observational and
interventional studies investigating the acute iatrogenic complications
following mitral valve repair, and essential review studies pertinent to
the topic. <br/>Result(s): The most frequent is the systolic anterior
motion. Due to a systolic dislocation of the anterior leaflet toward the
outflow tract, it causes both obstruction of the outflow tract and mitral
regurgitation. Often it is due to excess of catecholamines or to reduced
filling of the left ventricle but sometimes needs further surgical
maneuvers, focused on moving posteriorly the coaptation line. It can be
obtained by shortening the posterior leaflet or increasing the size of the
ring or applying an Alfieri stitch to limit the movements of the anterior
leaflet. Another complication, often underdiagnosed and potentially
lethal, is the injury of the circumflex artery that happens at the level
of the anterolateral commissure or P1 zone. Two mechanisms are involved.
The first one is the direct injury of the artery by a stitch (roughly 25%
of the patients present a distance artery-annulus <3 mm. The second one is
the distortion of the artery, attracted toward the annulus by a misplaced
stitch. The attraction causes kinking with stenosis of different degrees
till functional occlusion. However, the artery has to be far from the
annulus and the atrial tissue has to be stiff and resistant, as after an
infective process, to move the circumflex artery toward the annulus
without tearing. Positioning the stitches very close to the mitral
leaflets in the dangerous area is the only prevention to the complication.
The treatment in the operating theater is partial or total
removal/reimplantation of the annular sutures or coronary artery bypass
grafting to the circumflex area. If the injury is demonstrated only after
coronary angiography, percutaneous revascularization can be attempted
before further surgical treatment. <br/>Conclusion(s): Acute iatrogenic
complication after mitral repair exists and may compromize patient
outcome. Raising awareness about these issues, the precautions to prevent
them, and the manners of resolution is therefore mandatory.<br/>Copyright
&#xa9; 2022 Wiley Periodicals LLC.

<43>
Accession Number
2019657017
Title
Long-term outcomes of percutaneous versus surgical revascularization in
patients with diabetes and left main coronary artery disease: A
meta-analysis of randomized controlled trials.
Source
Journal of Cardiac Surgery. 37(12) (pp 4646-4653), 2022. Date of
Publication: December 2022.
Author
Carvalho P.E.P.; Veiga T.M.A.; Machado F.S.L.; Porto G.V.; Pirez J.;
Rivera M.; Melo P.C.; Braghiroli J.; Cardoso R.
Institution
(Carvalho, Veiga, Machado, Porto) Department of Medicine, Federal
University of Minas Gerais, Belo Horizonte, Brazil
(Pirez) Department of Medicine, Cesumar University, Maringa, Brazil
(Rivera) Division of Cardiology, Washington University in St. Louis, St.
Louis, MO, United States
(Melo) Cardiovascular Research Foundation, New York, NY, United States
(Braghiroli) Jackson Memorial Hospital, Miami, FL, United States
(Cardoso) Heart and Vascular Center, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The efficacy and safety of percutaneous coronary interventions
(PCI) relative to coronary artery bypass grafting (CABG) in patients with
diabetes and unprotected left main coronary artery disease (LMCAD) are not
well established. <br/>Objective(s): To perform a meta-analysis evaluating
the long-term outcomes after PCI with drug-eluting stents (DES), as
compared with CABG, in patients with diabetes and unprotected LMCAD.
<br/>Method(s): MEDLINE, Cochrane, and Embase were searched for randomized
controlled trials (RCTs) that reported outcomes after PCI with DES versus
CABG in unprotected LMCAD among patients with diabetes. To evaluate the
long-term effects of these interventions, we restricted this analysis to
studies with a minimum follow-up period of 3 years. Risk ratios (RRs) with
95% confidence intervals (CIs) were pooled with a random-effects model.
Quality assessment and risk of bias were performed according to Cochrane
recommendations. <br/>Result(s): Four RCTs with a total of 1080 patients
were included, 553 (51.2%) of whom underwent PCI. There was no difference
for individual outcomes of all-cause mortality (RR: 1.21; 95% CI:
0.86-1.71; p =.27; I² = 28%), cardiovascular death (RR 1.29;
95% CI: 0.76-2.18; p =.34; I² = 0%), or myocardial infarction
(MI) (RR: 0.94; 95% CI: 0.61-1.45; p =.79; I² = 0%). However,
the risk of stroke was reduced with PCI relative to CABG (RR: 0.41; 95%
CI: 0.18-0.94; p =.04; I² = 0%), whereas the risk of any repeat
revascularization was higher in the PCI group (RR: 1.99; 95% CI:
1.44-2.75; p <.001; I² = 0%). The risk of the composite outcome
of all-cause mortality, MI, stroke, or repeat revascularization was higher
after PCI compared with CABG (RR: 1.30; 95% CI: 1.09-1.56; p =.004;
I² = 0%). <br/>Conclusion(s): In this meta-analysis with more
than 1000 patients with diabetes and unprotected LMCAD followed for a
minimum of 3 years, the incidence of repeat revascularization was higher
among those treated with PCI, whereas the risk of stroke was higher in
patients treated with CABG.<br/>Copyright &#xa9; 2022 Wiley Periodicals
LLC.

<44>
Accession Number
2019627586
Title
Should nasogastric tube be used routinely in patients undergoing cardiac
surgery? A narrative review.
Source
Journal of Cardiac Surgery. 37(12) (pp 5300-5306), 2022. Date of
Publication: December 2022.
Author
Paleczny S.; Fatima R.; Amador Y.; El Diasty M.
Institution
(Paleczny, Fatima, El Diasty) Department of Surgery, Division of Cardiac
Surgery, Kingston General Hospital, Queen's University, Kingston, ON,
Canada
(Amador) Department of Anesthesiology and Perioperative Medicine, Kingston
General Hospital, Queen's University, Kingston, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim: Nasogastric tube (NGT) use has been common in the
immediate postoperative period in surgical patients for decades. Potential
advantages include the decompression of gastric contents and the early
administration of time-sensitive medications. However, its routine use
after cardiac surgery has not been established as a gold standard yet. The
NGT use for prevention of postoperative nausea and vomiting has been a
matter of debate in literature. Also, NGT use has also been associated
with the incidence of some respiratory and gastrointestinal complications
and it may be a source of significant pain and discomfort to patients. In
this article, we review the current available literature regarding the use
of NGT during and immediately after cardiac surgery, with particular
emphasis on its potential role in enhanced postoperative recovery.
<br/>Method(s): We performed a database search in October 2021 using
Embase, Cochrane Library, and Medline to identify studies that examined
the use of NGT in patients that underwent cardiac surgery. Data and
literature about NGT's impact on post-operative nausea and vomiting, early
administration of medications, interference with imaging, post-operative
complications, respiratory complications, gastrointestinal complications,
pain and discomfort, and enhanced recovery after surgery were examined.
<br/>Result(s): Three reports investigating the use of NGT to reduce
post-operative nausea and vomiting were examined with sample sizes of 114,
104, and 202. The use of NGT did not significantly reduce the incidence of
post-operative nausea and vomiting in 2/3 of the studies: a 2% nausea
reduction with NGT (p < 0.05), a 7.7% nausea reduction with NGT (p = 0.6),
and a 14% vomiting reduction with NGT (p = 0.007). The prevalence of
pneumonia following NGT use has been shown to vary ranging from 4 to 95%
with associated mortality rates of 17 to 62%. <br/>Conclusion(s): Based on
our findings, there is currently not sufficient evidence to support the
routine use of NGT during cardiac surgery. Further research is needed to
establish the role of NGT in this patient population.<br/>Copyright &#xa9;
2022 Wiley Periodicals LLC.

<45>
Accession Number
2019504140
Title
Modified Warden procedure using aortic homograft for superior vena caval
translocation: Where is the evidence?.
Source
Journal of Cardiac Surgery. 37(12) (pp 4492-4494), 2022. Date of
Publication: December 2022.
Author
Williams I.M.; Jubouri M.; Bailey D.M.; Bashir M.
Institution
(Williams) Department of Vascular Surgery, University Hospital of Wales,
Cardiff, United Kingdom
(Jubouri) Hull York Medical School, University of York, York, United
Kingdom
(Bailey) Neurovascular Research Laboratory, Faculty of Life Sciences and
Education, University of South Wales, Pontypridd, United Kingdom
(Bashir) Vascular and Endovascular Surgery, Velindre University NHS Trust,
Health Education and Improvement Wales (HEIW), Cardiff, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Partial anomalous pulmonary venous connection (PAPVC) occurs
when at least one pulmonary vein drains into the right atrium or its
tributaries rather than the left atrium, most commonly connecting with the
superior vena cava (SVC). The Warden procedure involves transecting the
SVC proximal to the uppermost connection of the pulmonary vein followed by
proximal SVC reattachment to the right atrial appendage. However,
descending thoracic aortic homograft replacement for SVC translocation has
recently been introduced as a modified technique. <br/>Aim(s): This
commentary aims to discuss the recent study by Said et al. who reported
their experiences with six PAPVC cases undergoing a modified Warden
procedure using thoracic aortic homograft SVC translocation.
<br/>Method(s): A comprehensive literature search was performed using
multiple electronic databases to collate the relevant research evidence.
<br/>Result(s): The Warden procedure is associated with a 10% incidence of
SVC obstruction with many requiring reintervention. Meanwhile, using the
aortic homograft for SVC translocation, Said et al. observed no SVC
obstructions. In addition, this modified technique does not require
anticoagulation and has demonstrated an improvement in long-term SVC
patency. Nevertheless, it can be considered an expensive procedure.
Moreover, since the thoracic aortic homograft utilized is biological
tissue, only long-term follow-up will determine whether calcification and
graft degeneration is an issue. <br/>Conclusion(s): It can be concluded
that the modified Warden procedure is a safe and effective method to
reconstruct the systemic venous drainage into the right atrium when a
direct anastomosis under tension might be prone to
re-stenosis.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<46>
Accession Number
2019504136
Title
Erector spinae plane block as perioperative analgesia for midline
sternotomy in cardiac surgery: A systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 37(12) (pp 5220-5229), 2022. Date of
Publication: December 2022.
Author
King M.; Stambulic T.; Servito M.; Mizubuti G.B.; Payne D.; El-Diasty M.
Institution
(King, Stambulic, Servito) School of Medicine, Queen's University,
Kingston, ON, Canada
(Mizubuti) Department of Anesthesiology and Perioperative Medicine,
Queen's University, Kingston, ON, Canada
(Payne, El-Diasty) Division of Cardiac Surgery, Department of Surgery,
Queen's University, Kingston, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Inadequate analgesia following cardiac surgery increases
postoperative complications. Opioid-based analgesia is associated with
side effects that may compromise postoperative recovery. Regional
anesthetic techniques provide an alternative thereby reducing opioid
requirements and potentially enhancing postoperative recovery. The erector
spinae plane block has been used in multiple surgical procedures including
sternotomy for cardiac surgery. We, therefore, aimed to characterize the
impact of this block on post-sternotomy pain and recovery in cardiac
surgery patients. <br/>Method(s): We conducted an electronic search for
studies reporting on the use of the erector spinae plane block in adult
cardiac surgery via midline sternotomy. Randomized controlled trials,
cohort studies, and case-control studies were considered for inclusion.
Outcomes of interest included postoperative pain, time-to-extubation, and
intensive care unit length of stay. <br/>Result(s): In total, 498
citations were identified and five were included in the meta-analysis. The
erector spinae plane block did not significantly reduce self-reported
postoperative pain scores at 4 h (-2.04; 95% confidence interval [CI]
-8.15 to 4.07; p =.29) or 12 h (-0.27; 95% CI -2.48 to 1.94; p =.65)
postextubation, intraoperative opioid requirements (-3.07; 95% CI -6.25 to
0.11; p =.05], time-to-extubation (-1.17; 95% CI -2.81 to 0.46; p =.12),
or intensive care unit (ICU) length of stay (-4.51; 95% CI -14.23 to 5.22;
p =.24). <br/>Conclusion(s): Erector spinae plane block was not associated
with significant reduction in postoperative pain, intraoperative opioid
requirements, time-to-extubation, and ICU length of stay in patients
undergoing cardiac surgery. The paucity of large randomized controlled
trials and the high heterogeneity among studies suggest that further
studies are required to assess its effectiveness in cardiac surgery
patients.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<47>
Accession Number
2019398873
Title
Role of advanced imaging techniques in cardiac surgery: Aortic dissection.
Source
Journal of Cardiac Surgery. 37(12) (pp 4165-4171), 2022. Date of
Publication: December 2022.
Author
Paneitz D.C.; Hedgire S.; Jassar A.S.
Institution
(Paneitz, Jassar) Division of Cardiac Surgery, Harvard Medical School,
Massachusetts General Hospital, Boston, MA, United States
(Hedgire) Department of Radiology, Division of Cardiovascular Imaging,
Harvard Medical School, Massachusetts General Hospital, Boston, MA, United
States
Publisher
John Wiley and Sons Inc
Abstract
Background: Collaboration among cardiac surgeons and radiologists is
essential to fully leverage advanced imaging technologies and improve the
care of cardiac surgery patients. In this review, a cardiac surgeon and
cardiovascular radiologist discuss imaging pearls and considerations in
aortic dissection cases. <br/>Method(s): The surgeon and the radiologist
discuss imaging considerations in two aortic dissection cases.
<br/>Result(s): It is essential to obtain and review all phases of a CTA
when diagnosing acute aortic pathology. Optimizing scan parameters and
careful multiplanar image review is necessary for adept interpretation.
Current CT technology allows ECG gating to eliminate motion artifact and
allow for dynamic assessment of the aortic pathology. Concurrent
evaluation of thoracic aorta and coronary arteries is feasible. A
systematic review of the scan using landmarks is critical for appropriate
diagnosis and reporting. As TEVAR is increasingly used for arch repair,
collaboration with radiologists is essential for preoperative planning in
redo cases. <br/>Conclusion(s): Collaboration among cardiac surgeons and
radiologists is mutually beneficial for surgeons, radiologists, and their
patients.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<48>
Accession Number
2019354098
Title
Coronary artery involvement in type A aortic dissection: Fate of the
coronaries.
Source
Journal of Cardiac Surgery. 37(12) (pp 5233-5242), 2022. Date of
Publication: December 2022.
Author
Kayali F.; Jubouri M.; Al-Tawil M.; Tan S.Z.C.P.; Williams I.M.; Mohammed
I.; Velayudhan B.; Bashir M.
Institution
(Kayali) School of Medicine, University of Central Lancashire, Preston,
United Kingdom
(Jubouri) Hull York Medical School, University of York, York, United
Kingdom
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Tan) Barts and The London School of Medicine and Dentistry, Queen Mary
University of London, London, United Kingdom
(Williams) Department of Vascular Surgery, University Hospital of Wales,
Cardiff, United Kingdom
(Mohammed, Velayudhan) Institute of Cardiac and Aortic Disorders (ICAD),
SRM Institutes for Medical Science (SIMS Hospital), Tamil Nadu, Chennai,
India
(Bashir) Vascular and Endovascular Surgery, Velindre University NHS Trust,
Health Education and Improvement Wales (HEIW), Cardiff, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Type A aortic dissection (TAAD) involves a tear in the intimal
layer of the thoracic aorta proximal to the left subclavian artery, and
hence, carries a high risk of mortality and morbidity and requires urgent
intervention. This dissection can extend into the main coronary arteries.
Coronary artery involvement in TAAD can either be due to retrograde
extension of the dissection flap into the coronaries or compression and/or
blockage of these vessels by the dissection flap, possibly causing
myocardial ischemia. Due to the emergent nature of TAAD, coronary
involvement is often missed during diagnosis, thereby delaying the
required intervention. <br/>Aim(s): The main scope of this review is to
summarize the literature on the incidence, mechanism, diagnosis, and
treatment of coronary artery involvement in TAAD. <br/>Method(s): A
comprehensive literature search was performed using multiple electronic
databases, including PubMed, Ovid, Scopus and Embase, to identify and
extract relevant studies. <br/>Result(s): Incidence of coronary artery
involvement in TAAD was seldom reported in the literature, however, some
studies have described patients diagnosed either preoperatively,
intraoperatively following aortic clamping, or even during autopsy. Among
the few studies that reported on this matter, the treatment choice for
coronary involvement in TAAD was varied, with the majority revascularizing
the coronary arteries using coronary artery bypass grafting or direct
local repair of the vessels. It is well-established that coronary artery
involvement in TAAD adds to the already high mortality and morbidity
associated with this disease. Lastly, the right main coronary artery was
often more implicated than the left. <br/>Conclusion(s): This review
reiterates the significance of an accurate diagnosis and timely and
effective interventions to improve prognosis. Finally, further large
cohort studies and longer trials are needed to reach a definitive
consensus on the best approach for coronary involvement in
TAAD.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<49>
Accession Number
2019260540
Title
Aortic valve neocuspidization using autologous versus bovine pericardium:
Ozaki versus Batista.
Source
Journal of Cardiac Surgery. 37(12) (pp 5207-5209), 2022. Date of
Publication: December 2022.
Author
Jubouri M.; Tan S.Z.C.P.; Mohammed I.; Bashir M.
Institution
(Jubouri) Hull York Medical School, University of York, York, United
Kingdom
(Tan) Barts and The London School of Medicine and Dentistry, Queen Mary
University of London, London, United Kingdom
(Mohammed) Institute of Cardiac and Aortic Disorders (ICAD), SRM
Institutes for Medical Science (SIMS Hospital), Tamil Nadu, Chennai, India
(Bashir) Vascular & Endovascular Surgery, Velindre University NHS Trust,
Health Education & Improvement Wales (HEIW), Cardiff, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: The average living age of the population is constantly
increasing and so is the incidence and prevalence of aortic valve disease.
Surgical aortic valve replacement (SAVR) is the current gold standard
treatment. Nevertheless, the use of prosthetic valves in SAVR is
associated with issues that impact patients' quality of life. Aortic valve
neocuspidization (AV Neo) offers a means to solve this dilemma by
minimizing foreign valve tissue. AV Neo can either be performed using
glutaraldehyde-treated autologous pericardium (Ozaki procedure) or bovine
pericardium (Batista procedure). <br/>Aim(s): This commentary aims to
discuss the recent study by Chan and colleagues which highlighted the
surgical approach, clinical outcomes, and limitations of the Ozaki
procedure, and compare this to the Batista procedure. <br/>Method(s): A
comprehensive literature search was performed using multiple electronic
databases including PubMed, Ovid, Embase, and Scopus to collate the
relevant research evidence. <br/>Result(s): Although the Ozaki procedure
can achieve favorable results whilst mainly avoiding the need for
life-long oral anticoagulation with mechanical valves, it still has
several limitations that may hinder results. AV Neo using
glutaraldehyde-treated bovine pericardium, developed by pioneer cardiac
surgeon Dr. Randas J. Vilela Batista, yields superior clinical outcomes to
Ozaki's, including excellent survival, lower complications, and minimal
need for reoperation as well as shorter operative times.
<br/>Conclusion(s): AV Neo offers a means to perform SAVR whilst escaping
the prosthetic valve issues. However, the Batista procedure has shown
beyond doubt that it can be considered the superior approach for AV Neo
over the Ozaki procedure.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<50>
Accession Number
2019260475
Title
Understanding aortic valve repair through Ozaki procedure: A review of
literature evidence.
Source
Journal of Cardiac Surgery. 37(12) (pp 5202-5206), 2022. Date of
Publication: December 2022.
Author
Chan J.; Basu A.; Di Scenza G.; Bartlett J.; Fan K.S.; Oo S.; Harky A.
Institution
(Chan, Oo) Department of Cardiac Surgery, Bristol Heart Institute,
University of Bristol, Bristol, United Kingdom
(Basu, Di Scenza, Fan) Department of Medical Education, St George's
University of London, London, United Kingdom
(Bartlett) Department of Medical Education, Institute of Life Sciences,
Swansea University Medical School, Wales, Swansea, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Aortic valve neocuspidization (AV Neo) using
glutaraldehyde-treated autologous pericardium was first reported by Ozaki
et al. in 2007. This technique has become an alternative to tissue and
mechanical valve in selected patients as long-term anticoagulation is not
required and shows promising midterm results and durability.
<br/>Method(s): A comprehensive search was performed on the major database
using the search terms "Ozaki technique" AND "Aortic Valve
Neocuspidization" AND "AV Neocuspidization" AND "Autologous pericardium"
AND "glutaraldehyde-treated autologous pericardium." Articles up to August
1st, 2021 were included in this study. <br/>Result(s): A total of nine
studies with a total of 1342 patients were included. The mean age was
67.36 and 54.23% were male. 66.32% and 23.92% of patients had aortic
stenosis and aortic regurgitation, respectively. 66% of patients had a
native tricuspid aortic valve (AV) and 31.37% of patients' native AV was
bicuspid. Three studies reported their experience performing AV Neo via
ministernotomy. <br/>Conclusion(s): AV Neo can be a suitable alternative
to surgical AV replacement in selected patients. The short- and midterm
outcomes are comparable without the need for long-term oral
anticoagulation. Long-term follow-up data are required for this novel
approach to be widely adopted.<br/>Copyright &#xa9; 2022 Wiley Periodicals
LLC.

<51>
Accession Number
2019037875
Title
Long-term outcomes of total arch replacement versus proximal aortic
replacement in acute type A aortic dissection: Meta-analysis of
Kaplan-Meier-derived individual patient data.
Source
Journal of Cardiac Surgery. 37(12) (pp 4256-4266), 2022. Date of
Publication: December 2022.
Author
Michel Pompeu S.a.; Jacquemyn X.; Tasoudis P.T.; Van den Eynde J.; Erten
O.; Sicouri S.; Dokollari A.; Torregrossa G.; Kurz S.; Heuts S.; Nienaber
C.A.; Coselli J.S.; Ramlawi B.
Institution
(Michel Pompeu, Torregrossa, Ramlawi) Department of Cardiothoracic
Surgery, Lankenau Medical Center, Lankenau Heart Institute, Main Line
Health, Wynnewood, PA, United States
(Michel Pompeu, Tasoudis, Erten, Sicouri, Dokollari, Torregrossa, Ramlawi)
Department of Cardiothoracic Surgery Research, Lankenau Institute for
Medical Research, Wynnewood, PA, United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Kurz) Department of Cardiothoracic and Vascular Surgery, German Heart
Center Berlin, Berlin, Germany
(Kurz) Department of Cardiovascular Surgery, Charite-Universitatsmedizin,
Berlin, Germany
(Heuts) Department of Cardiothoracic Surgery, Maastricht University
Medical Centre, Maastricht, Netherlands
(Nienaber) Cardiology and Aortic Centre, The Royal Brompton & Harefield
NHS Trust, London, United Kingdom
(Coselli) Department of Surgery, Division of Cardiothoracic Surgery,
Michael E. DeBakey Baylor College of Medicine, Houston, TX, United States
(Coselli) Department of Cardiovascular Surgery, Texas Heart Institute,
Houston, TX, United States
(Coselli) CHI St Luke's-Baylor St. Luke's Medical Center, Houston, TX,
United States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To evaluate the long-term outcomes of a conservative approach
(with proximal aortic replacement with or without hemiarch replacement)
versus an aggressive approach (with total aortic arch replacement) in the
treatment of acute type A aortic dissection (ATAAD). <br/>Method(s): We
performed a pooled analysis of Kaplan-Meier-derived individual patient
data from studies with follow-up comparing the aforementioned approaches
to treat patients with ATAAD. <br/>Result(s): Eighteen studies met our
eligibility criteria, comprising 5243 patients with follow-up
(Conservative: 3676 patients; Aggressive: 1567 patients). We observed a
statistically significant difference in overall survival favoring the
aggressive approach (hazard ratios [HR] 0.86, 95% confidence interval [CI]
0.76-0.98, p =.022), but no statistically significant difference in the
risk of reoperation (HR 0.89, 95% CI 0.66-1.2, p =.439) in the overall
follow-up. Landmark analyses revealed that, in the first 3 months after
the procedure, mortality rates were comparable between conservative and
aggressive approaches (HR 1.04, 95% CI 0.88-1.24, p =.627), but the
results beyond 3 months showed improved survival in patients undergoing
the aggressive surgical procedure (HR 0.71, 95% CI 0.59-0.85, p <.001).
The landmark analyses also revealed that, in the first 7 years after the
procedure, reoperation rates were comparable between the approaches (HR
1.03, 95% CI 0.76-1.40, p =.848), but the results beyond 7 years showed a
lower risk of reoperation in patients undergoing the aggressive surgical
procedure (HR 0.10, 95% CI 0.01-0.75, p =.025). <br/>Conclusion(s): The
aggressive approach seems to confer better long-term survival and lower
risk of the need for reoperation in the follow-up of patients treated for
ATAAD.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<52>
Accession Number
2020475414
Title
Safety of apixaban and rivaroxaban compared to warfarin after cardiac
surgery.
Source
Journal of Cardiac Surgery. 37(12) (pp 4740-4747), 2022. Date of
Publication: December 2022.
Author
Naik K.D.; Whitson B.A.; McLaughlin E.M.; Matre N.B.; Rozycki A.J.
Institution
(Naik) Department of Pharmacy, Cleveland Clinic Foundation, Columbus, OH,
United States
(Whitson) Department of Surgery, The Ohio State University Wexner Medical
Center, Columbus, United States
(McLaughlin) Department of Biostatistics, The Ohio State University,
Columbus, OH, United States
(Matre) Department of Quality and Operations, The Ohio State University
Wexner Medical Center, Columbus, OH, United States
(Rozycki) Department of Pharmacy, The Ohio State University Wexner Medical
Center, Columbus, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Direct oral anticoagulants (DOACs) are frequently prescribed
for the management of atrial fibrillation and venous thrombosis. There is
a lack of published data on the utilization of DOACs in individuals who
have undergone recent cardiac surgery. The purpose of this study was to
evaluate the safety and efficacy of apixaban and rivaroxaban compared to
warfarin in patients postcardiac surgery. <br/>Method(s): In this
retrospective cohort study, patients were separated into a DOAC cohort or
a warfarin cohort based on the agent they received after cardiac surgery.
Patients could be included if they were >=18 years of age and received or
were discharged on either rivaroxaban, apixaban, or warfarin within 7 days
after cardiac surgery. The primary outcome for the study was the rate of
International Society on Thrombosis and Hemostasis (ISTH) major bleeding
during hospitalization and for 30 days following discharge or until first
follow-up appointment. <br/>Result(s): There were a total of 194 patients
included in the analysis, 97 in the DOAC cohort and 97 in the warfarin
cohort. Four patients (4.1%) in the DOAC group experienced ISTH major
bleeding, while 2 patients (2.1%) in the warfarin cohort experienced ISTH
major bleeding (p = 0.68). No patients in the DOAC cohort experienced a
thrombotic event, whereas 2 patients (2.1%) in the warfarin cohort
experienced a thrombotic complication (p = 0.5). <br/>Conclusion(s):
Apixaban and rivaroxaban demonstrated similar safety when compared to a
matched cohort of warfarin patients. Larger prospective randomized studies
are needed to confirm these findings.<br/>Copyright &#xa9; 2022 The
Authors. Journal of Cardiac Surgery published by Wiley Periodicals LLC.

<53>
Accession Number
2020375153
Title
Impact of rapid rehabilitation surgery on perioperative nursing in
patients undergoing cardiac surgery: A meta-analysis.
Source
Journal of Cardiac Surgery. 37(12) (pp 5326-5335), 2022. Date of
Publication: December 2022.
Author
Feng W.; Zhou J.; Lei Y.; Chen W.; Miao Y.; Fu X.; Pi J.; Zhang M.; Na Z.;
Lou W.
Institution
(Feng, Lei, Chen, Miao, Fu, Pi, Zhang, Na) Cardiac Surgery Department,
Yan'an Hospital, Kunming, China
(Zhou) Department of Stomatology, Kunming Yanan Hospital, Kunming, China
(Zhou) Key Laboratory of Tumor Immunological Prevention and Treatment of
Yunnan Province, Yan'an Hospital, Yunnan, Kunming, China
(Lou) E.N.T. Department, Yan'an Hospital, Yunnan, Kunming, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: To systematically evaluate the effect of enhanced recovery
after surgery (ERAS) on perioperative nursing of patients undergoing
cardiac surgery. <br/>Method(s): A systematic literature search was
performed in PubMed, Embase, Web of science, Cochrane, CNKI, Wanfang, and
VIP using predefined search strings from inception of database to May
2021. Randomized control trials (RCTs) with sample size >40 on cardiac
surgery with either ERAS nursing or routine nursing reporting extubation
(trachea) time, length of stay, out of bed activity time, and nursing
satisfaction were included in the analysis. Stata SE 12.0 software was
used for statistical analysis. <br/>Result(s): A total of 27 RCTs were
included. All the included studies were Chinese due to lack of studies in
English. The results of meta-analysis showed that the extubation time
standardized mean difference ([SMD] = -3.11; 95% confidence interval [CI]:
-3.77, -2.45; p <.001), out of bed activity time (SMD = -2.89; 95% CI:
-3.34, -2.44; p <.001), and hospitalization time (SMD = -2.08; 95% CI:
-2.37, -1.79; p <.001) of cardiac surgery patients with ERAS nursing was
significantly shorter than those with routine nursing. The patient's
satisfaction after surgery with ERAS was higher than that of routine
nursing relative risk ([RR] = 1.24; 95% CI: 1.18, 1.30; p <.001).
<br/>Conclusion(s): ERAS nursing can accelerate perioperative
rehabilitation of patients undergoing cardiac surgery and highly accepted
by patients.<br/>Copyright &#xa9; 2022 The Authors. Journal of Cardiac
Surgery published by Wiley Periodicals LLC.

<54>
Accession Number
2020227844
Title
A comprehensive review of cerebral oximetry in cardiac surgery.
Source
Journal of Cardiac Surgery. 37(12) (pp 5418-5433), 2022. Date of
Publication: December 2022.
Author
Moore C.C.; Yu S.; Aljure O.
Institution
(Moore, Aljure) Jackson Memorial Hospital/University of Miami Miller
School of Medicine, Miami, FL, United States
(Yu) Mayo Clinic, Phoenix, AZ, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Patients who undergo cardiac surgery are at increased risk of
stroke, postoperative cognitive decline, and delirium. These
neurocognitive complications have led to increased costs, intensive care
unit stays, morbidity, and mortality. As a result, there is a significant
push to mitigate any neurological complications in cardiac surgery
patients. Near-infrared spectroscopy to measure regional cerebral oxygen
saturations has gained consideration due to its noninvasive and
user-friendly nature. Cerebral oximetry desaturations during cardiac
surgery have been linked to an array of adverse clinical outcomes.
However, the most effective intraoperative interventions to protect this
vulnerable patient population have yet to be ascertained. Aim of Study: To
provide a comprehensive summary of the intraoperative management for
cerebral oximetry desaturations during cardiac surgery. The review
highlights clinical outcomes from cerebral oximetry use to quantify the
importance of identifying cerebral desaturations during cardiac surgery.
The review then interrogates possible interventions for cerebral oximetry
desaturations in an effort to determine which interventions are most
efficacious and to enlighten possible areas for further research.
<br/>Method(s): A narrative review of randomized controlled trials,
observational studies, and systematic reviews with metanalyses was
performed through August 2021. <br/>Result(s): There is significant
heterogeneity among patient populations for which cerebral oximetry
monitoring has been studied in cardiac surgery. Further, the definition of
a clinically significant cerebral desaturation and the assessment of
neurocognitive outcomes varied substantially across studies. As a result,
metanalysis is challenging and few conclusions can be drawn. Cerebral
oximetry use during cardiac surgery has not been associated with
improvements in neurocognitive outcomes, morbidity, or mortality to date.
The evidence to support a particular intervention for an acute
desaturation is equivocal. <br/>Conclusion(s): Future research is needed
to quantify a clinically significant cerebral desaturation and to
determine which interventions for an acute desaturation effectively
improve clinical outcomes.<br/>Copyright &#xa9; 2022 Wiley Periodicals
LLC.

<55>
Accession Number
2020227833
Title
Health-related quality of life impacts upon 5-year survival after coronary
artery bypass surgery.
Source
Journal of Cardiac Surgery. 37(12) (pp 4899-4905), 2022. Date of
Publication: December 2022.
Author
Bishawi M.; Hattler B.; Almassi G.H.; Quin J.A.; Grover F.L.; Collins
J.F.; Ebrahimi R.; Wolbrom D.H.; Shroyer A.L.
Institution
(Bishawi) Department of Surgery, Duke University, Durham, NC, United
States
(Hattler) Rocky Mountain Regional Veterans Affairs Medical Center, Aurora,
CO, United States
(Hattler) Division of Cardiology, University of Colorado School of
Medicine, Aurora, CO, United States
(Almassi) Department of Surgery, Clement J. Zablocki Veterans Affairs (VA)
Medical Center, Milwaukee, WI, United States
(Almassi) Department of Surgery, Division of Cardiothoracic Surgery,
Medical College of Wisconsin, Milwaukee, WI, United States
(Quin) Department of Surgery, Division of Cardiac Surgery, VA Boston
Healthcare System, Boston, MA, United States
(Grover) Department of Surgery, Division of Cardiothoracic Surgery,
University of Colorado School of Medicine, Denver, CO, United States
(Collins) Cooperative Studies Program Coordinating Center, Veterans
Affairs Medical Center, Perry Point, MD, United States
(Ebrahimi) Department of Cardiology, Veterans Affairs Greater Los Angeles
Healthcare System, Los Angeles, CA, United States
(Ebrahimi) Department of Medicine, University of California Los Angeles,
Los Angeles, CA, United States
(Wolbrom, Shroyer) Northport Veterans Affairs Medical Center, Research and
Development Office, Northport, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Poor preoperative health-related quality of life (HRQoL) has
been associated with reduced short-term survival after coronary artery
bypass graft (CABG) surgery; however, its impact on long-term mortality is
unknown. This study's objective was to determine if baseline HRQoL status
predicts 5-year post-CABG mortality. <br/>Method(s): This prespecified,
randomized on/off bypass follow-up study (ROOBY-FS) subanalysis compared
baseline patient characteristics and HRQoL scores, obtained from the
Seattle Angina Questionnaire (SAQ) and Veterans RAND Short Form-36
(VR-36), between 5-year post-CABG survivors and nonsurvivors. Standardized
subscores were calculated for each questionnaire. Multivariable logistic
regression assessed whether HRQoL survey subcomponents independently
predicted 5-year mortality (p <=.05). <br/>Result(s): Of the 2203 ROOBY-FS
enrollees, 2104 (95.5%) completed baseline surveys. Significant
differences between 5-year post-CABG deaths (n = 286) and survivors (n =
1818) included age, history of chronic obstructive pulmonary disease,
stroke, peripheral vascular disease, renal dysfunction, diabetes, lower
left ventricular ejection fraction, atrial fibrillation, depression,
non-White race/ethnicity, lower education status, and off-pump CABG.
Adjusting for these factors, baseline VR-36 physical component summary
score (p =.01), VR-36 mental component summary score (p <.001), and SAQ
physical limitation score (p =.003) were all associated with 5-year
all-cause mortality. <br/>Conclusion(s): Pre-CABG HRQoL scores may provide
clinically relevant prognostic information beyond traditional risk models
and prove useful for patient-provider shared decision-making and enhancing
pre-CABG informed consent.<br/>Copyright Published 2022. This article is a
U.S. Government work and is in the public domain in the USA.

<56>
Accession Number
2020227831
Title
Pre-emptive intraoperative administration of PCC4 in cardiac surgery
patients at high risk of bleeding: A pilot study.
Source
Journal of Cardiac Surgery. 37(12) (pp 5130-5134), 2022. Date of
Publication: December 2022.
Author
Elder J.; McComb J.; Lirette S.; Herndon B.; Yancey G.; Mohammed A.;
Copeland H.
Institution
(Elder, McComb, Herndon, Yancey, Mohammed) Cardiothoracic and Transplant
Surgery, Lutheran Hospital of Indiana, Fort Wayne, IN, United States
(Lirette) Fulcrum, Jackson, MS, United States
(Copeland) Cardiothoracic Surgery, Heart Transplant and Mechanical
Circulatory Support, Lutheran Hospital - Fort Wayne Indiana, United States
(Copeland) Indiana University School of Medicine, Fort Wayne (IUSM-FW),
IN, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Four-factor prothrombin complex (PCC4), a concentrate of
factors II, VII, IX, and X and proteins C and S, has been used selectively
for reversal of oral anticoagulation before surgery. There is data to
support PCC4 as opposed to supplemental fresh frozen plasma (FFP) to
manage postoperative bleeding following cardiac surgery. The preemptive,
intraoperative use of PCC4 in cardiothoracic surgery has not been studied
though it may prevent postoperative bleeding, the need for blood
transfusion and the risk of transfusion-related acute lung injury, volume
overload, and right ventricular (RV) heart failure. The purpose of this
study is to evaluate the intraoperative administration of PCC4 to decrease
bleeding and lower the rate of blood transfusion. <br/>Method(s): A single
institution retrospective chart review was conducted from May 2020 to
November 2021 of patients who received PCC4 intraoperatively during
cardiothoracic surgery of high-risk variety. Patients were evaluated for
the type of surgery, demographics, baseline anticoagulation, PCC4 dose,
type and quantity of blood transfusion within 72 hours (h)
postoperatively, chest tube output, the incidence of RV failure,
hypersensitivity reactions, acute kidney injury (AKI), thrombosis, acute
lung injury, and mortality within 45 days of the operative dose of PCC4.
<br/>Result(s): Thirty-five patients received PCC4 at a mean dose of 2920
units (U). Sixty-five percent of cases were left ventricular assist
devices (LVADs) or heart transplants. The protocol is to use PCC4 30 units
(U)/kg immediately after the completion of protamine administration.
Inclusion criteria are cardiothoracic surgery with increased risk of
postoperative right heart failure commonly secondary to blood product
transfusion, or cardiothoracic surgery associated with increased risk of
bleeding, including heart transplant, LVAD implant, aortic dissection, and
redo sternotomy (e.g., coronary artery bypass). Total chest tube output
was recorded as a mean of 757 ml for 24 h after surgery (32 ml/h). Overall
median event rates of FFP and red blood cell (RBC) transfusions were 0
(interquartile range [IQR]: 0-3 U) and 4 (IQR: 2-5 U). Overall, 43% and
89% of cases received FFP and RBC, respectively. There was one occurrence
of RV failure, one occurrence of AKI requiring renal replacement therapy,
one occurrence of venoarterial extracorporeal membrane oxygenation, one
occurrence of venous thromboembolism related to a central venous access
line, and one death unrelated to surgery or PCC4 that was attributed to
advanced heart failure not amenable to advanced therapies.
<br/>Conclusion(s): Overall patients received a low rate of blood
transfusion, had minimal chest tube output, and there was a small
incidence of right heart failure. Patients did not have an increased risk
of adverse effects such as AKI or venous thromboembolism. A randomized
controlled clinical trial comparing the observed dose and timing of PCC4
versus routine postoperative bleeding management with blood product
transfusion is recommended.<br/>Copyright &#xa9; 2022 Wiley Periodicals
LLC.

<57>
Accession Number
2020227824
Title
Contemporary utilization of the axillary artery in cardiac surgery.
Source
Journal of Cardiac Surgery. 37(12) (pp 5404-5410), 2022. Date of
Publication: December 2022.
Author
Rogers M.P.; DeSantis A.J.; Gemayel K.; Bommareddi S.R.; Caceres Polo M.;
Hooker R.L.
Institution
(Rogers, DeSantis, Gemayel, Bommareddi) Department of Surgery, University
of South Florida Morsani College of Medicine, Tampa, FL, United States
(Caceres Polo) Department of Cardiac Surgery, Christus Spohn Hospital,
Corpus Christi, TX, United States
(Hooker) Department of Surgery, Division of Cardiothoracic Surgery,
University of Arizona College of Medicine, Tucson, AZ, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The axillary artery is a reliable inflow vessel when
addressing pathology of the aortic root and aortic arch that may preclude
standard central cannulation strategies. This narrative review examines
the use of the axillary artery in cardiac surgery. Anatomy, indications
for use, cannulation strategies, and potential complications will be
discussed. <br/>Method(s): A comprehensive review of the current
literature was performed using PubMed, Cochrane Review, and authoritative
committee guidelines. A narrative review incorporating current available
evidence was undertaken. Comment: Use of the axillary artery in select
cardiac surgical cases is reliable, reproducible, and may be preferable in
certain cases involving ascending aortic pathology, reoperative surgery,
porcelain aorta, access for transcatheter valve therapies, and peripheral
mechanical circulatory support.<br/>Copyright &#xa9; 2022 Wiley
Periodicals LLC.

<58>
Accession Number
639922203
Title
THORAFLEX HYBRID AS FROZEN ELEPHANT TRUNK.
Source
European Heart Journal, Supplement. Conference: 83rd SIC National
Congress. Virtual. 24(Supplement K) (pp K246), 2022. Date of Publication:
December 2022.
Author
Vincenzo G.A.A.P.
Institution
(Vincenzo) Aorn Ospedali Dei Colli - V.Monaldi, Italy
Publisher
Oxford University Press
Abstract
Introduction: Dissection and aneurysms of the aorta are pathologies that
greatly compromise the prognosis of patients. By examining these
pathologies in the area under consideration, knowing that they also
subject the epiacortic arterial structures to this dilation, an
endovascular solution was sought that would reduce the long and risky
times of surgery. A hybrid operation that is implemented is that of the
Thora flex TM implant. During cardiac surgery, the replacement of the
ascending aorta, whether by dissection or aneurysm, is incorporated with
the endovascular implant with this state-of-the-art prosthesis that can
circumscribe the problem to the descending thoracic aorta. This device has
three outlets that will play the role of the supraortic arteries.
<br/>Purpose(s): Assessment of patients for the treatment of aneurysms and
chronic thrombosed dissections of the aortic arch and describe the
effectiveness of this treatment. <br/>Method(s): A Pubmed search related
to clinical data and field experience was performed. <br/>Result(s):
Patients with different aortic pathology were treated and evaluated. The
recovery, compared to the classic surgery, was faster due to the lower
exposure to extra-body circulation and a reduced surgical time.
<br/>Conclusion(s): Thora flex TM hybrid as frozen elephant trunk presents
a cutting-edge option and a valid alternative for the treatment of complex
aortic pathologies. It is clear how much, despite the surgery, the risks
of stroke, of infections due to the procrastination of the operation are
considerably reduced and above all how the mortality rate has been
reduced, making the approach to a pathology that is usually treated less
complex in an emergency.

<59>
Accession Number
639922137
Title
NATURAL HISTORY AND CLINICAL BURDEN OF MODERATE AORTIC STENOSIS: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
European Heart Journal, Supplement. Conference: 83rd SIC National
Congress. Virtual. 24(Supplement K) (pp K262), 2022. Date of Publication:
December 2022.
Author
Morelli M.; Galasso M.; Soriano F.S.; Nava S.; Da Pozzo C.; Esposito G.;
Piccaluga E.; Bossi I.; Montalto C.; Oreglia J.A.; Giannattasio C.
Institution
(Morelli, Galasso, Giannattasio) School of Medicine and Surgery,
University of Milano-Bicocca, Milan, Italy
(Soriano, Nava, Esposito, Bossi, Montalto, Oreglia) Emodinamica,
Cardiologia I, Asst Grande Ospedale Metropolitano Niguarda, Milan, Italy
(Da Pozzo) School of Medicine and Surgery, University of Milan, Milan,
Italy
(Piccaluga, Giannattasio) Cardiologia Iv,Dipartimento A. De Gasperis, Asst
Grande Ospedale Metropolitano Niguarda, Milan, Italy
Publisher
Oxford University Press
Abstract
Objectives: The aim of this study was to assess the natural history and
clinical burden of moderate aortic stenosis and to investigate the
interaction of left ventricular ejection fraction and of age with
prognosis. <br/>Background(s): The mortality risk of patients with
moderate aortic stenosis is not well known but recent studies suggested
that it might negatively affect prognosis. <br/>Method(s): A systematic
research was conducted on PubMed. The inclusion criteria were: 1)
inclusion of patients with moderate aortic stenosis; 2) report of the
survival at 1-year follow-up (minimum). Incidence ratios related to
all-cause mortality in patients and controls of each study were estimated
and then pooled using a fixed effects model. Meta-regression analysis was
performed to assess the impact of left ventricular ejection fraction and
age on the prognosis of patients with moderate aortic stenosis.
<br/>Result(s): Fifteen studies and 11,596 patients with moderate aortic
stenosis were included. All-cause mortality was significantly higher among
patients with moderate aortic stenosis than among controls: 10.7% (95% CI:
0.1010-0.1136) vs 4.5% (95% CI: 0.0438-0.0454) at 1-year, 17.7% (95% CI:
0.1692-0.1854) vs 7.6% (95% CI: 0.0754-0.0775) at 2-year, 23.0% (95% CI:
0.2204-0.2387) vs 9.9% (95% CI: 0.0973-0.0997) at 3-year, 27.9% (95% CI:
0.2685-0.2899) vs 11.9% (95% CI: 0.1177-0.1203) at 4-year, and 32.4% (95%
CI: 0.3125-0.3360) vs 14.2% (95% CI: 0.1402-0.1430) at 5-year follow-up.
Left ventricular ejection fraction did not significantly impact on the
prognosis of patients with moderate aortic stenosis (estimate = -0.0020;
95% CI: -0.0078-0.0038; p = 0.4584), unlike of age (estimate = 0.0067; 95%
CI: 0.0007-0.0127; p = 0.0323). <br/>Conclusion(s): Moderate aortic
stenosis is not a benign disease. Further studies are necessary to confirm
the prognostic impact of this valvulopathy and the possible benefit of the
aortic valve replacement..

<60>
Accession Number
639922120
Title
APPLICABILITY AND PERFORMANCE OF HEART FAILURE PROGNOSTIC SCORES IN
DILATED CARDIOMYOPATHY: THE EXPERIENCE OF AN ITALIAN REFERRAL CENTER FOR
CARDIOMYOPATHIES.
Source
European Heart Journal, Supplement. Conference: 83rd SIC National
Congress. Virtual. 24(Supplement K) (pp K227-K228), 2022. Date of
Publication: December 2022.
Author
Rossi M.; Teso M.V.; Mase M.; Barbati G.; Stolfo D.; Merlo M.; Sinagr G.
Institution
(Rossi, Teso, Mase, Barbati, Stolfo, Merlo, Sinagr) Cardiovascular
Department, Azienda Sanitaria-Universitaria Giuliano-Isontina (Asugi),
University of Trieste, Italy
Publisher
Oxford University Press
Abstract
Background: Many prognostic risk scores have been developed for ambulatory
Heart Failure (HF) patients, but none of these has been validated in
Dilated Cardiomyopathy (DCM), that is a peculiar model of HF. <br/>Aim(s):
To evaluate and compare the applicability and performance of major HF risk
models in a large real-world population of DCM patients Methods: This was
a retrospective study including 784 consecutive non ischemic DCM patients,
both inpatients and outpatients, enrolled in the Heart Muscle Disease
Registry (HMDR) of Trieste between January 2000 and December 2017. The
following scores designed to estimate 1- to 3-year all-cause mortality
were calculated in each participant: CHARM (Candesartan in Heart
Failure-Assessment of Reduction in Mortality), MAGGIC (Meta-analysis
Global Group in Chronic Heart Failure), simplified-SHFM (Seattle Heart
Failure Model), 3-CHF (Cardiac and Comorbid Conditions), GISSI-HF (Gruppo
Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico-Heart
Failure), MECKI (Metabolic Exercise test data combined with Cardiac and
Kidney Indexes), Barcelona Bio-HF, Krakow score. <br/>Result(s): During
the follow-up (5,83 +/- 4,9 years) 191 patients (20% of the population)
met the primary composite endpoint (158 deaths, 30 heart transplantations
and 3 LVAD implants). Due to the high quote of missing parameters, only
four of the prognostic models (MAGGIC, CHARM, 3-CHF and simplified-SHFM)
could be tested in the final statistical analysis. The
observed-to-predicted mortality ratios suggested an overestimation of
mortality by all scores. The prognostic accuracy of the scales was
suboptimal in DCM patients for MAGGIC (AUC 0.754) and CHARM (AUC 0.720)
scores, worse for 3-CHF (AUC 0,677) and simplified-SHFM (AUC 0,667)
scores, with the MAGGIC and simplified-SHFM respectively providing the
best and worst performance <br/>Conclusion(s): The performance of HF
prognostic risk scores is suboptimal for DCM patients. The need for new
precise risk models tailored for this disease has to be considered..

<61>
Accession Number
639922013
Title
COMPARISON OF DEMOGRAPHIC, CLINICAL, BIOCHEMICAL AND IMAGING AND IMAGING
FINDINGS IN HYPERTROPHIC CARDIOMYOPATHY PROGNOSIS: A NETWORK
META-ANALYSES.
Source
European Heart Journal, Supplement. Conference: 83rd SIC National
Congress. Virtual. 24(Supplement K) (pp K209-K210), 2022. Date of
Publication: December 2022.
Author
Beltrami M.; Olivotto I.; Figliozzi S.; Pateras K.; Niccoli F.; Bampatsias
D.; Finocchiaro G.; Chiribiri A.; Masci P.G.; Georgiopoulos G.
Institution
(Beltrami) San Giovanni Di Dio Hospital,Florence, Cardiomyopathy Unit,
University of Florence, Italy
(Olivotto) Cardiomyopathy Unit, Careggi University Hospital, Italy
(Finocchiaro, Chiribiri, Masci, Georgiopoulos) King's College, London,
United Kingdom
(Bampatsias) University of Athens, Greece
(Figliozzi) Humanitas Research, Rozzano, Mi, Italy
(Pateras) University Medical Center, Utrecht, Netherlands
(Niccoli) Humanitas Gavazzeni, Bergamo, Italy
Publisher
Oxford University Press
Abstract
Background: Despite hypertrophic cardiomyopathy (HCM) being the most
common inherited heart disease and conferring increased risk for heart
failure (HF) and sudden cardiac death (SCD), risk assessment in HCM
patients is still largely unresolved. <br/>Objective(s): To synthesize and
compare the prognostic impact of demographic, clinical, biochemical, and
imaging findings in patients with HCM. <br/>Method(s): We searched PubMed,
Embase, and Cochrane Library for studies published from inception to
November 2020, and the endpoints were: i) all-cause death; ii) an
arrhythmic endpoint including SCD, sustained ventricular tachycardia,
ventricular fibrillation, or aborted SCD; iii) a composite endpoint
including i) or ii) plus hospitalization for HF or cardiac
transplantation. We performed a pairwise meta-analysis obtaining the
pooled estimate separately for the association between baseline variables
and study endpoints. A random-effects network meta-analysis (NMA) was
subsequently used to comparatively assess the prognostic value of outcome
predictors. <br/>Result(s): One-hundred-eleven studies with 56,792 HCM
patients were included. Among others, increased BNP/NT-proBNP,
late-gadolinium-enhancement (LGE), positive genotype, impaired global
longitudinal strain and presence of apical aneurysm conferred increased
risk for the composite endpoint. At NMA, LGE showed the highest prognostic
value for all endpoints and was superior to all other predictors except
NYHA class>=II. A multiparametric imaging-based model was superior in
predicting the composite endpoint compared to a pre-specified model based
on conventional risk factors. <br/>Conclusion(s): This network
meta-analysis supports the development of multiparametric risk prediction
algorithms, including advanced imaging markers additively to conventional
risk factors, for refined risk stratification in HCM.

<62>
Accession Number
639921940
Title
ULTRASOUND GUIDED CANNULATION OF FEMORAL ARTERY IN PATIENTS UNDERGOING
TRANSCATHETER AORTIC VALVE REPLACEMENT.
Source
European Heart Journal, Supplement. Conference: 83rd SIC National
Congress. Virtual. 24(Supplement K) (pp K117), 2022. Date of Publication:
December 2022.
Author
Di Costanzo A.; Sorrentino S.; Panarello A.; Spinali M.; Bellantoni A.;
Boccuto F.; Mariani A.; Manzo R.; Molaro M.I.; Polimeni A.; Spaccarotella
C.; Mongiardo A.; Esposito G.; Indolfi C.
Institution
(Di Costanzo, Sorrentino, Panarello, Spinali, Bellantoni, Boccuto,
Mariani, Polimeni, Mongiardo, Indolfi) Division of Cardiology, Departement
of Medical and Surgical Science, Magna Graecia University, Catanzaro,
Italy
(Manzo, Molaro, Spaccarotella, Esposito) Division of Cardiology, Advanced
Biomedical Sciences, Federico Ii University, Naples, Italy
Publisher
Oxford University Press
Abstract
Background: Vascular access complications are a significant source of
morbidity and mortality after transcatheter aortic valve replacement
(TAVR). Ultrasound-guided cannulation (UGC) of central veins or arteries
is a widely used approach for patients undergoing invasive procedures.
Whether UGC significantly decreases the risk of vascular access
complications also for large-bore access procedures, such as TAVR, lacks
evidence Objectives: in this study, we aimed to evaluate the benefits of
routine use of UGC in patients undergoing TAVR. <br/>Method(s): Data were
retrospectively collected from two high-volume TAVR centers from September
2009 to March 2022. UGC was performed using a two-dimensional ultrasound
short-axis views, while manual palpation, fluoroscopy, or contralateral
angiography were used for the other patients. The odds ratio (OR) for
vascular complications was calculated using a multivariate logistic
regression model including as dependent variables all relevant baseline
and procedural characteristics (forward stepwise selection process).
Vascular complications were adjudicated according to the Valve Academic
Research Consortium definitions 3. <br/>Result(s): Out of 874 patients
included in the study, UGC access was performed in 177 subjects. Overall
mean age was 80.2+/-5.8 years old, 60% of patients were females, 35.5% had
diabetes, 61.4% had dyslipidemia, and 27.8% had chronic kidney disease,
with a mean left ventricular ejection fraction of 52.7+/-9.7%. Looking at
the procedural variables Euroscore II was 5.8+/-5.4, second and third
valves generation have been used in 85% of the cases, while suture-based
closure devices in 84% of subjects. After adjustment for clinical and
procedural variables, routinely use of UGC was associated with a lower
rate of total [Odds Ratio (OR): 0.38; 95% confidence interval (CI) 0.15%
to 0.95%)] and major vascular complications [Odds Ratio (OR): 0.21; 95%
confidence interval (CI) 0.05% to 0.75%)], while no differences were
observed for minor vascular complications. <br/>Conclusion(s): Routinely
use of UGC significantly decreases the risk of vascular complications in
patients undergoing TAVR. However, a dedicated randomized clinical trial
assessing the safety and efficacy of this approach is warranted to confirm
our results in this high-risk population.

<63>
Accession Number
639921911
Title
THE USEFULNESS OF CEREBRAL PROTECTION DURING TAVR: A METANALYSIS.
Source
European Heart Journal, Supplement. Conference: 83rd SIC National
Congress. Virtual. 24(Supplement K) (pp K256), 2022. Date of Publication:
December 2022.
Author
Boccuto F.; Carabetta N.; Cacia M.A.; Panuccio G.; Critelli C.; Indolfi
C.; De Rosa S.
Institution
(Boccuto, Carabetta, Panuccio, Critelli, Indolfi, De Rosa) Division of
Cardiology and Center of Cardiovascular Research, Department of Medical
and Surgical Sciences, Magna Graecia University of Catanzaro, Italy
(Cacia) Clinical and Interventional Cardiology, Cardiac Center, Irccs
Humanitas Research Hospital, Rozzano-Milan, Italy
Publisher
Oxford University Press
Abstract
Introduction: although transcatheter aortic valve replacement (TAVR)
represents a milestone in the treatment of degenerative aortic stenosis,
stroke remains an important complication compared to surgical aortic valve
replacement (SAVR). Multiple magnetic resonance imaging (MRI) studies
demonstrated a substantial rate of new cerebral ischemic lesions after
TAVR. In order to avoid debris passage into the circulation and to prevent
procedure-related embolic stroke, cerebral embolic protection (CEP)
devices were developed. However, their safety and efficacy remain
controversial. Very recently, new studies provided additional evidence on
this topic. <br/>Aim(s): to assess the entire body of evidence from
randomized controlled studies about neurological outcomes after TAVR.
<br/>Material(s) and Method(s): a systematic meta-analysis was conducted
according to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines. We searched MEDLINE, Scopus, and Google
Scholar for randomized controlled studies. The following keywords were
used for the search: "transcatheter aortic valve implantation or "stroke
prevention or "embolic protection and "cerebral protection. Study groups
were defined as a the "CEP group and the "control group. Non-randomized
studies reporting outcomes with cerebral embolic protection (CEP) during
TAVR were excluded to reduce the selection and confounding bias of
observational pilot studies. The primary outcome was post-procedural
stroke. Secondary outcomes included total lesion volume on MRI and new
ischemic lesions on MRI. <br/>Result(s): nine trials including 4077
patients were eligible for analysis and included to the meta-analysis. Of
those, 2203 patients were randomized to cerebral embolic protection and
1874 patients to control group. Despite the rate of post-procedural stroke
was higher in the CEP arm (2.27%) compared to the control arm (2.87%,
p<0.001), the use of cerebral embolic protection was not associated with a
significantly lower risk of stroke (OR=0.82, 95% CI 0.59-1.15; p=0.255).
Cumulative meta-analysis revealed a trend towards a lower impact on stroke
prevention with more recent trials. <br/>Conclusion(s): use of cerebral
embolic protection devices during TAVR is a safe procedure. However, the
current outline of results from all randomized controlled trials available
does not support its routine use, as no significant reduction of stroke
risk was evident. The use of these devices might be considered in selected
high-risk patients, such as in the setting of heavy calcified cusps or
atherosclerotic aortic lesions..

<64>
Accession Number
639921785
Title
LEFT ATRIAL STRAIN AS A PRGONOSTIC MARKER IN ACUTE AND CHRONIC HEART
FAILURE : A META-ANALYSIS AND META-REGRESSION ANALYSIS.
Source
European Heart Journal, Supplement. Conference: 83rd SIC National
Congress. Virtual. 24(Supplement K) (pp K78), 2022. Date of Publication:
December 2022.
Author
Pastore M.C.; Mandoli G.E.; Saglietto A.; Stefanini A.; Vigna M.;
Carrucola C.; Fusini L.; Cavigli L.; D'Ascenzi F.; Focardi M.; Valente S.;
Cameli M.
Institution
(Pastore, Mandoli, Stefanini, Vigna, Carrucola, Cavigli, D'Ascenzi,
Focardi, Valente, Cameli) Department of Medical Biotechnologies, Division
of Cardiology, University of Siena, Siena, Italy
(Fusini) Department of Cardiovascular Imaging, Centro Cardiologico Monzino
Irccs, Milan, Italy
(Saglietto) Division of Cardiology, Cardiovascular and Thoracic
Department, Citta Della Salute E Della Scienza Hospital, Turin, Italy
Publisher
Oxford University Press
Abstract
Background: Heart failure (HF) is a global health burden which prognostic
assessment is currently challenging. Speckle tracking echocardiography
(STE) has gained increasing importance for the diagnostic and prognostic
assessment of HF. Left atrial (LA) strain by STE is widely recognized as
an index of diastolic function and left ventricular (LV) filling pressures
and fibrosis. Moreover, many studies have investigated its prognostic
value in HF with reduced, mildly reduced and preserved ejection fraction
(HFrEF, HFmrEF and HFpEF). <br/>Objective(s): our aim was to
systematically investigate the prognostic value of peak atrial
longitudinal strain (PALS) for cardiovascular (CV) events in HF and its
variation in acute/chronic HF and according to LV function, age and
gender. <br/>Method(s): A systematic literature search of medical
databases including Pubmed, Scopus, Ovid Online, EMBASE, Web of Science,
Cochrane Central Register, Scopus was performed using PRISMA principles.
All relevant studies in English language reporting the predictive value of
LA strain for mortality and/or CV events (CV death, hospitalization for
HF, cardiac transplant, ventricular assist device implantat) in HFrEF,
HFmrEF and HFpEF, with follow up>6 months were identified. All-cause
mortality and HF hospitalizations were considered as primary endpoint.
Hazard ratios (HR) were performed using a random effect model reporting on
the association of global PALS and outcome and described as pooled
estimates with 95% confidence intervals (CI). <br/>Result(s): Eight
studies (5767 patients, median [IQR] age=66.3 [65;68.6], 37% female)
satisfied the inclusion criteria (5 studies chronic HF, 2 studies acute
HF, 1 study in acute and chronic HF). Overall, 6 studies included patients
with HFrEF, 3 studies patients with HFmrEF and 5 patients with HFpEF.
Median global PALS value was 17.6 [14.9;26.8]%, median LVEF was 36
[30;56]% and median LV global longitudinal strain (GLS) was -9
[-7;-16.9]%. Over a median follow up of 903 [321;1062] months, 2688
patients reached the primary endpoint (944 all-cause mortality, 1963 HF
hospitalization). Each unit decrease in Global PALS was independently
associated with a 5% increase for the primary endpoint (meta-analytic HR
1.05; 95% CI [1.02-1.07]; p<0.01). Subgroup analysis conducted in patients
with acute and chronic HF showed no differences (p=0.18). Meta-regression
analysis showed that the prognostic value of global PALS was higher for
lower LVEF values (beta=-0.0023), a similar trend was observed for worse
LV GLS and lower age without reaching statistical significance. Funnel
plot analysis showed no publication bias (Egger's p=0.45).
<br/>Conclusion(s): Global PALS may be used as a useful prognostic tool in
HF, both in acute and chronic setting and especially in patients with
HFrEF, providing an additional independent value for risk stratification
of these patients in clinical practice. (Figure Presented).

<65>
Accession Number
639921749
Title
ACUTE ACALCULOUS CHOLECYSTITIS AND CARDIOVASCULAR DISEASE, WHICH CAME
FIRST?.
Source
European Heart Journal, Supplement. Conference: 83rd SIC National
Congress. Virtual. 24(Supplement K) (pp K184), 2022. Date of Publication:
December 2022.
Author
Fiore D.; Sarago M.; Rizzuto A.; Indolfi C.; Pulitano L.; De Rosa S.;
Amaddeo A.; Bozzarello C.; Iannello A.M.; Sammarco G.
Institution
(Fiore, Sarago, Rizzuto, Indolfi, Pulitano, De Rosa, Amaddeo, Bozzarello,
Iannello, Sammarco) Department of Medical and Surgical Sciences,
University Magna Graecia of Catanzaro, Italy
Publisher
Oxford University Press
Abstract
Background: The existence of a close association between disease of the
biliary tract and heart's disease is known from the mists of time. Acute
acalculous cholecystitis (AAC) can be defined as an acute
necro-inflammatory disease of the gallbladder in the absence of
cholelithiasis. AAC is a challenging diagnosis. The atypical clinical
onset associated to a paucity and similarity of symptoms and to laboratory
data mimicking cardiovascular disease (CVD) often results in under and
misdiagnosed cases. Moreover, AAC has commonly a fulminant course compared
to calculous cholecystitis and it is often associated with gangrene,
perforation and empyema as well as considerable morbidity and mortality(up
50%). Early diagnosis is crucial to a prompt treatment in order to avoid
complications and to increase survivability. Even today, although
scientific evidence has shown a close association between AAC and CVD, due
to the lack of RCT, there is still a lot of confusion regarding the
relationship and consequently the clinical management AAC and CVD. In
addition, emergency physicians are not always familiar with transient ECG
changes with AAC. <br/>Aim(s): the aim of this review was to provide
evidence regarding epidemiology, pathophysiology, clinical presentation
and treatment of the complex association between AAC and CVD.
<br/>Method(s): we searched for publications addressing Acalculous
cholecystitis and cardiovascular disease, consulting Medline and Scopus
databases. Any retrospective or prospective study design or systematic
review focusing on the aforementioned topic was accepted. This study was
conducted in accordance with the PRISMA and AMSTAR Guidelines. Our search
rendered 1422 hits (995 from Medline and 427 from Scopus). After removing
the duplicates, there were 114 studies. After progressive screening, 268
full texts were assessed for eligibility and 135 studies were included in
qualitative synthesis. <br/>Result(s): According to the literature, 11
cases of AAC were reported after cardiopulmonary bypass surgery. Besides,
in patients recovering from open-heart surgery with extracorporeal
circulation, prolonged bypass time and depressed cardiac output were
identified 22 cases of AAC. Similarly, in 6 of 7 patients following aortic
reconstruction. Small vessel occlusion has shown to be the predominant
phenomenon in AAC, concluding that the common cause was visceral
hypoperfusion. Histological analysis of AAC resulted in leukocyte
margination of blood vessels, suggesting involvement of ischaemia and
reperfusion mediated injury. These types of histopathological alterations
are typical of myocardium after reperfusion injury. Moreover, bile
infiltration into the bladder mucosa demonstrated by many authors,
validates the abnormal epithelial permeability in AAC. Data suggest that
AAC is a manifestation of systemic critical illness. The most common ECG
alterations noted in AAC are changes in Twaves in significant leads,
slurring and notching of the QRS complex and elevation or depression of
the S-Tsegment, hypothesizing a vagally reflex mechanism, due to the
distention of the common bile duct, with a reduced coronary blood flow.
Finally it was reported a resolution of ECG changes due to AAC after
cholecystectomy or antibiotic treatment within a few days.
<br/>Conclusion(s): AAC should be suspected after each general disease
leading to hypoperfusion such as cardiovascular diseases and major heart
or aortic surgery. ECG changes in absence of significant laboratory data
for IMA could be related to a misdiagnosed AAC. Ultrasonography plays a
key role in the early diagnosis and also in the follow up of AAC.
Cholecystostomy and cholecystectomy represent the two prevailing treatment
options for AAC.

<66>
Accession Number
639921703
Title
PERSISTENT FIFTH AORTIC ARCH IN A PATIENT WITH CHARGE SYNDROME: A CASE
REPORT AND SYSTEMATIC REVIEW OF LITERATURE.
Source
European Heart Journal, Supplement. Conference: 83rd SIC National
Congress. Virtual. 24(Supplement K) (pp K95), 2022. Date of Publication:
December 2022.
Author
Ferraioli M.; Nocilla A.; Polito M.V.; Malinconico M.; Coppola G.; Ferrara
F.; Ciccarelli M.; Vecchione C.; Galasso G.
Institution
(Ferraioli, Nocilla, Ciccarelli, Vecchione, Galasso) Department of
Medicine,Surgery and Dentistry, University of Salerno, Baronissi, Salerno,
Italy
(Polito, Malinconico, Coppola, Ferrara) Department of Cardiology, A.O.U.
San Giovanni Di Dio E Ruggi D'aragona, Po Cava De' Tirreni, Salerno, Italy
Publisher
Oxford University Press
Abstract
Background: CHARGE syndrome (CS) is a rare genetic disease characterized
by a constellation of clinical findings including Coloboma, Heart defects,
choanal Atresia, Retardation of growth and/or development, Genitourinary
malformation and Ear abnormalities. We present a case of persistent fifth
aortic arch (PFAA), an extremely rare congenital anomaly of aortic arch
(AA), in a child with genetically confirmed CS and perform a systematic
review of published studied, in an effort to examinate the distribution of
congenital heart diseases (CHDs) and their impact in CHARGE patients. Case
presentations and results: A 12 years-old child was referred to our
echocardiography laboratory for atypical chest pain. He had bilateral
ocular coloboma, left hypoacusis, scoliosis, mild motor impairments,
nocturnal enuresis, micropenis and facial dysmorphisms. Molecular
diagnostic testing identified a de novo mutation (variant
c.5290-5300+10del) in the CHD7 gene and CS was diagnosed. Echocardiography
showed a single posterolateral papillary muscle and a cleft of anterior
mitral leaflet. Interestingly, AA had a double-lumen appearance without
Doppler signs of coarctation. A PFFA was hypothesized and then confirmed
at angioCT. A systematic review of the literature was performed according
to PRISMA guidelines. All published articles reporting the association CS
and CHDs were chosen. A total of 975 records were identified. After the
screening of title and abstract, assessed for eligibility were 219 papers.
Finally, inclusion and fulltext analysis was made in 60 studies, of which
37 case reports and 23 case series. We found that ventricular septal
defects emerged as the most prevalent heart defect (32%), followed by
atrial septal defects reported in 23% of cases. Complex CHDs were also
described. Interestingly, AA abnormalities were reported in a high
percentage (27%) of patients, right AA in 20% in association or not with
aberrant subclavian artery and vascular ring, interrupted AA in 5% of
cases, as well as aortic coarctation in 10%. of note, almost half of the
cases (49%) required cardiac surgery, mostly performed within 1 year from
birth and, although outcome was available in a minority of patients, the
death was reported in almost 30%. <br/>Conclusion(s): Our case is the
first that reports PFFA in CS and may be mistaken for AA dissection. In
comparison with other syndromic diseases, a high prevalence of AA
abnormalities was found in patients with mutations in the CHD7 gene.
(Figure Presented).

<67>
Accession Number
639921584
Title
SAFETY OF PLUG-BASED AND SUTURE-BASED VASCULAR CLOSURE DEVICES IN PATIENTS
UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT: A MULTICENTER
OBSERVATIONAL STUDY.
Source
European Heart Journal, Supplement. Conference: 83rd SIC National
Congress. Virtual. 24(Supplement K) (pp K128), 2022. Date of Publication:
December 2022.
Author
Panarello A.; Sorrentino S.; Franzone A.; Bruno F.; Sportelli M.;
Carabetta N.; Di Costanzo A.; Polimeni A.; Angellotti D.; Castiello D.S.;
Simonetti F.; Spaccarotella C.; Mongiardo A.; Esposito G.; Indolfi C.
Institution
(Panarello, Sorrentino, Bruno, Sportelli, Carabetta, Di Costanzo,
Polimeni, Mongiardo, Esposito, Indolfi) Division of Cardiology, Department
of Medical and Surgical Sciences, Magna Graecia University, Catanzaro,
Italy
(Franzone, Angellotti, Castiello, Simonetti, Spaccarotella) Division of
Cardiology, Department of Advanced Biomedical Sciences, Federico Ii
University, Naples, Italy
Publisher
Oxford University Press
Abstract
Background: Transcatheter aortic valve replacement (TAVR), is the
treatment of choice for most patients with aortic stenosis. Transfemoral
access remains the most widely used peripheral vascular approach for TAVR
and dedicated plug-based or suture-based vascular closure devices are
available to achieve femoral hemostasis. However, the comparative safety
of such strategies is controversial in patients undergoing transfemoral
TAVR. <br/>Objective(s): in this study, we aimed to evaluate the rates of
vascular access complications according to the use of plug-based or
suture-based vascular closure in patients undergoing TAVR. <br/>Method(s):
Data were retrospectively collected from two high-volume TAVR centers from
September 2009 to March 2022. Patients were categorized according to the
use of plug-based or suture-based vascular closure devices. The plug-based
platform used was MANTA (Teleflex), while the suture-based devices were
the Perclose ProGlideTM or the ProstarTM Systems (Abbott Vascular).
Baseline demographic, clinical, and echocardiographic variables were
compared between these groups using an independent-sample Student's t-test
for continuous variables, presented as mean+/-SD, and the chi-square test
for categorical or binary variables, presented as number and percentage,
as appropriate. The odds ratio (OR) for vascular complications was
calculated using a multivariate logistic regression model including as
dependent variables all relevant baseline and procedural characteristics.
The closure device variable was included in the multivariate model using
the ProstarTM XL device group as reference. Vascular complications were
adjudicated according to the Valve Academic Research Consortium
definitions 3. <br/>Result(s): Out of 874 patients, hemostasis was
achieved with ProstarTMXL PVS in 120 (13.7%) patients, with Perclose
ProGlideTM in 525 (60.1%), and with MANTA 229 (26.2%). No differences in
age and common cardiovascular risk factors were observed between the group
except for the prevalence of peripheral arterial disease (30.6% vs. 17.0%,
p<0.0001) and dyslipidemia (58.9% vs. 68.6%, p=0.01) as well as for the
echo and procedural variables except for the Euroscore II that was lower
in the plug-based group (6.0+/-5.6 vs. 5.1+/-4.68), and for the higher use
of new generation devices (79.1% vs. 98.3%, p<0.0001). After adjustment
for common cardiovascular risk factors and procedural features, no
differences were observed for total vascular complications [OR: 0.68 (95%
confidence interval (CI): 0.33 to 1.38) and OR: 0.60 (95% CI: 0.33 to
1.53), for Perclose ProGlideTMand MANTA groups, respectively]. Likewise,
no substantial differences were observed for major and minor vascular
complications. <br/>Conclusion(s): Both suture-based and plug-based
devices have comparable outcomes with regard to the risk of vascular
complications. Further randomized clinical trials are warranted to confirm
this observation in high-risk sub-group patients with for example heavily
calcified access or obesity.

<68>
Accession Number
639921570
Title
DIRECT ORAL ANTICOAGULANTS OR VITAMIN K ANTAGONISTS IN AFTER TAVR.
Source
European Heart Journal, Supplement. Conference: 83rd SIC National
Congress. Virtual. 24(Supplement K) (pp K127-K128), 2022. Date of
Publication: December 2022.
Author
Oliveri F.; Montalto C.; Tua L.; Lanzillo G.; Compagnoni S.; Fasolino A.;
Gentile F.R.; Ferlini M.; Pepe A.; Visconti L.O.; Bongiorno A.; Leonardi
S.
Institution
(Oliveri, Tua, Lanzillo, Compagnoni, Fasolino, Gentile, Pepe, Bongiorno,
Leonardi) Universita Di Pavia, Italy
(Montalto) Ospedale Metropolitano Niguarda, Italy
(Ferlini, Visconti) Policlinico San Matteo, Italy
Publisher
Oxford University Press
Abstract
Background: Several patients undergoing transcatheter aortic valve
replacement (TAVR) also require oral anticoagulation (OAC) for atrial
fibrillation (AF) or deep vein thromboembolism. However, the optimal type
of OAC strategy (direct oral anticoagulants, DOACs, or vitamin K
antagonists, VKA) is still unclear in this setting. <br/>Method(s): We
performed systematic literature research and meta-analysis in PubMed,
Medline, and EMBASE databases for studies reporting either all-cause
mortality, major/life-threatening bleeding or stroke events.
<br/>Result(s): Ten observational studies and one randomized controlled
trial (RCT), including 29,333 patients, were eligible for inclusion.
Compared to VKA, DOACs use after TAVR was associated with a modest but
significantly lower rates of all-cause mortality (RR 0.88; 95% CI:
0.78-0.99, p-value 0.04). Total stroke events (RR 0.97; 95% CI: 0.76-1.23,
p-value 0.79) and major/life-threatening bleeding (RR 0.94; 95% CI:
0.70-1.27, p-value 0.69) were comparable among the two treatments. In the
following sensitivity analysis including observational studies only,
results in terms stroke events were consistent (RR 1.00;95% CI: 0.75-1.34,
p-value 0.99) . However, the overall mortality was comparable between the
two treatments (RR 0.88; 95% CI: 0.77-1.00, p-value 0.99), while
major/life-threatening bleeding occurred less in the DOACs group (RR 0.80;
95% CI: 0.68-0.94, p-value 0.006). <br/>Conclusion(s): Considering the
totality of published evidence in TAVR patients with a concomitant
indication for OAC, DOACs use was associated with reduced all-cause
mortality and comparable major/life-threatening bleeding and stroke events
compared to VKA.

<69>
Accession Number
2021978721
Title
Early Transcatheter or Surgical Aortic Valve Replacement Versus
Conservative Management in Asymptomatic Patients With Severe Aortic
Stenosis: A Systematic Review and Meta-analysis.
Source
Current Problems in Cardiology. 48(3) (no pagination), 2023. Article
Number: 101477. Date of Publication: March 2023.
Author
Yasmin F.; Shaikh A.; Asghar M.S.; Moeed A.; Najeeb H.; Waqar E.; Ram
M.D.; Nankani A.; Ochani R.K.; Aamir M.; Ullah W.; Waqar F.; Johnson D.M.
Institution
(Yasmin, Moeed, Najeeb, Waqar, Ram, Nankani, Ochani) Department of
Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
(Shaikh) Department of Medicine, Aga Khan University Hospital, Karachi,
Pakistan
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
MN
(Aamir) Lehigh Valley Heart Specialists, Lehigh Valley Health Network,
Allentown, PA, United States
(Ullah, Johnson) Division of Cardiology, Sidney Kimmel Medical College,
Thomas Jefferson University Hospitals, Philadelphia, PA
(Waqar) Division of Cardiovascular Health and Disease, University of
Cincinnati College of Medicine, Cincinnati, OH
Publisher
Elsevier Inc.
Abstract
The merits of conservative management vs early intervention in patients
with asymptomatic severe aortic stenosis remains unknown. Digital
databases (MEDLINE, Google Scholar, and Embase) were searched for all
relevant studies from inception through September 2022. Studies comparing
conservative management with early intervention were compared using a
random-effects model to calculate risk ratios (RRs) with 95% confidence
interval (CI). A total of 12 studies comprising 3624 asymptomatic aortic
stenosis patients (1747 receiving surgery, and 1877 receiving conservative
treatment) were included in the analysis. The average follow-up time was
4.45 (IQR 3.5-5) years. Early intervention was associated with a
significantly reduced risk of cardiac (RR 0.42, 95% CI 0.25-0.72; P =
0.001; I² = 54%), non-cardiac (RR 0.46, 95% CI 0.32-0.68; P <
0.0001; I² = 0%), all-cause mortality (RR 0.40, 95% CI
0.32-0.51; P < 0.00001; I² = 58%), heart failure
hospitalization (RR 0.21, 95% CI 0.13-0.36; P < 0.00001; I² =
0%), sudden cardiac death (RR 0.29, 95% CI 0.12-0.66; P = 0.004,
I² = 24%), and MACE (RR 0.46, 95% CI; 0.28-0.75; P = 0.002;
I² = 68%), compared with conservative management. There was no
significant difference in the 30-day mortality (RR 0.63, 95% CI 0.19-2.04;
P = 0.44; I² = 28%), myocardial infarction (RR 0.44, 95% CI
0.19-1.06; P = 0.07, I²=0%), and 90-day mortality (RR 0.68, 95%
CI 0.20-2.37; P = 0.55; I² = 61%) between the 2 groups. This
meta-analysis shows statistically significant reductions in the risk for
all-cause mortality, cardiac specific mortality, non-cardiac mortality,
heart failure hospitalization, MACE, and sudden cardiac death among
asymptomatic aortic stenosis patients who underwent early intervention as
opposed to conservative management.<br/>Copyright &#xa9; 2022 Elsevier
Inc.

<70>
Accession Number
2020848191
Title
Direct oral anticoagulant versus antiplatelet therapy following
transcatheter aortic valve replacement in patients without prior or
concurrent indication for anticoagulation: A meta-analysis of randomized
studies.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2022.
Date of Publication: 2022.
Author
Barbosa Moreira M.J.; Peixoto N.A.D.A.; Udoma-Udofa O.C.; de Araujo S.S.;
Enriquez S.K.T.
Institution
(Barbosa Moreira) Department of Medicine, Federal University of Rio Grande
do Norte, Natal, Brazil
(Peixoto) Department of Medicine, University of Buenos Aires, Buenos
Aires, Argentina
(Udoma-Udofa) Department of Medicine, Federal University of Juiz de Fora,
Juiz de Fora, Brazil
(de Araujo) Department of Medicine, Federal University of Pelotas,
Pelotas, Brazil
(Enriquez) Hospital de Especialidades Santa Margarita, Portoviejo, Ecuador
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The antithrombotic management following transcatheter aortic
valve replacement (TAVR) in patients who do not have a concurrent
indication for long-term anticoagulation therapy is an ongoing source of
debate. <br/>Method(s): We performed a systematic review and meta-analysis
to compare direct oral anticoagulants (DOACs) versus antiplatelet therapy
after TAVR in patients without a concomitant indication for chronic oral
anticoagulation. PubMed, Embase, and Cochrane databases were searched.
Only randomized controlled trials were included. Risk ratios (RR) with p <
0.05 were considered statistically significant. <br/>Result(s): Three
studies were included, with 2922 patients who underwent TAVR, of whom 1463
(50.1%) received DOACs. Patients who received DOACs therapy had
significantly higher all-cause mortality (RR: 1.68; 95% confidence
intervals [CI]: 1.22-2.30; p = 0.001) and non-cardiovascular mortality
(RR: 2.33; 95% CI: 1.13-4.80; p = 0.02). The incidence of major bleeding
was not significantly different between the groups (5.3% vs. 3.8%; RR:
1.44; 95% CI: 0.90-2.32; p = 0.13). There was no difference between DOACs
and antiplatelet therapy in terms of: ischemic stroke (RR: 1.28; 95% CI:
0.76-2.15; p = 0.35) and cardiovascular mortality (RR: 1.36; 95% CI:
0.92-2.03; p = 0.13). Lastly, the DOACs group had a significantly lower
risk of valve thrombosis than the antiplatelet group (0.8% vs. 3.2%; RR:
0.27; 95% CI: 0.14-0.51; p < 0.0001). <br/>Conclusion(s): In this
meta-analysis of randomized studies comparing DOACs to antiplatelet
therapy after TAVR in patients without a concomitant indication for
anticoagulation, DOACs were associated with a lower incidence of valve
thrombosis and a higher rate of all-cause mortality, driven by an increase
in noncardiac causes of death.<br/>Copyright &#xa9; 2022 Wiley Periodicals
LLC.

<71>
Accession Number
2020627055
Title
Von Willebrand factor in diagnostics and treatment of cardiovascular
disease: Recent advances and prospects.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 1038030. Date of Publication: 02 Dec 2022.
Author
Kozlov S.; Okhota S.; Avtaeva Y.; Melnikov I.; Matroze E.; Gabbasov Z.
Institution
(Kozlov, Okhota) Department of Problems of Atherosclerosis, National
Medical Research Centre of Cardiology Named After Academician E.I. Chazov
of the Ministry of Health of the Russian Federation, Moscow, Russian
Federation
(Avtaeva, Melnikov, Matroze, Gabbasov) Laboratory of Cell Hemostasis,
National Medical Research Centre of Cardiology Named After Academician
E.I. Chazov of the Ministry of Health of the Russian Federation, Moscow,
Russian Federation
(Melnikov) Laboratory of Gas Exchange, Biomechanics and Barophysiology,
State Scientific Center of the Russian Federation, The Institute of
Biomedical Problems of the Russian Academy of Sciences, Moscow, Russian
Federation
(Matroze) Department of Innovative Pharmacy, Medical Devices and
Biotechnology, Moscow Institute of Physics and Technology, Moscow, Russian
Federation
Publisher
Frontiers Media S.A.
Abstract
Von Willebrand factor (VWF) is a large multimeric glycoprotein involved in
hemostasis. It is essential for platelet adhesion to the subendothelium of
the damaged endothelial layer at high shear rates. Such shear rates occur
in small-diameter arteries, especially at stenotic sites. Moreover, VWF
carries coagulation factor VIII and protects it from proteolysis in the
bloodstream. Deficiency or dysfunction of VWF predisposes to bleeding. In
contrast, an increase in the concentration of high molecular weight
multimers (HMWM) of VWF is closely associated with arterial thrombotic
events. Severe aortic stenosis (AS) or hypertrophic obstructive
cardiomyopathy (HOCM) can deplete HMWM of VWF and lead to cryptogenic,
gastrointestinal, subcutaneous, and mucosal bleeding. Considering that VWF
facilitates primary hemostasis and a local inflammatory response at high
shear rates, its dysfunction may contribute to the development of coronary
artery disease (CAD) and its complications. However, current diagnostic
methods do not allow for an in-depth analysis of this contribution. The
development of novel diagnostic techniques, primarily microfluidic, is
underway. Such methods can provide physiologically relevant assessments of
VWF function at high shear rates; however, they have not been introduced
into clinical practice. The development and use of agents targeting VWF
interaction with the vessel wall and/or platelets may be reasonable in
prevention of CAD and its complications, given the prominent role of VWF
in arterial thrombosis.<br/>Copyright &#xa9; 2022 Kozlov, Okhota, Avtaeva,
Melnikov, Matroze and Gabbasov.

<72>
Accession Number
2015232640
Title
Transcatheter Aortic Valve Implantation With or Without Percutaneous
Coronary Artery Revascularization Strategy: A Systematic Review and
Meta-Analysis.
Source
Journal of the American Heart Association. 6(6) (no pagination), 2017.
Article Number: e005960. Date of Publication: 2017.
Author
Kotronias R.A.; Kwok C.S.; George S.; Capodanno D.; Ludman P.F.; Townend
J.N.; Doshi S.N.; Khogali S.S.; Geeneereux P.; Herrmann H.C.; Mamas M.A.;
Bagur R.
Institution
(Kotronias, Kwok, George, Mamas, Bagur) Keele Cardiovascular Research
Group, Institute for Applied Clinical Science and Centre for Prognosis
Research, Institute of Primary Care and Health Sciences, University of
Keele, Stoke-on-Trent, United Kingdom
(Kotronias) Oxford University Clinical Academic Graduate School, Oxford
University, Oxford, United Kingdom
(Kwok, George, Mamas) The Heart Centre, Royal Stoke Hospital, University
Hospital of North Midlands Trust, Stoke-on-Trent, United Kingdom
(Capodanno) Cardio-Thoracic-Vascular Department, Ferrarotto Hospital,
University of Catania, Italy
(Ludman, Townend, Doshi) Department of Cardiology, Queen Elizabeth
Hospital Birmingham, Birmingham, United Kingdom
(Khogali) The Heart and Lung Centre, New Cross Hospital, Wolverhampton,
United Kingdom
(Geeneereux) Cardiovascular Research Foundation, New York, NY, United
States
(Geeneereux) Columbia University Medical Center/New York-Presbyterian
Hospital, New York, NY, United States
(Geeneereux) Morristown Medical Center, Morristown, NJ, United States
(Herrmann) Cardiology Division, Department of Medicine, Perelman School of
Medicine of the University of Pennsylvania, Philadelphia, PA, United
States
(Bagur) Division of Cardiology, Department of Medicine, London Health
Sciences Centre, London, ON, Canada
(Bagur) Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, Western University, London, ON, Canada
Publisher
American Heart Association Inc.
Abstract
Background--Recent recommendations suggest that in patients with severe
aortic stenosis undergoing transcatheter aortic valve implantation and
coexistent significant coronary artery disease, the latter should be
treated before the index procedure; however, the evidence basis for such
an approach remains limited. We performed a systematic review and
meta-analysis to study the clinical outcomes of patients with coronary
artery disease who did or did not undergo revascularization prior to
transcatheter aortic valve implantation. Methods and Results--We conducted
a search of Medline and Embase to identify studies evaluating patients who
underwent transcatheter aortic valve implantation with or without
percutaneous coronary intervention. Random-effects meta-analyses with the
inverse variance method were used to estimate the rate and risk of adverse
outcomes. Nine studies involving 3858 participants were included in the
meta-analysis. Patients who underwent revascularization with percutaneous
coronary intervention had a higher rate of major vascular complications
(odd ratio [OR]: 1.86; 95% confidence interval [CI], 1.33-2.60; P=0.0003)
and higher 30-day mortality (OR: 1.42; 95% CI, 1.08-1.87; P=0.01). There
were no differences in effect estimates for 30-day cardiovascular
mortality (OR: 1.03; 95% CI, 0.35-2.99), myocardial infarction (OR: 0.86;
95% CI, 0.14-5.28), acute kidney injury (OR: 0.89; 95% CI, 0.42-1.88),
stroke (OR: 1.07; 95% CI, 0.38-2.97), or 1-year mortality (OR: 1.05; 95%
CI, 0.71-1.56). The timing of percutaneous coronary intervention (same
setting versus a priori) did not negatively influence outcomes.
Conclusions--Our analysis suggests that revascularization before
transcatheter aortic valve implantation confers no clinical advantage with
respect to several patient-important clinical outcomes and may be
associated with an increased risk of major vascular complications and
30-day mortality. In the absence of definitive evidence, careful
evaluation of patients on an individual basis is of paramount importance
to identify patients who might benefit from elective revascularization. (
J Am Heart Assoc.<br/>Copyright &#xa9; 2017 The Authors. Published on
behalf of the American Heart Association, Inc., by Wiley.

<73>
Accession Number
2018291005
Title
Indications, Clinical Impact, and Complications of Critical Care
Transesophageal Echocardiography: A Scoping Review.
Source
Journal of Intensive Care Medicine. 38(3) (pp 245-272), 2023. Date of
Publication: March 2023.
Author
Prager R.; Bowdridge J.; Pratte M.; Cheng J.; McInnes M.D.F.; Arntfield R.
Institution
(Prager, Cheng, Arntfield) Division of Critical Care, Western University,
Stn B. London, ON, Canada
(Bowdridge, Pratte) Department of Medicine, University of Ottawa, Ottawa,
ON, Canada
(McInnes) Department of Radiology, University of Ottawa, Ottawa, ON,
Canada
(McInnes) Clinical Epidemiology Program, The Ottawa Hospital Research
Institute, Ottawa, ON, Canada
Publisher
SAGE Publications Inc.
Abstract
Background: Critical care transesophageal echocardiography (ccTEE) is an
increasingly popular tool used by intensivists to characterize and manage
hemodynamics at the bedside. Its usage appears to be driven by expanded
diagnostic scope as well as the limitations of transthoracic
echocardiography (TTE) - lack of acoustic windows, patient positioning,
and competing clinical interests (eg, the need to perform chest
compressions). The objectives of this scoping review were to determine the
indications, clinical impact, and complications of ccTEE. <br/>Method(s):
MEDLINE, EMBASE, Cochrane, and six major conferences were searched without
a time or language restriction on March 31^st, 2021. Studies
were included if they assessed TEE performed for adult critically ill
patients by intensivists, emergency physicians, or anesthesiologists.
Intraoperative or post-cardiac surgical TEE studies were excluded. Study
demographics, indication for TEE, main results, and complications were
extracted in duplicate. <br/>Result(s): Of the 4403 abstracts screened,
289 studies underwent full-text review, with 108 studies (6739 patients)
included. Most studies were retrospective (66%), performed in academic
centers (84%), in the intensive care unit (73%), and were observational
(55%). The most common indications for ccTEE were hemodynamic instability,
trauma, cardiac arrest, respiratory failure, and procedural guidance.
Across multiple indications, ccTEE was reported to change the diagnosis in
52% to 78% of patients and change management in 32% to79% patients. During
cardiac arrest, ccTEE identified the cause of arrest in 25% to 35% of
cases. Complications of ccTEE included two cases of significant
gastrointestinal bleeding requiring intervention, but no other major
complications (death or esophageal perforation) reported.
<br/>Conclusion(s): The use of ccTEE has been described for the diagnosis
and management of a broad range of clinical problems. Overall, ccTEE was
commonly reported to offer additional diagnostic yield beyond TTE with a
low observed complication rate. Additional high quality ccTEE studies will
permit stronger conclusions and a more precise understanding of the trends
observed in this scoping review.<br/>Copyright &#xa9; The Author(s) 2022.

<74>
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. <br/>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.
<br/>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. <br/>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.<br/>Copyright &#xa9; 2023 Lippincott Williams
and Wilkins. All rights reserved.

<75>
Accession Number
2020858838
Title
Contemporary review of heart transplant immunology and immunosuppressive
therapy.
Source
Proceedings of Singapore Healthcare. 31 (no pagination), 2022. Date of
Publication: January-December 2022.
Author
Anbalakan K.; Chew K.M.; Loh J.K.; Sim D.; Lai S.H.; Teo Loon Yee L.
Institution
(Anbalakan, Chew, Loh, Sim, Teo Loon Yee) National Heart Centre Singapore,
Singapore, Singapore
(Lai) Anatomical Pathology, Singapore General Hospital, Singapore,
Singapore
Publisher
SAGE Publications Inc.
Abstract
Background: Survival after heart transplantation (HT) has improved
considerably since the first HT was performed in 1967 in Cape Town, South
Africa. Understanding immunology behind organ rejection has paved way for
advances in the assessment of pre-transplant compatibility, development of
newer and more specific immunosuppressive drugs, and management of
rejection. <br/>Objective(s): Unlike medical therapy for heart failure,
transplant protocols vary considerably between different centers. These
variations in protocols generally reflect unique population
characteristics and the availability of resources. This review article
aims to provide a consolidated update on contemporary cardiac transplant
medicine. We also aim to highlight local practice and its difference from
our international counterparts. <br/>Method(s): A literature search was
performed on Pubmed and Cochrane Central Register of Controlled Trials to
identify trials and review articles that discussed heart transplant
immunology and protocols. The International Society for Heart and Lung
Transplant (ISHLT) guidelines were also reviewed. We focused on risk
factors, prevention strategies, and treatment of cardiac rejection.
<br/>Result(s): A total of 48 articles were selected to provide a
comprehensive overview of the contemporary practice of cardiac transplant
immunosuppressive therapy. Comparisons were made with local data and
practice protocols to highlight key differences. <br/>Conclusion(s): Heart
transplant covers a small subset of cardiac patients and much of the
evidence is derived from empirical observations and retrospective
analysis. This accounts for the heterogeneity in care and treatment
protocols. More studies are needed to select best practices from around
the world to further improve outcomes.<br/>Copyright &#xa9; The Author(s)
2022.

<76>
Accession Number
2020843302
Title
Increasing preoperative cognitive reserve to prevent postoperative
delirium and postoperative cognitive decline in cardiac surgical patients
(INCORE): Study protocol for a randomized clinical trial on cognitive
training.
Source
Frontiers in Neurology. 13 (no pagination), 2022. Article Number: 1040733.
Date of Publication: 12 Dec 2022.
Author
Butz M.; Meyer R.; Gerriets T.; Sammer G.; Doerr J.M.; El-Shazly J.;
Doeppner T.R.; Choi Y.-H.; Schoenburg M.; Juenemann M.
Institution
(Butz, Meyer, Gerriets, Sammer, Doerr, Schoenburg, Juenemann) Heart and
Brain Research Group, Kerckhoff Heart and Thorax Center, Bad Nauheim,
Germany
(Butz, Gerriets, Doerr, Doeppner, Juenemann) Department of Neurology,
University Hospital Giessen and Marburg, Giessen, Germany
(Sammer) Cognitive Neuroscience at the Centre of Psychiatry, University
Giessen, Giessen, Germany
(Sammer) Department of Psychology, Justus-Liebig University, Giessen,
Germany
(El-Shazly) Department of Psychocardiology, Kerckhoff Heart and Thorax
Center, Bad Nauheim, Germany
(Choi, Schoenburg) Department of Cardiac Surgery, Kerckhoff Heart and
Thorax Center, Bad Nauheim, Germany
Publisher
Frontiers Media S.A.
Abstract
Introduction: Postoperative delirium (POD) and postoperative cognitive
decline (POCD) can be observed after cardiosurgical interventions. Taken
together, these postoperative neurocognitive disorders (PNCDs) contribute
to increased morbidity and mortality. Preoperative risk factors of PNCD,
such as decreased neuropsychometric performance or decreased cognitive
daily activities, can be interpreted as reduced cognitive reserve. This
study aims to build up cognitive reserves to protect against the
development of PNCD through preoperative, home-based, cognitive training.
<br/>Method(s): The planned research project is a monocentric, two-arm
randomized controlled intervention study involving 100 patients undergoing
elective cardiac surgery with extracorporeal circulation. Patients will be
assigned to a training group or control group. The intervention involves a
standardized, paper-and-pencil-based cognitive training that will be
performed by the patients at home for ~40 min per day over a preoperative
period of 2-3 weeks. The control group will receive neither cognitive
training nor a placebo intervention. A detailed assessment of
psychological functions will be performed ~2-3 weeks before the start of
training, at the end of the training, during hospitalization, at discharge
from the acute clinic, and 3 months after surgery. The primary objective
of this study is to investigate the interventional effect of preoperative
cognitive training on the incidence of POD during the stay in the acute
clinic, the incidence of POCD at the time of discharge from the acute
clinic, and 3 months after surgery. Secondary objectives are to determine
the training effect on objective cognitive functions before the surgery
and subjective cognitive functions, as well as health-related quality of
life 3 months after surgery. <br/>Discussion(s): Should it become evident
that the use of our cognitive training can both reduce the incidence of
POCD and POD and improve health-related quality of life, this intervention
may be integrated into a standardized prehabilitation
program.<br/>Copyright &#xa9; 2022 Butz, Meyer, Gerriets, Sammer, Doerr,
El-Shazly, Doeppner, Choi, Schoenburg and Juenemann.

<77>
Accession Number
2020398858
Title
Meta-analysis of short- and long-term clinical outcomes of the
self-expanding Evolut R/pro valve versus the balloon-expandable Sapien 3
valve for transcatheter aortic valve implantation.
Source
International Journal of Cardiology. 371 (pp 100-108), 2023. Date of
Publication: 15 Jan 2023.
Author
Lerman T.T.; Levi A.; Kornowski R.
Institution
(Lerman) Department of Internal Medicine F-Recanati, Beilinson Hospital,
Rabin Medical Center, Petah Tikva, Israel
(Lerman, Levi, Kornowski) Department of Cardiology, Rabin Medical Center,
Petah Tikva, Israel
(Lerman, Levi, Kornowski) The Faculty of Medicine, Tel Aviv University,
Tel Aviv, Israel
Publisher
Elsevier Ireland Ltd
Abstract
Background: The Evolut R/Pro and the Sapien 3 are the most commonly valve
systems used today for transcatheter aortic valve implantation (TAVI).
However, there is a still uncertainty regarding the efficacy and safety
comparison of these two valves. <br/>Method(s): We conducted a systematic
review and meta-analysis of randomized controlled trials (RCTs) and
observational studies comparing the Evolut R/Pro versus the Sapien 3. The
primary outcome was all-cause mortality (short and long-term). The
secondary outcomes were stroke, bleeding, permanent pacemaker implantation
(PPI), acute kidney injury (AKI), major vascular complication, device
success, moderate- severe aortic regurgitation (AR), and pressure
gradients. <br/>Result(s): Twenty-one publications totaling 35,248
patients were included in the analysis. Evolut R/Pro was associated with
higher risk of short-term all-cause mortality (OR = 1.31;95% CI 1.15-1.49,
p < 0.001) and a trend of higher long-term mortality (OR = 1.07;95% CI
1.00-1.16, p = 0.06). The Evolut R/Pro was associated with higher risk of
PPI and AR and lower risk for bleeding, major vascular complication, and
pressure gradients. There was no significant difference between the groups
regarding the risk of stroke, AKI and device success. <br/>Conclusion(s):
The Evolut R/Pro valve system compared to the Sapien 3 is associated with
higher risk of short-term mortality, significant AR and PPI while
providing the advantage of lower risk of bleeding, major vascular
complication, and lower residual transvalvular gradients.<br/>Copyright
&#xa9; 2022 Elsevier B.V.

<78>
Accession Number
2021047305
Title
COMPETENCE Trial: The EVAHEART 2 continuous flow left ventricular assist
device.
Source
Journal of Heart and Lung Transplantation. 42(1) (pp 33-39), 2023. Date of
Publication: January 2023.
Author
Allen S.R.; Slaughter M.S.; Ahmed M.M.; Bartoli C.R.; Dhingra R.; Egnaczyk
G.F.; Gulati S.K.; Kiernan M.S.; Mahr C.; Meyer D.M.; Motomura T.; Ono M.;
Ravichandran A.; Shafii A.; Smith J.; Soleimani B.; Toyoda Y.; Yarboro
L.T.; Dowling R.D.
Institution
(Allen, Soleimani) Penn State Health, Milton S. Hershey Medical Center,
Hershey, Pennsylvania, United States
(Slaughter) University of Louisville, Louisville, Kentucky
(Ahmed) University of Florida, Gainesville, FL, United States
(Bartoli) Geisinger Medical Center, Danville, Pennsylvania, United States
(Dhingra, Smith) University of Wisconsin Hospitals and Clinics, Madison,
WI, United States
(Egnaczyk, Dowling) The Christ Hospital, Cincinnati, Ohio, United States
(Gulati) Atrium Health Sanger Heart and Vascular Institute, Charlotte,
North Carolina
(Kiernan) Tufts Medical Center, Boston, Massachusetts, United States
(Mahr) University of Washington, Seattle, WA, United States
(Meyer) Baylor Scott and White, Dallas, Texas, United States
(Motomura) Evaheart, Inc, Houston, Texas, United States
(Ono) Methodist Healthcare, San Antonio, Texas, United States
(Ravichandran) Saint Vincent Health, Indianapolis, IN, United States
(Shafii) Baylor College of Medicine St. Luke's Medical Center, Houston,
Texas, United States
(Toyoda) Temple University Medical Center, Philadelphia, Pennsylvania,
United States
(Yarboro) University of Virginia, Charlottesville, VA, United States
Publisher
Elsevier Inc.
Abstract
Background: Continuous flow left ventricular assist devices have improved
outcomes in patients with end-stage heart failure that require mechanical
circulatory support. Current devices have an adverse event profile that
has hindered widespread application. The EVAHEART2 left ventricular assist
device (EVA2) has design features such as large blood gaps, lower pump
speeds and an inflow cannula that does not protrude into the left
ventricle that may mitigate the adverse events currently seen with other
continuous flow devices. <br/>Method(s): A prospective, multi-center
randomized non-inferiority study, COMPETENCE Trial, is underway to assess
non-inferiority of the EVA2 to the HeartMate 3 LVAS when used for the
treatment of refractory advanced heart failure. The primary end-point is a
composite of the individual primary outcomes: Survival to cardiac
transplant or device explant for recovery; Free from disabling stroke;
Free from severe Right Heart Failure after implantation of original
device. Randomization is in a 2:1 (EVA2:HM3) ratio. <br/>Result(s): The
first patient was enrolled into the COMPETENCE Trial in December of 2020,
and 25 subjects (16 EVA2 and 9 HM3) are currently enrolled. Enrollment of
a safety cohort is projected to be completed by third quarter of 2022 at
which time an interim analysis will be performed. Short-term cohort (92
EVA2 subjects) and long-term cohort is expected to be completed by the end
of 2023 and 2024, respectively. <br/>Conclusion(s): The design features of
the EVA2 such as a novel inflow cannula and large blood gaps may improve
clinical outcomes but require further study. The ongoing COMPETENCE trial
is designed to determine if the EVA2 is non-inferior to the
HM3.<br/>Copyright &#xa9; 2022 International Society for Heart and Lung
Transplantation

<79>
Accession Number
2018839345
Title
Gender Differences in Treatment Delays, Management and Mortality among
Patients with Acute Coronary Syndrome: A Systematic Review and
Meta-analysis.
Source
Current Cardiology Reviews. 19(1) (pp 111-126), 2023. Article Number:
e300622206530. Date of Publication: January 2023.
Author
Lunova T.; Komorovsky R.; Klishch I.
Institution
(Lunova, Komorovsky, Klishch) Horbachevsky Ternopil National Medical
University, Ternopil, Ukraine
Publisher
Bentham Science Publishers
Abstract
Background: We aimed to provide a comprehensive overview of existing
gender differences in acute coronary syndrome (ACS), with respect to
treatment delays, invasive management of ACS, and short and long-term
mortality in patients with ACS. <br/>Method(s): We defined 37
observational studies (OSs) and 21 randomized trials (RCTs) that best
corresponded to our interests. OSs and RCTs were analyzed separately.
<br/>Result(s): Women with ACS more often experienced delays in treatment
compared to men (OR 1.43; 95% CI, 1.12-1.82) in RCTs. Female patients were
less often treated invasively: RCTs (OR 0.87; 95% CI, 0.83-0.9), OSs: (OR
0.66; 95% CI, 0.63-0.68). Women had higher crude in-hospital mortality (OR
1.56; 95% CI, 1.53-1.59) and 30-day mortality (OR 1.71; 95% CI, 1.22-2.4)
in OSs and (OR 2.74; 95% CI, 2.48-3.02) in RCTs. After adjustment for
multiple covariates, gender difference was attenuated: in-hospital
mortality (OR 1.19; 95% CI, 1.17-1.2), 30-day mortality (OR 1.18; 95% CI,
1.12-1.24) in OSs. Unadjusted long-term mortality in women was higher than
in men (OR 1.41; 95% CI, 1.31-1.52) in RCTs and (OR 1.4; 95% CI, 1.3-1.5)
in OSs. <br/>Conclusion(s): Women with ACS experience a delay in time to
treatment more often than men. They are also less likely to be treated
invasively. Females have shown worse crude short-and long-term all-cause
mortality compared to males. However, after adjustment for multiple
covariates, a less significant gender difference has been observed.
Considering the difference between crude and ad-justed mortality, we deem
it reasonable to conduct further investigations on gender-related
influence of particular risk factors on the outcomes of ACS.<br/>Copyright
&#xa9; 2023 Bentham Science Publishers.

<80>
Accession Number
2018839310
Title
Incidence, Current Guidelines and Management of Gastrointestinal Bleeding
after Transcatheter Aortic Valve Replacement: A Systematic Review.
Source
Current Cardiology Reviews. 19(1) (pp 65-77), 2023. Article Number:
e230622206351. Date of Publication: 01 Jan 2023.
Author
Adalja D.; Zala H.; Victor V.; Sheth A.; Willyard C.; Suzu-Ki E.; Patel
H.P.; Majmundar M.; Vallabhajosyula S.; Doshi R.
Institution
(Adalja) Department of Internal Medicine, St Joseph's University Medical
Center, Paterson, NJ, United States
(Zala) Department of Clinical Research, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Victor) Department of Internal Medicine, Canton Medical Education
Foundation, Canton, OH, United States
(Sheth) Department of Internal Medicine, Louisiana State University Health
Sciences Center, Shreveport, LA, United States
(Willyard) Department of Internal Medicine, University of Nevada Reno
School of Medicine, Reno, NV, United States
(Suzu-Ki) Department of Pediatrics, UCSF-Fresno, Fresno, CA, United States
(Patel) Department of Internal Medi-cine, Louis A Weiss Memorial Hospital,
Chicago, IL, United States
(Majmundar) Department of Cardiology, Maimonides Medical Center, Brooklyn,
NY, United States
(Vallabhajosyula) Section of Cardiovascular Medicine, Wake Forest
University School of Medicine, Winston-Salem, NC, United States
(Doshi) Department of Cardiology, St Joseph's University Medical Center,
Paterson, NJ, United States
Publisher
Bentham Science Publishers
Abstract
Background: There is a significant increase in morbidity and mortality in
patients complicated by major bleeding following transcatheter aortic
valve replacement (TAVR). It has become more challenging to manage such
complications when the patient needs to be on anticoagulation or
antiplatelet agent post-procedure to prevent thrombotic/embolic
complications. <br/>Method(s): We systematically reviewed all available
randomized controlled trials and observational studies to identify
incidence rates of gastrointestinal bleeding post-procedure. After
performing a systematic search, a total of 8731 patients from 15 studies
(5 RCTs and 10 non-RCTs) were included in this review. <br/>Result(s): The
average rate of gastrointestinal bleeding during follow-up was 3.0% in
randomized controlled trials and 1.9% among observational studies.
<br/>Conclusion(s): Gastrointestinal bleeding has been noted to be higher
in the RCTs as compared to observational studies. This review expands
knowledge of current guidelines and possible management of patients
undergoing TAVR.<br/>Copyright &#xa9; 2023 Bentham Science Publishers.

<81>
Accession Number
2019599662
Title
Use of vasoactive agents in non-cardiac surgery: Protocol for a scoping
review.
Source
Acta Anaesthesiologica Scandinavica. 67(1) (pp 120-122), 2023. Date of
Publication: January 2023.
Author
Baekgaard E.S.; Moller M.H.; Vester-Andersen M.; Krag M.
Institution
(Baekgaard, Krag) Department of Anaesthesia and Intensive Care, Holbaek
Hospital, Zealand, Denmark
(Moller) Department of Intensive Care, Rigshospitalet, Copenhagen, Denmark
(Moller, Vester-Andersen, Krag) Collaboration for Research in Intensive
Care (CRIC), Copenhagen, Denmark
(Moller, Krag) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
(Vester-Andersen) Department of Anaesthesia and Intensive Care,
Herlev-Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: An increasing number of patients undergo surgical procedures
worldwide each year, and despite advances in quality and care, morbidity
and mortality rates remain high. Perioperative hypotension is a
well-described condition, and is associated with adverse outcomes. Both
fluids and vasoactive agents are commonly used to treat hypotension,
however, whether one vasoactive agent is preferable over another has yet
to be explored. <br/>Method(s): In accordance with the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses extension for Scoping
Reviews (PRISMA-ScR) statement, we plan to conduct a scoping review of
studies assessing the use of vasoactive agents in patients undergoing
non-cardiac surgery. We will provide an overview of indications, agents
used and outcomes assessed. We will assess and report the certainty of
evidence according to the Grading of Recommendations Assessment,
Development and Evaluation (GRADE) approach. <br/>Result(s): We will
provide descriptive analyses of the included studies accompanied by
tabulated results. <br/>Conclusion(s): The outlined scoping review will
provide a summary of the body of evidence on the use of vasoactive agents
in the non-cardiac surgical population.<br/>Copyright &#xa9; 2022 The
Authors. Acta Anaesthesiologica Scandinavica published by John Wiley &
Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

<82>
Accession Number
2020657376
Title
Risk of stroke and retinopathy during GLP-1 receptor agonist
cardiovascular outcome trials: An eight RCTs meta-analysis.
Source
Frontiers in Endocrinology. 13 (no pagination), 2022. Article Number:
1007980. Date of Publication: 05 Dec 2022.
Author
Wei J.; Yang B.; Wang R.; Ye H.; Wang Y.; Wang L.; Zhang X.
Institution
(Wei, Yang, Wang, Ye, Wang, Wang) Department of Endocrinology and
Metabolism, First Affiliated Hospital of Jinan University, Guangzhou,
China
(Wang) The Guangzhou Key Laboratory of Basic and Translational Research on
Chronic Diseases, The First Affiliated Hospital, Jinan University,
Guangzhou, China
(Zhang) Department Clinical Experimental Center, First Affiliated Hospital
of Jinan University, Guangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Purpose: To explore the risk of stroke (including ischemic and hemorrhagic
stroke) in type 2 diabetes mellitus treated with glucagon-like peptide 1
receptor agonist (GLP-1RA) medication according to data from the
Cardiovascular Outcome Trials(CVOT). <br/>Method(s): Randomized controlled
trials (RCT) on GLP-1RA therapy and cardiovascular outcomes in type 2
diabetics published in full-text journal databases such as Medline (via
PubMed), Embase, Clinical Trials.gov, and the Cochrane Library from
establishment to May 1, 2022 were searched. We assess the quality of
individual studies by using the Cochrane risk of bias algorithm. RevMan
5.4.1 software was use for calculating meta- analysis. <br/>Result(s): A
total of 60,081 randomized participants were included in the data of these
8 GLP-1RA cardiovascular outcomes trials. Pooled analysis reported
statistically significant effect on total stroke risk[RR=0.83, 95%CI(0.73,
0.95), p=0.005], and its subtypes such as ischemic Stroke [RR=0.83,
95%CI(0.73, 0.95), p=0.008] from treatment with GLP-1RA versus placebo,
and have no significant effect on the risk of hemorrhagic stroke[RR=0.83,
95%CI(0.57, 1.20), p=0.31] and retinopathy [RR=1.54, 95%CI(0.74, 3.23),
p=0.25] <br/>Conclusion(s): GLP-1RA significantly reduces the risk of
ischemic stroke in type 2 diabetics with cardiovascular risk
factors.<br/>Copyright &#xa9; 2022 Wei, Yang, Wang, Ye, Wang, Wang and
Zhang.

<83>
Accession Number
2020626845
Title
Effect of alirocumab and evolocumab on all-cause mortality and major
cardiovascular events: A meta-analysis focusing on the number needed to
treat.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 1016802. Date of Publication: 02 Dec 2022.
Author
Wang H.-F.; Mao Y.-C.; Xu X.-Y.; Zhao S.-Y.; Han D.-D.; Ge S.-Y.; Song K.;
Geng C.; Tian Q.-B.
Institution
(Wang, Mao, Zhao, Han, Ge, Song, Geng, Tian) Department of Epidemiology
and Statistics, School of Public Health, Hebei Medical University,
Shijiazhuang, China
(Wang, Mao, Zhao, Han, Ge, Song, Geng, Tian) Hebei Province Key Laboratory
of Environment and Human Health, Shijiazhuang, China
(Xu) Postdoctoral Research Station in Basic Medicine, Hebei Medical
University, Shijiazhuang, China
(Xu) School of Nursing, Hebei Medical University, Shijiazhuang, China
Publisher
Frontiers Media S.A.
Abstract
Aims: The efficacy of anti-proprotein convertase subtilisin/Kexin type 9
(PCSK9) monoclonal antibodies in patients with atherosclerotic
cardiovascular disease (ASCVD) remains unclear. Therefore, this study aims
to assess the effect of PCSK9 inhibitors (alirocumab and evolocumab) on
ASCVD patients considering the number needed to treat (NNT).
<br/>Method(s): We reviewed randomized controlled trials (RCTs) which
compared the effects of alirocumab or evolocumab and placebo or standards
of care. All articles were published in English up to May 2022. Using
random effect models, we estimated risk ratios (RRs), NNT, and 95%
confidence intervals (CI). <br/>Result(s): We incorporated 12 RCTs with 53
486 patients total, of which 27 674 received PCSK9 inhibitors and 25 812
received placebos. The mean follow-up duration was 1.56 years. The effect
of PCSK9 inhibitors on major adverse cardiovascular events (MACE) was
statistically significant, and the corresponding mean NNT was 36.
Alirocumab reduced the risk of MACE, stroke, and coronary
revascularization; the corresponding mean NNT were 37, 319, and 107,
respectively. Evolocumab positively affected MACE, myocardial infarction,
stroke, and coronary revascularization; the corresponding mean NNT were
32, 78, 267, and 65, respectively. The effects of alirocumab or evolocumab
on all-cause mortality and cardiovascular mortality were not statistically
significant. <br/>Conclusion(s): This study suggests that preventing one
patient from MACE needed to treat 36 patients with ASCVD with PCSK9
inhibitors for 1.56 years. Both alirocumab and evolocumab reduced MACE,
stroke, and coronary revascularization. Evolocumab had a positive effect
on myocardial infarction, but no effects were noted for alirocumab. In
addition, alirocumab may not be as effective as evolocumab. NNT visualizes
the magnitude of efficacy to assist in clinical decisions. Systematic
review registration:
[https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=344908],
identifier [CRD42022344908].<br/>Copyright &#xa9; 2022 Wang, Mao, Xu,
Zhao, Han, Ge, Song, Geng and Tian.

<84>
Accession Number
2020622085
Title
Colchicine for prevention of post-operative atrial fibrillation:
Meta-analysis of randomized controlled trials.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 1032116. Date of Publication: 01 Dec 2022.
Author
Ge P.; Fu Y.; Su Q.; Jin M.; Guo L.; Miao C.; Zhu S.; Zhuang J.; Zhang Z.;
Hong J.
Institution
(Ge, Guo, Hong) Shanghai General Hospital of Nanjing Medical University,
Shanghai, China
(Ge) Department of Cardiology, The Affiliated Huaian No.1 People's
Hospital of Nanjing Medical University, Jiangsu, Huaian, China
(Fu, Su, Jin, Zhu, Hong) Department of Emergency and Critical Care,
Shanghai General Hospital, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
(Miao, Zhuang) Department of Internal and Emergency Medicine, Shanghai
General Hospital, Shanghai Jiao Tong University School of Medicine,
Shanghai, China
(Zhang) Department of Cardiology, Shanghai General Hospital, Shanghai Jiao
Tong University School of Medicine, Shanghai, China
Publisher
Frontiers Media S.A.
Abstract
Objective: This study intended to assess the efficacy of colchicine for
prevention of post-operative atrial fibrillation (AF). <br/>Background(s):
Post-operative AF is a common complication of surgery operations.
Inflammation plays a crucial role in the pathogenesis of post-operative
AF. Colchicine, a potent anti-inflammatory drug, may have a role in
mitigating the incidence of post-operative AF. <br/>Method(s): We searched
Cochrane Library, Web of Science, PubMed, China National Knowledge
Infrastructure (CNKI), Database of Chinese sci-tech periodicals (COVIP),
and Wanfang Database for randomized controlled trials (RCTs) comparing
colchicine versus placebo, or usual care for prevention of post-operative
AF. The main outcome was the occurrence of AF post operation, which
includes cardiac surgery, lung surgery, or pulmonary vein isolation. The
estimated risk ratio (RR) for the occurrence of post-operative AF was
evaluated using a random-effects model. The safety end point was the
development of any side effects. <br/>Result(s): A total of 12 RCTs with
2274 patients were eventually included in this meta-analysis, where 1141
patients received colchicine and 1133 patients received placebo or usual
care. Perioperative colchicine treatment was related to a decreased
incidence of post-operative AF (RR: 0.65; 95% confidence interval [CI]:
0.56 to 0.75, p<0.001). Although the incidence of gastrointestinal side
effects was increased with colchicine therapy when compared to placebo (RR
= 2.49, 95% CI 1.85 to 3.34, p < 0.001), the incidence of major adverse
events was not increased (RR = 0.86, 95% CI 0.46 to 1.60, p = 0.64).
<br/>Conclusion(s): In conclusion, the results of our meta-analysis
suggest that colchicine treatment could lower the incidence of
post-operative AF. Further studies are needed to determine the optimal
colchicine treatment regime to minimize the incidence of adverse
events.<br/>Copyright &#xa9; 2022 Ge, Fu, Su, Jin, Guo, Miao, Zhu, Zhuang,
Zhang and Hong.

<85>
Accession Number
2020589875
Title
Machine learning models in heart failure with mildly reduced ejection
fraction patients.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 1042139. Date of Publication: 30 Nov 2022.
Author
Zhao H.; Li P.; Zhong G.; Xie K.; Zhou H.; Ning Y.; Xu D.; Zeng Q.
Institution
(Zhao, Li, Zhong, Xie, Zhou, Xu, Zeng) State Key Laboratory of Organ
Failure Research, Department of Cardiology, Nanfang Hospital, Southern
Medical University, Guangzhou, China
(Zhao, Li, Zhong, Xie, Zhou, Xu, Zeng) Guangdong Provincial Key Laboratory
of Shock and Microcirculation, Southern Medical University, Guangzhou,
China
(Zhao, Li, Zhong, Xie, Zhou, Xu, Zeng) Bioland Laboratory (Guangzhou
Regenerative Medicine and Health Guangdong Laboratory), Guangzhou, China
(Zhao, Ning) School of Laboratory Medicine and Biotechnology, Southern
Medical University, Guangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Objective: Heart failure with mildly reduced ejection fraction (HFmrEF)
has been recently recognized as a unique phenotype of heart failure (HF)
in current practical guideline. However, risk stratification models for
mortality and HF re-hospitalization are still lacking. This study aimed to
develop and validate a novel machine learning (ML)-derived model to
predict the risk of mortality and re-hospitalization for HFmrEF patients.
<br/>Method(s): We assessed the risks of mortality and HF
re-hospitalization in HFmrEF (45-49%) patients enrolled in the TOPCAT
trial. Eight ML-based models were constructed, including 72 candidate
variables. The Harrell concordance index (C-index) and DeLong test were
used to assess discrimination and the improvement in discrimination
between models, respectively. Calibration of the HF risk prediction model
was plotted to obtain bias-corrected estimates of predicted versus
observed values. <br/>Result(s): Least absolute shrinkage and selection
operator (LASSO) Cox regression was the best-performing model for 1- and
6-year mortality, with a highest C-indices at 0.83 (95% CI: 0.68-0.94)
over a maximum of 6 years of follow-up and 0.77 (95% CI: 0.64-0.89) for
the 1-year follow-up. The random forest (RF) showed the best
discrimination for HF re-hospitalization, scoring 0.80 (95% CI: 0.66-0.94)
and 0.85 (95% CI: 0.71-0.99) at the 6- and 1-year follow-ups,
respectively. For risk assessment analysis, Kansas City Cardiomyopathy
Questionnaire (KCCQ) subscale scores were the most important predictor of
readmission outcome in the HFmrEF patients. <br/>Conclusion(s): ML-based
models outperformed traditional models at predicting mortality and
re-hospitalization in patients with HFmrEF. The results of the risk
assessment showed that KCCQ score should be paid increasing attention to
in the management of HFmrEF patients.<br/>Copyright &#xa9; 2022 Zhao, Li,
Zhong, Xie, Zhou, Ning, Xu and Zeng.

<86>
Accession Number
637331081
Title
Non-Vitamin K Oral Anticoagulant After Transcatheter Aortic Valve
Replacement: A Systematic Review and Meta-Analysis.
Source
Frontiers in Pharmacology. 13 (no pagination), 2022. Article Number:
755009. Date of Publication: 11 Feb 2022.
Author
Li D.; Ma X.; Zhou X.; Qian Y.
Institution
(Li, Qian) Department of Cardiovascular Surgery, West China Hospital,
Sichuan University, Chengdu, China
(Ma) Department of Emergency Medicine, Emergency Medical Laboratory, West
China Hospital, Sichuan University, Chengdu, China
(Zhou) Evidence-based Medicine Research Center, Jiangxi University of
Traditional Chinese Medicine, Nanchang, China
(Qian) National Clinical Research Center for Geriatrics, West China
Hospital, Sichuan University, Chengdu, China
Publisher
Frontiers Media S.A.
Abstract
Objective: We aimed to compare non-vitamin K oral anticoagulants (NOACs)
with a traditional antithrombotic such as vitamin K antagonist (VKA) and
antiplatelet agents in patients after transcatheter aortic valve
replacement (TAVR). <br/>Method(s): We conducted a search in PubMed,
EMBASE, and the Cochrane Library until November 2021 for studies involving
comparisons of any type of NOACs, including dabigatran, apixaban,
rivaroxaban, and edoxaban, with VKA or antiplatelet agents after TAVR. A
comparison of NOACs versus VKA was performed in patients with an
indication for oral anticoagulation. In addition, we compared NOACs versus
antiplatelet in patients without such indication. We calculated the hazard
ratios with 95% confidence intervals (CIs) to determine long-term
outcomes. The primary outcome was a combined endpoint consisting of
all-cause mortality, stroke, major bleeding, or any related clinical
adverse events. Secondary outcomes were all-cause mortality, major
bleeding, and stroke, respectively. <br/>Result(s): A total of 10 studies
including 10,563 patients after TAVR were included in this meta-analysis.
There were no significant differences in any of the long-term outcomes
between the NOAC and VKA groups. Although there were no significant
differences in the combined endpoint, major bleeding, or stroke, a
significant difference was observed in the all-cause mortality (HR 1.74,
95% CI 1.25-2.43, p = 0.001) between the NOAC and antiplatelet groups.
<br/>Conclusion(s): For patients with an indication for oral
anticoagulation after TAVR, NOACs seem to be associated with noninferior
outcomes compared with VKA therapy. However, for patients without an
indication for oral anticoagulation, NOACs appear to be associated with a
higher risk of all-cause death as compared with antiplatelet treatment.
Systematic Review Registration: https://clinicaltrials.gov/, identifier
CRD42020155122.<br/>Copyright &#xa9; 2022 Li, Ma, Zhou and Qian.

<87>
Accession Number
2014200081
Title
Outcomes of contemporary versus conventional reverse controlled and
antegrade and retrograde subintimal tracking in chronic total occlusion
revascularization.
Source
Catheterization and Cardiovascular Interventions. 99(2) (pp 226-233),
2022. Date of Publication: February 1, 2022.
Author
Xu R.; Shi Y.; Chang S.; Qin Q.; Li C.; Fu M.; Ge L.; Qian J.; Ma J.; Ge
J.
Institution
(Xu, Shi, Chang, Qin, Li, Fu, Ge, Qian, Ma, Ge) Department of Cardiology,
Zhongshan Hospital, Fudan University, Shanghai, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Chronic total occlusion (CTO) lesions remain technically
challenging for percutaneous coronary intervention (PCI). The introduction
of a retrograde approach has allowed marked improvement in the success
rate of CTO recanalization. Reverse controlled anterograde and retrograde
sub-intimal tracking (reverse CART) is the predominant retrograde wire
crossing technique and can be broadly classified into three categories:
(1) conventional (2) contemporary and (3) extended. The present study
aimed to compare the safety and efficacy of conventional and contemporary
reverse CART techniques. <br/>Method(s): From March 2015 to May 2020, 303
patients achieving successful retrograde guidewire crossing with
conventional or contemporary reverse CART during CTO PCI were included in
the study. The patient characteristics, procedural outcomes and
in-hospital and 1-year clinical events were compared between the
conventional and contemporary groups. <br/>Result(s): The distributions of
the baseline and angiographic characteristics were similar in both study
arms, except the CTO lesions of the conventional group were more complex,
as reflected by borderline significantly higher mean J-CTO scores (3.4 +/-
0.7 vs. 3.3 +/- 0.8; p = 0.059). Recanalization using contemporary reverse
CART was associated with a short procedure time (189.8 +/- 44.4 vs. 181.7
+/- 37.3 min; p = 0.044) and decreased procedural complications,
particularly target vessel perforation (3.6% vs. 0.6%; p = 0.063) and
major side-branch occlusion (36.7% vs. 28.0%; p = 0.051). Technical and
procedural success and the in-hospital and 1-year outcomes were not
significantly different between the groups. <br/>Conclusion(s):
Contemporary reverse CART is associated with favorably high efficiency and
low-complication rates and carries a comparable success rate and 1-year
clinical outcomes as conventional reverse CART.<br/>Copyright &#xa9; 2021
Wiley Periodicals LLC.

<88>
Accession Number
2021901588
Title
Custodiol-N versus Custodiol: a prospective randomized double-blind
multicentre phase III trial in patients undergoing elective coronary
bypass surgery.
Source
European Journal of Cardio-thoracic Surgery. 62(5) (no pagination), 2022.
Article Number: ezac287. Date of Publication: 01 Nov 2022.
Author
Szabo G.; Brlecic P.; Loganathan S.; Wagner F.; Rastan A.; Doenst T.;
Karck M.; Veres G.
Institution
(Szabo, Brlecic, Loganathan, Karck, Veres) Department of Cardiac Surgery,
University of Heidelberg, Heidelberg, Germany
(Szabo, Loganathan, Veres) Department of Cardiac Surgery, University of
Halle, Halle (Saale), Germany
(Wagner) Department of Cardiac Surgery, University of Hamburg, Hamburg,
Germany
(Rastan) Department of Cardiac and Vascular Surgery, Heart Center
Rotenburg, Rotenburg, Germany
(Doenst) Department of Cardiac Surgery, University of Jena, Jena, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: HTK-Solution (Custodiol) is a well-established cardioplegic
and organ preservation solution. We currently developed a novel HTK-based
solution, Custodiol-N, which includes iron chelators to reduce oxidative
injury, as well as l-arginine, to improve endothelial function. In this
first-in-human study, Custodiol-N was compared to Custodiol in patients
undergoing elective coronary artery bypass surgery. The aim of this
comparison was to evaluate the safety and ability of Custodiol-N to
protect cardiac tissue. <br/>METHOD(S): The study was designed as a
prospective randomized double-blind non-inferiority trial. Primary end
point was area under the curve (AUC) of creatine kinase muscle-brain
(CK-MB) within the first 24 h after surgery. Secondary end points included
peak CK-MB and troponin-T and AUC of troponin-T release, cardiac index,
cumulative catecholamine dose, intensive care unit stay and mortality. All
values in the abstract are given as mean +/- SD, P < 0.05 was considered
statistically significant. <br/>RESULT(S): Early termination of the trial
was performed per protocol as the primary non-inferiority end-point was
reached after inclusion of 101 patients. CK-MB AUC (878+/-549 vs 779+/-439
h U/l, non-inferiority P < 0.001, Custodiol vs Custodiol-N) and troponin-T
AUC (12990+/-8347 vs 13498+/-6513 h pg/ml, noninferiority P < 0.001,
Custodiol vs Custodiol-N) were similar in both groups. Although the trial
was designed for non-inferiority, peak CK-MB (52+/-40 vs 42+/-28 U/l,
superiority P < 0.03, Custodiol vs Custodiol-N) was significantly lower in
the Custodiol-N group. <br/>CONCLUSION(S): This study shows that
Custodiol-N is safe and provides similar cardiac protection as the
established HTK-Custodiol solution. Significantly reduced peak CK-MB
levels in the Custodiol-N group in the full analysis set may implicate a
beneficial effect on ischaemia/reperfusion injury in the setting of
coronary bypass surgery.<br/>Copyright &#xa9; 2022 The Author(s).
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<89>
Accession Number
2021901583
Title
Preoperative oral magnesium loading to prevent postoperative atrial
fibrillation following coronary surgery: a prospective randomized
controlled trial.
Source
European Journal of Cardio-thoracic Surgery. 62(5) (no pagination), 2022.
Article Number: ezac269. Date of Publication: 01 Nov 2022.
Author
Tohme J.; Sleilaty G.; Jabbour K.; Gergess A.; Hayek G.; Jebara V.;
Madi-Jebara S.
Institution
(Tohme, Jabbour, Gergess, Hayek, Madi-Jebara) Department of Anesthesia and
Critical Care, Hotel-Dieu de France Hospital, Universite Saint-Joseph,
Beirut, Lebanon
(Sleilaty, Jebara) Department of Cardiovascular and Thoracic Surgery,
Hotel-Dieu de France Hospital, Universite Saint-Joseph, Beirut, Lebanon
(Sleilaty) Clinical Research Center, Faculty of Medicine, Universite
Saint-Joseph, Beirut, Lebanon
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Postoperative atrial fibrillation (POAF) is common following
coronary artery bypass grafting (CABG) surgery. Hypomagnesemia is frequent
after CABG surgery. No previous trials have assessed the effect of
preoperative magnesium (Mg) loading on POAF incidence. <br/>METHOD(S):
This was a single-centre, double-blind, placebo-controlled, parallel-group
trial, with balanced randomization [1:1]. The participants were recruited
from November 2018 until May 2019. Patients received either 3.2 g of Mg
daily (4 tablets of 0.4 g each twice daily) for 72 h preoperatively and
1.6 g of Mg (4 tablets) on the day of surgery or placebo tablets.
<br/>RESULT(S): The primary outcome was the incidence of POAF. Secondary
outcomes included time to extubation, transfusion rate, critical care unit
and hospital length of stay. Of the 210 randomized participants, 200 (100
in each group) completed the study. A total of 10 (10%) and 22 (22%)
subjects developed POAF in the Mg and placebo groups, respectively (RR =
0.45, 95% confidence interval: 0.23-0.91). Hospital and critical care unit
length of stay were comparable between the 2 groups. No side effects
related to Mg administration were documented. <br/>CONCLUSION(S): In this
randomized controlled trial, preoperative loading with oral administration
of Mg for 3 days in patients admitted for CABG surgery decreases the
incidence of POAF compared to placebo. Clinical trial registration number:
NCT03703349.<br/>Copyright &#xa9; 2022 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<90>
Accession Number
2021901582
Title
Effects of postoperative cognitive training on neurocognitive decline
after heart surgery: a randomized clinical trial.
Source
European Journal of Cardio-thoracic Surgery. 62(5) (no pagination), 2022.
Article Number: ezac251. Date of Publication: 01 Nov 2022.
Author
Butz M.; Gerriets T.; Sammer G.; El-Shazly J.; Tschernatsch M.; Huttner
H.B.; Braun T.; Boening A.; Mengden T.; Choi Y.-H.; Schoenburg M.;
Juenemann M.
Institution
(Butz, Gerriets, Sammer, Tschernatsch, Braun, Schoenburg, Juenemann) Heart
and Brain Research Group, Kerckhoff Heart and Thorax Center, Bad Nauheim,
Germany
(Butz, Gerriets, Tschernatsch, Huttner, Braun, Juenemann) Department of
Neurology, University Hospital Giessen and Marburg, Giessen, Germany
(Sammer) Cognitive Neuroscience at the Center of Psychiatry, University
Giessen, Giessen, Germany
(Sammer) Department of Psychology, Justus-Liebig University, Giessen,
Germany
(El-Shazly) Department of Psychocardiology, Kerckhoff Heart and Thorax
Center, Bad Nauheim, Germany
(Boening) Department of Cardiovascular Surgery, University Hospital
Giessen and Marburg, Giessen, Germany
(Mengden) Department of Rehabilitation, Kerckhoff Heart and Thorax Center,
Bad Nauheim, Germany
(Choi, Schoenburg) Department of Cardiac Surgery, Kerckhoff Heart and
Thorax Center, Bad Nauheim, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Following cardiac surgery, postoperative cognitive decline
(POCD) is a common complication that can impair the quality of life and
increase mortality. The aim of this study was to investigate whether early
postoperative cognitive training can decrease POCD after cardiac surgery.
<br/>METHOD(S): The study was a multi-centred, two-arm, randomized (1:1
ratio), controlled trial involving older patients undergoing elective
heart valve surgery with extracorporeal circulation. Recruitment took
place at the Department of Cardiac Surgery of the Kerckhoff-Clinic in Bad
Nauheim (Germany) and the University-Hospital in Giessen (Germany). The
patients were randomized to either a paper-and-pencil-based cognitive
training group or a standard rehabilitation care control group. The
cognitive training started 1 week after surgery and lasted about 3 weeks
until discharge from rehabilitation. To detect POCD, neuropsychological
functions were assessed prior to surgery, upon discharge from
rehabilitation (primary outcome), and 3 months after discharge (secondary
outcome). Data were primarily analysed in a per-protocol fashion.
<br/>RESULT(S): The frequency of POCD at discharge from rehabilitation
(training group, n = 37; control group, n = 44) was 50% in the control
group and 19% in the training group (chi2[1] = 8.45, P = 0.004; odds ratio
= 4.29, 95% confidence interval [1.56-11.80]). Three months after the
cognitive training (training group, n = 33; control group, n = 34), POCD
frequency was 29% in the control group and 6% in the training group
(chi2[1] = 6.21, P = 0.013; odds ratio = 6.46, 95% confidence interval
[1.29-32.28]). <br/>CONCLUSION(S): Since our cognitive training showed
beneficial effects, it could be a promising method to prevent
POCD.<br/>Copyright &#xa9; 2022 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<91>
Accession Number
2021901533
Title
The inclusion criteria was flawed in the systematic review and
meta-analysis by Wu et al.
Source
European Journal of Cardio-thoracic Surgery. 62(4) (no pagination), 2022.
Article Number: ezac107. Date of Publication: 01 Oct 2022.
Author
Huang Y.; Li H.; Zhang J.
Institution
(Huang, Li) Department of Anesthesiology, The Affiliated Hospital of
Guizhou Medical University, Guiyang, China
(Zhang) Department of General Surgery, The Affiliated Hospital of Guizhou
Medical University, Guiyang, China
Publisher
European Association for Cardio-Thoracic Surgery

<92>
Accession Number
2021901016
Title
Evaluation of rhomboid intercostal and subserratus plane block under
direct vision for postoperative analgesia in thoracic surgeries: a
prospective, randomized controlled trial.
Source
European Journal of Cardio-thoracic Surgery. 62(6) (no pagination), 2022.
Article Number: ezac498. Date of Publication: 01 Dec 2022.
Author
Kozanhan B.; Semerkant T.; Esme H.; Canitez A.; Iyisoy M.S.
Institution
(Kozanhan) Department of Anesthesiology and Reanimation, University of
Health Sciences, Konya City Hospital, Konya, Turkey
(Semerkant, Esme) Department of Thorax Surgery, University of Health
Sciences, Konya City Hospital, Konya, Turkey
(Canitez) Department of Anesthesiology and Reanimation, Abdulkadir Yuksel
City Hospital, Gaziantep, Turkey
(Iyisoy) Department of Medical Education and Informatics, Necmettin
Erbakan University, Konya, Turkey
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: This study is designed to evaluate the efficacy of rhomboid
intercostal and subserratus plane (RISS) block under the surgeon's direct
vision for providing postoperative pain relief after thoracic surgeries.
<br/>METHOD(S): Forty patients who underwent thoracotomy were
prospectively recruited and randomly assigned to group R (intravenous
patient-controlled analgesia + continued RISS block; n = 20) and group C
(intravenous patient-controlled analgesia; n = 20). Numeric rating scale
at rest and cough, at post-anaesthetic care unit, 1, 2, 6, 9, 12, 24 and
48 h, was used as the primary outcome measure. Secondary outcome measures
were the amount of tramadol consumption, the number of patients required
rescue analgesia, the occurrence of postoperative adverse effects,
pulmonary functions and the overall satisfaction with pain management.
<br/>RESULT(S): Numeric rating scale scores both at rest and during
coughing were significantly lower in group R than in group C at all time
intervals (P < 0.001 in each). Tramadol consumption at 24 and 48 h was
significantly lower in the group R block than in group C (P < 0.001 for
each). None of the patients in group R requires rescue analgesia. The
incidence of nausea and vomiting was similar among the groups. Compared
with group C, change in lung function from baseline levels was
significantly less in group R (P = 0.047 and P = 0.04 for FEV1 and FVC,
respectively). The satisfaction scores in group R were significantly
higher than that in group C (P < 0.001). <br/>CONCLUSION(S): Continuous
RISS block improved postoperative outcomes of thoracic surgery in terms of
reduced postoperative pain scores, sparing opioid consumption, pulmonary
function and patient satisfaction.<br/>Copyright &#xa9; 2022 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<93>
Accession Number
2018890406
Title
Valve-in-Valve Transcatheter Aortic Valve Replacement Versus Redo Surgical
Aortic Valve Replacement for Failed Surgical Aortic Bioprostheses: A
Systematic Review and Meta-Analysis.
Source
Journal of the American Heart Association. 11(24) (no pagination), 2022.
Article Number: e7965. Date of Publication: 20 Dec 2022.
Author
Raschpichler M.; de Waha S.; Holzhey D.; Schwarzer G.; Flint N.; Kaewkes
D.; Brauchle P.T.; Dvir D.; Makkar R.; Ailawadi G.; Abdel-Wahab M.; Thiele
H.; Borger M.A.
Institution
(Raschpichler, de Waha, Brauchle, Abdel-Wahab, Borger) Heart Center
Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig,
Germany
(Raschpichler, Flint, Kaewkes, Makkar) Smidt Heart Institute, Department
of Interventional Cardiology, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Holzhey) Department of Cardiac Surgery, University Hospital Wuppertal,
Wuppertal, Germany
(Schwarzer) Institute of Medical Biometry and Statistics, Faculty of
Medicine and Medical Center, University of Freiburg, Germany
(Flint) Tel Aviv Sourasky Medical Center affiliated to the Sackler faculty
of Medicine, Department of Cardiology, Tel Aviv University, Tel Aviv,
Israel
(Kaewkes) Department of Medicine, Khon Kaen University, Khon Kaen,
Thailand
(Dvir) Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Abdel-Wahab, Thiele) Heart Center Leipzig at University of Leipzig,
Department of Cardiology, Leipzig, Germany
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: In the absence of randomized controlled trials, reports from
nonrandomized studies comparing valve-in-valve implantation (ViV) to redo
surgical aortic valve replacement (rAVR) have shown inconsistent results.
METHODS AND RESULTS: PubMed/MEDLINE, Google Scholar, and CENTRAL (Cochrane
Central Register of Controlled Trials) were searched through December
2021. Meta-Analysis of Observational Studies in Epidemiology guidelines
were followed. The protocol was registered at the International
Prospective Register of Systematic Reviews. Random effects models were
applied. The primary outcomes of interest were short-term and midterm
mortality. Secondary outcomes included stroke, myocardial infarction,
acute renal failure, and permanent pacemaker implantation, as well as
prosthetic aortic valve regurgi-tation, mean transvalvular gradient, and
severe prosthesis-patient mismatch. Of 8881 patients included in 15
studies, 4458 (50.2%) underwent ViV and 4423 (49.8%) rAVR. Short-term
mortality was 2.8% in patients undergoing ViV compared with 5.0% in
patients undergoing rAVR (risk ratio [RR] 0.55 [95% CI, 0.34-0.91],
P=0.02). Midterm mortality did not differ in patients undergoing ViV
compared with patients undergoing rAVR (hazard ratio, 1.27 [95% CI,
0.72-2.25]). The rate of acute kidney failure was lower following ViV,
(RR, 0.54 [95% CI, 0.33-0.88], P=0.02), whereas prosthetic aortic valve
regurgitation (RR, 4.18 [95% CI, 1.88-9.3], P=0.003) as well as severe
patient-prothesis mismatch (RR, 3.12 [95% CI, 2.35-4.1], P<0.001) occurred
more frequently. The mean transvalvular gradient was higher following ViV
(standard mean difference, 0.44 [95% CI, 0.15- 0.72], P=0.008). There were
no significant differences between groups with respect to stroke (P=0.26),
myocardial infarction (P=0.93), or pacemaker implantation (P=0.21).
<br/>CONCLUSION(S): Results of this meta-analysis demonstrate better
short-term mortality after ViV compared with rAVR. Midterm mortality was
similar between groups. Given the likely selection bias in these
individual reports, an adequately powered mul-ticenter randomized clinical
trial with sufficiently long follow-up in patients with
low-to-intermediate surgical risk is warranted.<br/>Copyright &#xa9; 2022
The Authors.

<94>
[Use Link to view the full text]
Accession Number
2021813674
Title
Edge-to-Edge Transcatheter Mitral Valve Repair Versus Optimal Medical
Treatment in Nonresponders to Cardiac Resynchronization Therapy: The
MITRA-CRT Trial.
Source
Circulation: Heart Failure. 15(12) (pp E009501), 2022. Date of
Publication: 01 Dec 2022.
Author
Freixa X.; Tolosana J.M.; Cepas-Guillen P.L.; Hernandez-Enriquez M.;
Sanchis L.; Flores-Umanzor E.; Farrero M.; Andrea R.; Roque M.; Carretero
M.J.; Regueiro A.; Brugaletta S.; Rodes-Cabau J.; Mont L.; Sitges M.;
Sabate M.; Castel M.A.
Institution
(Freixa, Tolosana, Cepas-Guillen, Hernandez-Enriquez, Sanchis,
Flores-Umanzor, Farrero, Andrea, Roque, Regueiro, Brugaletta, Rodes-Cabau,
Mont, Sitges, Sabate, Castel) Cardiology Department, Cardiovascular
Institute (ICCV), Hospital Clinic, IDIBAPS, University of Barcelona, Spain
(Carretero) Anesthesiology Department, Hospital Clinic, IDIBAPS,
University of Barcelona, Spain
(Rodes-Cabau) Quebec Heart and Lung Institute, Quebec City, Canada
Publisher
Lippincott Williams and Wilkins

<95>
Accession Number
2021812922
Title
Pre-Operative Forced Air Warming and In Preventing Incidence of
Perioperative Hypothermia in Patients Undergoing General Anaesthesia- a
Randomised Comparative Prospective Study.
Source
Journal of Pharmaceutical Negative Results. 13 (pp 160-165), 2022. Date of
Publication: 2022.
Author
Amit K.; Mahima L.; Ritesh K.
Institution
(Amit, Mahima, Ritesh) Department Of Anaesthesiology and Critical Care,
Santosh Medical College, Ghaziabad, India
Publisher
ResearchTrentz Academy Publishing Education Services
Abstract
Background and Aims: Inadvertent perioperative hypothermia (IPH) is
defined as a peri-operative core temperature of less than 36degreeC. IPH
is known to increase the risk of blood loss, prolonged and altered drug
effects, post-operative shivering, and adverse cardiac events.
Pre-operative warming with forced air reduces post-induction
redistribution hypothermia and prevents complications associated with
hypothermia. The present study was conducted to compare the effect of
preoperative forced-air warming on the incidence of perioperative
hypothermia in patients undergoing general anaesthesia, who are pre-warmed
versus those who are not pre-warmed. <br/>Material(s) and Method(s): This
randomized comparative prospective study was carried out on 170 adult
persons of either sex, ASA (American Society of Anesthesiologists)
physical status I -III scheduled for different surgeries under general
anaesthesia who met eligibility criteria were randomly assigned either to
group A in which preoperative forced-air warming was done for 30 minutes
or to group B in which pre-operative forced-air warming was not done. The
incidence of hypothermia was compared between the two groups.
<br/>Result(s): The incidence of hypothermia was significantly higher in
the non-pre-warmed group as compared to the pre-warmed group. The
incidence of postoperative shivering was significantly higher in the
non-pre-warmed group. However, the incidence of an adverse cardiac event
and increased blood loss was insignificant between the two groups.
Conclusion-Based on observations and results of this study, the incidence
of perioperative hypothermia was reduced in patients who were pre-warmed
for 30 minutes before general anaesthesia in comparison to patients who
were not pre-warmed.<br/>Copyright &#xa9; 2022 Wolters Kluwer Medknow
Publications. All rights reserved.

<96>
Accession Number
2021803165
Title
Intraoperative Methadone Use in Cardiac Surgery: A Systematic Review.
Source
Pain Medicine (United States). 22(12) (pp 2827-2834), 2021. Date of
Publication: 01 Dec 2021.
Author
Lobova V.A.; Roll J.M.; Roll M.L.C.
Institution
(Lobova, Roll) Elson S. Floyd College of Medicine, Washington State
University, Spokane, WA, United States
(Roll) Department of Community and Behavioral Health, Program of
Excellence in the Addictions, Washington State University, Spokane, WA,
United States
(Roll) Macalester College, Saint Paul, MN, United States
Publisher
Oxford University Press
Abstract
Objective: To investigate the effects of intraoperative methadone in
comparison with those of standard-of-care intraoperative opioids, such as
fentanyl and morphine, on pain scores, opioid consumption, and adverse
effects in adults undergoing cardiothoracic surgery. <br/>Method(s): The
literature was reviewed in PubMed, Embase, Cochrane Library, and Google
Scholar, followed by a manual search of the reference lists of the
identified articles. Search terms included a combination of
"intraoperative methadone,""methadone,"and "cardiac surgery."Our review
includes four studies published between 2011 and 2020. Quality assessment
of the studies was performed. <br/>Result(s): The initial search
identified 715 articles, from which 461 duplicates were removed and 236
were eliminated on the basis of inclusion and exclusion criteria. Eighteen
articles underwent full-text review. Four studies evaluating a total of
435 patients with various cardiothoracic procedures were included in this
review. We found that intraoperative methadone decreased acute
postoperative pain and reduced postoperative opioid consumption in the
first 24 postoperative hours in patients who received 0.1-0.3 mg/kg
intraoperative methadone in comparison with morphine and fentanyl. No
difference was found in adverse effects between the groups. Quality
assessment of the studies showed a low risk of bias in three of the
randomized controlled trials and a high risk of bias in the retrospective
review because of the baseline confounding bias in the study design.
<br/>Conclusion(s): Intraoperative methadone use reduces acute
postoperative pain and lowers opioid consumption in comparison with
morphine and fentanyl. Initial results suggest that methadone may be an
equivalent opioid to be administered during cardiothoracic procedures to
reduce acute postsurgical pain, though further research is
warranted.<br/>Copyright &#xa9; 2021 The Author(s). Published by Oxford
University Press on behalf of the American Academy of Pain Medicine. All
rights reserved.

<97>
[Use Link to view the full text]
Accession Number
2016472849
Title
The design of an adaptive clinical trial to evaluate the efficacy of
platelets stored at low temperature in surgical patients.
Source
Journal of Trauma and Acute Care Surgery. 84(6S) (pp S41-S46), 2018. Date
of Publication: 01 Jun 2018.
Author
Krachey E.; Viele K.; Spinella P.C.; Steiner M.E.; Zantek N.D.; Lewis R.J.
Institution
(Krachey, Viele, Lewis) Berry Consultants, LLC, Austin, TX, United States
(Spinella) Division Critical Care, Department of Pediatrics, Washington
University in St Louis, St Louis, MO, United States
(Steiner) Divisions of Hematology/Oncology and Critical Care Medicine,
Department of Pediatrics, University of Minnesota, Minneapolis, MN, United
States
(Zantek) Department of Laboratory Medicine and Pathology, University of
Minnesota, Minneapolis, MN, United States
(Lewis) Department of Emergency Medicine, Harbor-UCLA Medical Center, Los
Angeles Biomedical Research Institute, Torrance, United States
(Lewis) Department of Emergency Medicine, David Geffen School of Medicine
at UCLA, Los Angeles, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Storage of platelets at 4degreeC compared with 22degreeC may
increase both hemostatic activity and storage duration; however, the
maximum duration of cold storage is unknown. We report the design of an
innovative, prospective, randomized, Bayesian adaptive, "duration finding"
clinical trial to evaluate the efficacy and maximum duration of storage of
platelets at 4degreeC. <br/>METHOD(S): Patients undergoing cardiac surgery
and requiring platelet transfusions will be enrolled. Patients will be
randomized to receive platelets stored at 22degreeC up to 5 days or
platelets stored at 4degreeC up to 5 days, 10 days, or 15 days. Longer
durations of cold storage will only be used if shorter durations at
4degreeC appear noninferior to standard storage, based on a four-level
clinical hemostatic efficacy score with a NIM of a half level. A Bayesian
linear model is used to estimate the hemostatic efficacy of platelet
transfusions based on the actual duration of storage at 4degreeC.
<br/>RESULT(S): The type I error rate, if platelets stored at 4degreeC are
inferior, is 0.0247 with an 82% probability of early stopping for
futility. With a maximum sample size of 1,500, the adaptive trial design
has a power of over 90% to detect noninferiority and a high probability of
correctly identifying the maximum duration of storage at 4degreeC that is
noninferior to 22degreeC. <br/>CONCLUSION(S): An adaptive,
duration-finding trial design will generate Level I evidence and allow the
determination of the maximum duration platelet storage at 4degreeC that is
noninferior to standard storage at 22degreeC, with respect to hemostatic
efficacy. The adaptive trial design helps to ensure that longer cold
storage durations are only explored once substantial supportive data are
available for the shorter duration(s) and that the trial stops early if
continuation is likely to be futile.<br/>Copyright &#xa9; 2018 Wolters
Kluwer Health, Inc. All rights reserved.

<98>
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. <br/>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.
<br/>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).
<br/>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.<br/>Copyright &#xa9; 2021 British
Journal of Anaesthesia

<99>
Accession Number
2020808294
Title
Long-Term Consequences of Acute Kidney Injury After Pediatric Cardiac
Surgery: A Systematic Review.
Source
Journal of Pediatrics. 252 (pp 83-92.e5), 2023. Date of Publication:
January 2023.
Author
Van den Eynde J.; Rotbi H.; Schuermans A.; Hassanabad A.F.; Gewillig M.;
Budts W.; Kutty S.; Mekahli D.
Institution
(Van den Eynde, Kutty) Helen B. Taussig Heart Center, The Johns Hopkins
Hospital and School of Medicine, Baltimore, MA, United States
(Van den Eynde, Schuermans, Gewillig, Budts) Department of Cardiovascular
Sciences, KU Leuven, Leuven, Belgium
(Rotbi) Faculty of Medicine, Radboud University, Nijmegen, Netherlands
(Rotbi) Radboud Institute for Health Sciences, Department of Physiology,
Radboud University Medical Center, Nijmegen, Netherlands
(Hassanabad) Section of Cardiac Surgery, Department of Cardiac Sciences,
Libin Cardiovascular Institute, Cumming School of Medicine, Calgary, AB,
Canada
(Gewillig) Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Budts) Congenital and Structural Cardiology, UZ Leuven, Leuven, Belgium
(Mekahli) Department of Pediatric Nephrology, University Hospitals of
Leuven, Leuven, Belgium
(Mekahli) PKD Research Group, GPURE, Department of Development and
Regeneration, KU Leuven, Leuven, Belgium
Publisher
Elsevier Inc.
Abstract
Objective: The objective of this study was to evaluate the available data
on long-term kidney dysfunction, hypertension, and mortality after cardiac
surgery-associated acute kidney injury (AKI) in the pediatric population.
Study design: PubMed/MEDLINE, Embase, Scopus, and reference lists of
relevant articles were searched for eligible studies published from
inception through March 2022. Long-term outcomes after pediatric cardiac
surgery complicated by AKI and those without were investigated.
<br/>Result(s): We identified 14 studies published between 2013 and 2022
that included a total of 6701 patients (AKI: 1376 patients; no AKI: 5325
patients). These studies used different well-established classifications
to define AKI. All the studies suggested that AKI after heart surgery is
common in the pediatric patient population and reported a potential link
between cardiac surgery-associated AKI and important clinical outcomes.
However, only 4 out of 11 studies found a strong association between
(absence of recovery from) cardiac surgery-associated AKI and risk of
developing chronic kidney disease, and 3 out of 5 studies found a
significant increase in mortality rates for pediatric patients who
developed AKI after cardiac surgery. Only 1 out of 4 studies found an
association between AKI and hypertension at 12 months postoperatively, but
found no association at later follow-up times. <br/>Conclusion(s):
Although there is a trend, evidence on the long-term consequences of
cardiac surgery-associated AKI in the pediatric population is mixed.
Genetic syndromes, preexisting kidney disease, univentricular or cyanotic
heart conditions, and/or high-complexity surgery may be more important for
the development of kidney dysfunction by adolescence and early adulthood.
Regardless, these children may benefit from a long-term kidney
follow-up.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<100>
Accession Number
2021965966
Title
Meta-Analysis Comparing Valve-in-Valve Transcatheter Mitral Valve
Replacement Versus Redo Surgical Mitral Valve Replacement in Degenerated
Bioprosthetic Mitral Valve.
Source
American Journal of Cardiology. 189 (pp 98-107), 2023. Date of
Publication: 15 Feb 2023.
Author
Ismayl M.; Abbasi M.A.; Mostafa M.R.; Aboeata A.; Vora A.N.; Ben-Dor I.;
Anavekar N.S.; Goldsweig A.M.
Institution
(Ismayl) Division of XXX, Department of Internal Medicine, Creighton
University School of Medicine, Omaha, NE, United States
(Abbasi, Anavekar) Division of Cardiovascular Medicine, Department of
Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
(Mostafa) Department of Internal Medicine, Rochester Regional/Unity
Hospital, Rochester, New York, United States
(Aboeata) Division of Cardiovascular Medicine, Department of Internal
Medicine, Creighton University School of Medicine, Omaha, NE, United
States
(Vora) UPMC Heart and Vascular Institute, Harrisburg, Pennsylvania, United
States
(Ben-Dor) Division of Interventional Cardiology, Medstar Washington
Hospital Center, Washington, District of Columbia, United States
(Goldsweig) Division of Cardiovascular Medicine, Department of Internal
Medicine, University of Nebraska Medical Center, Omaha, NE, United States
Publisher
Elsevier Inc.
Abstract
Valve-in-valve transcatheter mitral valve replacement (ViV-TMVR) and redo
surgical mitral valve replacement (redo-SMVR) are 2 treatment strategies
for patients with bioprosthetic mitral valve dysfunction. We conducted a
systematic review and meta-analysis to compare the outcomes of ViV-TMVR
versus redo-SMVR. We searched PubMed, EMBASE, Cochrane, and Google Scholar
for studies comparing outcomes of ViV-TMVR versus redo-SMVR in degenerated
bioprosthetic mitral valves. We used a random-effects model to calculate
odd ratios (ORs) with 95% confidence intervals (CIs). Outcomes included
in-hospital, 30-day, 1-year, and 2-year mortality, stroke, bleeding, acute
kidney injury, arrhythmias, permanent pacemaker insertion, and hospital
length of stay (LOS). A total of 6 observational studies with 707 subjects
were included. The median follow-up was 2.7 years. Despite their older age
and greater co-morbidity burden, patients who underwent ViV-TMVR had a
similar in-hospital mortality (OR 0.52, 95% CI 0.22 to 1.23, p = 0.14),
30-day mortality (OR 0.65, 95% CI 0.36 to 1.17, p = 0.15), 1-year
mortality (OR 0.97, 95% CI 0.63 to 1.49, p = 0.89), and 2-year mortality
(OR 1.17, 95% CI 0.65 to 2.13, p = 0.60) compared with redo-SMVR. ViV-TMVR
was associated with significantly lower periprocedural complications,
including stroke, bleeding, acute kidney injury, arrhythmias, and
permanent pacemaker insertion, and shorter hospital LOS than redo-SMVR. In
conclusion, ViV-TMVR was associated with better outcomes than redo-SMVR in
patients with degenerated bioprosthetic mitral valves, including lower
complication rates and shorter hospital LOS, with no significant
difference in mortality rates. Large-scale randomized trials are needed to
mitigate biases and confirm our findings.<br/>Copyright &#xa9; 2022
Elsevier Inc.

<101>
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. <br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9; 2023, Iranian Heart Association. All
rights reserved.

<102>
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.
<br/>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. <br/>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]). <br/>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.<br/>Copyright &#xa9; 2023, Iranian Heart Association.
All rights reserved.

<103>
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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2023, Iranian Heart Association.
All rights reserved.

<104>
Accession Number
2021848289
Title
Triglyceride Lowering with Pemafibrate to Reduce Cardiovascular Risk.
Source
New England Journal of Medicine. 387(21) (pp 1923-1934), 2022. Date of
Publication: 24 Nov 2022.
Author
Das Pradhan A.; Glynn R.J.; Fruchart J.-C.; MacFadyen J.G.; Zaharris E.S.;
Everett B.M.; Campbell S.E.; Oshima R.; Amarenco P.; Blom D.J.; Brinton
E.A.; Eckel R.H.; Elam M.B.; Felicio J.S.; Ginsberg H.N.; Goudev A.;
Ishibashi S.; Joseph J.; Kodama T.; Koenig W.; Leiter L.A.; Lorenzatti
A.J.; Mankovsky B.; Marx N.; Nordestgaard Bo.G.; Pall D.; Ray K.K.; Santos
R.D.; Soran H.; Susekov A.; Tendera M.; Yokote K.; Paynter N.P.; Buring
J.E.; Libby P.; Ridker P.M.
Institution
(Das Pradhan) Center for Cardiovascular Disease Prevention, Division of
Preventive Medicine, United States
(Glynn, Blom) Division of Cardiovascular Medicine, Brigham and Women s
Hospital, United States
(Fruchart) Division of Cardiovascular Medicine, Veteran Affairs Boston
Health Care System
(MacFadyen) Kowa Pharma Development, Boston, United States
(Zaharris) University of Lille, Lille, France
(Everett) Department of Neurology and Stroke Center, Paris Cit University,
Paris, France
(Campbell) Kowa Research Institute, Morrisville, NC, United States
(Oshima) Division of Lipidology, Department of Medicine, University of
Cape Town, Cape Town, South Africa
(Amarenco) Utah Lipid Center, Salt Lake City ; the University of Colorado
School of Medicine, Aurora, United States
(Brinton) The University of Tennessee Health Science Center, Memphis,
United States
(Eckel) Division of Endocrinology, Universit rio Hospital Jo o de Barros
Barreto, Belm, Brazil
(Elam, Joseph) Heart Institute, University of S o Paulo Medical School
Hospital, Hospital Israelita Albert Einstein, So Paulo, Brazil
(Felicio, Kodama) Columbia University Vagelos, College of Physicians and
Surgeons, New York, United States
(Ginsberg, Koenig) Queen Giovanna University Hospital, Sofia, Bulgaria
(Goudev, Leiter) Jichi Medical University, Shimotsuke, Research Center for
Advanced Science and Technology, University of Tokyo, Tokyo, Japan
(Ishibashi, Mankovsky) Chiba University Graduate School of Medicine,
Chiba, Japan
(Marx) Deutsches Herzzentrum M nchen, Technische Universit t M nchen and
German Center for Cardiovascular Research, Partner Site Munich Heart
Alliance, Munich, Germany
(Lorenzatti, Nordestgaard) Institute of Epidemiology and Medical Biometry,
University of Ulm, Ulm, Germany
(Pall) Rheinisch Westf lische Technische Hochschule Aachen, University
Hospital Aachen, Aachen, Germany
(Ray) McMaster University and Population Health Research Institute,
Hamilton, ON, Canada
(Santos) Division of Endocrinology and Metabolism, St. Michael s Hospital,
University of Toronto, Toronto, Canada
(Soran) Docencia, Asistencia M dica e Investigaci n Cl nica Med. Inst.
Rusculleda Foundation for Research, Cordoba, Argentina
(Susekov) Shupyk Na Tional Healthcare University of Ukraine, Kyiv, Ukraine
(Tendera) Copenhagen University Hospital Herlev Gentofte, University of
Copenhagen, Copenhagen, Denmark
(Yokote) Department of Medical Clinical Pharmacology, University of
Debrecen, Debrecen, Hungary
(Paynter) Department of Primary Care and Public Health, Imperial College
London, London, United Kingdom
(Buring) Department of Endocrinology, Diabetes, and Metabolism, Manchester
University Hospital Nhs Foundation Trust, Manchester, United Kingdom
(Libby) Russian Academy of Postgraduate Medical Education, Moscow, Russian
Federation
(Ridker) Department of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Katowice, Poland
Publisher
Massachussetts Medical Society
Abstract
Background High triglyceride levels are associated with increased
cardiovascular risk, but whether reductions in these levels would lower
the incidence of cardiovascular events is uncertain. Pemafibrate, a
selective peroxisome proliferator-activated receptor alpha modulator,
reduces triglyceride levels and improves other lipid levels. Methods In a
multinational, double-blind, randomized, controlled trial, we assigned
patients with type 2 diabetes, mild-to-moderate hypertriglyceridemia
(triglyceride level, 200 to 499 mg per deciliter), and high-density
lipoprotein (HDL) cholesterol levels of 40 mg per deciliter or lower to
receive pemafibrate (0.2-mg tablets twice daily) or matching placebo.
Eligible patients were receiving guideline-directed lipid-lowering therapy
or could not receive statin therapy without adverse effects and had
low-density lipoprotein (LDL) cholesterol levels of 100 mg per deciliter
or lower. The primary efficacy end point was a composite of nonfatal
myocardial infarction, ischemic stroke, coronary revascularization, or
death from cardiovascular causes. Results Among 10,497 patients (66.9%
with previous cardiovascular disease), the median baseline fasting
triglyceride level was 271 mg per deciliter, HDL cholesterol level 33 mg
per deciliter, and LDL cholesterol level 78 mg per deciliter. The median
follow-up was 3.4 years. As compared with placebo, the effects of
pemafibrate on lipid levels at 4 months were -26.2% for triglycerides,
-25.8% for very-low-density lipoprotein (VLDL) cholesterol, -25.6% for
remnant cholesterol (cholesterol transported in triglyceride-rich
lipoproteins after lipolysis and lipoprotein remodeling), -27.6% for
apolipoprotein C-III, and 4.8% for apolipoprotein B. A primary end-point
event occurred in 572 patients in the pemafibrate group and in 560 of
those in the placebo group (hazard ratio, 1.03; 95% confidence interval,
0.91 to 1.15), with no apparent effect modification in any prespecified
subgroup. The overall incidence of serious adverse events did not differ
significantly between the groups, but pemafibrate was associated with a
higher incidence of adverse renal events and venous thromboembolism and a
lower incidence of nonalcoholic fatty liver disease. Conclusions Among
patients with type 2 diabetes, mild-to-moderate hypertriglyceridemia, and
low HDL and LDL cholesterol levels, the incidence of cardiovascular events
was not lower among those who received pemafibrate than among those who
received placebo, although pemafibrate lowered triglyceride, VLDL
cholesterol, remnant cholesterol, and apolipoprotein C-III levels. (Funded
by the Kowa Research Institute; PROMINENT ClinicalTrials.gov number,
NCT03071692.) <br/>Copyright &#xa9; 2022 Massachusetts Medical Society.

<105>
Accession Number
2018935218
Title
Intraoperative Intravenous Infusion of Esmketamine Has Opioid-Sparing
Effect and Improves the Quality of Recovery in Patients Undergoing
Thoracic Surgery: A Randomized, Double-Blind, Placebo-Controlled Clinical
Trial.
Source
Pain Physician. 25(9) (pp E1389-E1397), 2022. Date of Publication: 01 Dec
2022.
Author
Yuan J.; Chen S.; Xie Y.; Wang Z.; Xing F.; Mao Y.; Wang J.; Yang J.; Li
Y.; Fan X.
Institution
(Yuan, Chen, Xie, Wang, Xing, Mao, Yang, Fan) Department of
Anesthesiology, Pain and Perioperative Medicine, the First Affiliated
Hospital of Zhengzhou University, Henan Province, Zhengzhou, China
(Yuan, Chen, Xie, Wang, Xing, Mao, Yang, Fan) Henan Province International
Joint Laboratory of Pain, Cognition and Emotion, Henan Province,
Zhengzhou, China
(Wang) Massachusetts General Hospital Department of Anesthesia, Critical
Care and Pain Medicine, Harvard Medical School, Boston, MA, United States
(Li) Department of Anesthesiology, Tianjin Medical University General
Hospital, Tianjin Research Institute of Anesthesiology, Tianjin, China
Publisher
American Society of Interventional Pain Physicians
Abstract
Background: Postoperative thoracic surgery is often accompanied by severe
pain, and opioids are a cornerstone of postoperative pain management, but
their use may be limited by many adverse events. Several studies have
shown that the perioperative application of esketamine adjuvant therapy
can reduce postoperative opioid consumption. However, whether esketamine
has an opioid-sparing effect after thoracic surgery is unclear.
<br/>Objective(s): To explore the opioid-sparing effect of different doses
of esketamine infusion during thoracic surgery and its impact on patient
recovery. <br/>Study Design: Randomized controlled study. <br/>Setting(s):
A single-center study with a total of 120 patients. <br/>Method(s):
Patients were randomly allocated to 1 or 3 groups receiving intraoperative
intravenous infusions of esketamine 0.15 mg . kg^-1.
h^-1 (group K1), esketamine 0.25 mg . kg^-1.
h^-1(group K2), or placebo (group C). Postoperative opioid
consumption, and postoperative indicators like extubation time, PACU stay
time, and adverse events were recorded for each group. <br/>Result(s): The
consumption of hydromorphone during the first 24 and 48 postoperative
hours was significantly reduced in patients of group K2 compared to those
of group C and group K1. The time to extubation and post anesthesia care
unit (PACU) stay were significantly shorter in group K2 than in group K1
and group C. The time to first feed and off the bed time after surgery
were shorter in groups K1 and K2 than in group C. Patients in group K2
were significantly satisfied with patient controlled intravenous analgesia
(PCIA) than in groups K1 and C. <br/>Limitation(s): The sample size
calculation was based mainly on the index of hydromorphone consumption.
<br/>Conclusion(s): Intraoperative intravenous esketamine at 0.25 mg .
kg^-1 . h^-1 reduced postoperative opioids consumption
by 34% in postoperative 24 hours and 30% in postoperative 48 hours in
patients undergoing thoracic surgery. It also improved the quality of
perioperative recovery.<br/>Copyright &#xa9; 2022, American Society of
Interventional Pain Physicians. All rights reserved.

<106>
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. <br/>Objective(s): The present study aimed to analyze
the effect of SAPB following thoracic surgery. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; 2022, Author(s).

<107>
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.
<br/>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. <br/>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<br/>Copyright &#xa9; 2022
Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights
reserved.

<108>
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.
<br/>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. <br/>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).<br/>Copyright &#xa9; 2022, The
Author(s).

<109>
Accession Number
2020814772
Title
Minimally Invasive Anatomical Segmentectomy versus Lobectomy in Stage IA
Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis +.
Source
Cancers. 14(24) (no pagination), 2022. Article Number: 6157. Date of
Publication: December 2022.
Author
Bertolaccini L.; Prisciandaro E.; Bardoni C.; Cara A.; Diotti C.; Girelli
L.; Spaggiari L.
Institution
(Bertolaccini, Prisciandaro, Bardoni, Cara, Diotti, Girelli, Spaggiari)
Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS,
Milan 20141, Italy
(Spaggiari) Department of Oncology and Hemato-Oncology, University of
Milan, Milan 20141, Italy
Publisher
MDPI
Abstract
Objective. A systematic review and meta-analysis was performed to assess
potential differences in perioperative outcomes and disease-free survival
(DFS) and overall survival (OS) of patients with pathological stage IA
non-small cell lung cancer (NSCLC) who underwent minimally invasive
anatomical segmentectomy or lobectomy. Methods. This systematic review and
meta-analysis followed the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search of
EMBASE (through Ovid), MEDLINE (via PubMed), and Cochrane CENTRAL was
conducted. Two researchers independently reviewed each eligible study that
included patients with stage IA NSCLC who underwent minimally invasive
anatomical segmentectomy and lobectomy and compared perioperative and/or
survival outcomes of patients. Results. A total of 887 publications were
identified. Of these, 10 articles met our eligibility criteria. A
significantly higher number of lymph nodes were harvested in lobectomies.
The two groups did not significantly differ in postoperative complication
rates, DFS, and OS. Patients who underwent segmentectomy had shorter
postoperative hospital stays. Conclusions. Minimally invasive lobectomy
and segmentectomy showed comparable short-term and long-term outcomes in
stage IA NSCLC patients. Postoperative complication rates were similar.
Minimally invasive lobectomies are associated with a higher number of
harvested lymph nodes, although this did not affect the final staging or
the survival outcomes.<br/>Copyright &#xa9; 2022 by the authors.

<110>
Accession Number
2020846537
Title
Pre-anesthetic use of butorphanol for the prevention of emergence
agitation in thoracic surgery: A multicenter, randomized controlled trial.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 1040168.
Date of Publication: 13 Dec 2022.
Author
Meng T.; Lin X.; Yue F.; Zhang Y.; Wang Y.; Gu J.; Yang Z.; Yu H.; Lv K.;
Liang S.; Li X.; Zhu W.; Yu G.; Li T.; Ren Y.; Li Y.; Xu J.; Xu W.; Wang
S.; Wu J.
Institution
(Meng, Wu) Department of Anesthesiology, Qilu Hospital of Shandong
University, Jinan, China
(Lin) Department of Pain Management, Shandong Provincial Hospital
Affiliated to Shandong First Medical University, Jinan, China
(Li) Department of Anesthesiology, Linyi People's Hospital, Linyi, China
(Yue) Department of Anesthesiology, Weifang People's Hospital, Weifang,
China
(Zhang) Department of Anesthesiology, Zibo Central Hospital, Zibo, China
(Wang) Department of Anesthesiology, Lanzhou University Second Hospital,
Lanzhou, China
(Gu) Department of Anesthesiology, Jinan People's Hospital, Jinan, China
(Yang) Department of Anesthesiology, Taian City Central Hospital, Taian,
China
(Yu) Department of Anesthesiology, Tianjin First Central Hospital,
Tianjin, China
(Lv) Department of Anesthesiology, Jining No.1 People's Hospital, Jining,
China
(Liang) Department of Anesthesiology, Feicheng People's Hospital,
Feicheng, China
(Li) Department of Anesthesiology, Linyi Central Hospital, Linyi, China
(Zhu) Department of Anesthesiology, Binzhou People's Hospital, Binzhou,
China
(Yu) Department of Anesthesiology, Binzhou Central Hospital, Binzhou,
China
(Li) Department of Anesthesiology, Yantai Yuhuangding Hospital, Yantai,
China
(Ren) Department of Anesthesiology, The Affiliated Hospital of Qingdao
University, Qingdao, China
(Li) Department of Anesthesiology, Affiliated Hospital of Jining Medical
University, Jining, China
(Xu) Department of Anesthesiology, Daqing Oilfield General Hospital,
Daqing, China
(Xu) Department of Anesthesiology, Shengli Oilfield Central Hospital,
Dongying, China
(Wang) Department of Anesthesiology, Benxi Central Hospital, Benxi, China
(Wu) Department of Anesthesiology and Perioperative Medicine, Qilu
Hospital Dezhou Hospital, Shandong University, Dezhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: Emergence agitation (EA) is common in patients after general
anesthesia (GA) and is associated with poor outcomes. Patients with
thoracic surgery have a higher incidence of EA compared with other
surgery. This study aimed to investigate the impact of pre-anesthetic
butorphanol infusion on the incidence of EA in patients undergoing
thoracic surgery with GA. <br/>Material(s) and Method(s): This prospective
randomized controlled trial (RCT) was conducted in 20 tertiary hospitals
in China. A total of 668 patients undergoing elective video-assisted
thoracoscopic lobectomy/segmentectomy for lung cancer were assessed for
eligibility, and 620 patients were enrolled. In total, 296 patients who
received butorphanol and 306 control patients were included in the
intention-to-treat analysis. Patients in the intervention group received
butorphanol 0.02 mg/kg 15 min before induction of anesthesia. Patients in
the control group received volume-matched normal saline in the same
schedule. The primary outcome was the incidence of EA after 5 min of
extubation, and EA was evaluated using the Riker Sedation-Agitation Scale
(RSAS). The incidence of EA was determined by the chi-square test, with a
significance of P < 0.05. <br/>Result(s): In total, 296 patients who
received butorphanol and 306 control patients were included in the
intention-to-treat analysis. The incidence of EA 5 min after extubation
was lower with butorphanol treatment: 9.8% (29 of 296) vs. 24.5% (75 of
306) in the control group (P = 0.0001). Patients who received butorphanol
had a lower incidence of drug-related complications (including injecting
propofol pain and coughing with sufentanil): 112 of 296 vs. 199 of 306 in
the control group (P = 0.001) and 3 of 296 vs. 35 of 306 in the control
group (P = 0.0001). <br/>Conclusion(s): The pre-anesthetic administration
of butorphanol reduced the incidence of EA after thoracic surgery under
GA. Clinical trial registration:
[http://www.chictr.org.cn/showproj.aspx?proj=42684], identifier
[ChiCTR1900025705].<br/>Copyright &#xa9; 2022 Meng, Lin, Li, Yue, Zhang,
Wang, Gu, Yang, Yu, Lv, Liang, Li, Zhu, Yu, Li, Ren, Li, Xu, Xu, Wang and
Wu.

<111>
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. <br/>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). <br/>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.
<br/>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].<br/>Copyright
&#xa9; 2022 Li, Jia, Liu and He.

<112>
Accession Number
2020842102
Title
Hyperglycemia is associated with worse 3-year survival in older patients
admitted to the intensive care unit after non-cardiac surgery: Post hoc
analysis of a randomized trial.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 1003186.
Date of Publication: 12 Dec 2022.
Author
Li M.; Deng C.-M.; Su X.; Zhang D.-F.; Ding M.; Ma J.-H.; Wang D.-X.
Institution
(Li, Deng, Su, Zhang, Ding, Ma, Wang) Department of Anesthesiology and
Critical Care Medicine, Peking University First Hospital, Beijing, China
(Wang) Outcomes Research Consortium, Cleveland, OH, United States
(Zhang) Department of Anesthesiology, Fujian Medical University Union
Hospital, Fuzhou, China
Publisher
Frontiers Media S.A.
Abstract
Objective: Hyperglycemia is common in critically ill patients after
surgery and is associated with worse perioperative outcomes. Yet, the
impact of postoperative hyperglycemia on long-term outcomes remains
unclear. We therefore analyzed the association between early postoperative
hyperglycemia and 3-year overall survival in older patients who were
admitted to the intensive care unit after surgery. <br/>Method(s): This
was a post hoc analysis of database obtained from a previous randomized
trial and 3-year follow-up. The underlying trial enrolled 700 patients
aged 65 years or older who were admitted to the intensive care unit after
elective non-cardiac surgery. Early postoperative time-weighted average
blood glucose was calculated and was divided into three levels, i.e., <8.0
mmol/L, from 8.0 to 10.0 mmol/L, and >10.0 mmol/L. The primary outcome was
3-year overall survival. The association between time-weighted average
blood glucose level and 3-year overall survival was analyzed with Cox
proportional hazard regression models. Subgroup analyses were also
performed in patients with or without diabetes, and in patients following
cancer or non-cancer surgery. <br/>Result(s): A total of 677 patients
(mean age 74 years, 60% male sex) were included in the final analysis.
Within 3 years after surgery, deaths occurred in 22.1% (30/136) of
patients with time-weighted average blood glucose <8.0 mmol/L, compared
with 35.7% (81/227) of those from 8.0 to 10.0 mmol/L (unadjusted hazard
ratio 1.75, 95% CI 1.15 to 2.67, P = 0.009), and 36.9% (116/314) of those
>10.0 mmol/L (unadjusted hazard ratio 1.91, 95% CI 1.28 to 2.85, P =
0.002). After adjustment for confounding factors, the risk of 3-year
mortality remained higher in patients with time-weighted average blood
glucose from 8.0 to 10.0 mmol/L (adjusted hazard ratio 2.28, 95% CI 1.47
to 3.54, P < 0.001) and in those >10.0 mmol/L (adjusted hazard ratio 2.00,
95% CI 1.29 to 3.10, P = 0.002). Similar results were obtained in the
subgroups of patients without diabetes and patients following cancer
surgery. <br/>Conclusion(s): For older patients admitted to the intensive
care unit after elective non-cardiac surgery, high early blood glucose
(time-weighted average blood glucose >= 8.0 mmol/L) was associated with
poor 3-year overall survival. The impact of moderate glycemic control on
long-term survival deserves further investigation.<br/>Copyright &#xa9;
2022 Li, Deng, Su, Zhang, Ding, Ma and Wang.

<113>
Accession Number
2020248260
Title
Racial Disparity Among Patients Undergoing Surgical Aortic Valve
Replacement and Transcatheter Aortic Valve Replacement in the United
States.
Source
Angiology. (no pagination), 2022. Date of Publication: 2022.
Author
Kulkarni A.; Arafat M.; Hou L.; Liang S.; Kassotis J.
Institution
(Kulkarni) Rutgers Robert Wood Johnson Medical School, Piscataway, NJ,
United States
(Arafat, Hou, Liang) Department of Medicine, Rutgers Robert Wood Johnson
Medical School, New Brunswick, NJ, United States
(Kassotis) Department of Cardiology, Rutgers Robert Wood Johnson Medical
School, New Brunswick, NJ, United States
Publisher
SAGE Publications Inc.
Abstract
Transcatheter aortic valve replacement (TAVR) has emerged as a minimally
invasive alternative to surgical aortic valve replacement (SAVR). However,
racial disparities in the utilization of TAVR persist. This meta-analysis
attempts to determine whether the prevalence of adverse outcomes
(procedure-related complications) represent barriers to the use of TAVR
among African Americans (AA). The TAVR cohort consisted of 89.6% Caucasian
(C) and 4.7% AA, while the SAVR cohort included 86.9% C and 6.4% AA. The
utilization rate (UR) of TAVR was 1.48 and.35 among C and AA,
respectively, while the UR of SAVR was 1.44 and.48 among C and AA,
respectively. Following TAVR, for AA the odds ratio (OR) was greater for
stroke (OR = 1.22, P =.02) and transient ischemic attack (TIA) (OR = 1.57,
P <.001) and lower for undergoing the insertion of a permanent pacemaker
(OR =.81, P <.001). While there was a significant difference between C and
AA in TAVR and SAVR utilization, outcomes between groups following TAVR
are comparable; therefore, adverse outcomes do not appear to be a barrier
to the use of TAVR among eligible AA.<br/>Copyright &#xa9; The Author(s)
2022.

<114>
Accession Number
639898457
Title
Testing for EGFR Variants in Pleural and Pericardial Effusion Cell-free
DNA in Patients With Non-Small Cell Lung Cancer.
Source
JAMA oncology. (no pagination), 2022. Date of Publication: 29 Dec 2022.
Author
Lee K.W.C.; Li M.S.C.; Gai W.; Lau Y.M.; Chan A.K.C.; Chan O.S.H.; Lee
C.K.; Yeung R.M.W.; Fung S.Y.H.; Cheung W.F.; Chan V.W.; Leung L.; Kam
K.N.P.; Mok T.S.K.
Institution
(Lee, Li, Chan, Mok) Department of Clinical Oncology, Chinese University
of Hong Kong, Hong Kong
(Li, Mok) State Key Laboratory of Translational Oncology, Chinese
University of Hong Kong, Hong Kong
(Gai, Chan, Fung, Cheung) Department of Chemical Pathology, Chinese
University of Hong Kong, Hong Kong
(Lau, Leung, Kam) Department of Clinical Oncology, Prince of Wales
Hospital, Hong Kong
(Chan, Yeung) Department of Clinical Oncology, Pamela Youde Nethersole
Eastern Hospital, Hong Kong
(Lee) National Health and Medical Research Council (NHMRC) Clinical Trials
Centre, University of Sydney, Sydney, NSW, Australia
Publisher
NLM (Medline)
Abstract
Importance: Molecular testing in non-small cell lung cancer (NSCLC) is
commonly limited by inadequate tumor sample. Plasma cell-free DNA (cfDNA)
genotyping as a complementary test is specific but only moderately
sensitive. Genotyping of cfDNA in pleural and pericardial effusion
(PE-cfDNA) can further optimize molecular diagnostic yield and reduce the
need for repeated biopsies. <br/>Objective(s): To prospectively validate
droplet digital polymerase chain reaction (ddPCR) for detection of
sensitizing EGFR variants and acquired Thr790Met variant (T790M) from
PE-cfDNA in patients with NSCLC. <br/>Design, Setting, and Participant(s):
This prospective diagnostic validation study was conducted between
September 6, 2016, and January 21, 2021 at 2 major Hong Kong cancer
centers. Patients with advanced NSCLC with both wild-type and variant EGFR
status and exudative PE who underwent thoracocentesis or
pericardiocentesis were randomly enrolled. Patients were either
EGFR-tyrosine kinase inhibitor (TKI) naive (cohort 1) or EGFR-TKI treated
but osimertinib naive (cohort 2). Enrolled patients underwent pleural- or
pericardial-fluid and blood sampling for ddPCR EGFR testing. EGFR status
results with ddPCR testing of PE-cfDNA and blood were compared with EGFR
status in matched tumor biopsy or PE cell block samples. <br/>Main
Outcomes and Measures: Specificity, sensitivity, and concordance of
PE-cfDNA for detection of sensitizing EGFR variants and acquired T790M
variation. <br/>Result(s): Among 171 patients (54% female) enrolled, there
were 104 in cohort 1 and 67 in cohort 2. In cohort 1, 37% (38/102) were
EGFR-variant positive; PE-cfDNA showed 97% sensitivity (95% CI, 92%-100%),
97% specificity (95% CI, 93%-100%), and 97% concordance (k=0.94, P<.001)
for the detection of sensitizing EGFR variants. It was more sensitive than
plasma in detecting sensitizing EGFR variants (97% vs 74%, P<.001). In
cohort 2, 38% (15 of 40) were positive for the EGFR T790M variant;
PE-cfDNA showed 87% sensitivity (95% CI, 69%-100%), 60% specificity (95%
CI, 41%-79%), and 70% concordance (k=0.42, P=.004) for acquired T790M. The
EGFR T790M variant was detected in 51% of PE-cfDNA vs 25% of PE cell block
samples. <br/>Conclusions and Relevance: In this diagnostic study, EGFR
variants could be accurately detected from PE-cfDNA in patients with
NSCLC. More EGFR T790M was detected in PE-cfDNA than in
guideline-recommended PE cell block preparations. These results suggest
that PE-cfDNA can complement plasma and tumor genotyping for detecting
EGFR variants in patients with advanced NSCLC.

<115>
Accession Number
639898074
Title
Response to correspondence regarding 5-year follow up of the Amaze
Randomized Controlled trial of ablation treatment for arrhythmia as an
adjunct to cardiac surgery.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2022.
Date of Publication: 29 Dec 2022.
Author
Nashef S.A.M.; Sharples L.D.
Institution
(Nashef) Royal Papworth Hospital, Cambridge, United Kingdom
(Sharples) London School of Hygiene and Tropical Medicine, London WC1E
7HT, United Kingdom
Publisher
NLM (Medline)

<116>
Accession Number
639897154
Title
Benefits of pre-operative oral Sucrosomial iron supplementation
in cardiac surgery: influence of patient's baseline hemoglobin and gender.
Source
Blood transfusion = Trasfusione del sangue. (no pagination), 2022. Date
of Publication: 25 Nov 2022.
Author
Weltert L.P.; De Rosa A.; Rondinelli M.B.; Falco M.; Turani F.; Pierelli
L.
Institution
(Weltert) Heart Surgery, European Hospital, Rome, Italy
(De Rosa, Rondinelli, Pierelli) Transfusion Medicine Department "San
Camillo Forlanini" Hospital, Rome, Italy
(Falco) Anesthesiology Department, European Hospital, Rome, Italy
(Turani) Anesthesiology Department, "Aurelia" Hospital, Rome, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: The prevalence of low pre-operative hemoglobin (Hb) among
cardiac surgery patients is high. As iron homeostasis is often impaired in
these patients, restoration of iron availability might over-ride
iron-restricted erythropoiesis. This post-hoc analysis of a previously
published, large, randomized clinical trial (ClincalTrials.gov
NCT03560687; n=1,000) assesses which sub-cohort of patients benefits the
most from pre-operative Hb optimization with oral Sucrosomial iron.
MATERIALS AND METHODS: Patients without baseline Hb (n=349) or receiving
>5 red blood cell units (n=57) were excluded from the study. Data from the
remaining 594 were reanalyzed according to treatment, baseline anemia (Hb
<13 g/dL) or gender. Patients (pt) received a one-month course of 60
mg/day Sucrosomial iron (Iron group, n=309) or routine care (Control
group, n=285) prior to elective cardiac surgery. Main end-point variables
were increase in Hb from randomization to hospital admission, transfusion
requirements, and cost-effectiveness of Sucrosomial iron administration.
<br/>RESULT(S): At hospital admission, Hb had increased 0.7 g/dL and 0.1
g/dL, for Iron and Control groups, respectively (p<0.001), with no
gender-related differences, leading to a decrease in transfusion rate (30
vs 59%, respectively; p<0.001) and transfusion index (0.5 units/patient vs
1.2 units/pt, respectively; p<0.001). Sucrosomial iron administration was
well-tolerated, and yielded cost-savings of 92/pt (p<0.001), particularly
in those presenting with baseline Hb <13 g/dL. <br/>CONCLUSION(S): This
post-hoc analysis confirms pre-operative Sucrosomial iron administration
is a safe and cost-effective strategy to increase preoperative Hb and
decrease transfusion requirements in elective cardiac surgery, especially
in those anemic at baseline.

<117>
Accession Number
2018819542
Title
Coronary Computed Tomography Angiography for Evaluation of Chest Pain in
the Emergency Department.
Source
Texas Heart Institute Journal. 49(6) (no pagination), 2022. Article
Number: e217550. Date of Publication: 01 Nov 2022.
Author
Dahal S.; Budoff M.J.; Roy S.K.
Institution
(Dahal) Department of Cardiology, Virginia Commonwealth University,
Richmond, VA, United States
(Budoff, Roy) Department of Cardiology, Harbor-UCLA Medical Center,
Torrance, CA, United States
Publisher
Texas Heart Institute
Abstract
Coronary computed tomography angiography has emerged as an important
diagnostic mo-dality for evaluation of acute chest pain in the emergency
department for patients at low to intermediate risk for acute coronary
syndromes. Several clinical trials have shown excellent negative
predictive value of coronary computed tomography angiography to detect
obstructive coronary artery disease. Cardiac biomarkers such as troponins
and creatine kinase MB, along with history, electrocardiogram, age, risk
factors, troponin score, and Thrombolysis in Myocardial Infarction score
should be used in conjunction with coronary computed to-mography
angiography for safe and rapid discharge of patients from the emergency
depart-ment. Coronary computed tomography angiography along with
high-sensitivity troponin assays could be effective for rapid evaluation
of acute chest pain in the emergency depart-ment, but high-sensitivity
troponins are not always available. Emergency department physi-cians are
not quite comfortable making clinical decisions, especially if the
coronary stenosis is in the range of 50% to 70%. In these cases, further
evaluation with functional testing, such as nuclear stress testing or
stress echocardiogram, is a common approach in many centers; however,
newer methods such as fractional flow reserve computed tomography could be
safely incorporated in coronary computed tomography angiography to help
with clinical decision-making in these scenarios.<br/>Copyright &#xa9;
2022 by the Texas Heart Institute, Houston.

<118>
Accession Number
2021938432
Title
CO122 Mapping the Characteristics of Network Meta-Analyses on
Antithrombotic Therapies: An Overview and Critical Appraisal.
Source
Value in Health. Conference: ISPOR Europe 2022. Vienna Austria. 25(12
Supplement) (pp S42), 2022. Date of Publication: December 2022.
Author
Sousa P.G.D.; Tonin F.; Mainka F.; Pontarolo R.
Institution
(Sousa) Universidade Estadual do Oeste do Parana, Cascavel, Brazil
(Tonin) Health & Technology Research Center, Escola Superior de Tecnologia
da Saude (H&TRC-ESTeSL), Instituto Politecnico de Lisboa, PR, Lisbon,
Portugal
(Mainka, Pontarolo) Universidade Federal do Parana, Curitiba, Brazil
Publisher
Elsevier Ltd
Abstract
Objectives: A large number of network meta-analysis (NMAs) in the field of
cardiac disease are available, yet the scientific literature lacks on
updated straightforward synthesis of this evidence to ground
decision-making process. We aimed to map and critical appraise NMAs on
antithrombotic therapies used as treatment or prophylaxis of cardiac
diseases and cardiac surgical procedures. <br/>Method(s): A systematic
review of systematic reviews with meta-analysis was conducted following
Cochrane Collaboration and Joanna Briggs recommendations
(PROSPERO-CRD2020166468). Searches to identify NMAs meeting the
eligibility criteria of this this study were performed in PubMed and
Scopus (Jan-2022). NMAs characteristics including metadata, statistical
models' description and main pooled results were collected. The
methodological quality of NMAs was evaluated using PRISMA-NMA checklist
and AMSTAR-2 tools. Descriptive statistical analyses with categorical
variables reported as frequencies and continuous variables as median and
interquartile range (IQR) were performed (SPSS-Statistics v.25.0).
<br/>Result(s): Overall, n=88 NMAs published between 2007-2022 were
identified. The most evaluated clinical condition was atrial fibrillation
(n=57; 64.7%); around one third of studies (38.6%) assessed cardiac
surgical procedures. Only 28.4% NMAs had a registered study protocol.
Fifty NMAs (56.8%) were published by authors from one single country being
China the most frequent. A median of 14 primary studies (IQR 5-20.75)
(mostly randomized clinical trials) were included per NMA. A median of 40
(IQR 24-84.25) indirect meta-analyses per study was found. At least one
network diagram for a given outcome was provided by 68 (77.2%) studies,
yet only 22 (25.6%) performed a treatment ranking analyses. Conflict of
interest declarations and study's funding were informed by 34 (38.6%) and
38 (43.2%) NMAs, respectively. <br/>Conclusion(s): Although there is a
wide spread of NMA-type studies assessing different antithrombotic agents
for different cardiac conditions, the lack of standardized conduction and
reporting of NMAs (poor-moderate methodological quality) may limit their
comparison and results implementation into clinical
practice.<br/>Copyright &#xa9; 2022

<119>
Accession Number
2020813019
Title
IMPACT OF DIABETES AND GLUCOSE-LOWERING THERAPY ON POST-OPERATIVE ATRIAL
FIBRILLATION AFTER CARDIAC SURGERY: SECONDARY ANALYSIS OF THE SEARCH-AF
CARDIOLINK-1 RANDOMIZED CLINICAL TRIAL.
Source
Canadian Journal of Cardiology. Conference: Canadian Cardiovascular
Congress 2022. Ottawa Canada. 38(10 Supplement 2) (pp S192-S193), 2022.
Date of Publication: October 2022.
Author
Pandey A.; Hibino M.; Ha A.; Quan A.; Puar P.; Verma R.; Bisleri G.; Verma
A.; Mazer C.; Verma S.
Institution
(Pandey, Hibino, Ha, Quan, Puar, Verma, Bisleri, Verma, Mazer, Verma)
Waterloo, Ontario
Publisher
Elsevier Inc.
Abstract
Background: Diabetes mellitus is an important risk factor for atrial
fibrillation (AF) and is associated with an increased risk of
complications for patients with AF. The impact of diabetes on
post-operative AF after cardiac surgery is not well-defined. <br/>Methods
and Results: We sought to characterize the effect of diabetes, insulin,
and oral hypoglycemic agents on the incidence of post-operative atrial
fibrillation (POAF) after cardiac surgery. We performed a sub-analysis
from the Post-Surgical Enhanced Monitoring for Cardiac Arrhythmias and
Atrial Fibrillation (SEARCH-AF) CardioLink-1 randomized trial
(NCT02793895). It randomized 336 patients with risk factors for stroke
(CHA2DS2-VASc score >=2) and no history of preoperative AF were randomized
to usual care or continuous cardiac rhythm monitoring for 30 days after
discharge from cardiac surgery with a wearable, patched-based device. The
primary outcome was occurrence of cumulative atrial fibrillation/flutter
(AF/AFL) lasting for >=6 minutes detected by continuous monitoring or
AF/AFL documented by a 12-lead electrocardiogram within 30 days of
randomization. We examined the association between: (i) diabetes and risk
of POAF and (ii) glucose-lowering therapy among patients with diabetes and
risk of POAF. Of the 176 (52%) patients with diabetes in the study cohort,
80 (45%) patients were treated with at least 1 oral hypoglycemic agent and
44 (25%) patients were treated with insulin. The incidence of POAF
occurring within 30 days after discharge from surgery was similar between
patients with or without diabetes (cumulative incidence: 10.8% vs. 10.0%,
log-rank p=0.77). Among patients with diabetes, the incidence of POAF was
highest in those who were not treated with glucose-lowering therapy
(17.3%), followed by those treated with oral hypoglycemic agents (10.0%)
and insulin (4.5%) (log-rank p=0.045 for trend). A trend suggesting a
lower incidence of POAF was observed among cardiac surgical patients who
were treated with SGLT-2 inhibitors (log-rank p=0.084 for trend).
<br/>Conclusion(s): Even among patients with little to no POAF immediately
after cardiac surgery, the risk of POAF within 30 days after discharge is
high. Among patients with diabetes, oral anticoagulation should be
considered as per current guidelines. There are possible associations
between specific glucose-lowering therapies and risk of POAF after cardiac
surgery, meriting further investigations. [Formula
presented]<br/>Copyright &#xa9; 2022

<120>
Accession Number
2020812987
Title
PREDICTORS OF MITRAL VALVE HEMODYNAMICS AFTER MITRAL VALVE REPAIR FOR
DEGENERATIVE MITRAL REGURGITATION: A SUBANALYSIS OF THE CAMRA RANDOMIZED
TRIAL.
Source
Canadian Journal of Cardiology. Conference: Canadian Cardiovascular
Congress 2022. Ottawa Canada. 38(10 Supplement 2) (pp S212-S213), 2022.
Date of Publication: October 2022.
Author
Rumman R.; Verma S.; Chan V.; Mazer D.; Quan A.; De Varennes B.; Chu M.; d
latter; Teoh H.; Yanagawa B.; Leong-Poi H.; Connelly K.
Institution
(Rumman, Verma, Chan, Mazer, Quan, De Varennes, Chu, d latter, Teoh,
Yanagawa, Leong-Poi, Connelly) TorontoOntario
Publisher
Elsevier Inc.
Abstract
Background: Intra-operative predictors of mid-to-late mitral valve
dysfunction after surgical repair of mitral regurgitation caused by
prolapse remain poorly characterized. This study aims to evaluate the
effect of annuloplasty prosthesis size on post-operative mitral valve (MV)
hemodynamics at rest and during exercise, and to identify perioperative
predictors of MV dysfunction. <br/>Methods and Results: 104 patients were
randomly assigned to resection or preservation for surgical treatment of
posterior leaflet prolapse in the Canadian Mitral Research Alliance
CardioLink-2 study. Echocardiograms were performed at baseline and 1-year
postoperatively. Intraoperative transesophageal echocardiography was
performed to assess immediate MV gradients. Exercise transthoracic
echocardiography was performed 1-year after repair. Linear regression
analysis was used to identify associations between MV indices (rest and
peak exercise gradients) at 12 months, and perioperative echocardiographic
and clinical factors. Mean age of participants was 65+/-10 years, and 83%
were male. Larger annuloplasty size was associated with lower transmitral
gradients at rest and during peak exercise. In multivariable analysis,
annuloplasty size>=34mm was associated with lower mean and peak rest and
exercise gradients at 12 months, after adjustment for repair type, age,
sex, and BSA. Higher pre-operative pulmonary artery pressures were
associated with reduced functional capacity post-operatively.
Intra-operative TEE gradients predicted resting and exercise MV
hemodynamics at follow-up. <br/>Conclusion(s): Annuloplasty size >=34mm is
associated with improved MV hemodynamics at rest and during peak exercise
1 year post MV repair. MV repair prior to onset of pulmonary hypertension
confers favourable post-operative functional capacity. Finally,
intra-operative TEE predicts MV dysfunction within 1 year post-repair.
[Formula presented] [Formula presented]<br/>Copyright &#xa9; 2022

<121>
Accession Number
2020439140
Title
Patient-centered evaluation of an expectation-focused intervention for
patients undergoing heart valve surgery.
Source
Clinical Nutrition ESPEN. Conference: 8th World Congress of the ERAS
Society. Madrid Spain. 51 (pp 509), 2022. Date of Publication: October
2022.
Author
Clifford C.; Lowe B.; Ketels G.; Girdauskas E.; Kohlmann S.
Institution
(Clifford, Lowe, Kohlmann) Department of Psychosomatic Medicine and
Psychotherapy
(Ketels) Department of Physiotherapy, University Medical Center
Hamburg-Eppendorf, Hamburg
(Girdauskas) Department of Cardiothoracic Surgery, University Medical
Center Augsburg, Augsburg, Germany
Publisher
Elsevier Ltd
Abstract
Objectives: Randomized controlled trials show that expectation-focused
interventions can improve recovery after cardiac surgery. In addition to
efficacy studies, it is important for the dissemination of this effective
intervention to capture the perspective of affected individuals. This
qualitative study explores perceived benefits, intervention-specific
needs, and potential barriers of patients who received an
expectation-focused intervention before heart valve surgery.
<br/>Method(s): Patients in the intervention group received an
expectation-focused intervention as part of a multicentered randomized
controlled trial examining the interdisciplinary treatment approach for
patients undergoing heart valve surgery. Approximately three months after
the intervention, a planned sample of 40 patients will undergo a
semi-structured interview. The interview will ask about issues such as
feasibility, acceptance, barriers, benefits, and side effects associated
with the expectation-focused intervention. The sampling aims to maximize
variance in age, gender, and disease experience. The transcribed
interviews will be analyzed using qualitative content analysis.
<br/>Result(s): Preliminary results show that patients express conflicting
opinions regarding the acceptance of the expectation-focused intervention.
Some patients believe that an expectation-focused intervention is
appropriate for every operation, whereas others value the offer but see no
personal need for it. Building a trusting relationship within the
expectation-focused intervention is described as a challenge. While
positive benefits are mentioned, for example, in preparation for surgery
and pre- and postoperative reflection, there are no reports of side
effects. <br/>Conclusion(s): Initial results show that patients see
personal benefits and develop acceptance of the expectation-focused
intervention despite initial skepticism and experienced barriers.
Establishing a trusting relationship between the patient and the therapist
realizing the expectation-focused intervention can be considered a
challenge for dissemination of the intervention manual. In summary, the
results provide initial indications of the factors that should be
considered when disseminating an expectation-focused intervention in the
healthcare of patients undergoing heart valve surgery. Disclosure of
Interest: None declared<br/>Copyright &#xa9; 2022

<122>
Accession Number
2020438235
Title
Interdisciplinary and cross-sectoral perioperative care model in cardiac
surgery: Implementation in the setting of minimally-invasive heart valve
surgery (increase) - Study protocol for a randomized controlled trial.
Source
Clinical Nutrition ESPEN. Conference: 8th World Congress of the ERAS
Society. Madrid Spain. 51 (pp 522), 2022. Date of Publication: October
2022.
Author
Klotz S.G.R.; Ketels G.; Petersen J.; Stock S.; Girdauskas E.
Institution
(Klotz, Ketels) Department of Physiotherapy
(Petersen) Department of Cardiovascular Surgery, University Heart and
Vascular Center, University Medical Center Hamburg-Eppendorf, Hamburg
(Stock, Girdauskas) Department of Cardiothoracic Surgery, University
Hospital Augsburg, Augsburg, Germany
Publisher
Elsevier Ltd
Abstract
Objectives: To evaluate the effectiveness of an interprofessional enhanced
recovery after surgery (ERAS) program in patients undergoing minimally
invasive heart valve procedures in comparison to the standard treatment in
a bicentric randomized controlled trial. <br/>Method(s): 186 eligible
patients scheduled for minimally invasive heart valve surgery will be
randomized either to the ERAS program or to the control group (i.e,
standard treatment) at two university hospitals, including the University
Medical Center Hamburg-Eppendorf, Germany, and the University Hospital
Augsburg, Germany. The ERAS approach combines evidence-based interventions
in cardiac surgery, anesthesiology, nursing, physiotherapy, and
psychosomatics. Patients play an active role by determining their
individualized goals, supported by physiotherapists, psychologists, and an
advanced practice nurse. Preoperative components will guide patients with
regard to physical activity, nutrition, and psychological preparedness.
Intraoperative anesthesiologic and surgical management are trimmed to
enable early extubation and first mobilization three hours after surgery.
After spending one night at a specialized postoperative anesthesia care
unit, patients will be transferred to low care ward and discharged on the
fourth-fifth postoperative day. A diary will support the perioperative
course, acting as a motivator and self-regulating tool. Primary endpoints
include functional status at discharge and total days of in-hospital stay
during the first twelve postoperative months. Secondary outcomes include
health-related quality of life, costs of health care, and others in both
groups. <br/>Result(s): This is an ongoing study still in the recruitment
phase; we aim to present the study protocol with its unique features.
<br/>Conclusion(s): To the best of our knowledge, this is the first
randomized controlled trial evaluating the effectiveness of an ERAS
process after minimally invasive heart valve surgery. The key factor of an
ERAS process should be the interprofessional approach including surgical,
anesthesiological, physiotherapeutic, advanced nursing and psychosocial
components in particular. A clinical implication guideline will be
developed facilitating the adoption of our ERAS model in other heart
centers. Disclosure of Interest: None declared<br/>Copyright &#xa9; 2022

<123>
Accession Number
2020820981
Title
Dexmedetomidine Increases MMP-12 and MBP Concentrations after Coronary
Artery Bypass Graft Surgery with Extracorporeal Circulation Anaesthesia
without Impacting Cognitive Function: A Randomised Control Trial.
Source
International Journal of Environmental Research and Public Health. 19(24)
(no pagination), 2022. Article Number: 16512. Date of Publication:
December 2022.
Author
Kowalczyk M.; Panasiuk-Kowalczyk A.; Stadnik A.; Guz M.; Cybulski M.;
Jeleniewicz W.; Stepulak A.; Kwiatosz-Muc M.
Institution
(Kowalczyk, Panasiuk-Kowalczyk, Kwiatosz-Muc) 1st Department of
Anaesthesiology and Intensive Care, Medical University of Lublin, ul.
Jaczewskiego 8, Lublin 20-954, Poland
(Stadnik) Department of Cardiac Surgery, Medical University of Lublin, ul.
Jaczewskiego 8, Lublin 20-954, Poland
(Guz, Cybulski, Jeleniewicz, Stepulak) Department of Biochemistry and
Molecular Biology, Medical University of Lublin, ul. Chodzki 1, Lublin
20-093, Poland
Publisher
MDPI
Abstract
Postoperative neurological deficits remain a concern for patients
undergoing cardiac surgeries. Even minor injuries can lead to
neurocognitive decline (i.e., postoperative cognitive dysfunction).
Dexmedetomidine may be beneficial given its reported neuroprotective
effect. We aimed to investigate the effects of dexmedetomidine on brain
injury during cardiac surgery anaesthesia. This prospective observational
study analysed data for 46 patients who underwent coronary artery bypass
graft surgery with extracorporeal circulation between August 2018 and
March 2019. The patients were divided into two groups: control (CON) with
typical anaesthesia and dexmedetomidine (DEX) with dexmedetomidine
infusion. Concentrations of the biomarkers matrix metalloproteinase-12
(MMP-12) and myelin basic protein (MBP) were measured preoperatively and
at 24 and 72 h postoperatively. Cognitive evaluations were performed
preoperatively, at discharge, and 3 months after discharge using
Addenbrooke's Cognitive Examination version III (ACE-III). The primary
endpoint was the ACE-III score at discharge. Increased MMP-12 and MBP
concentrations were observed in the DEX group 24 and 72 h postoperatively.
No significant differences in ACE-III scores were observed between the
groups at discharge; however, the values were increased when compared with
initial values after 3 months (p = 0.000). The current results indicate
that the administration of dexmedetomidine as an adjuvant to anaesthesia
can increase MMP-12 and MBP levels without effects on neurocognitive
outcomes at discharge and 3 months postoperatively.<br/>Copyright &#xa9;
2022 by the authors.

<124>
Accession Number
2021956084
Title
Concordance between Patient-Reported Health Data and Electronic Health
Data in the ADAPTABLE Trial.
Source
JAMA Cardiology. 7(12) (pp 1235-1243), 2022. Date of Publication: 14 Dec
2022.
Author
O'Brien E.C.; Mulder H.; Jones W.S.; Hammill B.G.; Sharlow A.; Hernandez
A.F.; Curtis L.H.
Institution
(O'Brien, Hammill, Curtis) Department of Population Health Sciences, Duke
University, School of Medicine, Durham, NC, United States
(O'Brien, Mulder, Jones, Hernandez, Curtis) Duke Clinical Research
Institute, Duke University, School of Medicine, Durham, NC, United States
(Jones, Hernandez, Curtis) Department of Medicine, Duke University, School
of Medicine, Durham, NC, United States
(Sharlow) Medidata Solutions, New York, NY, United States
Publisher
American Medical Association
Abstract
Importance: Patient-reported health data can facilitate clinical event
capture in pragmatic clinical trials. However, few data are available on
the fitness for use of patient-reported data in large-scale health
research. <br/>Objective(s): To evaluate the concordance of a set of
variables reported by patients and available in the electronic health
record as part of a pragmatic clinical trial. <br/>Design, Setting, and
Participant(s): Data from ADAPTABLE (Aspirin Dosing: A Patient-Centric
Trial Assessing Benefits and Long-term Effectiveness), a pragmatic
clinical trial, were used in a concordance substudy of a comparative
effectiveness research trial. The trial randomized 15076 patients with
existing atherosclerotic cardiovascular disease in a 1:1 ratio to low- or
high-dose aspirin from April 2016 through June 30, 2019. <br/>Main
Outcomes and Measures: Concordance of data was evaluated from 4 domains
(demographic characteristics, encounters, diagnoses, and procedures)
present in 2 data sources: patient-reported data captured through an
online portal and data from electronic sources (electronic health record
data). Overall agreement, sensitivity, specificity, positive predictive
value, negative predictive value, and kappa statistics with 95% CIs were
calculated using patient report as the criterion standard for demographic
characteristics and the electronic health record as the criterion standard
for clinical outcomes. <br/>Result(s): Of 15076 patients with complete
information, the median age was 67.6 years (range, 21-99 years), and 68.7%
were male. With the use of patient-reported data as the criterion
standard, agreement (kappa) was high for Black and White race and
ethnicity but only moderate for current smoking status. Electronic health
record data were highly specific (99.6%) but less sensitive (82.5%) for
Hispanic ethnicity. Compared with electronic health record data, patient
report of clinical end points had low sensitivity for myocardial
infarction (33.0%), stroke (34.2%), and major bleeding (36.6%). Positive
predictive value was similarly low for myocardial infarction (40.7%),
stroke (38.8%), and major bleeding (21.9%). Coronary revascularization was
the most concordant event by data source, with only moderate agreement
(kappa = 0.54) and positive predictive value. Agreement metrics varied by
site for all demographic characteristics and several clinical events.
<br/>Conclusions and Relevance: In a concordance substudy of a large,
pragmatic comparative effectiveness research trial, sensitivity and
chance-corrected agreement of patient-reported data captured through an
online portal for cardiovascular events were low to moderate. Findings
suggest that additional work is needed to optimize integration of
patient-reported health data into pragmatic research studies. Trial
Registration: ClinicalTrials.gov Identifier: NCT02697916.<br/>Copyright
&#xa9; 2022 Authors. All rights reserved.

<125>
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. <br/>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.<br/>Copyright &#xa9; 2022, The Author(s).

<126>
Accession Number
639875250
Title
Effect of Decompressive Craniectomy with stepwise Decompression of the
Intracranial Compartment on Postoperative Neurologic Function,
Hemodynamics, and Glasgow Outcome Scale Score of Patients with Severe
Traumatic Brain Injury.
Source
Journal of neurological surgery. Part A, Central European neurosurgery.
(no pagination), 2022. Date of Publication: 26 Dec 2022.
Author
Wu H.; Jiang B.; Yan X.; Zhan C.; Dai W.; Yu G.
Institution
(Wu, Jiang, Yan, Zhan, Dai, Yu) Department of Neurosurgery, Quzhou
Affiliated Hospital of Wenzhou Medical University, Quzhou People's
Hospital, Zhejiang Province, Quzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: We assess the effects of standard decompressive craniectomy
with stepwise decompression of the intracranial compartment on the
postoperative neurologic function, hemodynamics, and Glasgow Outcome Scale
(GOS) score of patients with severe traumatic brain injury (sTBI).
<br/>METHOD(S): One hundred sTBI patients admitted from July 2017 to
February 2019 were enrolled and randomly divided into step and standard
groups (n=50) using a random number table. The standard group received
traditional standard decompression during surgery, while the step group
underwent multistep decompression during surgery. Heart rate (HR),
systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean
arterial pressure (MAP) were measured immediately after surgery (T0),
3hours after surgery (T1), 6hours after surgery (T2), and 12hours after
surgery (T3). The postoperative Glasgow Coma Scale (GCS) score, neurologic
function deficit score, and GOS score were evaluated. <br/>RESULT(S):
After treatment, the excellent/good rate of neurologic function
improvement and GCS and GOS scores of the step group significantly
exceeded those of the standard group (p<0.05). Compared with the standard
group, the HR, SBP, DBP, and MAP decreased significantly in the step group
at T1, T2, and T3 (p<0.05). <br/>CONCLUSION(S): Standard decompressive
craniectomy under multistep decompression can markedly improve the
neurologic function, hemodynamics, and prognosis of
patients.<br/>Copyright Thieme. All rights reserved.