EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 132

Results Generated From:
Embase <1980 to 2023 Week 07>
Embase Weekly Updates (updates since 2023-02-11)

<1>
Accession Number
639869980
Title
H1 and H2 antihistamines pretreatment for attenuation of protamine
reactions after cardiopulmonary bypass: a randomized-controlled study.
Source
Annals of palliative medicine. 12(1) (pp 47-59), 2023. Date of
Publication: 01 Jan 2023.
Author
Suksompong S.; Wongsripuemtet P.; Srinoulprasert Y.; Khamtuikrua C.;
Chaikittisilpa N.
Institution
(Suksompong, Wongsripuemtet, Khamtuikrua, Chaikittisilpa) Department of
Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University,
Bangkok, Thailand
(Srinoulprasert) Department of Immunology, Faculty of Medicine, Siriraj
Hospital, Mahidol University, Bangkok, Thailand
Publisher
NLM (Medline)
Abstract
BACKGROUND: Protamine administration post-cardiopulmonary bypass (CPB) can
potentially cause hemodynamic instability. Histamine released from mast
cells is believed to be responsible for hypotension after protamine
administration. The aim of this study was to examine the effects of
pretreatment with H1 and H2 antihistamines on changes in systemic arterial
pressure following protamine administration. <br/>METHOD(S): This study
was a randomized, triple-blinded, placebo-controlled study, conducted at a
university hospital. Forty adult patients undergoing elective coronary
artery bypass grafting (CABG) or single valve surgery were included. The
patients were randomly allocated (20 patients in each group) to receive a
single dose of combined chlorpheniramine 10 mg and ranitidine 50 mg or
normal saline intravenously immediately after separation from CPB prior to
protamine administration. Trajectory changes in systolic blood pressure
(SBP), mean arterial pressure (MAP), and vasoactive-inotropic score (VIS)
from baseline until 35 minutes following protamine administration (24-time
points) were compared between the two groups. Serial serum tryptase levels
were also obtained at baseline, 30 and 60 minutes after protamine was
given. <br/>RESULT(S): Forty patients were included in the analysis.
Demographic and baseline blood pressure were similar between the two
groups. At 30 minutes after protamine administration, there were no
significant differences in both crude SBP [mean difference: -7.1 mmHg, 95%
confidence interval (CI), -1.1 to 15.3 mmHg, P=0.09] and SBP after
adjustment for the European System for Cardiac Operative Risk Evaluation
(EuroSCORE II), CPB time, and VIS (mean difference: -3.9 mmHg, 95% CI,
-11.9 to 4.0 mmHg, P=0.33). There were also no significant differences in
crude MAP (mean difference: -2.1 mmHg, 95% CI, -6.9 to 2.7 mmHg, P=0.39)
and adjusted MAP (mean difference: -0.7 mmHg, -5.9 to 4.4 mmHg, P=0.78)
between the two groups. None of the patients in both groups had a
significant increase in serum tryptase from baseline. No differences in
median serum tryptase levels at baseline, 30 and 60 minutes were
demonstrated between the two groups. <br/>CONCLUSION(S): Pretreatment with
H1 and H2 antihistamines does not attenuate blood pressure responses to
protamine administration in patients after CPB. Mechanisms other than
histamine release from mast cells might be responsible for
protamine-induced cardiovascular changes. TRIAL REGISTRATION:
ClinicalTrials.gov NCT03583567.

<2>
Accession Number
639609694
Title
Rationale and design for the myocardial ischemia and transfusion (MINT)
randomized clinical trial.
Source
American heart journal. 257 (pp 120-129), 2023. Date of Publication: 01
Mar 2023.
Author
Carson J.L.; Brooks M.M.; Chaitman B.R.; Alexander J.H.; Goodman S.G.;
Bertolet M.; Abbott J.D.; Cooper H.A.; Rao S.V.; Triulzi D.J.; Fergusson
D.A.; Kostis W.J.; Noveck H.; Simon T.; Steg P.G.; DeFilippis A.P.;
Goldsweig A.M.; Lopes R.D.; White H.; Alsweiler C.; Morton E.; Hebert P.C.
Institution
(Carson, Kostis, Noveck) Rutgers Robert Wood Johnson Medical School, New
Brunswick, NJ
(Brooks, Bertolet) University of Pittsburgh School of Public Health,
Pittsburgh, PA, United States
(Chaitman) St Louis University School of Medicine, St Louis, MO, United
States
(Alexander) Duke Clinical Research Institute, Durham, NC, United States
(Goodman) St. Michael's Hospital, University of Toronto, Toronto Canada;
Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada
(Abbott) Warren Alpert Medical School. Brown University, Providence, RI,
United States
(Cooper) Westchester Medical Center, Valhalla, NY, United States
(Rao) Durham VA Medical Center, Durham, NC; NYU Langone Health, New York,
NY
(Triulzi) University of Pittsburgh School of Medicine, Pittsburgh, PA,
United States
(Fergusson) Ottawa Hospital Research Institute Ottawa, ON, Canada
(Simon) Hopital Saint Antoine, Paris, France
(Steg) ParisFrance
(DeFilippis) Vanderbilt University, Nashville, TN, United States
(Goldsweig) University of Nebraska Medical Center, Omaha, NE, United
States
(Lopes) Brazilian Clinical Research Institute, Sao Paulo, Brazil; Duke
Clinical Research Institute, Durham, NC
(White, Alsweiler) Green Lane Clinical Coordinating Centre Ltd, Auckland,
New Zealand
(Morton) Finders University, Adelaide, Australia
(Hebert) Centre de Recherche du Centre Hosp. Universitaire de Montreal,
Montreal, Quebec, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Accumulating evidence from clinical trials suggests that a
lower (restrictive) hemoglobin threshold (<8 g/dL) for red blood cell
(RBC) transfusion, compared with a higher (liberal) threshold (>=10 g/dL)
is safe. However, in anemic patients with acute myocardial infarction
(MI), maintaining a higher hemoglobin level may increase oxygen delivery
to vulnerable myocardium resulting in improved clinical outcomes.
Conversely, RBC transfusion may result in increased blood viscosity,
vascular inflammation, and reduction in available nitric oxide resulting
in worse clinical outcomes. We hypothesize that a liberal transfusion
strategy would improve clinical outcomes as compared to a more restrictive
strategy. <br/>METHOD(S): We will enroll 3500 patients with acute MI (type
1, 2, 4b or 4c) as defined by the Third Universal Definition of MI and a
hemoglobin <10 g/dL at 144 centers in the United States, Canada, France,
Brazil, New Zealand, and Australia. We randomly assign trial participants
to a liberal or restrictive transfusion strategy. Participants assigned to
the liberal strategy receive transfusion of RBCs sufficient to raise their
hemoglobin to at least 10 g/dL. Participants assigned to the restrictive
strategy are permitted to receive transfusion of RBCs if the hemoglobin
falls below 8 g/dL or for persistent angina despite medical therapy. We
will contact each participant at 30 days to assess clinical outcomes and
at 180 days to ascertain vital status. The primary end point is a
composite of all-cause death or recurrent MI through 30 days following
randomization. Secondary end points include all-cause mortality at 30
days, recurrent adjudicated MI, and the composite outcome of all-cause
mortality, nonfatal recurrent MI, ischemia driven unscheduled coronary
revascularization (percutaneous coronary intervention or coronary artery
bypass grafting), or readmission to the hospital for ischemic cardiac
diagnosis within 30 days. The trial will assess multiple tertiary end
points. <br/>CONCLUSION(S): The MINT trial will inform RBC transfusion
practice in patients with acute MI.<br/>Copyright &#xa9; 2022 Elsevier
Inc. All rights reserved.

<3>
Accession Number
2014435285
Title
Coronary artery bypass with single versus multiple arterial grafts in
women: A meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(3) (pp 1093-1098),
2023. Date of Publication: March 2023.
Author
Robinson N.B.; Lia H.; Rahouma M.; Audisio K.; Soletti G.; Demetres M.;
Leonard J.R.; Fremes S.E.; Girardi L.N.; Gaudino M.
Institution
(Robinson, Rahouma, Audisio, Soletti, Leonard, Girardi, Gaudino)
Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY
(Lia, Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell, Medicine, New York, NY
Publisher
Elsevier Inc.
Abstract
Objective: The study objective was to investigate the impact of multiple
arterial grafting on long-term all-cause mortality in women undergoing
isolated coronary artery bypass grafting. <br/>Method(s): A comprehensive
search was performed to identify observational studies reporting outcomes
after coronary artery bypass grafting reported by sex and stratified into
multiple arterial grafting versus single arterial grafting strategies.
Articles were considered for inclusion if they were written in English and
were propensity-matched observational studies. Included studies were then
pooled in a meta-analysis performed using the generic inverse variance
method. The primary outcome was long-term all-cause mortality. Secondary
outcomes were operative mortality and spontaneous myocardial infarction.
Meta-regression was used to explore the effects of preoperative and
intraoperative variables on the primary outcome. <br/>Result(s): A total
of 6 studies with 32,793 women (25,714 single arterial grafting and 7079
multiple arterial grafting) were included. Women who received multiple
arterial grafting had lower long-term mortality (incidence rate ratio,
0.86; 95% confidence interval, 0.76-0.96; P =.007) and spontaneous
myocardial infarction (incidence rate ratio, 0.80; 95% confidence
interval, 0.68-0.93; P =.003) compared with women who received single
arterial grafting, but the difference in mortality disappeared when
including only the 3 largest studies. There was no difference between
groups in operative mortality (odds ratio, 0.99; 95% confidence interval,
0.84-1.17; P =.91). Meta-regression did not identify any associations with
the incidence rate ratio for long-term mortality. <br/>Conclusion(s): The
use of multiple arterial grafting in women undergoing coronary artery
bypass grafting is associated with lower long-term mortality, although the
difference is mostly driven by small series. Further studies, including
randomized trials, are needed to evaluate the efficacy of multiple
arterial grafting in women undergoing coronary artery bypass
grafting.<br/>Copyright &#xa9; 2021 The American Association for Thoracic
Surgery

<4>
Accession Number
2022635033
Title
CRT-700.04 Aspirin Versus Warfarin After Transcatheter Aortic Valve
Replacement in Low-Risk Patients: A 2-Year Follow-Up.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2023, Cardiovascular
Research Technologies. Omni Shoreham Hotel, Washington, DC United States.
16(4 Supplement) (pp S84), 2023. Date of Publication: 27 Feb 2023.
Author
Merdler I.; Rogers T.; Bhogal S.; Reddy P.K.; Zhang C.; Satler L.;
Weissman G.; Ben-Dor I.; Waksman R.
Institution
(Merdler, Rogers, Bhogal, Reddy, Zhang, Satler, Weissman, Ben-Dor,
Waksman) MedStar Washington Hospital Center, Washington, DC
Publisher
Elsevier Inc.
Abstract
Background: Leaflet thrombosis may occur with transcatheter heart valves
and has been associated with early structural valve degeneration.
Anticoagulation with warfarin has shown to prevent valve dysfunction
without excess bleeding in the short term. Guidelines recommend the use of
antiplatelets post-transcatheter aortic valve replacement (TAVR) but not
the routine use of oral anticoagulation (OAC). <br/>Method(s): Patients
LRT (Low Risk TAVR) 2.0 trial were randomized 1:1 to receive low-dose
aspirin or warfarin plus low-dose aspirin, with 50 patients receiving
aspirin alone and 44 patients receiving aspirin plus warfarin with no OAC
indication. A non-randomized arm in our analysis included patients with a
preexisting indication for OAC or those who developed a new indication.
After 30 days of treatment, ongoing medication regimens were at the
operator's discretion and those not requiring warfarin were taken off the
medication. <br/>Result(s): Hypoattenuated leaflet thickening at 30 days
was 16.3% for aspirin and 4.7% for warfarin plus aspirin. At 24 months,
15.4% of the warfarin group patients were still on OAC, while 12.8% of the
aspirin patients were on OAC. In the aspirin group, 5.6% of patients had
symptoms that can be attributed to heart failure vs. 2.9% of the warfarin
group (p=0.57). Echocardiography follow-up showed no difference in
paravalvular leak (72.3% vs. 61%, p=0.26), aortic valve area (1.9+/-0.51
cm² vs.1.85+/-0.48 cm², p=0.64) and mean pressure
gradient (11.55+/-5.0 mmHg vs. 11.05+/-4.02 mmHg, p=0.6). A composite
clinical endpoint including both the randomized and the non-randomized
patients did not show any difference at long-term follow-up (p=0.155).
<br/>Conclusion(s): In low-risk TAVR patients, initial anticoagulation
with warfarin for one month is safe without excess of bleeding and may
prevent leaflet thrombosis; however, anticoagulation with warfarin for one
month did not impact long-term valve dysfunction. [Formula
presented]<br/>Copyright &#xa9; 2023

<5>
Accession Number
2022635009
Title
CRT-100.02 On-Pump and Off-Pump Coronary Artery Bypass Grafting on 10-Year
Mortality Versus Percutaneous Coronary Intervention.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2023, Cardiovascular
Research Technologies. Omni Shoreham Hotel, Washington, DC United States.
16(4 Supplement) (pp S31), 2023. Date of Publication: 27 Feb 2023.
Author
Serruys P.W.; Kageyama S.; Ninomiya K.; O'Leary N.; Masuda S.; Kotoku N.;
Colombo A.; van Geuns R.-J.; Milojevic M.; Mack M.J.; Soo A.; Garg S.;
Onuma Y.
Institution
(Serruys, Kageyama, Ninomiya, O'Leary, Masuda, Kotoku, Soo, Onuma)
University of Galway, Galway, Ireland
(Colombo) Humanitas University, Rozzano-Milan, Italy
(van Geuns) Radboud University Medical Centre, Nijmegen, Netherlands
(Milojevic) Erasmus University Medical Centre, Rotterdam, Netherlands
(Mack) Baylor University Medical Center, Dallas, TX, United States
(Garg) Royal Blackburn Hospital, Blackburn, United Kingdom
Publisher
Elsevier Inc.
Abstract
Objective: This study aims to investigate the impact of on-pump and
off-pump coronary artery bypass grafting (CABG) versus percutaneous
coronary intervention (PCI) on 10-year all-cause mortality.
<br/>Background(s): The very long-term mortality of off-pump and on-pump
CABG versus PCI in a randomized complex coronary artery disease (CAD)
population is unknown. <br/>Method(s): The SYNTAXES trial randomized 1800
patients with three-vessel and/or left main CAD to PCI or CABG and
assessed their survival at 10 years. In this sub-study, the hazard of
mortality over 10 years was compared according to the technique of
revascularization: on-pump CABG (n=725), off-pump CABG (n=128), and PCI
(n=903). <br/>Result(s): There was substantial inter-site variation in the
use of off-pump CABG despite baseline characteristics being largely
homogeneous amongst the three groups. The crude rate of mortality was
significantly lower following on-pump CABG versus PCI (25.6% vs 28.4%,
Hazard Ratio [HR] 0.79, 95% Confidence Interval [CI] 0.65-0.96), whilst it
was comparable between off-pump CABG and PCI (28.5% vs 28.4%, HR 0.98,
95%CI 0.69-1.40). After adjusting for the nine variables included in the
SYNTAX score II 2020, 10-year mortality remained significantly lower with
on-pump CABG than PCI (HR 0.75 against PCI, p=0.009). <br/>Conclusion(s):
In the SYNTAXES trial, 10-year mortality adjusted for major confounders
was significantly lower following on-pump CABG compared to PCI, whilst
off-pump CABG offered no prognostic survival benefit over PCI. Site
heterogeneity in the technique used in bypass surgery has had measurable
effects on treatment performance. Given its impact on outcomes, it should
be pre-stratified in future studies. [Formula presented]<br/>Copyright
&#xa9; 2023

<6>
Accession Number
2022634997
Title
CRT-700.64 Transcatheter Aortic Valve Replacement in Patients With and
Without Concomitant Aortic Aneurysm: A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2023, Cardiovascular
Research Technologies. Omni Shoreham Hotel, Washington, DC United States.
16(4 Supplement) (pp S96-S97), 2023. Date of Publication: 27 Feb 2023.
Author
Aggarwal G.; Narmi A.E.; Bansal S.; Reddy A.K.; Aggarwal S.; Umeh C.;
Agarwal H.; Alla M.V.; Narayan M.A.; Pershad A.; Haddad T.M.; DelCore M.G.
Institution
(Aggarwal, Narmi, Reddy, Agarwal, Alla, Haddad, DelCore) Creighton
University Medical Center, Omaha, NE, United States
(Bansal) Maharishi Markandeshwar Institute of Medical sciences and
research, Haryana, Mullana, India
(Aggarwal, Umeh) Hemet Global Medical Center, Hemet, CA, United States
(Narayan) White River Medical Center, Batesville, AZ, United States
(Pershad) University of Arizona College of Medicine, Phoenix, AZ, United
States
Publisher
Elsevier Inc.
Abstract
Background: Patients with aortic stenosis and concomitant aortic aneurysm
(AA) are usually referred for surgical aortic valve replacement but may be
referred for transcatheter aortic valve replacement (TAVR) if deemed to be
high surgical risk. Data assessing TAVR outcomes in patients with and
without AA are limited. We performed a meta-analysis of published studies
to assess any differences in outcomes of TAVR in patients with and without
AA. <br/>Method(s): We searched PubMed, EMBASE, Google scholar and Ovid
databases for studies comparing outcomes for patients with and without AA
who underwent TAVR. Pooled risk ratios (RR) with 95% confidence intervals
(CI) were calculated and statistical analyses were performed using
Openmeta software. <br/>Result(s): A total of 3 studies with 200,760
patients were included in the analysis. There were no significant
differences in the risk of in-hospital mortality (RR 0.46, 95% CI
0.08-2.4; p>0.05), bleeding rates (RR 0.98 95% CI 0.85-1.13 p>0.05),
aortic dissection (RR 0.71, 95% CI 0.12-4.06; p>0.05) and stroke (RR 0.54,
95% CI 0.06-4.6; p>0.05) in patients with and without AA undergoing TAVR.
<br/>Conclusion(s): TAVR appears to be a safe procedure in patients who
have concomitant AA. Larger studies with long term follow up are needed to
assess the efficacy of TAVR is such patients. [Formula
presented]<br/>Copyright &#xa9; 2023

<7>
Accession Number
2022634928
Title
CRT-600.01 Ultrathin Bioresorbable-Polymer Sirolimus-Eluting Stents in US
Patients Undergoing Coronary Revascularization: 1-Year Outcomes From the
BIOFLOW-VII Trial.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2023, Cardiovascular
Research Technologies. Omni Shoreham Hotel, Washington, DC United States.
16(4 Supplement) (pp S76), 2023. Date of Publication: 27 Feb 2023.
Author
Kandzari D.E.; Garcia-Garcia H.M.; Stoler R.C.; Wang J.; Picone M.;
Ben-Dor I.; Garcia S.A.
Institution
(Kandzari) Piedmont Heart Institute, Atlanta, GA, United States
(Garcia-Garcia, Ben-Dor) Division of Interventional Cardiology, MedStar
Cardiovascular Research Network, MedStar Washington Hospital Center,
Washington, DC
(Stoler) Baylor Scott and White Heart and Vascular Hospital, Dallas, TX,
United States
(Wang) MedStar Union Memorial Hospital, MedStar Health Research Institute,
Baltimore, MD, United States
(Picone) Austin Heart, Austin, TX, United States
(Garcia) Minneapolis Heart Institute, Minneapolis, MN, United States
Publisher
Elsevier Inc.
Abstract
Background: Ultrathin strut coronary drug-eluting stents (DES) have
demonstrated improved safety and efficacy in large contemporary trials.
The evaluation of an ultrathin strut DES in a post-market United States
(U.S.) patient population was undertaken. <br/>Method(s): BIOFLOW-VII
(ClinicalTrials.gov NCT04175626) is a prospective, multicenter, single-arm
study to confirm the clinical performance of an ultrathin strut (60 mum)
bioresorbable polymer sirolimus-eluting stent (BP SES) in a real-world
setting in the U.S. The study evaluates the primary endpoint of 1-year
target lesion failure (TLF) against a performance goal of 6.9% based on an
adapted BIOFLOW-V trial BP SES TLF rate and TLF rates from other U.S.
market-released DES utilizing the SCAI definition for peri-procedural
myocardial infarction (MI). Subjects with coronary artery disease who
underwent a percutaneous coronary intervention (PCI) with BP SES were
consented within 24 hours post-index procedure. Enrolled subjects will be
followed through 5 years. <br/>Result(s): The study enrolled 556 subjects
at 31 sites in the U.S. The patient population included female patients;
34.7%; diabetes mellitus, 35.6%; and acute coronary syndromes, 56.8%. The
average stent length (mean+/-SD) was 20.2 +/- 11.8 mm, and mean number of
stents per patient was 1.3 +/- 0.6. Procedure success was 99.1% (551/556),
and device success was 99.9% (689/690). Of the 531 subjects included in
the primary endpoint analysis, 9 subjects experienced a TLF event
resulting in a 1-year rate of 1.7% (9/531), and the primary endpoint was
met compared with the performance goal (p<0.0001, 95% CI:0.69%, 3.43%).
Individual endpoints of the composite included: 1.3% target vessel
myocardial infarction (7/531), 0.9% clinically driven target lesion
revascularization (5/531) and no cases of cardiac death. Definite stent
thrombosis was observed for 2 cases (0.4%; 2/556) with one acute (<= 24
hours; 0.2%, 1/556) and one late (> 30 days and <= 1 year; 0.2%, 1/531)
event. <br/>Conclusion(s): The study outcomes at 1-year demonstrated
clinical performance consistent with prior trials supporting the safety
and effectiveness of ultrathin BP SES.<br/>Copyright &#xa9; 2023

<8>
Accession Number
2022634843
Title
CRT-700.03 TAVR in Intermediate-Risk Patients: 5-Year Outcomes From the
SURTAVI Continued Access Study.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2023, Cardiovascular
Research Technologies. Omni Shoreham Hotel, Washington, DC United States.
16(4 Supplement) (pp S83-S84), 2023. Date of Publication: 27 Feb 2023.
Author
Mahoney P.; Newton J.; Gada H.; Mumtaz M.; Williams M.; Waksman R.; Bafi
A.; Fail P.; Netherland D.; Davis T.; Batra S.; Chhim R.; Verdoliva S.;
Reardon M.J.
Institution
(Mahoney, Newton) Sentara Norfolk General Hospital, Norfolk, VA, United
States
(Gada, Mumtaz) UPMC Pinnacle Health, Harrisburg, PA, United States
(Williams) NYU Langone Medical Center, New York, NY, United States
(Waksman, Bafi) MedStar Washington Hospital Center, Washington, DC
(Fail, Netherland) Terrebonne General Medical Center, Houma, LA, United
States
(Davis, Batra) Saint John Hospital and Medical Center, Detroit, MI, United
States
(Chhim) North American Science Associates, Chicago, IL, United States
(Verdoliva) Medtronic, Minneapolis, MN, United States
(Reardon) Houston Methodist Hospital, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: The Surgical Replacement and Transcatheter Aortic Valve
Implantation Continued Access Study (SURTAVI CAS) evaluated the safety and
effectiveness of transcatheter aortic valve replacement (TAVR) in patients
with severe symptomatic aortic stenosis (AS) at intermediate surgical
risk. Long-term follow-up data after TAVR are limited, and the objective
of this analysis is to report 5-year outcomes for these patients.
<br/>Method(s): SURTAVI CAS was designed as a single-arm prospective,
multicenter, non-randomized phase of the primary SURTAVI randomized
controlled trial. Patients enrolled in CAS were selected based on detailed
inclusion and exclusion criteria and assigned to TAVR with either the
CoreValve or Evolut R device (Medtronic, Mpls, MN). The primary endpoint
was the composite of all-cause mortality or disabling stroke at 2 years.
Prespecified secondary endpoints were also defined, and echocardiographic
assessment of hemodynamics and measurements of health status and quality
of life were included. Echocardiograms were assessed by a central core
laboratory. Patients were followed through 5 years. <br/>Result(s): A
total of 275 patients underwent an attempted TAVR at 44 investigational
sites in the U.S. Mean age was 79.0+/-6.1 years, and 46.2% were male. At
baseline, most patients were in New York Heart Association class II
(54.5%) or III (42.9%), and the mean Society of Thoracic Surgeons
predicted risk of mortality score was 4.1+/-1.5%. Study compliance through
five years was 88.6% for follow-up visits. At 5-year follow-up, the rate
of all-cause mortality or disabling stroke was 29.9% (all-cause mortality,
29.2%; disabling stroke, 3.4%). The rate of reintervention was 1.1%, and
the new permanent pacemaker implantation rate was 27.6%. There were no
cases of clinical valve thrombosis, and 3 cases of valve endocarditis
(1.2%). The 5-year mean gradient was 9.16 mmHg and 5-year mean effective
orifice area was 2.06 cm². Most patients had no or trace aortic
regurgitation (87.9%) and no or trace paravalvular leak (89.4%). At 5-year
follow-up, the average increase in Kansas City Cardiomyopathy
Questionnaire overall summary score from baseline was 16.6 +/- 24.8,
p<0.001. <br/>Conclusion(s): For patients with severe symptomatic AS at
intermediate surgical risk treated with TAVR, 5-year data from SURTAVI CAS
shows favorable clinical outcomes, with excellent valve hemodynamics, low
reintervention rates, and no clinical valve thrombosis. These data
demonstrate the long-term safety and effectiveness of TAVR in this risk
population.<br/>Copyright &#xa9; 2023

<9>
Accession Number
2022634841
Title
CRT-700.19 Transcatheter Aortic Valve Replacement With Self-Expanding
Acurate Neo2 Valve Versus Acurate Neo Valve: A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2023, Cardiovascular
Research Technologies. Omni Shoreham Hotel, Washington, DC United States.
16(4 Supplement) (pp S88-S89), 2023. Date of Publication: 27 Feb 2023.
Author
Aggarwal G.; Haddad T.M.; Bansal S.; Aggarwal S.; Umeh C.; Gokhroo R.;
Agarwal H.; Narmi A.E.; Reddy A.K.; DelCore M.G.
Institution
(Aggarwal, Haddad, Agarwal, Narmi, Reddy, DelCore) Creighton University
Medical Center, Omaha, NE, United States
(Bansal) Maharishi Markandeshwar Institute of Medical Sciences and
Research, Haryana, Mullana, India
(Aggarwal, Umeh, Gokhroo) Hemet Global Medical Center, Hemet, CA, United
States
Publisher
Elsevier Inc.
Abstract
Background: The ACURATE Neo2 valve was developed due to high rates of
para-valvular leak and other complications associated with first
generation ACURATE Neo valves in patients undergoing transcatheter aortic
valve replacement (TAVR). However, limited data have been published
comparing the two valves. We performed a meta-analysis of published
studies comparing the two valves in patients with aortic stenosis.
<br/>Method(s): We searched PubMed, EMBASE, Google Scholar and Ovid
databases for studies comparing outcomes of patients who underwent
transcatheter aortic valve replacement (TAVR) using ACURATE Neo2 versus
first generation ACURATE neo valves. Pooled risk ratios (RR) with 95%
confidence intervals (CI) were calculated using Openmeta software.
Heterogeneity and publication bias were also assessed. <br/>Result(s): A
total of six studies with 6028 patients were included. Compared with
patients who underwent TAVR with first generation ACURATE Neo, patients
with ACURATE Neo2 had significantly lower risk of moderate to severe PVL
(RR 0.41, 95% CI 0.27-0.6; p<0.001) and major bleeding (RR 0.63 95% CI
0.46-0.85 p=0.003). Rates of permanent pacemaker implantation (RR 0.90,
95% CI 0.74-1.1; p>0.05), all-cause mortality (RR 1.008, 95% CI 0.72-1.42;
p>0.05), major vascular complications (RR 0.65, 95% CI 0.36-1.17; p>0.05)
and device success (RR 1.02, 95% CI 0.98-1.07; p>0.05) were similar in
both groups. <br/>Conclusion(s): In patients undergoing TAVR, rates of
moderate to severe PVL and bleeding were significantly lower in ACURATE
Neo2 group compared to ACURATE Neo. [Formula presented]<br/>Copyright
&#xa9; 2023

<10>
Accession Number
2022634772
Title
CRT-100.06 Impact of Left Ventricular Ejection Fraction on 10-Year
Mortality After Percutaneous Coronary Intervention or Coronary Artery
Bypass Grafting: Is CABG Safer Than PCI in All Patients With Reduced
Ejection Fraction?.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2023, Cardiovascular
Research Technologies. Omni Shoreham Hotel, Washington, DC United States.
16(4 Supplement) (pp S19), 2023. Date of Publication: 27 Feb 2023.
Author
Serruys P.W.; Masuda S.; Ninomiya K.; Kageyama S.; Kotoku N.; Mack M.J.;
Morice M.-C.; Kappetein A.-P.; Onuma Y.
Institution
(Serruys, Masuda, Ninomiya, Kageyama, Kotoku, Onuma) National University
of Ireland Galway, Galway, Ireland
(Mack) Baylor University Medical Center, Dallas, TX, United States
(Morice) Hopital Prive Jacques Cartier, Massy, France
(Kappetein) Erasmus University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: The impact of reduced left ventricular ejection fraction
(LVEF) on long-term all-cause mortality after either PCI or CABG has been
established. <br/>Method(s): In the SYNTAX trial, 1,800 randomized pts
were categorized into 3 groups according to their LVEF; (1) reduced EF
(rEF: <=40%), (2) mildly reduced EF (mrEF: 41-49%), (3) preserved EF (pEF:
>=50%). The primary endpoint was 10-year all-cause mortality. The SYNTAX
score 2020 (SS-2020) was applied to the patients with EF<50% and >=50% and
their individual predicted and observed all-cause mortality assessed.
<br/>Result(s): Ten year mortality were 44.0% with rEF (n=168), 31.8% with
mrEF (n=179) and 22.6% with pEF (n=1453) (p<0.001). No significant
interaction was found between EF classification and treatment
(p<inf>interaction</inf>=0.183). In patients with rEF and mrEF, mortality
was numerically higher with PCI than with CABG (52.9% vs 39.6%, p=0.054
and 36.0% vs. 28.6%, p=0.273) whereas in pts with pEF mortality was
similar (23.9% vs. 22.2%, p=0.275). According to the SS-2020, PCI was an
equally safe modality of revascularization in 37.8% of the patients with
reduced EF <50%. In patients with preserved EF>=50%, the proportion of
patients eligible to either PCI or CABG with individual predicted
equipoise in mortality was 57.5%. <br/>Conclusion(s): EF is a determinant
factor in the choice of a revascularization strategy in patients
presenting with complex coronary artery disease and altered EF. Prediction
of individualized 10-year prognosis using the SS-2020 may add precision in
the decision-making process. [Formula presented]<br/>Copyright &#xa9; 2023

<11>
Accession Number
2021586672
Title
Oligorecurrent Non-Small-Cell Lung Cancer Treated by Chemo-Radiation
Followed by Immunotherapy and Intracranial Radiosurgery: A Case Report and
Mini Review of Literature.
Source
International Journal of Molecular Sciences. 24(3) (no pagination), 2023.
Article Number: 1892. Date of Publication: February 2023.
Author
Bruni A.; Bertolini F.; D'Angelo E.; Guaitoli G.; Imbrescia J.; Cappelli
A.; Guidi G.; Stefani A.; Dominici M.; Lohr F.
Institution
(Bruni, D'Angelo, Imbrescia, Cappelli, Lohr) Radiation Oncology Unit,
Department of Oncology and Hematology, University Hospital of Modena,
Modena 41124, Italy
(Bertolini, Guaitoli, Dominici) Division of Oncology, Department of
Oncology and Hematology, Modena University Hospital, Modena 41124, Italy
(Guaitoli) PhD Program Clinical and Experimental Medicine, University of
Modena and Reggio Emilia, Modena 41124, Italy
(Cappelli, Lohr) Radiation Oncology Unit, Department of Medical and
Surgical Sciences for Children & Adults, University of Modena and Reggio
Emilia, Modena 41124, Italy
(Guidi) Medical Physics Unit, University Hospital of Modena, Modena 41124,
Italy
(Stefani) Division of Thoracic Surgery, Department of Medical and Surgical
Sciences, University of Modena and Reggio Emilia, Modena 41124, Italy
(Dominici) Laboratory of Cellular Therapy, Division of Oncology,
Department of Medical and Surgical Sciences for Children and Adults,
University of Modena and Reggio Emilia, Modena 41124, Italy
Publisher
MDPI
Abstract
Locally advanced non-small-cell lung cancer still represents a "grey zone"
in terms of the best treatment choice and optimal clinical outcomes.
Indeed, most patients may be suitable to receive different treatments with
similar outcomes such as chemo-radiotherapy (CHT-RT) followed by
immunotherapy (IO) or surgery followed by adjuvant local/systemic
therapies. We report a clinical case of a patient submitted to primary
thoracic surgery who developed a mediastinal nodal recurrence successfully
treated by CHT-RT-IO. Subsequently, a single brain lesion was found to
have been successfully treated by single fraction stereotactic ablative
radiotherapy. The patient is still on follow-up and she is free from
disease having a good quality of life. In this report, we also perform a
mini review about the role of CHT-RT followed by IO in treating
loco-regional relapse after surgery. The role of SABR after IO is also
evaluated, finding that it is safe and well tolerated. More robust and
larger clinical data are needed in this particular setting to better
define the role of the combination of systemic and local treatments in the
management of intrathoracic and intracranial relapse for patients already
submitted to CHT-RT followed by immunotherapy.<br/>Copyright &#xa9; 2023
by the authors.

<12>
Accession Number
2021562412
Title
Effect of Supplemental Oxygen on von Willebrand Factor Activity and
Ristocetin Cofactor Activity in Patients at Risk for Cardiovascular
Complications Undergoing Moderate-to High-Risk Major Noncardiac Surgery-A
Secondary Analysis of a Randomized Trial.
Source
Journal of Clinical Medicine. 12(3) (no pagination), 2023. Article Number:
1222. Date of Publication: February 2023.
Author
Horvath K.; Taschner A.; Adamowitsch N.; Falkner von Sonnenburg M.;
Fleischmann E.; Kabon B.; Fraunschiel M.; Reiterer C.; Graf A.
Institution
(Horvath, Taschner, Adamowitsch, Falkner von Sonnenburg, Fleischmann,
Kabon, Reiterer) Department of Anaesthesia, General Intensive Care
Medicine and Pain Medicine, Medical University of Vienna, Vienna 1090,
Austria
(Fraunschiel) IT Systems and Communications, Medical University of Vienna,
Vienna 1090, Austria
(Graf) Center for Medical Data Science, Medical University of Vienna,
Vienna 1090, Austria
Publisher
MDPI
Abstract
Increased von Willebrand Factor (vWF) activity mediates platelet adhesion
and might be a contributor to the development of thrombotic complications
after surgery. Although in vitro studies have shown that hyperoxia induces
endovascular damage, the effect of perioperative supplemental oxygen as a
possible trigger for increased vWF activity has not been investigated yet.
We tested our primary hypothesis that the perioperative administration of
80% oxygen concentration increases postoperative vWF activity as compared
to 30% oxygen concentration in patients at risk of cardiovascular
complications undergoing major noncardiac surgery. A total of 260 patients
were randomly assigned to receive 80% versus 30% oxygen throughout surgery
and for two hours postoperatively. We assessed vWF activity and Ristocetin
cofactor activity in all patients shortly before the induction of
anesthesia, within two hours after surgery and on the first and third
postoperative day. Patient characteristics were similar in both groups. We
found no significant difference in vWF activity in the overall
perioperative time course between both randomization groups. We observed
significantly increased vWF activity in the overall study population
throughout the postoperative time course. Perioperative supplemental
oxygen showed no significant effect on postoperative vWF and Ristocetin
cofactor activity in cardiac risk patients undergoing major noncardiac
surgery. In conclusion, we found no significant influence of supplemental
oxygen in patients undergoing major non-cardiac surgery on postoperative
vWF activity and Ristocetin cofactor activity.<br/>Copyright &#xa9; 2023
by the authors.

<13>
Accession Number
2021562338
Title
Prehabilitation in Cardiovascular Surgery: The Effect of Neuromuscular
Electrical Stimulation (Randomized Clinical Trial).
Source
International Journal of Environmental Research and Public Health. 20(3)
(no pagination), 2023. Article Number: 2678. Date of Publication: February
2023.
Author
Sumin A.N.; Oleinik P.A.; Bezdenezhnykh A.V.; Bezdenezhnykh N.A.
Institution
(Sumin, Oleinik, Bezdenezhnykh, Bezdenezhnykh) Laboratory for Comorbidity
in Cardiovascular Diseases, Federal State Budgetary Institution "Research
Institute for Complex Issues of Cardiovascular Diseases", 6, Sosnoviy
blvd, Kemerovo 650002, Russian Federation
Publisher
MDPI
Abstract
Objective: We aimed to determine the effects of prehabilitation with
neuromuscular electrical stimulation (NMES) on muscle status and exercise
capacity in patients before cardiac surgery. <br/>Method(s): Preoperative
elective cardiac surgery patients were randomly assigned to the NMES group
or control group. Intervention in the NMES group was 7-10 sessions,
whereas the control group carried out breathing exercises and an
educational program. The outcome measures included a six-minute walk test
(6MWT) and a muscle status assessment (knee extensor strength (KES), knee
flexor strength (KFS), and handgrip strength (HS)) after the course of
prehabilitation. <br/>Result(s): A total of 122 patients (NMES, n = 62;
control, n = 60) completed the study. During the NMES course, no
complications occurred. After the course prehabilitation KES, KFS, and
6MWT distance were significantly increased (all p < 0.001) in the NMES
group compared to the control. There was no significant difference in HS
before surgery. <br/>Conclusion(s): A short-term NMES course before
cardiac surgery is feasible, safe, and effective to improve preoperative
functional capacity (six-minute walk distance) and the strength of
stimulated muscles.<br/>Copyright &#xa9; 2023 by the authors.

<14>
Accession Number
2021562116
Title
Development and Validation of a Machine Learning Predictive Model for
Cardiac Surgery-Associated Acute Kidney Injury.
Source
Journal of Clinical Medicine. 12(3) (no pagination), 2023. Article Number:
1166. Date of Publication: February 2023.
Author
Li Q.; Lv H.; Chen Y.; Shen J.; Shi J.; Zhou C.
Institution
(Li, Lv, Chen, Shen, Shi, Zhou) State Key Laboratory of Cardiovascular
Disease, National Center for Cardiovascular Diseases, Department of
Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences and
Peking Union Medical College, 167 Beilishi Rd., Xicheng District, Beijing
100037, China
Publisher
MDPI
Abstract
Objective: We aimed to develop and validate a predictive machine learning
(ML) model for cardiac surgery associated with acute kidney injury
(CSA-AKI) based on a multicenter randomized control trial (RCT) and a
Medical Information Mart for Intensive Care-IV (MIMIC-IV) dataset.
<br/>Method(s): This was a subanalysis from a completed RCT approved by
the Ethics Committee of Fuwai Hospital in Beijing, China (NCT03782350).
Data from Fuwai Hospital were randomly assigned, with 80% for the training
dataset and 20% for the testing dataset. The data from three other centers
were used for the external validation dataset. Furthermore, the MIMIC-IV
dataset was also utilized to validate the performance of the predictive
model. The area under the receiver operating characteristic curve
(ROC-AUC), the precision-recall curve (PR-AUC), and the calibration brier
score were applied to evaluate the performance of the traditional logistic
regression (LR) and eleven ML algorithms. Additionally, the Shapley
Additive Explanations (SHAP) interpreter was used to explain the potential
risk factors for CSA-AKI. <br/>Result(s): A total of 6495 eligible
patients undergoing cardiopulmonary bypass (CPB) were eventually included
in this study, 2416 of whom were from Fuwai Hospital (Beijing), for model
development, 562 from three other cardiac centers in China, and 3517 from
the MIMICIV dataset, were used, respectively, for external validation. The
CatBoostClassifier algorithms outperformed other models, with excellent
discrimination and calibration performance for the development, as well as
the MIMIC-IV, datasets. In addition, the CatBoostClassifier achieved
ROC-AUCs of 0.85, 0.67, and 0.77 and brier scores of 0.14, 0.19, and 0.16
in the testing, external, and MIMIC-IV datasets, respectively. Moreover,
the utmost important risk factor, the N-terminal brain sodium peptide
(NT-proBNP), was confirmed by the LASSO method in the feature section
process. Notably, the SHAP explainer identified that the preoperative
blood urea nitrogen level, prothrombin time, serum creatinine level, total
bilirubin level, and age were positively correlated with CSA-AKI;
preoperative platelets level, systolic and diastolic blood pressure,
albumin level, and body weight were negatively associated with CSA-AKI.
<br/>Conclusion(s): The CatBoostClassifier algorithms outperformed other
ML models in the discrimination and calibration of CSA-AKI prediction
cardiac surgery with CPB, based on a multicenter RCT and MIMIC-IV dataset.
Moreover, the preoperative NT-proBNP level was confirmed to be strongly
related to CSA-AKI.<br/>Copyright &#xa9; 2023 by the authors.

<15>
Accession Number
2021562020
Title
A Practical Approach to Systemic Mastocytosis Complications in Cardiac
Surgery: A Case Report and Systematic Review of the Literature.
Source
Journal of Clinical Medicine. 12(3) (no pagination), 2023. Article Number:
1156. Date of Publication: February 2023.
Author
Suleiman M.N.; Brueckl V.; Fechner J.; Kaemmerer A.-S.; Wilk F.; Weyand
M.; Harig F.
Institution
(Suleiman, Kaemmerer, Weyand, Harig) Department of Cardiac Surgery,
University Hospital Erlangen, Friedrich-Alexander-University
Erlangen-Nurnberg, Erlangen 91054, Germany
(Brueckl) Department of Haematology and Oncology, University Hospital
Erlangen, Friedrich-Alexander-University Erlangen-Nurnberg, Erlangen
91054, Germany
(Fechner, Wilk) Department of Anesthesiology, University Hospital
Erlangen, Friedrich-Alexander-University Erlangen-Nurnberg, Erlangen
91054, Germany
Publisher
MDPI
Abstract
(1) Background: Systemic mastocytosis is a rare, non-curable disease with
potential life-threatening complications in patients receiving cardiac
surgery. (2) Methods: This systematic review of the literature was
prompted by the case of a life-threatening anaphylactic reaction during
cardiac surgery related to systemic mastocytosis. The search of all types
of studies, using several databases (Pubmed, Scopus and Web of Science),
was conducted through September 2022 to identify the relevant studies. (3)
Results: Twelve studies were included describing cases of patients
undergoing cardiac surgery who were diagnosed with systemic mastocytosis.
An adverse effect, namely anaphylaxis, has happened in three cases.
Different strategies of premedication, intraoperative and postoperative
management were used. In our case, the patient was admitted for elective
biological aortic valve replacement due to severe aortic stenosis.
Intraoperatively, the patient developed an anaphylactic shock during the
administration of protamine after separation from the cardiopulmonary
bypass. This anaphylaxis reaction was a complication of the pre-existing
systemic mastocytosis and could be successfully managed by the
administration of epinephrine, antihistamines and corticosteroids. (4)
<br/>Conclusion(s): This systematic literature search and case report
highlight the importance of careful preoperative planning, as well as
coordination between cardiac surgeons, anesthesiologists and
hemato-oncological specialists, in patients with rare but
complication-prone diseases such as systemic mastocytosis.<br/>Copyright
&#xa9; 2023 by the authors.

<16>
Accession Number
640307998
Title
Association Between Achieved Low-Density Lipoprotein Cholesterol Levels
and Long-Term Cardiovascular and Safety Outcomes: An Analysis of
FOURIER-OLE.
Source
Circulation. (no pagination), 2023. Date of Publication: 13 Feb 2023.
Author
Gaba P.; O'Donoghue M.L.; Park J.-G.; Wiviott S.D.; Atar D.; Kuder J.F.;
Im K.; Murphy S.A.; De Ferrari G.M.; Gaciong Z.A.; Toth K.; Gouni-Berthold
I.; Lopez-Miranda J.; Schiele F.; Mach F.; Flores-Arredondo J.H.; Lopez
J.A.G.; Elliott-Davey M.; Wang B.; Monsalvo M.L.; Abbasi S.; Giugliano
R.P.; Sabatine M.S.
Institution
(Gaba, O'Donoghue, Park, Wiviott, Kuder, Im, Murphy, Giugliano, Sabatine)
Thrombolysis in Myocardial Infarction (TIMI) Study Group, Brigham and
Women's Hospital and Harvard Medical School, K.I., S.A.M., Boston, United
States
(Atar) Division of Medicine, University of Oslo, Norway
(De Ferrari) Department of Medical Sciences, University of Turin and
Department of Cardiology, Azienda Ospedaliera Universitaria Citta della
Salute e della Scienza, Turin, United States
(Gaciong) Department of Internal Medicine, Hypertension and Vascular
Diseases, Medical University of Warsaw, Poland (Z.A.G.), Poland
(Toth) 1st Department of Medicine, University of Pecs, Medical School,
Hungary (K.T.), Hungary
(Gouni-Berthold) Center for Endocrinology, Diabetes, Preventative
Medicine, University of Cologne, Faculty of Medicine and University
Hospital, Germany (I.G.-B.), Germany
(Lopez-Miranda) Lipids and Atherosclerosis Unit, Maimonides Biomedical
Research Institute of Cordoba, Reina Sofia University Hospital, University
of Cordoba, CIBEROBN, Spain
(Schiele) University Hospital Center Besancon, EA 3920, Spain
(Mach) Cardiology Department, Geneva University Hospital, Switzerland
(Flores-Arredondo, Lopez, Elliott-Davey, Wang, Monsalvo, Abbasi) Amgen
Inc, Thousand Oaks, M.E.-D., B.W.
Publisher
NLM (Medline)
Abstract
BACKGROUND: Low-density lipoprotein cholesterol (LDL-C) level is a
well-established risk factor for atherosclerotic cardiovascular disease.
However, the optimal achieved LDL-C level with regard to efficacy and
safety in the long term remains unknown. <br/>METHOD(S): In FOURIER
(Further Cardiovascular Outcomes Research With PCSK9 Inhibition in
Subjects With Elevated Risk), 27564 patients with stable atherosclerotic
cardiovascular disease were randomized to evolocumab versus placebo, with
a median follow-up of 2.2 years. In the open-label extension
(FOURIER-OLE), 6635 of these patients were transitioned to open-label
evolocumab regardless of initial treatment allocation in the parent trial
and were followed up with for an additional median of 5 years. In this
prespecified analysis, we examined the relationship between achieved LDL-C
levels (an average of the first 2 LDL-C levels measured) in FOURIER-OLE
(available in 6559 patients) and the incidence of subsequent
cardiovascular and safety outcomes. We also performed sensitivity analyses
evaluating cardiovascular and safety outcomes in the entire FOURIER and
FOURIER-OLE patient population. Multivariable modeling was used to adjust
for baseline factors associated with achieved LDL-C levels.
<br/>RESULT(S): In FOURIER-OLE, 1604 (24%), 2627 (40%), 1031 (16%), 486
(7%), and 811 (12%) patients achieved LDL-C levels of <20, 20 to <40, 40
to <55, 55 to <70, and >=70 mg/dL, respectively. There was a monotonic
relationship between lower achieved LDL-C levels-down to very low levels
<20 mg/dL-and a lower risk of the trial's primary efficacy end point
(composite of cardiovascular death, myocardial infarction, stroke, or
hospital admission for unstable angina or coronary revascularization) and
the key secondary efficacy end point (composite of cardiovascular death,
myocardial infarction, or stroke) that persisted after multivariable
adjustment (adjusted Ptrend<0.0001 for both end points). No statistically
significant associations existed in the primary analyses between lower
achieved LDL-C levels and increased risk of the safety outcomes (serious
adverse events, new or recurrent cancer, cataract-related adverse events,
hemorrhagic stroke, new-onset diabetes, neurocognitive adverse events,
muscle-related events, or noncardiovascular death). Similar findings were
noted in the entire FOURIER and FOURIER-OLE cohort up to a maximum
follow-up of 8.6 years. <br/>CONCLUSION(S): In patients with
atherosclerotic cardiovascular disease, long-term achievement of lower
LDL-C levels, down to <20 mg/dL (<0.5 mmol/L), was associated with a lower
risk of cardiovascular outcomes with no significant safety concerns.
REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier:
NCT01764633.

<17>
Accession Number
640306681
Title
Head-to-Head Comparison Between Left Atrial Appendage Occlusion and
Non-vitamin K Oral Anticoagulants in Non-Valvular Atrial Fibrillation
Patients: A Systematic Review and Meta-analysis Study.
Source
Trends in cardiovascular medicine. (no pagination), 2023. Date of
Publication: 10 Feb 2023.
Author
Waranugraha Y.; Lin L.-Y.; Tsai C.-T.
Institution
(Waranugraha) Department of Cardiology and Vascular Medicine, Universitas
Brawijaya Faculty of Medicine and Hospital, Malang, Indonesia
(Lin) Division of Cardiology, Department of Internal Medicine, National
Taiwan University College of Medicine and Hospital, Taipei, Taiwan
(Republic of China)
(Tsai) Division of Cardiology, Department of Internal Medicine, National
Taiwan University College of Medicine and Hospital, Taipei, Taiwan
(Republic of China)
Publisher
NLM (Medline)
Abstract
Left atrial appendage occlusion (LAAO) was found to be non-inferior to
warfarin. In non-valvular atrial fibrillation (AF), there is still a
scarcity of data comparing LAAO versus non-vitamin K oral anticoagulants
(NOACs). Our purpose was to compare the clinical benefits between LAAO and
NOACs in non-valvular AF patients. The patient, intervention, comparison,
and outcome principles were used to develop the research question in this
systematic review and meta-analysis. Literature searches were conducted in
online scientific databases such as ProQuest, PubMed, and ScienceDirect.
All important information was extracted. The random-effect model was
applied to estimate all pooled effects. The Mantel-Haenszel statistical
method was used to determine the pooled risk ratio (RR) and 95% confidence
interval (CI). A total of 4411 participants from 5 studies were involved.
LAAO significantly decreased the cardiovascular mortality risk compared to
NOACs (RR=0.56; 95% CI=0.42 to 0.75; p <0.01). Major bleeding risk in the
LAAO group was significantly lower than in the NOACs group (RR=0.66;
RR=0.53 to 0.82; p <0.01). A significantly lower risk of major bleeding or
non-major bleeding in the patients receiving LAAO than NOACs was also
observed in this meta-analysis (RR=0.66; 95% CI=0.54 to 0.81; p <0.01).
LAAO was superior to the NOACs in reducing cardiovascular mortality, major
bleeding, and major or non-major bleeding risks in non-valvular AF
patients. In high-risk for thromboembolism and bleeding patients, LAAO can
be considered first as a long-term treatment strategy.<br/>Copyright
&#xa9; 2023. Published by Elsevier Inc.

<18>
Accession Number
640306669
Title
Anatomic, stage-based repair of secondary mitral valve disease.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2023. Date of Publication: 11 Jan 2023.
Author
Drake D.H.; Zhang P.; Zimmerman K.G.; Morrow C.D.; Sidebotham D.A.
Institution
(Drake) Department of Cardiac Surgery, University of Michigan Medical
School, Ann Arbor, Mich; Department of Surgery, Munson Medical Center,
Traverse City, Mich
(Zhang) Department of Surgery, University of Michigan Medical School,
Mich, Ann Arbor, United States
(Zimmerman) Department of Cardiology, Henry Ford Health System, Mich,
Detroit, United States
(Morrow) Health Systems, Management & Policy, Colorado School of Public
Health, Aurora, Colo
(Sidebotham) Department of Cardiothoracic Anaesthesia and Cardiothoracic
Intensive Care, Auckland City Hospital, Auckland, New Zealand
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Intervention for repair of secondary mitral valve disease is
frequently associated with recurrent regurgitation. We sought to determine
if there was sufficient evidence to support inclusion of anatomic indices
of leaflet dysfunction in the management of secondary mitral valve
disease. <br/>METHOD(S): We performed a systematic review and
meta-analysis of published reports comparing anatomic indices of leaflet
dysfunction with the complexity of valve repair and the outcome from
intervention. Patients were stratified by the severity of leaflet
dysfunction. A secondary analysis was performed comparing outcomes when
procedural complexity was optimally matched to severity of leaflet
dysfunction and when intervention was not matched to dysfunction.
<br/>RESULT(S): We identified 6864 publications, of which 65 met inclusion
criteria. An association between the severity of leaflet dysfunction and
the procedural complexity was highly predictive of satisfactory freedom
from recurrent regurgitation. Patients were categorized into 4 groups
based on stratification of leaflet dysfunction. Satisfactory results were
achieved in 93.7% of patients in whom repair complexity was appropriately
matched to severity of leaflet dysfunction and in 68.8% in whom repair was
not matched to dysfunction (odds ratio, 0.148; 95% confidence interval,
0.119-0.184; P < .0001). <br/>CONCLUSION(S): For patients with secondary
mitral valve disease, satisfactory outcome from valve repair improves when
procedural complexity is matched to anatomic indices of leaflet
dysfunction. Anatomic indices of leaflet dysfunction should be considered
when planning interventions for secondary mitral regurgitation. Routine
inclusion of anatomic indices in trial design and reporting should
facilitate comparison of results and strengthen guidelines. There are
sufficient data to support anatomic staging of secondary mitral valve
disease.<br/>Copyright &#xa9; 2023 The American Association for Thoracic
Surgery. Published by Elsevier Inc. All rights reserved.

<19>
Accession Number
2021254972
Title
Intercostal nerve cryoanalgesia in the treatment of pain in patients
operated on by the modified Nuss method with the BackOnFeet application-a
new strategy to improve outcomes.
Source
Frontiers in Pediatrics. 10 (no pagination), 2023. Article Number:
1069805. Date of Publication: 12 Jan 2023.
Author
Zacha S.; Andrzejewska A.; Jastrzebska-Ligocka B.; Szwed A.; Modrzejewska
E.; Zacha W.; Skonieczna-Zydecka K.; Miegon J.; Jarosz K.; Biernawska J.
Institution
(Zacha, Szwed, Modrzejewska) Department of Pediatric Orthopedics and
Oncology of the Musculoskeletal System, Pomeranian Medical University,
Szczecin, Poland
(Andrzejewska, Jastrzebska-Ligocka, Miegon, Biernawska) Department of
Anesthesiology and Intensive Care, Pomeranian Medical University,
Szczecin, Poland
(Zacha) Department of Orthopedics, Traumatology and Oncology of the
Musculoskeletal System, Pomeranian Medical University, Szczecin, Poland
(Skonieczna-Zydecka) Department of Biochemical Science, Pomeranian Medical
University, Szczecin, Poland
(Jarosz) Department of Clinical Nursing, Pomeranian Medical University,
Szczecin, Poland
Publisher
Frontiers Media S.A.
Abstract
Introduction: The surgical Nuss correction of the funnel chest deformity
is a painful procedure without an established consensus of pain relief
methods. High doses and long duration of opioids requirements impedes the
ERAS protocol introduction. The aim of this study was to evaluate the
effectiveness of intraoperative intercostal nerve cryolysis in terms of
pain management in relation to the routinely used multimodal analgesia in
Poland. We also assessed the impact of using the proprietary "BackOnFeet"
application on the quality of life of patients after surgery in relation
to the ERAS protocol. <br/>Method(s): The prospective, single-centre,
non-randomised, before-after pilot study was conducted. Inclusion criteria
were: funnel-shaped chest deformity, age range 11-18 years, first chest
wall operation, agreement for the cryolysis and regional analgesia, no
history of chronic painkillers use. The results of the "control group"
(multimodal analgesia with regional analgesia commonly performed in
Poland) were assessed. The interdisciplinary perioperative protocol with
the "BackOnFeet" application and intraoperative intercostal nerve
cryoanalgesia were introduced to the "intervention group". <br/>Result(s):
Eighteen children were treated with standard protocol typical for Polish
management and matched to eighteen patients who received cryoanalgesia and
the "BackOnFeet" application access "intervention group". We noticed lower
NRS points in first 24 h (p = 0.0048), shortening of time of opioid use (p
= 0.0002), hospitalisation time (p = 0,01), improved quality of
postoperative rehabilitation (p < 0.0001) and quality of life (p < 0.0001)
among the "intervention group". <br/>Conclusion(s): Intraoperative
intercostal nerves cryolysis performed during the minimally invasive Nuss
correction of funnel deformation in combination with bilateral is more
effective in terms of acute pain management in relation to the routinely
used multimodal analgesia in Poland, allowing for the shortening of time
of opioid use, hospitalisation time, improved quality of postoperative
rehabilitation and enabled ERAS protocol introduction. The use of the
proprietary "BackOnFeet" application has a positive effect on the quality
of life of patients after surgery.<br/>Copyright 2023 Zacha, Andrzejewska,
Jastrzebska-Ligocka, Szwed, Modrzejewska, Zacha, Skonieczna-Zydecka,
Miegon, Jarosz and Biernawska.

<20>
Accession Number
2018177589
Title
Surgical site wound infection, and other postoperative problems after
coronary artery bypass grafting in subjects with chronic obstructive
pulmonary disease: A meta-analysis.
Source
International Wound Journal. 20(2) (pp 302-312), 2023. Date of
Publication: February 2023.
Author
Gao J.; Wang H.; Liu X.; Song X.; Zhong X.
Institution
(Gao, Wang, Zhong) Department of Respiratory and Critical Care Medicine,
The First Affiliated Hospital of Guangxi Medical University, Nanning,
China
(Gao, Liu, Song) Department of Rheumatism and Immunology, The Fourth
Affiliated Hospital of Guangxi Medical University, Liuzhou, China
Publisher
John Wiley and Sons Inc
Abstract
We performed a meta-analysis to evaluate the effect of chronic obstructive
pulmonary disease on surgical site wound infection, and other
postoperative problems after coronary artery bypass grafting. A systematic
literature search up to April 2022 was performed and 37 444 subjects with
coronary artery bypass grafting at the baseline of the studies; 4320 of
them were with the chronic obstructive pulmonary disease, and 33 124 were
without chronic obstructive pulmonary disease. Odds ratio (OR), and mean
difference (MD) with 95% confidence intervals (CIs) were calculated to
assess the effect of chronic obstructive pulmonary disease on surgical
site wound infection, and other postoperative problems after coronary
artery bypass grafting using the dichotomous, and contentious methods with
a random or fixed-effect model. The chronic obstructive pulmonary disease
subjects had a significantly higher surgical site wound infection (OR,
1.27; 95% CI, 1.01-1.60, P = 0.04), respiratory failure (OR, 1.84; 95% CI,
1.55-2.18, P < 0.001), mortality (OR, 1.61; 95% CI, 1.37-1.89, P < 0.001),
pneumonia (OR, 2.30; 95% CI, 1.97-2.68, P < 0.001), pleural effusion (OR,
1.78; 95% CI, 1.12-2.83, P = 0.02), stroke (OR, 1.99; 95% CI, 1.17-3.36, P
= 0.01), and length of intensive care unit stay (MD, 0.73; 95% CI,
0.19-1.26, P = 0.008) after coronary artery bypass grafting compared with
subjects without chronic obstructive pulmonary disease. However, chronic
obstructive pulmonary disease subjects did not show any significant
difference in length of hospital stay (MD, 0.83; 95% CI, -0.01 to 1.67, P
= 0.05), and pneumothorax (OR, 1.59; 95% CI, 0.98-2.59, P = 0.06) after
coronary artery bypass grafting compared with subjects without chronic
obstructive pulmonary disease. The chronic obstructive pulmonary disease
subjects had a significantly higher surgical site wound infection,
respiratory failure, mortality, pneumonia, pleural effusion, stroke, and
length of intensive care unit stay, and no significant difference in
length of hospital stay, and pneumothorax after coronary artery bypass
grafting compared with subjects without chronic obstructive pulmonary
disease. The analysis of outcomes should be with caution because of the
low sample size of 1 out of 11 studies in the meta-analysis and a low
number of studies in certain comparisons.<br/>Copyright &#xa9; 2022 The
Authors. International Wound Journal published by Medicalhelplines.com Inc
(3M) and John Wiley & Sons Ltd.

<21>
Accession Number
2020773795
Title
Mesenteric traction syndrome - Incidence, impact, and treatment: A
systematic scoping review of the literature.
Source
Anaesthesia Critical Care and Pain Medicine. 42(1) (no pagination), 2023.
Article Number: 101162. Date of Publication: February 2023.
Author
Olsen A.A.; Bazancir L.A.; Dahl S.; Fukumori D.; Shiwaku H.; Svendsen
L.B.; Achiam M.P.
Institution
(Olsen, Bazancir, Dahl, Fukumori, Svendsen, Achiam) Department of Surgery
and Transplantation, Copenhagen University Hospital, Rigshospitalet,
Copenhagen, Denmark
(Shiwaku) Department of Gastroenterological Surgery, Fukuoka University,
Faculty of Medicine, Fukuoka, Japan
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Mesenteric traction syndrome (MTS) is commonly seen during
major abdominal surgery and is characterised by facial flushing,
hypotension, and tachycardia 15 min into surgery. MTS also impacts the
postoperative course, as severe MTS has been associated with increased
postoperative morbidity. However, despite MTS being common and severe MTS
causing increased postoperative morbidity, the gaps in the literature are
not clearly defined. We aimed to examine the diagnostic criteria,
incidence, intraoperative and postoperative impact, and potential
preventative measures of MTS while highlighting potential gaps in the
literature. <br/>Method(s): We followed the Prisma guidelines and
performed a systematic literature search. We included only human studies
examining MTS. All hits were screened for title and abstract, followed by
a full-text review by at least two authors for determining eligibility for
inclusion. Data were extracted and risk of bias was assessed by two
independent reviewers. <br/>Result(s): A total of 37 studies, comprising
1102 patients were included in the review. The combined incidence of MTS
during open abdominal surgery was found to be 76%, with 35% developing
severe MTS. It was found that the development of MTS was associated with
marked haemodynamic changes. It was also found that several different
subjective diagnostic criteria exist and that severe MTS was associated
with increased postoperative morbidity. Furthermore, several preventative
measures for protecting against MTS have been examined, but only on the
incidence of MTS and not on the postoperative course. <br/>Conclusion(s):
MTS occurs in 76% of patients undergoing major abdominal surgery and is
associated with deleterious haemodynamic effects, which are more
pronounced in patients developing severe MTS. Severe MTS is also
associated with a worse postoperative outcome. However, gaps are still
present in the current literature on MTS.<br/>Copyright &#xa9; 2022 The
Author(s)

<22>
Accession Number
2022159089
Title
The Prognostic Significance of Red Cell Distribution Width in Cardiac
Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(3) (pp 471-479),
2023. Date of Publication: March 2023.
Author
Frentiu A.A.; Mao K.; Caruana C.B.; Raveendran D.; Perry L.A.; Penny-Dimri
J.C.; Ramson D.M.; Segal R.; Bellomo R.; Smith J.A.; Liu Z.
Institution
(Frentiu, Penny-Dimri, Ramson, Smith) Department of Surgery (School of
Clinical Sciences at Monash Health), Monash University, Clayton, Australia
(Mao, Raveendran, Perry, Segal, Bellomo, Liu) Department of Critical Care,
Melbourne Medical School, Faculty of Medicine, Dentistry and Health
Sciences, The University of Melbourne, Parkville, Australia
(Caruana, Bellomo) Department of Intensive Care, Austin Hospital, 145
Studley Road, Heidelberg, Victoria, Australia
(Perry, Segal, Liu) Department of Anaesthesia and Pain Management, Royal
Melbourne Hospital, Parkville, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Heidelberg,
Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Melbourne, Australia
(Bellomo) Monash University School and Public Health and Preventive
Medicine, Monash University, Clayton, Australia
(Bellomo) Data Analytics Research and Evaluation (DARE) Centre, Austin
Hospital, Heidelberg, Australia
(Smith) Department of Cardiothoracic Surgery, Monash Health, Clayton,
Australia
Publisher
W.B. Saunders
Abstract
RED CELL DISTRIBUTION WIDTH (RDW) is a routinely available biomarker of
likely erythropoietic dysfunction, which may be associated with adverse
outcomes after cardiac surgery. This systematic review and meta-analysis
aimed to clarify the prognostic value of RDW in patients undergoing
cardiac surgery. The authors searched MEDLINE, Embase, and the Cochrane
Library from inception to May 10, 2022 for studies investigating the
association between elevated RDW (as defined by the authors of included
studies) and adverse outcomes after cardiac surgery. Herein, the authors
extracted maximally adjusted hazard ratios (HRs) and odds ratios (ORs)
with associated CIs, and pooled them using random-effects inverse-
variance modeling. The authors explored interstudy heterogeneity using
metaregression. The authors included 26 studies involving 48,092 patients
who had undergone cardiac surgery. Elevated preoperative RDW was
associated with long-term mortality (pooled HR 1.63, 95% CI 1.05-2.52),
short-term mortality (pooled OR 2.16, 95% CI 1.21-3.87), acute kidney
injury (AKI; pooled OR 1.30, 95% CI 1.19-1.41) and postoperative atrial
fibrillation (POAF; pooled OR 1.44, 95% CI 1.05-1.96). Some studies
suggested a significant association between preoperative RDW elevation and
neurologic complications; however, their number was insufficient for
meta-analysis. The postoperative RDW levels were less consistently
reported and could not be meta-analyzed. In conclusion, the authors found
that elevated preoperative RDW was associated with increased short- and
long-term mortality, POAF, and AKI after cardiac surgery. Further research
is needed to investigate its role in the risk stratification of patients
undergoing cardiac surgery.<br/>Copyright &#xa9; 2022

<23>
Accession Number
2019170101
Title
Effect of Dexmedetomidine with Adjuvants (Fentanyl and Butorphanol) on
Postoperative Analgesia and Cognitive Dysfunction Following Cardiac
Surgery: A Prospective, DoubleBlinded Randomized Controlled Trial.
Source
International Journal of Pharmaceutical and Clinical Research. 14(11) (pp
138-146), 2022. Date of Publication: 2022.
Author
Mistry K.; Sharma A.; Verma A.; Patel D.; Patel K.
Institution
(Mistry, Patel, Patel) Department of Anaesthesia, Geetanjali Medical
College and Hospital, Rajasthan, Udaipur, India
(Sharma) Jaslok Hospital and Research Centre, Maharashtra, Mumbai, India
(Verma) Department of Anaesthesia, American International Institute of
Medical Sciences, Rajasthan, Udaipur, India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Background: Painafter cardiac surgery has various sites of origin and is
caused by several factors. Postoperative analgesia improves patient
satisfaction, reduces the incidence of postoperative complications and
shortens the duration of hospital stay. <br/>Objective(s): To evaluate and
compare the effect of intravenous infusion of dexmedetomidine and fentanyl
versus intravenous infusion of dexmedetomidine and butorphanol on
postoperative analgesia and postoperative cognitive dysfunction in
patients undergoing cardiac surgery. <br/>Material(s) and Method(s): This
study was conducted at tertiary care teaching hospital of Rajasthan from
February 2019 to June 2020. Patients in the two groups received
intravenous infusion of Dexmedetomidine 0.15mug/kg/h and Fentanyl
0.5mug/kg/h immediately postoperatively (Group DF) and intravenous
infusion of Dexmedetomidine 0.15mug/kg/h and Butorphanol 2 mug/kg/h
immediately postoperatively (Group DB) respectively. Both groups were
compared for demographic data, postoperative hemodynamic data, Ramsay
sedation scale, visual analogue scale (VAS) for pain and Montreal
Cognitive assessment (MoCA) for cognitive function. <br/>Result(s): There
was no statistical difference in the VAS score of the patients between the
group DB and DF at post extubation intervals of 12, 18, 24 and 48 Hours
(p>0.05) except at 4 hours and 8 hours post extubation (p<0.05). Time to
first rescue analgesic was significantly earlier for DF as compared to DB
group (p<0.05). There was no statistical significant difference found in
the mean of MoCA score between both the groups for both 1 day prior to
surgery and 24hrs Post extubation (p>0.05). Drowsiness had the highest
incidence in both the groups among all the adverse effects. There was no
significant difference in terms of adverse effects (p>0.05) except
drowsiness which was significantly higher in group DB (p<0.05).
<br/>Conclusion(s): The present study concluded that Dexmedetomidine in
combination with Butorphanol is more effective as an analgesic than
Dexmedetomidine with Fentanyl but no significant cognitive dysfunction was
found among the patients in both groups.<br/>Copyright &#xa9; 2022, Dr
Yashwant Research Labs Pvt Ltd. All rights reserved.

<24>
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.

<25>
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.

<26>
Accession Number
2022087792
Title
The Analgesic Effects of the Addition of Intravenous Ibuprofen to a
Multimodal Analgesia Regimen for Pain Management After Pediatric Cardiac
Surgery: A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(3) (pp 445-450),
2023. Date of Publication: March 2023.
Author
Abdelbaser I.; Abo-Zeid M.; Hayes S.; Taman H.I.
Institution
(Abdelbaser, Abo-Zeid, Hayes, Taman) Department of Anesthesia and Surgical
Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Publisher
W.B. Saunders
Abstract
Objective: Intravenous ibuprofen is used to control fever and pain. This
study aimed to assess the analgesic effects of the addition of intravenous
ibuprofen to a multimodal analgesia regimen for pain management after
pediatric cardiac surgery. <br/>Design(s): A randomized, controlled,
double-blinded, superiority study. <br/>Setting(s): University hospital.
<br/>Participant(s): Seventy-eight pediatric patients who underwent open
cardiac surgery using midline sternotomy incision were screened for
eligibility; 10 patients were excluded, leaving 68 patients (34 patients
in the ibuprofen group and 34 patients in the control group) for final
data analysis. <br/>Intervention(s): Patients were randomly allocated to
either the ibuprofen group, in which the patient received intravenous
ibuprofen infusion of 10 mg/kg/6 hours for 24 hours, or the control group,
in which the patient received a placebo 0.9% saline. <br/>Measurements and
Main Results: The primary endpoint was the 24-hour postoperative fentanyl
consumption, and the secondary endpoints were postoperative modified
objective pain score and the incidence of ibuprofen-related side effects
(eg, vomiting, epigastric pain, bleeding, and renal dysfunction). The mean
total fentanyl consumption (mug/kg) during the first postoperative 24
hours after extubation was significantly lower (p<0.001) in the ibuprofen
group (3.5 +/- 1.3) than the control group (5.1 +/- 1.4). The median
postoperative modified objective pain score was significantly lower (p <
0.05) in the ibuprofen group than the control group at 0 hours, 2 hours,
12 hours, 16 hours, 20 hours, and 24 hours postoperatively. Ibuprofen did
not cause significant increases in the incidences of bleeding, epigastric
pain, and vomiting. Postoperative renal dysfunction was not reported in
any patient. <br/>Conclusion(s): The addition of intravenous ibuprofen to
a multimodal analgesia regimen for pain management after pediatric cardiac
surgery improved postoperative analgesia in terms of reduction of opioid
consumption and pain scores.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<27>
Accession Number
2021903999
Title
Risk of bleeding after percutaneous coronary intervention and its impact
on further adverse events in clinical trial participants with comorbid
peripheral arterial disease.
Source
International Journal of Cardiology. 374 (pp 27-32), 2023. Date of
Publication: 01 Mar 2023.
Author
Pinxterhuis T.H.; Ploumen E.H.; Zocca P.; Doggen C.J.M.; Schotborgh C.E.;
Anthonio R.L.; Roguin A.; Danse P.W.; Benit E.; Aminian A.; Stoel M.G.;
Linssen G.C.M.; Geelkerken R.H.; von Birgelen C.
Institution
(Pinxterhuis, Ploumen, Zocca, Stoel, von Birgelen) Department of
Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede,
Netherlands
(Pinxterhuis, Ploumen, Doggen, von Birgelen) Health Technology and
Services Research, Faculty BMS, Technical Medical Centre, University of
Twente, Enschede, Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Anthonio) Department of Cardiology, Treant Zorggroep, Scheper Hospital,
Emmen, Netherlands
(Roguin) Department of Cardiology, Hillel Yaffe Medical Center, Hadera and
B. Rappaport-Faculty of Medicine, Israel, Institute of Technology, Haifa,
Israel
(Danse) Department of Cardiology, Rijnstate Hospital, Arnhem, Netherlands
(Benit) Department of Cardiology, Jessa Hospital, Hasselt, Belgium
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Charleroi, Belgium
(Linssen) Department of Cardiology, Ziekenhuisgroep Twente, and Hengelo,
Almelo, Netherlands
(Geelkerken) Department of Vascular Surgery, Medisch Spectrum Twente,
Enschede, Netherlands
(Geelkerken) Multi-modality Medical Imaging (M3I) group, Faculty of
Science and Technology, Technical Medical Centre, University of Twente,
Enschede, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background: Both patients with obstructive coronary artery disease (CAD)
and patients with peripheral arterial disease (PADs) have an increased
bleeding risk. Information is scarce on bleeding in CAD patients, treated
with percutaneous coronary intervention (PCI), who have comorbid PADs. We
assessed whether PCI patients with PADs have a higher bleeding risk than
PCI patients without PADs. Furthermore, in PCI patients with PADs we
evaluated the extent by which bleeding increased the risk of further
adverse events. <br/>Method(s): Three-year pooled patient-level data of
two randomized PCI trials (BIO-RESORT, BIONYX) with drug-eluting stents
were analyzed to assess mortality and the composite endpoint major adverse
cardiac events (MACE: all-cause mortality, any myocardial infarction,
emergent coronary artery bypass surgery, or target lesion
revascularization). <br/>Result(s): Among 5989 all-comer patients,
followed for 3 years, bleeding occurred in 7.7% (34/440) with comorbid
PADs and 5.0% (279/5549) without PADs (HR: 1.59, 95%CI: 1.11-2.23, p =
0.010). Of all PADs patients, those with a bleeding had significantly
higher rates of all-cause mortality (HR: 4.70, 95%CI: 2.37-9.33, p <
0.001) and MACE (HR: 2.39, 95%CI: 1.23-4.31, p = 0.003). Furthermore, PADs
patients with a bleeding were older (74.4 +/- 6.9 vs. 67.4 +/- 9.5, p <
0.001). After correction for age and other potential confounders, bleeding
remained independently associated with all-cause mortality (adj.HR: 2.97,
95%CI: 1.37-6.43, p = 0.006) while the relation of bleeding with MACE
became borderline non-significant (adj.HR: 1.85, 95%CI: 0.97-3.55, p =
0.06). <br/>Conclusion(s): PCI patients with PADs had a higher bleeding
risk than PCI patients without PADs. In PADs patients, bleeding was
associated with all-cause mortality, even after adjustment for potential
confounders.<br/>Copyright &#xa9; 2022 The Author(s)

<28>
Accession Number
2021562381
Title
Comparison of Postoperative Recovery between Balanced and Total
Intravenous Anesthesia in Patients Undergoing Off-Pump Coronary Artery
Bypass (OPCAB) Surgery: A Prospective, Single-Blind Randomized Study.
Source
International Journal of Environmental Research and Public Health. 20(3)
(no pagination), 2023. Article Number: 2310. Date of Publication: February
2023.
Author
Kang D.; Kim M.; Bae H.-B.; Moon S.; Kim J.
Institution
(Kang, Kim) Department of Anesthesiology and Pain Medicine, Chonnam
National University, Hwasun Hospital, Chonnam, Hwasun 58128, South Korea
(Bae, Kim) Department of Anesthesiology and Pain Medicine, Medical School,
Chonnam National University, Gwangju 61469, South Korea
(Bae, Moon, Kim) Department of Anesthesiology and Pain Medicine, Chonnam
National University Hospital, Gwangju 61469, South Korea
Publisher
MDPI
Abstract
Recovery after anesthesia has a significant impact on a patient's return
to daily life. This study was performed to compare the postoperative
quality of recovery according to the method of anesthesia administered
among patients undergoing OPCAB using the Korean version of the Quality of
Recovery-40 (QoR-40K) questionnaire. This single-blind, prospective study
(trial number: KCT0004726) was performed using a population of 102
patients undergoing OPCAB under general anesthesia. The patients were
randomly assigned to one of two groups using a computer-generated list: a
total intravenous anesthesia group (Group T) and a balanced anesthesia
group (Group B). The QoR-40K score was measured preoperatively and at 24
and 48 h after extubation. There was no significant difference in the
QoR-40K scores between the groups at 24 and 48 h after extubation. In
addition, there were no significant differences between groups with
respect to any of the five dimensions of QoR-40K at 24 and 48 h after
extubation. Finally, there were no differences in the postoperative opioid
consumption, time to extubation, or length of hospital stay. In this
study, there was no difference in the QoR-40K score at 24 h after
extubation between Groups T and B. Therefore, both methods of anesthesia
are suitable for use when performing OPCAB.<br/>Copyright &#xa9; 2023 by
the authors.

<29>
Accession Number
639794278
Title
Structural Valve Deterioration After Self-Expanding Transcatheter or
Surgical Aortic Valve Implantation in Patients at Intermediate or High
Risk.
Source
JAMA cardiology. 8(2) (pp 111-119), 2023. Date of Publication: 01 Feb
2023.
Author
O'Hair D.; Yakubov S.J.; Grubb K.J.; Oh J.K.; Ito S.; Deeb G.M.; Van
Mieghem N.M.; Adams D.H.; Bajwa T.; Kleiman N.S.; Chetcuti S.; Sondergaard
L.; Gada H.; Mumtaz M.; Heiser J.; Merhi W.M.; Petrossian G.; Robinson N.;
Tang G.H.L.; Rovin J.D.; Little S.H.; Jain R.; Verdoliva S.; Hanson T.; Li
S.; Popma J.J.; Reardon M.J.
Institution
(O'Hair) Cardiovascular Service Line, Boulder Community Health, Boulder,
CO, United States
(Yakubov) Department of Interventional Cardiology, Ohio Health Riverside
Methodist Hospital, Columbus, United States
(Grubb) Division of Cardiothoracic Surgery, Emory University School of
Medicine, Atlanta, Georgia
(Oh, Ito) Echocardiography Core Laboratory, Mayo Clinic, Rochester, MN,
United States
(Deeb, Chetcuti) Department of Interventional Cardiology, University of
Michigan Hospitals, Ann Arbor, United States
(Deeb, Chetcuti) Department of Cardiac Surgery, University of Michigan
Hospitals, Ann Arbor, United States
(Van Mieghem) Department of Interventional Cardiology, Erasmus University
Medical Center, Rotterdam, Netherlands
(Adams, Tang) Department of Cardiovascular Surgery, Mount Sinai Health
System, NY, United States
(Bajwa) Department of Cardiothoracic Surgery, Aurora St. Luke's Medical
Center, Milwaukee, WI, United States
(Kleiman, Little, Reardon) Department of Cardiology, Houston Methodist
DeBakey Heart and Vascular Center, Houston, TX, United States
(Kleiman, Little, Reardon) Department of Cardiothoracic Surgery, Houston
Methodist DeBakey Heart and Vascular Center, Houston, TX, United States
(Sondergaard) Department of Cardiology, Rigshospitalet, Copenhagen
University Hospital, Copenhagen, Denmark
(Gada, Mumtaz) Department of Interventional Cardiology, University of
Pittsburgh Medical Center Pinnacle Health, Harrisburg, PA, United States
(Gada, Mumtaz) Department of Cardiothoracic Surgery, University of
Pittsburgh Medical Center Pinnacle Health, Harrisburg, PA, United States
(Heiser, Merhi) Department of Interventional Cardiology, Spectrum Health,
Grand Rapids, MI, United States
(Heiser, Merhi) Department of Cardiothoracic Surgery, Spectrum Health,
Grand Rapids, MI, United States
(Petrossian, Robinson) Department of Cardiothoracic and Vascular Surgery,
Saint Francis Hospital, Roslyn, NY, United States
(Rovin) Center for Advanced Valve and Structural Heart Care, Morton Plant
Hospital, Clearwater, FL, Puerto Rico
(Jain) Aurora Cardiovascular Services, Aurora-St. Luke's Medical Center,
Milwaukee, WI, United States
(Verdoliva, Hanson, Li, Popma) Structural Heart and Aortic, Medtronic,
Minneapolis, MN, United States
Publisher
NLM (Medline)
Abstract
Importance: The frequency and clinical importance of structural valve
deterioration (SVD) in patients undergoing self-expanding transcatheter
aortic valve implantation (TAVI) or surgery is poorly understood.
<br/>Objective(s): To evaluate the 5-year incidence, clinical outcomes,
and predictors of hemodynamic SVD in patients undergoing self-expanding
TAVI or surgery. <br/>Design, Setting, and Participant(s): This post hoc
analysis pooled data from the CoreValve US High Risk Pivotal (n=615) and
SURTAVI (n=1484) randomized clinical trials (RCTs); it was supplemented by
the CoreValve Extreme Risk Pivotal trial (n=485) and CoreValve Continued
Access Study (n=2178). Patients with severe aortic valve stenosis deemed
to be at intermediate or increased risk of 30-day surgical mortality were
included. Data were collected from December 2010 to June 2016, and data
were analyzed from December 2021 to October 2022. <br/>Intervention(s):
Patients were randomized to self-expanding TAVI or surgery in the RCTs or
underwent self-expanding TAVI for clinical indications in the
nonrandomized studies. <br/>Main Outcomes and Measures: The primary end
point was the incidence of SVD through 5 years (from the RCTs). Factors
associated with SVD and its association with clinical outcomes were
evaluated for the pooled RCT and non-RCT population. SVD was defined as
(1) an increase in mean gradient of 10 mm Hg or greater from discharge or
at 30 days to last echocardiography with a final mean gradient of 20 mm Hg
or greater or (2) new-onset moderate or severe intraprosthetic aortic
regurgitation or an increase of 1 grade or more. <br/>Result(s): Of 4762
included patients, 2605 (54.7%) were male, and the mean (SD) age was 82.1
(7.4) years. A total of 2099 RCT patients, including 1128 who received
TAVI and 971 who received surgery, and 2663 non-RCT patients who received
TAVI were included. The cumulative incidence of SVD treating death as a
competing risk was lower in patients undergoing TAVI than surgery (TAVI,
2.20%; surgery, 4.38%; hazard ratio [HR], 0.46; 95% CI, 0.27-0.78;
P=.004). This lower risk was most pronounced in patients with smaller
annuli (23 mm diameter or smaller; TAVI, 1.32%; surgery, 5.84%; HR, 0.21;
95% CI, 0.06-0.73; P=.02). SVD was associated with increased 5-year
all-cause mortality (HR, 2.03; 95% CI, 1.46-2.82; P<.001), cardiovascular
mortality (HR, 1.86; 95% CI, 1.20-2.90; P=.006), and valve disease or
worsening heart failure hospitalizations (HR, 2.17; 95% CI, 1.23-3.84;
P=.008). Predictors of SVD were developed from multivariate analysis.
<br/>Conclusions and Relevance: This study found a lower rate of SVD in
patients undergoing self-expanding TAVI vs surgery at 5 years. Doppler
echocardiography was a valuable tool to detect SVD, which was associated
with worse clinical outcomes. Trial Registration: ClinicalTrials.gov
Identifiers: NCT01240902, NCT01586910, and NCT01531374.

<30>
Accession Number
2020594672
Title
Effect of bilateral ultrasound-guided erector spinae plane block on
postoperative pain after open lumbar spinal surgery: a double-blind,
randomized controlled trial.
Source
European Spine Journal. 32(2) (pp 420-427), 2023. Date of Publication:
February 2023.
Author
Wittayapairoj A.; Wittayapairoj K.; Vechvitvarakul M.
Institution
(Wittayapairoj, Vechvitvarakul) Department of Anesthesiology, Faculty of
Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
(Wittayapairoj) Department of Orthopedics, Faculty of Medicine, Khon Kaen
University, 123 Mittraparp Highway, Muang District, Khon Kaen 40002,
Thailand
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: The peripheral nerve blocks (PNB) are an important part of the
multimodal analgesia for reducing postoperative pain, opioids consumption
and its side effects. A new PNB, Erector spinae plane block (ESPB), has
been revealed postoperative analgesic effect in various surgical
procedures such as breast, thoracic and abdominal surgery, with the
limitation of the studies for spine surgery. We aimed to evaluate the
analgesic effect of ultrasound-guided bilateral erector spinae plane block
(ESPB) after open lumbar spinal surgery. <br/>Method(s): A double-blind,
randomized controlled trial was conducted. Sixty-two patients undergoing
posterior lumbar spinal surgery were randomly allocated into two groups.
The ESPB group (n = 31) received ultrasound (US)-guided bilateral ESPB
using 20 ml of 0.375% bupivacaine with adrenaline 5 mcg/ml per side. The
control group (n = 31) received no intervention. The same postoperative
analgesia regimen was applied by oral acetaminophen 10-15 mg/kg every 6 h,
naproxen 250 mg twice daily, and intravenous (IV) morphine via
patient-controlled analgesia (PCA) device. The postoperative morphine
consumption, numerical pain score (NRS) and the side effects were
recorded. <br/>Result(s): The bilateral ESPB group reduced the 24
h-morphine consumption by 42.9% (P < 0.001), decreased overall pain score
at rest by 1.4 points (P = 0.02), and decreased overall pain score on
movement by 2.2 points (P < 0.001). No severe complications related to the
block technique or morphine used occurred. <br/>Conclusion(s): The
US-guided bilateral ESPB demonstrated the effectiveness for postoperative
analgesia management after open lumbar spinal surgery regarding reduced
opioid consumption and pain score without any serious
complications.<br/>Copyright &#xa9; 2022, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature.

<31>
Accession Number
2022575514
Title
Subclinical Leaflet Thrombosis After Balloon versus Self-Expandable
Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. 192 (pp 88-97), 2023. Date of Publication:
01 Apr 2023.
Author
Bansal A.; Agarwal S.; Braghieri L.; Jaggi C.; Bakhtadze B.; Prasada S.;
Reed G.W.; Puri R.; Yun J.; Menon V.; Krishnaswamy A.; Kapadia S.R.
Institution
(Bansal, Braghieri, Jaggi, Bakhtadze, Prasada, Reed, Puri, Yun, Menon,
Krishnaswamy, Kapadia) Department of Cardiovascular Medicine, Heart and
Vascular Institute, Cleveland Clinic, Cleveland, OH, United States
(Agarwal) Department of Internal Medicine, University of Oklahoma,
Oklahoma City, OK, United States
Publisher
Elsevier Inc.
Abstract
Hypoattenuated leaflet thickening (HALT) has been recognized as one of the
complications after transcatheter aortic valve implantation and may
promote structural valve degeneration and increase the risk of
cerebrovascular events. The 2 main types of available transcatheter heart
valves (THVs), the balloon-expandable (BE) and the self-expanding (SE),
are interchangeably used in clinical practice despite substantial design
differences. There is unclear evidence on whether these 2 different THV
models are achieving similar or different rates of subclinical leaflet
thrombosis/HALT. A systematic search of electronic databases was conducted
to identify studies that reported the incidence of HALT between SE THVs
and BE THVs. The Mantel-Haenszel method was used to calculate the 95%
confidence interval and pooled risk ratio with a random-effects model. A
total of 126 records were identified, of which 22 studies comprising
14,401 patients were included in our final analysis. Among 5,951 patients
receiving SE THVs, 194 (3.2%) developed HALT, compared with 8,450 patients
receiving BE THVs, of whom 484 (5.7%) developed HALT. There was a
statistically significant decrease in the risk of developing HALT in
patients receiving SE THVs compared with those receiving BE THVs (risk
ratio 0.75, 95% confidence interval 0.59 to 0.95, I² 32%, p =
0.02). In conclusion, could potentially reduce the risk of
HALT/subclinical leaflet thrombosis.<br/>Copyright &#xa9; 2023 Elsevier
Inc.

<32>
Accession Number
2022623227
Title
Atrial Fibrillation After mRNA-1273 SARS-CoV-2 Vaccination: Case Report
with Literature Review.
Source
Risk Management and Healthcare Policy. 16 (pp 209-214), 2023. Date of
Publication: 2023.
Author
Chen C.-Y.; Hsieh M.-T.; Wei C.-T.; Lin C.-W.
Institution
(Chen, Hsieh, Wei, Lin) Department of Family Medicine and Community
Medicine, E-Da Hospital, Kaohsiung City, Taiwan (Republic of China)
(Hsieh) Department of Nursing, College of Medicine, I-Shou University,
Kaohsiung City, Taiwan (Republic of China)
(Lin) School of Medicine for International Students, College of Medicine,
I-Shou University, Kaohsiung City, Taiwan (Republic of China)
Publisher
Dove Medical Press Ltd
Abstract
Importance: COVID-19 vaccination has been associated with various adverse
outcomes. Although studies have reported cases of arrhythmia after
COVID-19 vaccination, the precise underlying mechanism remains to be
elucidated. <br/>Objective(s): Here, we report the case of a patient who
developed atrial fibrillation after receiving the mRNA-1273 vaccine and
describe our findings in light of relevant cases in the literature.
<br/>Design, Setting, and Participant(s): This is a case report and a
review of the relevant literature. A 55-year-old woman presented to our
clinic with a history of paroxysmal atrial fibrillation, hypertension, and
mild mitral valve prolapse. The patient developed atrial fibrillation 3
days after receiving a COVID-19 vaccine. She was diagnosed with
moderate-to-severe tricuspid regurgitation and severe mitral
regurgitation, and underwent valve repair surgery. To obtain relevant
articles (December 2020 through August 2022), we searched the following
key words on PubMed: atrial fibrillation and COVID-19 vaccination.
<br/>Result(s): A total of 5 relevant case reports were identified.
COVID-19 vaccination led to arrhythmia, including atrial fibrillation,
within 14 days. <br/>Conclusions and Relevance: Cases of patients
developing arrhythmia after COVID-19 vaccination have been increasingly
reported. Although the underlying mechanism remains unclear, we
hypothesize that mRNA vaccination may lead to arrhythmia and associated
valve diseases. Thus, before administering mRNA-1273 vaccines to patients
with a history of valvular heart disease or atrial fibrillation, the
patients' cardiologists must be consulted.<br/>Copyright &#xa9; 2023 Chen
et al.

<33>
Accession Number
2022608974
Title
Study Level Meta-Analysis of Transcatheter Aortic Valve Implantation With
the ACURATE neo Self-Expanding Transcatheter Heart Valve.
Source
Cardiology in Review. 31(2) (pp 108-114), 2023. Date of Publication: 01
Mar 2023.
Author
Koliastasis L.; Doundoulakis I.; Kokkinidis D.G.; Milkas A.; Kostopoulos
G.; Drakopoulou M.; Latsios G.; Synetos A.; Benetos G.; Lampropoulos K.;
Economou F.; Tsioufis K.; Toutouzas K.
Institution
(Koliastasis, Doundoulakis, Drakopoulou, Latsios, Synetos, Benetos,
Tsioufis, Toutouzas) First Department of Cardiology, National and
Kapodistrian University, "hippokration" Hospital, Athens, Greece
(Koliastasis, Milkas) Athens Naval and Veterans Hospital, Athens, Greece
(Doundoulakis, Economou) Department of Cardiology, 424 General Military
Training Hospital, Thessaloniki, Greece
(Kokkinidis) Section of Cardiovascular Medicine, Yale University School of
Medicine, Yale New Haven Hospital, New Haven, CT, United States
(Kostopoulos) Department of Endocrinology, 424 General Military Training
Hospital, Thessaloniki, Greece
(Lampropoulos) Department of Cardiology, Evangelismos General Hospital,
Athens, Greece
Publisher
Lippincott Williams and Wilkins
Abstract
The ACURATE neo transcatheter aortic valve is a self-expanding device.
Several studies have investigated safety and efficacy, but meta-analysis
and pooled data are lacking. We aimed to provide a comprehensive
systematic review and meta-analysis on the clinical outcomes of
transcatheter aortic valve implantation with the ACURATE neo valve. A
systematic literature search for eligible records was conducted. The
primary endpoint was device success as designated by Valve Academic
Research Consortium-2 criteria. The secondary endpoints (time frame: 30
days) were all-cause mortality, stroke, myocardial infarction, need for
new permanent pacemaker, major vascular complications, major bleeding,
acute kidney injury stage II or III, and paravalvular regurgitation grade
moderate or severe (II or III). Our search yielded a total of 355 records,
20 of those (n = 5858 ACURATE neo receivers) were included in our
meta-analysis. Device success was achieved in 94.5% (95% confidence
interval [CI], 91.4-96.5%) of the patients. The 30-day all-cause mortality
incidence proportion was 1.8% (95% CI, 1.3-2.4%). New pacemaker
implantation was required in 7.7% (95% CI, 6.4-9.2%) of the patients,
stroke occurred in 1.9% (95% CI, 1.6-2.3%), myocardial infarction in 0.5%
(95% CI, 0.3-0.7%), major bleeding in 5.0% (95% CI, 3.9-6.5%), major
vascular complication in 5.6% (95% CI, 4.0-7.8%), acute kidney injury
stage >=2 in 2.5% (95% CI, 1.8-3.4%), and paravalvular leak grade
>=moderate was observed in 4.3% (95% CI, 3.0-6.2%). Balloon predilatation
and postdilatation incidence was 93.9% (95% CI, 87.0-97.3%) and 43.2% (95%
CI, 37.9-48.6%), respectively. ACURATE neo appears to be safe and
effective in our analysis with high device success incidence, low
mortality, and low new pacemaker implantations.<br/>Copyright &#xa9; 2022
Wolters Kluwer Health, Inc. All rights reserved.

<34>
Accession Number
2022608972
Title
Infective Endocarditis After Transcatheter Aortic Valve Implantation: A
Systematic Review.
Source
Cardiology in Review. 31(2) (pp 93-98), 2023. Date of Publication: 01 Mar
2023.
Author
Hassanin A.; Afify H.; Zook S.; Frishman W.H.; Aronow W.S.
Institution
(Hassanin, Aronow) Department of Cardiology, Westchester Medical Center,
New York Medical College, Valhalla, NY, United States
(Afify) Department of Internal Medicine, University of Central Florida
College of Medicine, Orlando, FL, United States
(Zook) Division of Cardiovascular Medicine, Department of Medicine,
University of Louisville School of Medicine, Louisville, KY, United States
(Frishman) Houston Methodist DeBakey Heart & Vascular Center, Houston, TX,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Infective endocarditis (IE) after transcatheter aortic valve implantation
(TAVI) is a rare but potentially fatal event. In this systematic review,
we searched PubMed and Embase for large TAVI studies and registries to
identify the incidence, presentation, microbiology, risk factors, and
outcomes of IE in this population. After application of the selection
criteria and quality assessment, 8 studies representing 255,310 TAVR cases
and 4218 cases of IE qualified for this review. IE following TAVI is
uncommon with an incidence of 0.87 to 1.7 events per 100 person-years.
Most events occur in the first year following valve implantation.
Staphylococcus, Enterococcus, and Streptococcus species are the most
common pathogens. Risk factors include age, sex, concomitant
comorbidities, and procedural factors. Outcomes are dismal, and surgical
intervention is rare in this population.<br/>Copyright &#xa9; 2022 Wolters
Kluwer Health, Inc. All rights reserved.

<35>
Accession Number
2022518161
Title
Impact of Periprocedural Adverse Events After PCI and CABG on 5-Year
Mortality: The EXCEL Trial.
Source
JACC: Cardiovascular Interventions. 16(3) (pp 303-313), 2023. Date of
Publication: 13 Feb 2023.
Author
Jain S.S.; Li D.; Dressler O.; Kotinkaduwa L.; Serruys P.W.; Kappetein
A.P.; Sabik J.F.; Morice M.-C.; Puskas J.; Kandzari D.E.; Karmpaliotis D.;
Lembo N.J.; Brown W.M.; Banning A.P.; Stone G.W.
Institution
(Jain) Division of Cardiovascular Medicine, Stanford University, Palo
Alto, CA, United States
(Li, Dressler, Kotinkaduwa, Karmpaliotis, Lembo) Cardiovascular Research
Foundation, New York, NY, United States
(Serruys) International Centre for Circulatory Health, National Heart and
Lung Institute, Imperial College London, London, United Kingdom
(Kappetein) Erasmus Medical Center, Rotterdam, Netherlands
(Sabik) University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
(Morice) Hopital Prive Jacques Cartier, Ramsay Generale de Sante, Massy,
France
(Puskas) Mount Sinai Heart at Mount Sinai Saint Luke's, New York, NY,
United States
(Kandzari, Brown) Piedmont Heart Institute, Atlanta, GA, United States
(Karmpaliotis, Lembo) NewYork-Presbyterian Hospital and Columbia
University Medical Center, New York, NY, United States
(Banning) John Radckiffe, Oxford University Hospitals, Oxford, United
Kingdom
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The relative risks for different periprocedural major adverse
events (MAE) after percutaneous coronary intervention (PCI) and coronary
artery bypass grafting (CABG) on subsequent mortality have not been
described. <br/>Objective(s): The aim of this study was to assess the
association between periprocedural MAE occurring within 30 days
postprocedure and early and late mortality after left main coronary artery
revascularization by PCI and CABG. <br/>Method(s): In the EXCEL
(Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for
Effectiveness of Left Main Revascularization) trial, patients with left
main disease were randomized to PCI vs CABG. The associations between 12
prespecified nonfatal MAE and subsequent 5-year all-cause and
cardiovascular death in 1,858 patients were examined using logistic
regression. <br/>Result(s): One or more nonfatal MAE occurred in 111 of
935 patients (11.9%) after PCI and 419 of 923 patients (45.4%) after CABG
(P < 0.0001). Patients with MAE were older and had more baseline
comorbidities. Within 5 years, all-cause death occurred in 117 and 87
patients after PCI and CABG, respectively. Experiencing an MAE was a
strong independent predictor of 5-year mortality after both PCI (adjusted
OR: 4.61; 95% CI: 2.71-7.82) and CABG (adjusted OR: 3.25; 95% CI:
1.95-5.41). These associations were present within the first 30 days and
between 30 days and 5 years postprocedure. Major or minor bleeding with
blood transfusion >=2 U was an independent predictor of 5-year mortality
after both procedures. Stroke, unplanned revascularization for ischemia,
and renal failure were significantly associated with mortality only after
CABG. <br/>Conclusion(s): In the EXCEL trial, nonfatal periprocedural MAE
were strongly associated with early and late mortality after both PCI and
CABG for left main disease.<br/>Copyright &#xa9; 2023 American College of
Cardiology Foundation

<36>
Accession Number
2022448834
Title
Combined Minimally Invasive Surgical and Percutaneous Catheter Ablation of
Atrial Fibrillation: JACC Review Topic of the Week.
Source
Journal of the American College of Cardiology. 81(6) (pp 606-619), 2023.
Date of Publication: 14 Feb 2023.
Author
Bisleri G.; Pandey A.K.; Verma S.; Ali Hassan S.M.; Yanagawa B.; Khandaker
M.; Gaudino M.; Russo A.M.; Verma A.; Bhatt D.L.; Ha A.C.T.
Institution
(Bisleri, Verma, Ali Hassan, Yanagawa, Ha) University of Toronto, Toronto,
ON, Canada
(Bisleri, Verma, Yanagawa) St Michael's Hospital, Unity Health Toronto,
Toronto, ON, Canada
(Pandey) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Khandaker) William Osler Health System, Brampton, ON, Canada
(Gaudino) Department of Cardiothoracic Surgery, Cornell Medicine, New
York, NY, United States
(Russo) Cooper Medical School at Rowan University, Camden, NJ, United
States
(Verma) Division of Cardiology, McGill University, Montreal, QC, Canada
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health
System, New York, NY, United States
(Ha) Peter Munk Cardiac Centre, Toronto General Hospital, University
Health Network, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Hybrid ablation is a novel therapy in the invasive management of patients
with atrial fibrillation (AF) which combines minimally invasive surgical
and percutaneous catheter-based techniques. The evidence is mainly based
on observational studies from experienced centers, with success rates of
approximately 70% and risks that are 2.0-fold to 3.6-fold higher than
catheter-based ablation. Hybrid ablation is offered typically to patients
with persistent or longstanding persistent AF which, by design, requires 2
procedures (epicardial surgical and endocardial catheter-based ablation).
One randomized trial demonstrated that hybrid ablation was more effective
than catheter-based ablation, but with higher complication rates. The
incidence of the most serious complications has decreased in contemporary
studies of hybrid ablation. At present, hybrid ablation should be
performed by experienced centers on selected patients with persistent or
longstanding persistent AF. Additional randomized trials are needed to
define the risks, benefits, and cost effectiveness of hybrid ablation to
identify its most appropriate application in clinical
practice.<br/>Copyright &#xa9; 2023

<37>
Accession Number
2021359268
Title
The low-dose colchicine in patients after non-CABG cardiac surgery: a
randomized controlled trial.
Source
Critical Care. 27(1) (no pagination), 2023. Article Number: 49. Date of
Publication: December 2023.
Author
Pan T.; Jiang C.-Y.; Zhang H.; Han X.-K.; Zhang H.-T.; Jiang X.-Y.; Chen
W.; Wang K.; Fan F.-D.; Pan J.; Zhou Q.; Wang C.-S.; Zhang L.; Wang D.-J.
Institution
(Pan, Zhang, Zhang, Jiang, Wang) Department of Cardio-Thoracic Surgery,
Nanjing Drum Tower Hospital, Peking Union Medical College and Chinese
Academy of Medical Sciences, Graduate School of Peking Union Medical
College, Number 321 Zhongshan Road, Jiangsu, Nanjing 210008, China
(Pan, Fan, Pan, Zhou, Wang) Department of Cardio-Thoracic Surgery, Nanjing
Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical
School, Nanjing, China
(Jiang) Department of Cardio-Thoracic Surgery, Shanghai Children's Medical
Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
(Han) Department of Epidemiology, Harvard University T H Chan School of
Public Health, Boston, MA, United States
(Han) Program in Genetic Epidemiology and Statistical Genetics, Harvard
University T H Chan School of Public Health, Boston, MA, United States
(Chen, Wang) Department of Cardio-Thoracic Surgery, Nanjing Drum Tower
Hospital, Nanjing Medical University, Nanjing, China
(Wang, Wang) Department of Cardio-Thoracic Surgery, Nanjing Drum Tower
Hospital, The Affiliated Clinical College of Xuzhou Medical University,
Nanjing, China
(Wang) Medical Research and Biometrics Center, National Center for
Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical
Sciences and Peking Union Medical College, Mentougou District, Beijing
102300, China
(Zhang) Hongqiao International Institute of Medicine, Tongren Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
Publisher
BioMed Central Ltd
Abstract
Background: Recent high-quality trials have shown that the
anti-inflammatory effects of colchicine reduce the risk of cardiovascular
events in patients suffering post-myocardial infarction and chronic
coronary disease. The effect of colchicine in patients undergoing
non-coronary artery bypass grafting (non-CABG) with cardiopulmonary bypass
remains unclear. We aim to evaluate the effect of colchicine on myocardial
protection in patients who underwent non-CABG cardiac surgery.
<br/>Method(s): Patients were randomly assigned to colchicine or placebo
groups starting 72 h before scheduled cardiac surgery and for 5 days
thereafter (0.5 mg daily).The primary outcome was the level of cardiac
troponin T (cTnT) at postoperative 48 h. The secondary outcomes included
troponin I (cTnI) and creatine kinase-MB (CK-MB), inflammatory biomarkers
(procalcitonin and interleukin-6, etc.), and adverse events (30-day
mortality, stroke, ECMO and IABP use, etc.). <br/>Result(s): A total of
132 patients underwent non-CAGB cardiac surgery, 11were excluded because
of diarrhea (n = 6) and long aortic cross-clamp time > 2 h (n = 5), 59
were assigned to the colchicine group and 62 to the placebo group.
Compared with the placebo group, cTnT (median: 0.3 mug/L, IQR 0.2-0.4
mug/L vs. median: 0.4 mug/L, IQR 0.3-0.6 mug/L, P < 0.01), cardiac
troponin I (median: 0.9 ng/ml, IQR 0.4-1.7 ng/ml vs. median: 1.3 ng/ml,
IQR 0.6-2.3 ng/ml, P = 0.02), CK-MB (median: 1.9 ng/ml, IQR 0.7-3.2 ng/ml
vs. median: 4.4 ng/ml, IQR 1.5-8.2 ng/ml, P < 0.01), and interleukin-6
(median: 73.5 pg/ml, IQR 49.6-125.8 pg/ml vs. median: 101 pg/ml, IQR
57.5-164.7 pg/ml, P = 0.048) were significantly reduced in colchicine
group at postoperative 48 h. For safety evaluation, the colchicine (n =
65) significantly decreased post-pericardiotomy syndrome (3.08% vs. 17.7%,
P < 0.01) and increased the rate of diarrhea (9.23% vs. 0, P = 0.01)
compared with the placebo group (n = 62). No significant difference was
observed in other adverse events between the two groups.
<br/>Conclusion(s): A short perioperative course of low-dose colchicine
was effective to attenuate the postoperative biomarkers of myocardial
injury and inflammation, and to decrease the postoperative syndrome
compared with the placebo. Trial registration ChiCTR2000040129. Registered
22nd Nov. 2020. This trial was registered before the first participant was
enrolled. http://www.chictr.org.cn/showproj.aspx?proj=64370.<br/>Copyright
&#xa9; 2023, The Author(s).

<38>
Accession Number
2020664617
Title
Dexmedetomidine for adult cardiac surgery: a systematic review,
meta-analysis and trial sequential analysis.
Source
Anaesthesia. 78(3) (pp 371-380), 2023. Date of Publication: March 2023.
Author
Poon W.H.; Ling R.R.; Yang I.X.; Luo H.; Kofidis T.; MacLaren G.; Tham C.;
Teoh K.L.K.; Ramanathan K.
Institution
(Poon, Ling, Yang) Yong Loo Lin School of Medicine, National University of
Singapore, Singapore
(Luo, Kofidis, MacLaren, Teoh, Ramanathan) Department of Cardiac, Thoracic
and Vascular Surgery, National University Hospital, Singapore
(Tham) Department of Anesthesiology, National University Hospital,
Singapore
Publisher
John Wiley and Sons Inc
Abstract
The effects of dexmedetomidine in adults undergoing cardiac surgery are
inconsistent. We conducted a systematic review and meta-analysis to
analyse the effects of peri-operative dexmedetomidine in adults undergoing
cardiac surgery. We searched MEDLINE via Pubmed, EMBASE, Scopus and
Cochrane for relevant randomised controlled trials between 1 January 1990
and 1 March 2022. We used the Joanna Briggs Institute methodology
checklist to assess study quality and the GRADE approach to certainty of
evidence. We assessed the sensitivity of results to false data. We used
random-effects meta-analyses to analyse the primary outcomes: durations of
intensive care and tracheal intubation. We included 48 trials of 6273
participants. Dexmedetomidine reduced the mean (95%CI) duration of
intensive care by 5.0 (2.2-7.7) h, p = 0.001, and tracheal intubation by
1.6 (0.6-2.7) h, p = 0.003. The relative risk (95%CI) for postoperative
delirium was 0.58 (0.43-0.78), p = 0.001; 0.76 (0.61-0.95) for atrial
fibrillation, p = 0.015; and 0.49 (0.25-0.97) for short-term mortality, p
= 0.041. Bradycardia and hypotension were not significantly affected.
Trial sequential analysis was consistent with the primary meta-analysis.
Adjustments for possible false data reduced the mean (95%CI) reduction in
duration of intensive care and tracheal intubation by dexmedetomidine to
3.6 (1.8-5.4) h and 0.8 (0.2-1.4) h, respectively. Binary adjustment for
methodological quality at a Joanna Briggs Institute score threshold of 10
did not alter the results significantly. In summary, peri-operative
dexmedetomidine reduced the durations of intensive care and tracheal
intubation and the incidence of short-term mortality after adult cardiac
surgery. The reductions in intensive care stay and tracheal intubation may
or may not be considered clinically useful, particularly after adjustment
for possible false data.<br/>Copyright &#xa9; 2022 Association of
Anaesthetists.

<39>
Accession Number
2020084872
Title
Individual Patient Data Meta-analysis of Drug-eluting Versus Bare-metal
Stents for Percutaneous Coronary Intervention in Chronic Versus Acute
Coronary Syndromes.
Source
American Journal of Cardiology. 182 (pp 8-16), 2022. Date of Publication:
01 Nov 2022.
Author
Piccolo R.; Bonaa K.H.; Efthimiou O.; Varenne O.; Baldo A.; Urban P.;
Kaiser C.; de Belder A.; Lemos P.A.; Wilsgaard T.; Reifart J.; Ribeiro
E.E.; Serruys P.W.; Byrne R.A.; de la Torre Hernandez J.M.; Esposito G.;
Wijns W.; Juni P.; Windecker S.; Valgimigli M.
Institution
(Piccolo, Esposito) Department of Advanced Biomedical Sciences, University
of Naples Federico II, Naples, Italy
(Bonaa, Wilsgaard) Department of Community Medicine, University of Tromso,
The Arctic University of Norway, Tromso, Norway
(Efthimiou) Institute of Social and Preventive Medicine, University of
Bern, Bern, Switzerland
(Varenne) Department of Cardiology, Hopital Cochin, AP-HP, Paris, France
(Varenne, Valgimigli) Universite Paris Descartes, Faculte de Medecine,
Paris, France
(Baldo, Windecker) Department of Cardiology, Bern University Hospital,
University of Bern, Bern, Switzerland
(Urban) Hopital de la Tour, Geneva, Switzerland
(Kaiser) Department of Cardiology, University Hospital Basel, University
of Basel, Basel, Switzerland
(de Belder) Department of Cardiology, Sussex Cardiac Centre, Brighton and
Sussex University Hospitals, Brighton, United Kingdom
(Lemos) Heart Institute (InCor), University of Sao Paulo Medical School,
Brazil and Hospital Israelita Albert Einstein, Sao Paulo, Brazil
(Reifart) Department of Cardiology, Kerckhoff Klinik, Bad Nauheim, Germany
(Ribeiro) Instituto do Coracao (INCOR), Sao Paulo, Brazil
(Serruys) International Centre for Circulatory Health, National Heart and
Lung Institute, Imperial College, LondonLondon, United Kingdom
(Byrne) Cardiology Department, Cardiovascular Institute (ICCV), Deutsches
Herzzentrum Munchen, Technische Universitat Munchen and DZHK (German
Centre for Cardiovascular Research), partner site Munich Heart Alliance,
both Munich, Germany
(de la Torre Hernandez) Hospital Marques de Valdecilla, Santander, Spain
(Wijns) The Lambe Institute for Translational Medicine and Curam, National
University of Ireland Galway, Ireland
(Juni) Applied Health Research Centre of the Li Ka Shing Knowledge
Institute, Department of Medicine, St Michael's Hospital, University of
Toronto, Toronto, ON, Canada
(Valgimigli) Instituto Cardiocentro Ticino, Lugano, Switzerland
Publisher
Elsevier Inc.
Abstract
New-generation drug-eluting stents (DES) strongly reduce restenosis and
repeat revascularization compared with bare-metal stents (BMS) for
percutaneous coronary intervention. There is residual uncertainty as to
whether other prognostically relevant outcomes are affected by DES versus
BMS concerning initial presentation (chronic coronary syndrome [CCS] vs
acute coronary syndrome [ACS]). We performed an individual patient data
meta-analysis of randomized trials comparing new-generation DES versus BMS
(CRD42017060520). The primary outcome was the composite of cardiac death
or myocardial infarction (MI). Outcomes were examined at maximum follow-up
and with a 1-year landmark. Risk estimates are expressed as hazard ratio
(HR) with 95% confidence interval (CI). A total of 22,319 patients were
included across 14 trials; 7,691 patients (34.5%) with CCS and 14,628
patients (65.5%) with ACS. We found evidence that new-generation DES
versus BMS consistently reduced the risk of cardiac death or MI in both
patients with CCS (HR 0.83, 95% CI 0.70 to 0.98, p <0.001) and ACS (HR
0.83, 95% CI 0.75 to 0.92, p <0.001) (p-interaction = 0.931). This benefit
was mainly driven by a similar reduction in the risk of MI (p-interaction
= 0.898) for both subsets (HR<inf>CCS</inf> 0.80, 95% CI 0.65 to 0.97;
HR<inf>ACS</inf> 0.79, 95% CI 0.70 to 0.89). In CCS and ACS, we found a
time-dependent treatment effect, with the benefit from DES accumulating
during 1-year follow-up, without offsetting effects after that. In
conclusion, patients with CCS were slightly underrepresented in
comparative clinical trials. Still, they benefited similarly to patients
with ACS from new-generation DES instead of BMS with a sustained reduction
of cardiac death or MI because of lower event rates within 1
year.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<40>
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.

<41>
Accession Number
2015603123
Title
Phase angle of bioimpedance at 50 kHz is associated with cardiovascular
diseases: systematic review and meta-analysis.
Source
European Journal of Clinical Nutrition. 76(10) (pp 1366-1373), 2022. Date
of Publication: October 2022.
Author
de Borba E.L.; Ceolin J.; Ziegelmann P.K.; Bodanese L.C.; Goncalves M.R.;
Canon-Montanez W.; Mattiello R.
Institution
(de Borba, Ceolin, Bodanese, Mattiello) Pontificia Universidade Catolica
do Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
(Ziegelmann) Statistics, Universidade Federal do Rio Grande do Sul, UFRGS,
Porto Alegre, Brazil
(Goncalves) Universidade Federal do Rio Grande do Sul, UFRGS, Porto
Alegre, Brazil
(Canon-Montanez) Faculty of Nursing, Universidad de Antioquia, Medellin,
Colombia
Publisher
Springer Nature
Abstract
The phase angle of bioimpedance is an important prognostic tool in
clinical practice. The aim of this study was to investigate the
association between phase angle and cardiovascular diseases. Electronic
searches were carried out on MEDLINE, EMBASE, Cochrane, SCIELO, LILACS,
CINAHL, Scopus, and the Web of Science. The PECO was "P" adults over 18
years of age, "E" the presence of cardiovascular disease, "C" absence of
cardiovascular disease, and "O" phase angle values. The phase-angle means
difference (MD) was analyzed separately by sex. Subgroup metanalysis with
age, body mass index, and heart failure disease and meta-regressions were
analyzed with random-effects models. Sensitivity analysis was performed
considering only studies with high quality. The heterogeneity among
studies was assessed using the Q-Cochran test and I2 statistics.
Four-hundred-thirty-nine articles were identified, and 22 studies were
included in this systematic review, totaling 10.010 participants. Eight
studies met the criteria for the meta-analysis, involving 2164
participants. The phase angle (PA) was measured at 50 kHz frequency in all
studies. Individuals with cardiovascular disease had a smaller PA compared
to the control group, for both males (MD -0.70; 95% CI -1.01 to -0.39) and
females (MD -0.76; 95% CI -1.39 to -0.13). In the sensitivity analysis, in
men, the quality of studies (P < 0.01), and in women, heart failure (P <
0.01) was significantly different between groups.The values of the phase
angle were lower in individuals with cardiovascular disease than in
control subjects. This result reinforces the importance of this tool in
clinical practice, highlighting its potential to assess health status.
Registration: The systematic review protocol was registered in the
PROSPERO database as CRD42020164178.<br/>Copyright &#xa9; 2022, The
Author(s), under exclusive licence to Springer Nature Limited.

<42>
Accession Number
2019673505
Title
Analgesic efficacy and risk of low-to-medium dose intrathecal morphine in
patients undergoing cardiac surgery: An updated meta-analysis.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 1017676.
Date of Publication: 05 Oct 2022.
Author
Chen I.-W.; Sun C.-K.; Ko C.-C.; Fu P.-H.; Teng I.-C.; Liu W.-C.; Lin
C.-M.; Hung K.-C.
Institution
(Chen) Department of Anesthesiology, Chi Mei Medical Center, Tainan City,
Liouying, Taiwan (Republic of China)
(Sun) Department of Emergency Medicine, E-Da Hospital, Kaohsiung City,
Taiwan (Republic of China)
(Sun) College of Medicine, I-Shou University, Kaohsiung City, Taiwan
(Republic of China)
(Ko) Department of Medical Imaging, Chi Mei Medical Center, Tainan City,
Taiwan (Republic of China)
(Ko) Department of Health and Nutrition, Chia Nan University of Pharmacy
and Science, Tainan City, Taiwan (Republic of China)
(Ko) Institute of Biomedical Sciences, National Sun Yat-sen University,
Kaohsiung City, Taiwan (Republic of China)
(Fu, Teng, Liu, Lin, Hung) Department of Anesthesiology, Chi Mei Medical
Center, Tainan City, Taiwan (Republic of China)
Publisher
Frontiers Media S.A.
Abstract
Background: To evaluate the analgesic efficacy and risk of low-to-medium
dose intrathecal morphine (ITM) (i.e., <=0.5 mg) following cardiac
surgery. <br/>Method(s): Medline, Cochrane Library, Google scholar and
EMBASE databases were searched from inception to February 2022. The
primary outcome was pain intensity at postoperative 24 h, while the
secondary outcomes included intravenous morphine consumption (IMC),
extubation time, hospital/intensive care unit (ICU) length of stay (LOS),
and ITM-associated side effects (e.g., respiratory depression). Subgroup
analysis was performed on ITM dosage (low: <0.3 mg vs. medium: 0.3-0.5
mg). <br/>Result(s): Fifteen RCTs involving 683 patients published from
1988 to 2021 were included. Pooled results showed significantly lower
postoperative 24-h pain scores [mean difference (MD) = -1.61, 95%
confidence interval: -1.98 to -1.24, p < 0.00001; trial sequential
analysis: sufficient evidence; certainty of evidence: moderate] in the ITM
group compared to the controls. Similar positive findings were noted at 12
(MD = -2.1) and 48 h (MD = -1.88). Use of ITM was also associated with
lower IMC at 24 and 48 h (MD: -13.69 and -14.57 mg, respectively; all p <
0.05) and early tracheal extubation (i.e., 48.08 min). No difference was
noted in hospital/ICU LOS, and nausea/vomiting in both groups, but
patients receiving ITM had higher risk of pruritus (relative risk = 2.88,
p = 0.008). There was no subgroup difference in IMC except a lower pain
score with 0.3-0.5 mg than <0.3 mg at postoperative 24 h. Respiratory
depression events were not noted in the ITM group. <br/>Conclusion(s): Our
results validated the analgesic efficacy of low-to-medium dose ITM for
patients receiving cardiac surgery without increasing the risk of
respiratory depression.<br/>Copyright &#xa9; 2022 Chen, Sun, Ko, Fu, Teng,
Liu, Lin and Hung.

<43>
Accession Number
2017870001
Title
Impact of impaired renal function on outcomes of chronic total occlusion
undergoing revascularization: a systemic review and meta-analysis.
Source
International Urology and Nephrology. 54(12) (pp 3179-3191), 2022. Date of
Publication: December 2022.
Author
Qi Y.; He J.; Pan M.; Yan J.
Institution
(Qi, He, Pan) Blood Purification Center of Hainan General Hospital, Hainan
Affiliated Hospital of Hainan Medical University, No.19 Xiuhua Road,
Xiuying District, Hianan Province, Haikon City, China
(Yan) Department of Cardiovascular Medicine, Sanya Peoples Hospital, West
China Sanya Hospital of Sichuan University, No.558 Jiefang Road, Hainan
Province, Sanya City, China
Publisher
Springer Science and Business Media B.V.
Abstract
Purpose: Patients with chronic kidney disease (CKD) have an associated
burden of coronary artery disease, including chronic total occlusions
(CTO). It is unclear how the presence of CKD affects the outcomes of CTO
revascularization. Previous reviews have not taken into account all
relevant published studies that examined the association of CKD with
outcomes of CTO revascularization. <br/>Method(s): A systematic search was
conducted using PubMed, Scopus, and Google Scholar databases for studies
investigating patients with or without CKD who also had coronary chronic
total occlusion undergoing revascularization procedures Statistical
analysis was performed using STATA software. Effect sizes were reported as
pooled relative risk (RR). <br/>Result(s): A total of 13 studies were
included. CKD patients showed elevated risk of in-hospital mortality (RR
4.25, 95% CI 2.64, 6.82) and mortality at latest follow-up (RR 3.24, 95%
CI 2.56, 4.11), elevated risk of major cardio or cerebrovascular events
(RR 1.65, 95% CI 1.38, 1.98), major bleeding (RR 2.85, 95% CI 1.96, 4.13),
and contrast-induced acute kidney injury (RR 3.06, 95% CI 1.70, 5.52). CKD
patients also showed lower chances of technical success (RR 0.95, 95% CI
0.91, 1.00). <br/>Conclusion(s): The presence of CKD increases the risk of
mortality, complications and adversely affects the success of CTO
revascularization. Patients with CKD undergoing revascularization should
have their kidney function comprehensively evaluated and these patients
should be carefully monitored.<br/>Copyright &#xa9; 2022, The Author(s),
under exclusive licence to Springer Nature B.V.

<44>
Accession Number
2022552419
Title
Hemostatic effects of a dextran-based priming solution for cardiopulmonary
bypass: A secondary analysis of a randomized clinical trial.
Source
Thrombosis Research. 223 (pp 139-145), 2023. Date of Publication: March
2023.
Author
Barbu M.; Kolsrud O.; Radulovic V.; Dellgren G.; Bjork K.; Thoren A.;
Pivodic A.; Ricksten S.-E.; Jeppsson A.
Institution
(Barbu, Kolsrud, Dellgren, Jeppsson) Department of Molecular and Clinical
Medicine, Institute of Medicine, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
(Barbu) Department of Cardiology, Karlskrona Hospital, Karlskrona, Sweden
(Kolsrud, Bjork, Jeppsson) Department of Cardiothoracic Surgery,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Radulovic) Department of Haematology and Coagulation Disorders,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Dellgren) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Thoren, Ricksten) Department of Cardiothoracic Anesthesiology and
Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden
(Pivodic) APNC Sweden, Gothenburg, Sweden
(Pivodic) Department of Clinical Neuroscience, Institute of Neuroscience
and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
Publisher
Elsevier Ltd
Abstract
Introduction: Intravascular fluids administered to patients may influence
hemostasis. In patients undergoing cardiac surgery with cardiopulmonary
bypass, the heart-lung machine is primed with 1300 ml of fluid. We
assessed postoperative coagulation and platelet function in patients
randomized to two different priming solutions, one colloid-based (dextran
40) and one crystalloid-based. <br/>Material(s) and Method(s): Eighty-four
elective cardiac surgery patients were randomized to either a
dextran-based prime or Ringer's acetate with added mannitol. Blood samples
were collected before, and 2 and 24 h after cardiopulmonary bypass.
Coagulation was assessed by standard coagulation tests and rotational
thromboelastometry. Platelet function was assessed with impedance
aggregometry. Bleeding volumes and transfusion requirements were recorded.
<br/>Result(s): Comparing the groups 2 h after bypass, the dextran group
showed lower hemoglobin concentration, hematocrit, platelet count, and
fibrinogen concentration, and higher INR and aPTT, as well as longer clot
formation time (+41 +/- 21 % vs. +8 +/- 18 %, p < 0.001) and a larger
reduction in fibrinogen-dependent clot strength (-37 +/- 12 % vs. -7 +/-
20 %, p < 0.001). Adenosine diphosphate-dependent platelet activation was
reduced in the dextran group but not in the crystalloid group 2 h after
bypass (-14 +/- 29 % vs. -1 +/- 41 %, p = 0.041). No significant
between-group differences in hemostatic variables remained after 24 h, and
no significant differences in perioperative bleeding volumes,
re-explorations for bleeding, or transfusion rates were observed.
<br/>Conclusion(s): Compared to a crystalloid solution, a dextran-based
prime had measurable negative impact on hemostatic variables but no
detectable increase in bleeding volume or transfusion requirements in
cardiac surgery patients.<br/>Copyright &#xa9; 2023 The Authors

<45>
Accession Number
2022448835
Title
P2Y<inf>12</inf> Inhibitor Monotherapy or Dual Antiplatelet Therapy After
Complex Percutaneous Coronary Interventions.
Source
Journal of the American College of Cardiology. 81(6) (pp 537-552), 2023.
Date of Publication: 14 Feb 2023.
Author
Gragnano F.; Mehran R.; Branca M.; Franzone A.; Baber U.; Jang Y.; Kimura
T.; Hahn J.-Y.; Zhao Q.; Windecker S.; Gibson C.M.; Kim B.-K.; Watanabe
H.; Song Y.B.; Zhu Y.; Vranckx P.; Mehta S.; Hong S.-J.; Ando K.; Gwon
H.-C.; Calabro P.; Serruys P.W.; Dangas G.D.; McFadden E.P.; Angiolillo
D.J.; Heg D.; Valgimigli M.
Institution
(Gragnano, Calabro) Department of Translational Medical Sciences,
University of Campania Luigi Vanvitelli, Caserta, Italy
(Mehran, Dangas) Icahn School of Medicine at Mount Sinai, New York, NY,
United States
(Branca, Heg) Clinical Trials Unit, Bern, Switzerland
(Franzone) Department of Advanced Biomedical Sciences, University of
Naples Federico II, Naples, Italy
(Baber) University of Oklahoma Health Sciences Center, Oklahoma City, OK,
United States
(Jang, Kim, Hong) Department of Cardiology, CHA Bundang Medical Center,
CHA University College of Medicine, Seongnam, South Korea
(Kimura, Watanabe) Kyoto University Graduate School of Medicine,
Department of Cardiovascular Medicine, Kyoto, Japan
(Hahn, Song, Gwon) Heart Vascular Stroke Institute, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Korea, Seoul, South
Korea
(Zhao, Zhu) Department of Cardiovascular Surgery, Ruijin Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Windecker, Valgimigli) Department of Cardiology, Bern University
Hospital, University of Bern, Bern, Switzerland
(Gibson) Division of Cardiology, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Belgium
(Vranckx) Faculty of Medicine and Life Sciences, University of Hasselt,
Hasselt, Belgium
(Mehta) Department of Medicine, McMaster University, Hamilton, ON, Canada
(Mehta) Hamilton Health Sciences, Hamilton, ON, Canada
(Ando) Kokura Memorial Hospital, Department of Cardiology, Kitakyushu,
Japan
(Serruys) Department of Cardiology, National University of Ireland Galway,
Galway, Ireland
(Serruys) NHLI, Imperial College London, London, United Kingdom
(McFadden) Cardialysis Core Laboratories and Clinical Trial Management,
Rotterdam, Netherlands
(McFadden) Department of Cardiology, Cork University Hospital, Cork,
Ireland
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Lugano, Switzerland
Publisher
Elsevier Inc.
Abstract
Background: It remains unclear whether P2Y<inf>12</inf> inhibitor
monotherapy preserves ischemic protection while limiting bleeding risk
compared with dual antiplatelet therapy (DAPT) after complex percutaneous
coronary intervention (PCI). <br/>Objective(s): We sought to assess the
effects of P2Y<inf>12</inf> inhibitor monotherapy after 1-month to 3-month
DAPT vs standard DAPT in relation to PCI complexity. <br/>Method(s): We
pooled patient-level data from randomized controlled trials comparing
P2Y<inf>12</inf> inhibitor monotherapy and standard DAPT on centrally
adjudicated outcomes after coronary revascularization. Complex PCI was
defined as any of 6 criteria: 3 vessels treated, >=3 stents implanted, >=3
lesions treated, bifurcation with 2 stents implanted, total stent length
>60 mm, or chronic total occlusion. The primary efficacy endpoint was
all-cause mortality, myocardial infarction, and stroke. The key safety
endpoint was Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding.
<br/>Result(s): Of 22,941 patients undergoing PCI from 5 trials, 4,685
(20.4%) with complex PCI had higher rates of ischemic events. The primary
efficacy endpoint was similar between P2Y<inf>12</inf> inhibitor
monotherapy and DAPT among patients with complex PCI (HR: 0.87; 95% CI:
0.64-1.19) and noncomplex PCI (HR: 0.91; 95% CI: 0.76-1.09;
P<inf>interaction</inf> = 0.770). The treatment effect was consistent
across all the components of the complex PCI definition. Compared with
DAPT, P2Y<inf>12</inf> inhibitor monotherapy consistently reduced BARC 3
or 5 bleeding in complex PCI (HR: 0.51; 95% CI: 0.31-0.84) and noncomplex
PCI patients (HR: 0.49; 95% CI: 0.37-0.64; P<inf>interaction</inf> =
0.920). <br/>Conclusion(s): P2Y<inf>12</inf> inhibitor monotherapy after
1-month to 3-month DAPT was associated with similar rates of fatal and
ischemic events and lower risk of major bleeding compared with standard
DAPT, irrespective of PCI complexity. (PROSPERO [P2Y12 Inhibitor
Monotherapy Versus Standard Dual Antiplatelet Therapy After Coronary
Revascularization: Individual Patient Data Meta-Analysis of Randomized
Trials]; CRD42020176853)<br/>Copyright &#xa9; 2023 American College of
Cardiology Foundation

<46>
Accession Number
2022635031
Title
CRT-100.36 Impact of Calcified Nodules on 2-Year Clinical Outcomes After
IVL-Assisted Coronary Stenting: Pooled Analysis From the DISRUPT CAD OCT
Sub-Studies.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2023, Cardiovascular
Research Technologies. Omni Shoreham Hotel, Washington, DC United States.
16(4 Supplement) (pp S1), 2023. Date of Publication: 27 Feb 2023.
Author
Shlofmitz R.A.; Saito S.; Honton B.; Riley R.F.; Hill J.; Ali Z.A.;
Maehara A.; Stone G.W.; Kereiakes D.J.
Institution
(Shlofmitz, Ali) St. Francis Hospital, Roslyn, NY, United States
(Saito) Shonankamakura General Hospital, Kamakura, Japan
(Honton) Clinique Pasteur, Toulouse, France
(Riley) Overlake Clinics, Bellevue, WA, United States
(Hill) Royal Brompton Hospital, London, UK, London, United Kingdom
(Maehara) Cardiovascular Research Foundation, New York, NY, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Kereiakes) The Christ Hospital and the Lindner Research Center,
Cincinnati, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Calcified nodules (CN) have been associated with stent
under-expansion and worse long-term outcomes after percutaneous coronary
intervention (PCI). Consistent stent expansion and minimum stent area
(MSA) following intravascular lithotripsy (IVL) (Shockwave Medical, Santa
Clara, CA, USA) have been previously demonstrated in lesions with and
without calcified nodules. However, the long-term clinical impact of these
acute findings has not been reported. <br/>Method(s): Individual
patient-level follow-up data (N=155) were pooled from the Disrupt CAD III
and IV optical coherence tomography (OCT) sub-studies and were analysed
for the presence of CN by an independent OCT core laboratory.
CEC-adjudicated target lesion failure (TLF), major adverse cardiac events
(MACE), and stent thrombosis (ST) event rates at 2 years in lesions with
(N=29) and without (N=126) CN were assessed. <br/>Result(s): At 2 years,
TLF rates were 13.9% and 8.0% in the CN and non-CN group, respectively
(p=0.32), driven by target-vessel MI in both groups (TV-MI: 13.9% vs 7.2%
respectively, p=0.24) with low rates of ischemia-driven target lesion
revascularization (ID-TLR: 6.9% vs 2.4% respectively, p=0.21). The MACE
rates were 20.8% vs 11.2%, respectively (p=0.17). Stent thrombosis
(definite or probable) occurred in one patient in the CN group and in no
patients in the non-CN group. <br/>Conclusion(s): IVL treatment of CN
prior to stent implantation resulted in favorable clinical outcomes to 2
years. The rates of TLF and MACE in lesions with CN were acceptable given
the challenging lesion subset, with only one stent thrombosis event in the
CN cohort and low ID-TLR rates at 2 years. Larger studies and additional
analyses are needed to confirm these findings and to elucidate the factors
contributing to long-term clinical events in patients treated with
coronary IVL.<br/>Copyright &#xa9; 2023

<47>
Accession Number
2022638769
Title
Ultrasound-Guided Bilateral Sequential Thoracic Paravertebral Block for
Simultaneous Bilateral Uniportal Video-Assisted Thoracoscopic Surgery:
Study Protocol for a Randomized Controlled Trial.
Source
Journal of Pain Research. 16 (pp 373-381), 2023. Date of Publication:
2023.
Author
Lu Y.; Zhou Q.; Fu Y.; Wen Z.; Lv X.
Institution
(Lu, Zhou, Fu, Wen, Lv) Department of Anesthesiology, Shanghai Pulmonary
Hospital, Tongji University School of Medicine, Shanghai, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Simultaneous bilateral pulmonary resection via uniportal
video-assisted thoracoscopic surgery (UVATS) was safe and feasible for the
treatment of bilateral multiple pulmonary nodules. But, it should be noted
that considerable postoperative pain at the bilateral surgical site was a
crucial issue. The safety and efficacy of bilateral thoracic paravertebral
block (TPVB) have been reported for postoperative analgesia. But, whether
bilateral sequential TPVB can be safely and effectively used in
simultaneous bilateral UVATS remains unknown. Therefore, this study aimed
to determine the analgesic efficacy and safety of bilateral sequential
TPVB after simultaneous bilateral UVATS. Study Design and Methods: In this
study, 80 participants scheduled for UVATS will be randomly allocated to
the bilateral sequential TPVB group (G<inf>2</inf>) and the control group
(G<inf>1</inf>). The patient of G<inf>2</inf> will be performed bilateral
TPVB at 2 time-points: before the start of the first side of pulmonary
resection and before the start of the contralateral pulmonary resection.
G<inf>1</inf> will only receive standard analgesia protocol. The primary
outcome is the numeric rating scale score during coughing at 24 h
postoperatively. The secondary outcomes include the Prince Henry Pain
Score scores, sufentanil consumption, postoperative nausea and vomiting,
levels of inflammatory factors, and the Quality of Recovery-40 scores at
different time points, as well as chronic pain at postoperative day (POD)
90. <br/>Discussion(s): This is the first prospective trial to determine
the safety and effectiveness of ultrasound-guided bilateral sequential
TPVB for postoperative analgesia following simultaneous bilateral UVATS.
This study also intended to evaluate the effect of this intervention on
postoperative quality of recovery and inflammation levels. The final
results will provide clinical evidence related to bilateral sequential
TPVB, and promote the application of that acting as a more appropriate
analgesic method for simultaneous bilateral UVATS.<br/>Copyright &#xa9;
2023 Lu et al.

<48>
Accession Number
2022598853
Title
Short-Term Outcomes Of Complete Coronary Revascularization Compared To
Staged Revascularization During Primary Percutaneous Coronary Intervention
In Patients With Multivessel Coronary Artery Disease: Presenting With ST
Segment Elevation Myocardial Infarction.
Source
Journal of Pharmaceutical Negative Results. 14(2) (pp 1965-1971), 2023.
Date of Publication: 2023.
Author
Alnashar I.A.; Almissiri A.M.; Guindy R.R.; Zahran M.
Institution
(Alnashar) National Heart Institute, Giza, Cairo, Egypt
(Almissiri, Guindy, Zahran) Department of Cardiology, Ain Shams
University, Cairo, Egypt
Publisher
ResearchTrentz Academy Publishing Education Services
Abstract
Background: Complete revascularization has been recently popularized for
management of ST-Segment-Elevation Myocardial Infarction (STEMI) patients
with multivessel disease scheduled for Primary Percutaneous Coronary
Intervention (PPCI). We assessed the three months outcomes of Compete
Revascularization (CR) compared to staged revascularization in patients
with multivessel disease undergoing PPCI. <br/>Material(s) and Method(s):
We conducted a randomized, open-label, comparative trial on STEMI patients
with multivessel disease indicated for PPCI in the setting of STEMI.
Patients were randomly assigned to undergo PCI revascularization of the
non-culprit lesions during the index procedure, Complete Revascularization
(CR) or within 30 days later after discharge, Staged Revascularization
(SR). The primary endpoint was the composite of all-cause mortality,
re-infarction, Heart Failure (HF), recurrence of angina symptoms,
cerebrovascular stroke, and need for revascularization. <br/>Result(s): A
total of 100 patients were randomized in 1:1 ratio. The primary end point
occurred in 24% of the patients in CR and 20% in SR group (p=0.62). The
incidence of HF (14% vs. 12%; p=0.76), repeated revascularization (4% in
each group), persistent angina (8% vs. 2%, p=0.16), all-cause mortality
(2% in each group), MI (4% in each group), stent thrombosis (0% vs. 4%;
p=0.15), and cerebrovascular accident (0% vs. 2%; p=0.32).
<br/>Conclusion(s): Staged revascularization provided comparable
short-term benefits to complete revascularization in STEMI patients with
multivessel disease undergoing PPCI. The present trial demonstrated that
complete revascularization was associated with a trend towards higher
incidence of stent thrombosis and CVA than staged
revascularization.<br/>Copyright &#xa9; 2023 Authors. All rights reserved.

<49>
Accession Number
2020633875
Title
Cardiac surgery-associated acute kidney injury in newborns: A
meta-analysis.
Source
Electronic Journal of General Medicine. 20(2) (no pagination), 2023.
Article Number: em448. Date of Publication: April 2023.
Author
Suieubekov B.; Sepbayeva A.; Yeshmanova A.; Kusainov A.
Institution
(Suieubekov, Sepbayeva, Yeshmanova) Asfendiyarov Kazakh National Medical
University, Almaty, Kazakhstan
(Kusainov) Kazakh-Russian Medical University, Almaty, Kazakhstan
Publisher
Modestum LTD
Abstract
Introduction: Acute kidney injury is a common complication following
pediatric heart surgery, and it has been linked to an increased risk of
morbidity and fatality. <br/>Method(s): The PubMed and Medline databases
were combed for relevant research until May 2022. The terms [Cardiac
surgery] AND [acute renal injury] AND [newborns OR children OR neonates]
AND [randomized control studies OR randomized control trials] were used as
search criteria. The studies that met the inclusion criteria were
considered qualified using the preferred reporting items for systematic
reviews and meta-analyses (PRISMA) guidelines. <br/>Result(s): A total of
2,941 newborns or children were enrolled in 14 studies, with 931
developing acute renal damage. 2,095 of the enrolled infants and children
received steroid, aminophylline, dexmedetomidine, and acetaminophen
therapies. In seven studies, the odds ratio for steroids was not
significantly different from control. In contrast, two studies comparing
aminophylline to a control group found no statistically significant
change. Two studies found no significant difference in dexmedetomidine
therapy compared to control. Three trials, however, found a significant
difference between the acetaminophen treatment and control groups.
<br/>Conclusion(s): Acetaminophen was linked to a decreased risk of
postoperative acute renal injury, while steroids had no benefit and
aminophylline treatment could be justified.<br/>Copyright &#xa9; 2023 by
Author/s and Licensed by Modestum. All rights reserved.

<50>
Accession Number
2022623920
Title
Fractional Flow Reserve-Guided Coronary Revascularization: Evidence from
Randomized and Non-Randomized Studies.
Source
Diagnostics. 12(11) (no pagination), 2022. Article Number: 2659. Date of
Publication: November 2022.
Author
Paolucci L.; Mangiacapra F.; Viscusi M.M.; Nusca A.; Zimbardo G.;
Cialdella P.; Donahue M.E.; Calo L.; Ussia G.P.; Grigioni F.
Institution
(Paolucci, Mangiacapra, Viscusi, Nusca, Ussia, Grigioni) Unit of
Cardiovascular Science, Department of Medicine, Campus Bio-Medico
University, Rome 00128, Italy
(Zimbardo, Cialdella, Donahue, Calo) Division of Cardiology, Policlinic
Casilino, Rome 00169, Italy
Publisher
MDPI
Abstract
Simple visual estimation of coronary angiography is limited by several
factors that can hinder the proper classification of coronary lesions.
Fractional flow reserve (FFR) is the most widely used tool to perform a
physiological evaluation of coronary stenoses. Compared to isolated
angiog-raphy, FFR has been demonstrated to be more effective in selecting
those lesions associated with myocardial ischemia and, accordingly,
impaired outcomes. At the same time, deferring coronary intervention in
those lesions that do not show ischemic FFR values has proven safe and not
associated with adverse events. Despite a major randomized clinical trial
(RCT) and several non-randomized studies showing that FFR-guided
revascularization could be superior to isolated angiography in improving
clinical outcomes, subsequent RCTs have reported conflicting results. In
this review, we summarize the principles behind FFR and the data currently
available in the literature, highlighting the main differences between
randomized and non-randomized studies that investigated this
topic.<br/>Copyright &#xa9; 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<51>
Accession Number
640285342
Title
Rationale and design of the colchicine for the prevention of perioperative
atrial fibrillation in patients undergoing major noncardiac thoracic
surgery (COP-AF) trial.
Source
American heart journal. (no pagination), 2023. Date of Publication: 06
Feb 2023.
Author
Conen D.; Popova E.; Wang M.K.; Chan M.T.V.; Landoni G.; Reimer C.;
Srinathan S.K.; Cata J.P.; McLean S.R.; Reyes J.C.T.; Grande A.M.; Tallada
A.G.; Sessler D.I.; Fleischmann E.; Maziak D.E.; Kabon B.; Voltolini L.;
Gutierrez-Soriano L.; Tandon V.; DuMerton D.; Kidane B.; Rajaram R.;
Shargall Y.; Neary J.D.; Wells J.R.; McIntyre W.F.; Blum S.; Ofori S.N.;
Vincent J.; Xu L.; Li Z.; Healey J.S.; Garg A.X.; Devereaux P.J.
Institution
(Conen, Wang, McIntyre, Healey, Devereaux) Population Health Research
Institute, Hamilton, ON, Canada; Department of Medicine, McMaster
University, Hamilton, ON, Canada; Department of Health Research Methods,
Evidence, and Impact, McMaster University, Hamilton, ON, Canada
(Popova) Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain;
Iberoamerican Cochrane Centre, Barcelona, Spain
(Chan) Chinese University of Hong Kong, Hong Kong Special Administrative
Region, Shatin, China
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University,
Milan, Italy
(Reimer, DuMerton) Kingston Health Sciences Centre, Kingston, ON, Canada
(Srinathan) Department of Surgery, University of Manitoba, Winnipeg, MB,
Canada
(Cata) Department of Anesthesiology and Perioperative Medicine, University
of Texas - MD Anderson Cancer Center, Houston, TX, United States
(McLean) Department of Anesthesia, Vancouver Acute (Vancouver General
Hospital and UBC Hospital), The University of British Columbia, Vancouver,
BC, Canada; Department of Anesthesia, Pharmacology and Therapeutics, The
University of British Columbia, Vancouver, BC, Canada
(Reyes) Department of Thoracic Surgery, Hospital de la Santa Creu i Sant
Pau, Barcelona, Spain
(Grande) Hospital Universitario Ramon y Cajal, Madrid, Spain
(Tallada) Department of Anesthesiology, Hospital Universitari Vall
d'Hebron, Barcelona, Spain
(Sessler) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, United States
(Fleischmann, Kabon) Department of Anesthesia, Intensive Care Medicine and
Pain Medicine, Medical University of Vienna, Vienna, Austria
(Maziak) University of Ottawa, Ottawa, ON, Canada
(Voltolini) Thoracic Surgery Unit, Careggi University Hospital, Florence,
Italy
(Gutierrez-Soriano) Department of Anesthesiology, Fundacion CardioInfantil
- Instituto de Cardiologia, Bogota, Colombia
(Tandon, Neary) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Kidane) Departments of Surgery, Physiology and Pathophysiology,
University of Manitoba, Winnipeg, MB, Canada
(Rajaram) Department of cardiothoracic surgery, University of Texas - MD
Anderson Cancer Center, Houston, TX, United States
(Shargall) Division of Thoracic Surgery, Department of Surgery, Faculty of
Health Sciences, McMaster University, Hamilton, ON, Canada
(Wells, Vincent, Li) Population Health Research Institute, Hamilton, ON,
Canada
(Blum) Population Health Research Institute, Hamilton, ON, Canada;
Cardiovascular Research Institute Basel, University Hospital Basel, Basel,
Switzerland
(Ofori) Population Health Research Institute, Hamilton, ON, Canada;
Department of Medicine, McMaster University, Hamilton, ON, Canada;
University of Port Harcourt, Choba, Nigeria
(Xu) Population Health Research Institute, Hamilton, ON, Canada;
Department of Medicine, McMaster University, Hamilton, ON, Canada
(Garg) Population Health Research Institute, Hamilton, ON, Canada;
Department of Health Research Methods, Evidence, and Impact, McMaster
University, Hamilton, ON, Canada; Departments of Medicine, Epidemiology
and Biostatistics, Western University, London, ON, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Perioperative atrial fibrillation (AF) and myocardial injury
after noncardiac surgery (MINS) are common complications after noncardiac
surgery. Inflammation has been implicated in the pathogenesis of both
disorders. The COP-AF trial tests the hypothesis that colchicine reduces
the incidence of perioperative AF and MINS in patients undergoing major
noncardiac thoracic surgery. DESIGN: The 'COlchicine for the Prevention of
Perioperative Atrial Fibrillation' (COP-AF) trial is an international,
blinded, randomized trial that compares colchicine to placebo in patients
aged at least 55 years and undergoing major noncardiac thoracic surgery
with general anesthesia. Exclusion criteria include a history of AF and a
contraindication to colchicine (e.g., severe renal dysfunction). Oral
colchicine at a dose of 0.5 mg or matching placebo is given within 4 hours
before surgery. Thereafter, patients receive colchicine 0.5 mg or placebo
twice daily for a total of 10 days. The two independent co-primary
outcomes are clinically important perioperative AF (including atrial
flutter) and MINS during 14 days of follow-up. The main safety outcomes
are sepsis or infection and non-infectious diarrhea. We aim to enroll
3,200 patients from approximately 40 sites across 11 countries to have at
least 80% power for the independent evaluation of the two co-primary
outcomes. SUMMARY: COP-AF is a large randomized and blinded trial designed
to determine whether colchicine reduces the risk of perioperative AF or
MINS in patients who have major noncardiac thoracic surgery.<br/>Copyright
&#xa9; 2023. Published by Elsevier Inc.

<52>
Accession Number
2021375508
Title
Advances in the available pharmacotherapy for the management of acute
coronary syndromes in patients presenting without persistent ST-segment
elevation.
Source
Expert Opinion on Pharmacotherapy. (no pagination), 2023. Date of
Publication: 2023.
Author
Greco A.; Finocchiaro S.; Angiolillo D.J.; Capodanno D.
Institution
(Greco, Finocchiaro, Capodanno) Division of Cardiology, Azienda
Ospedaliero-Universitaria Policlinico "G. Rodolico - San Marco,",
University of Catania, Catania, Italy
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Non-ST-segment elevation acute coronary syndromes
(NSTE-ACS), including non-ST-segment-elevation myocardial infarction
(NSTEMI) and unstable angina, represent a leading cause of mortality
worldwide, with important socio-economic consequences. NSTEMI accounts for
the majority of acute coronary syndromes and usually develops on the
background of a nonocclusive thrombus. We searched for relevant literature
in the field in PubMed and clinicaltrials.gov as of July 2022. Areas
covered: A number of pharmacotherapies are currently available for
treatment and secondary prevention, mainly including antithrombotic,
lipid-lowering and anti-inflammatory drugs. Pretreatment with aspirin,
anticoagulant and statin therapy is of key importance in the preprocedural
phase, while pretreating with an oral P2Y<inf>12</inf> inhibitor is not
routinely indicated in patients undergoing early invasive management. For
patients undergoing percutaneous coronary revascularization,
pharmacotherapy essentially consists of antithrombotic drugs, which should
be carefully selected. Finally, antithrombotic, lipid-lowering and
anti-inflammatory drugs are important components of long-term secondary
prevention after a NSTE-ACS. Expert opinion: This article reviews the
evidence supporting recommendation on pharmacotherapy in patients
presenting with a NSTE-ACS. Several randomized clinical trials are still
ongoing and are expected to further inform scientific knowledge and
clinical practice, with the final aim to improve the treatment of NSTE-ACS
patients.<br/>Copyright &#xa9; 2023 Informa UK Limited, trading as Taylor
& Francis Group.

<53>
Accession Number
2022380473
Title
Intraoperative infusion of dexmedetomidine for prevention of postoperative
delirium in elderly patients undergoing craniotomy: A protocol of
randomised clinical trial.
Source
BMJ Open. 13(1) (no pagination), 2023. Article Number: e063976. Date of
Publication: 23 Jan 2023.
Author
Cui Q.; Ma T.; Liu M.; Shen Z.; Li S.; Zeng M.; Liu X.; Zhang L.; Peng Y.
Institution
(Cui, Ma, Liu, Shen, Li, Zeng, Liu, Zhang, Peng) Anesthesiology, Beijing
Tiantan Hospital, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium (POD) is a common surgical
complication. The incidence is 19% in neurological procedures, and
advanced age is a risk factor for neurological procedures. Many studies
have shown that dexmedetomidine (DEX) reduced the incidence of delirium
after non-cardiac surgery in elderly patients. However, there are few
studies focus on the effect of DEX on POD in elderly patients undergoing
neurosurgery. Methods and analysis This is a randomised, double-blinded,
paralleled-group and controlled trial. Patients older than 65 years and
scheduled for elective craniotomy will be randomly assigned to the DEX
group and the control group. After endotracheal intubation, patients in
the DEX group will be administered with continuous DEX infusion at rate of
0.4 mug/kg/hour until the surgical haemostasis. In the control group,
patients will receive the identical volume of normal saline in the same
setting. The primary outcome is the incidence of POD during the first 5
days. Delirium will be evaluated through a combination of three methods,
including the Richmond Agitation Sedation Scale (RASS), the confusion
assessment method for ICU (CAM-ICU) and the 3 min diagnostic interview for
CAM (3D-CAM). The RASS, CAM-ICU and 3D-CAM will be evaluated two times per
day (08:00-10:00 and 18:00-20:00 hours) during the first postoperative 5
days. Secondary outcomes include pain severity score, quality of recovery,
quality of sleep, cognitive function, psychological health state,
intraoperative data, physiological status, length of stay in ICU and
hospital, hospitalisation costs, non-delirium complications, and 30-day
all-cause mortality. Ethics and dissemination The protocol (V.4.0) has
been approved by the medical ethics committee of Beijing Tiantan Hospital,
Capital Medical University (KY2021-194-03). The findings of the study will
be disseminated in a peer-reviewed journal and at a scientific conference.
Trial registration number NCT05168280.<br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<54>
Accession Number
2021314790
Title
Transcatheter mitral valve replacement versus redo surgery for mitral
prosthesis failure: A systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1058576. Date of Publication: 18 Jan 2023.
Author
Zhou J.; Li Y.; Chen Z.; Zhang H.
Institution
(Zhou, Li, Chen, Zhang) Department of Cardiac Surgery, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Transcatheter mitral valve replacement (TMVR) has emerged as
an alternative to redo surgery. TMVR compared with redo surgical mitral
valve replacement (SMVR) in patients with mitral prosthesis failure
remains limited. In this study, we performed a meta-analysis to assess the
outcomes of TMVR (including valve-in-valve and valve-in-ring) versus redo
surgery for mitral prosthesis failure. <br/>Method(s): We comprehensively
searched the PubMed, Embase, and Cochrane library databases according to
predetermined inclusion and exclusion criteria, and then we extracted
data. We compared the outcomes of TMVR and redo SMVR for mitral prosthesis
failure in terms of the in-hospital mortality, stroke, renal dysfunction,
vascular complication, pacemaker implantation, exploration for bleeding,
paravalvular leak, mean mitral valve gradient, 30-day mortality, and
1-year mortality. <br/>Result(s): Nine retrospective cohort studies and a
total of 3,038 patients were included in this analysis. Compared with redo
SMVR for mitral prosthesis failure, TMVR was associated with lower
in-hospital mortality [odds ratios (OR): 0.44; 95% confidence interval
(CI): 0.30-0.64; P < 0.001], stroke (OR: 0.44; 95% CI: 0.29-0.67; P =
0.0001), renal dysfunction (OR: 0.52; 95% CI: 0.37-0.75; P = 0.0003),
vascular complication (OR: 0.58; 95% CI: 0.43-0.78; P = 0.004), pacemaker
implantation (OR: 0.23; 95% CI: 0.15-0.36; P < 0.00001), and exploration
for bleeding (OR: 0.24; 95% CI: 0.06-0.96; P = 0.04). Conversely, redo
SMVR had lower paravalvular leak (OR: 22.12; 95% CI: 2.81-174.16; P =
0.003). There was no difference in mean mitral valve gradient (MD: 0.04;
95% CI: -0.47 to 0.55; P = 0.87), 30-day mortality (OR: 0.65; 95% CI:
0.36-1.17; P = 0.15), and 1-year mortality (OR: 0.96; 95% CI: 0.63-1.45; P
= 0.84). <br/>Conclusion(s): In patients with mitral prosthesis failure,
TMVR is associated with lower in-hospital mortality and lower occurrence
of postoperative complications, except for paravalvular leak. TMVR offers
a viable alternative to the conventional redo surgery in selected
patients.<br/>Copyright &#xa9; 2023 Zhou, Li, Chen and Zhang.

<55>
Accession Number
2022449623
Title
Transfusion trigger after operations in high cardiac risk patients (TOP)
trial protocol. Protocol for a multicenter randomized controlled
transfusion strategy trial.
Source
Contemporary Clinical Trials. 126 (no pagination), 2023. Article Number:
107095. Date of Publication: March 2023.
Author
Kougias P.; Mi Z.; Zhan M.; Carson J.L.; Dosluoglu H.; Nelson P.; Sarosi
G.A.; Arya S.; Norman L.E.; Sharath S.; Scrymgeour A.; Ollison J.; Calais
L.A.; Biswas K.
Institution
(Kougias, Sharath, Ollison) Department of Surgery, State University of New
York (SUNY) Downstate Health Sciences University, VA New York Harbor
Healthcare System, Brooklyn, NY 11203, United States
(Mi, Zhan, Norman, Biswas) VA Cooperative Studies Program Coordinating
Center, Perry Point, MD, United States
(Carson) Division of General Internal Medicine, Department of Medicine,
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United
States
(Dosluoglu) Division of Vascular Surgery, Department of Surgery, SUNY at
Buffalo/VA Western NY Healthcare System, Buffalo, NY, United States
(Nelson) Division of Vascular Surgery, Department of Surgery, University
of Oklahoma School of Community Medicine, Tulsa, OK, United States
(Sarosi) Department of Surgery, University of Florida College of Medicine,
General Surgery Section, Department of Surgery, Malcolm Randall Veterans
Affairs Medical Center, Gainesville, FL, United States
(Arya) Division of Vascular Surgery, Department of Surgery, Stanford
University School of Medicine, Vascular Section, Surgery Service Line,
Palo Alto Veterans Affairs Medical Center, Palo Alto, CA, United States
(Scrymgeour) Cooperative Studies Program Clinical Research Pharmacy
Coordinating Center, Albuquerque, NM, United States
(Calais) Cooperative Studies Program Site Monitoring, Auditing, and
Resource Team (SMART), Albuquerque, NM, United States
Publisher
Elsevier Inc.
Abstract
Background: There is substantial uncertainty regarding the effects of
restrictive postoperative transfusion among patients who have underlying
cardiovascular disease. The TOP Trial's objective is to compare adverse
outcomes between liberal and restrictive transfusion strategies in
patients undergoing vascular and general surgery operations, and with a
high risk of postoperative cardiac events. <br/>Method(s): A two-arm,
single-blinded, randomized controlled superiority trial will be used
across 15 Veterans Affairs hospitals with expected enrollment of 1520
participants. Postoperative transfusions in the liberal arm commence when
Hb is <10 g/ dL and continue until Hb is greater than or equal to 10 g/dL.
In the restrictive arm, transfusions begin when Hb is <7 g/dL and continue
until Hb is greater than or equal to 7 g/dL. Study duration is estimated
to be 5 years including a 3-month start-up period and 4 years of
recruitment. Each randomized participant will be followed for 90 days
after randomization with a mortality assessment at 1 year. <br/>Result(s):
The primary outcome is a composite endpoint of all-cause mortality,
myocardial infarction (MI), coronary revascularization, acute renal
failure, or stroke occurring up to 90-days after randomization. Events
rates will be compared between restrictive and liberal transfusion groups.
<br/>Conclusion(s): The TOP Trial is uniquely positioned to provide high
quality evidence comparing transfusion strategies among patients with high
cardiac risk. Results will clarify the effect of postoperative transfusion
strategies on adverse outcomes and inform postoperative management
algorithms. TRIAL REGISTRATION: http://clinicaltrials.gov identifier:
NCT03229941<br/>Copyright &#xa9; 2023

<56>
Accession Number
2021133322
Title
The feasibility and safety of combining atrial septal defect/patent
foramen ovale and left atrial appendage closure: A systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1080257. Date of Publication: 06 Jan 2023.
Author
Song Y.; Xing H.; Koch P.D.; Li X.; Zhang Y.
Institution
(Song, Zhang) Department of Ultrasound, The First Affiliated Hospital of
Zhengzhou University, Henan, Zhengzhou, China
(Xing) Department of Surgery, Rhode Island Hospital, Warren Alpert Medical
School of Brown University, Providence, RI, United States
(Koch) Center for Systems Biology, Massachusetts General Hospital, Boston,
MA, United States
(Li) Division of Cardiology, Department of Medicine, Cardiovascular
Research Center, Rhode Island Hospital, Warren Alpert Medical School of
Brown University, Providence, RI, United States
Publisher
Frontiers Media S.A.
Abstract
Introduction: Atrial Septal Defect/Patent Foramen Ovale (ASD/PFO)
occlusion is performed to prevent paradoxical embolism and reduce the risk
of recurrent ischemic stroke. Left atrial appendage (LAA) closure is used
as an alternative to medical therapy of non-valvular atrial fibrillation
for prevention of stroke. Multiple studies have examined performing LAA
and ASD/PFO occlusion. However, the feasibility and safety of combined
occlusion of the left atrial appendage and ASD/PFO are not clear,
furthermore, these studies are limited by their small sample sizes and
retrospective analysis. In this study, we aimed to systematically review
and meta-analyze the feasibility and safety of combining left atrial
appendage and ASD/PFO closure. <br/>Method(s): PubMed, Web of Science,
CNKI, Cochrane Library, Embase, and WanFang database were searched up to
April 2022 to identify peer-reviewed human studies on assessing the
feasibility, safety, and efficacy of combining left atrial appendage and
ASD/PFO closure. The primary outcome was calculated: procedural
feasibility outcome and procedural safety outcome. <br/>Result(s): A total
of 10 articles, including 340 patients from multiple countries, were
included in the analysis. The principal findings of our study are:
compared with single LAA closure, (i) combining PFO/ASD occlusion and LAA
closure had similar procedural success proportion (98.43%, 95% CI:
96.67-100.00%), (ii) similar safety event incidences developed (1.67%, 95%
CI: 0.24-3.92%), subgroup analyzed safety event incidences in death was
0.00 (95% CI: 0.00-0.33%), cardiac tamponade was 0.87% (95% CI:
0.00-2.77%), device embolization was 0.00 (95% CI: 0.00-0.60%), major
bleeding was 0.00 (95% CI: 0.00-0.33%), stroke was 0.00 (95% CI:
0.00-0.02%). <br/>Conclusion(s): Although this systematic review and
meta-analysis demonstrate the technical feasibility and safety of
combining closure of PFO/ASD and LAA, further studies of sufficient sample
size, long-term follow-up, and rigor endpoint criteria are yet needed to
fully evaluate this combination procedure for its role in clinical
outcomes.<br/>Copyright &#xa9; 2023 Song, Xing, Koch, Li and Zhang.

<57>
Accession Number
2021261206
Title
Effect of intubation in the lateral position under general anesthesia
induction on the position of double-lumen tube placement in patients
undergoing unilateral video-assisted thoracic surgery: study protocol for
a prospective, single-center, parallel group, randomized, controlled
trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 67. Date of
Publication: December 2023.
Author
Zhang X.; Wang D.-X.; Zhang Q.; Shen Q.-B.; Tong F.; Hu Y.-H.; Zhang
Z.-D.; Liu F.-F.; Tang Y.-W.; Chen J.-L.; Liu H.; Zhou F.; Hu S.-P.
Institution
(Zhang, Wang, Zhang, Tong, Hu, Zhang, Liu, Tang, Liu, Hu) Department of
Anesthesiology & Huzhou Key Laboratory of Basic Research and Clinical
Translation for Neuromodulation, Huzhou Central Hospital

The Affiliated Huzhou Hospital, Zhejiang University School of Medicine

Affiliated Central Hospital Huzhou University, No. 1558 Sanhuan North
Road, Wuxing District, Zhejiang Province, Huzhou 313000, China
(Zhang) Department of Anesthesiology, The First Affiliated Hospital,
Zhejiang University School of Medicine, Hangzhou, China
(Shen) Department of Cardiothoracic Surgery, Huzhou Central Hospital

The Affiliated Huzhou Hospital, Zhejiang University School of Medicine

Affiliated Central Hospital Huzhou University, No. 1558 Sanhuan North
Road, Wuxing District, Zhejiang Province, Huzhou 313000, China
(Chen) Department of Operating Room Nursing, Huzhou Central Hospital

The Affiliated Huzhou Hospital, Zhejiang University School of Medicine

Affiliated Central Hospital Huzhou University, No. 1558 Sanhuan North
Road, Wuxing District, Zhejiang Province, Huzhou 313000, China
(Zhou) Medical Department, Huzhou Central Hospital

The Affiliated Huzhou Hospital, Zhejiang University School of Medicine

Affiliated Central Hospital Huzhou University, No. 1558 Sanhuan North
Road, Wuxing District, Zhejiang Province, Huzhou 313000, China
Publisher
BioMed Central Ltd
Abstract
Background: The double-lumen tube (DLT) is an essential equipment for
thoracic anesthesia and the precise position of DLT placement is
particularly important for anesthesia and surgery. However, the incidence
of DLT malposition remains high and it leads to lung isolation failure and
hypoxemia during one-lung ventilation. This trial aims to explore the
clinical application and efficacy of intubation in the lateral position
under general anesthesia induction to reduce the incidence of DLT
malposition in patients undergoing unilateral video-assisted thoracic
surgery (VATS). <br/>Method(s): In this prospective, single-center,
parallel group, randomized, controlled trial, we will recruit 108
patients, aged 18-80 years, scheduled for elective unilateral VATS with
DLT intubation under general anesthesia, and they will be randomly
assigned to two groups: a lateral DLT intubation group (group L) and a
conventional supine DLT intubation group (group C). The left-sided DLT
will be used to intubate in patients of both groups. The position of DLT
will be confirmed and adjusted by using the fiberoptic bronchoscopy (FOB).
The primary outcome is the incidence of DLT malposition observed via the
FOB, and the secondary outcomes include the time of intubation, the
frequency and duration of re-adjustments of DLT placement under FOB,
whether to re-intubate, intraoperative vital signs, and postoperative
recovery. <br/>Discussion(s): Accurate DLT positioning is crucially
important for thoracic surgery, but the incidence of DLT malposition is
still high in the present clinical practice of thoracic anesthesia. This
trial aims to investigate whether lateral DLT intubation can reduce the
incidence of DLT malposition, with more stable intraoperative vital signs
and less postoperative complications. Trial registration: The study
protocol was registered at Chinese Clinical Trial Registry
(http://www.chictr.org.cn) with registration number: ChiCTR2200060794 on
June 11, 2022.<br/>Copyright &#xa9; 2023, The Author(s).

<58>
[Use Link to view the full text]
Accession Number
2022338347
Title
Immature Platelet Fraction Predicts Adverse Events in Patients with Acute
Coronary Syndrome: The ISAR-REACT 5 Reticulated Platelet Substudy.
Source
Arteriosclerosis, Thrombosis, and Vascular Biology. 43(2) (pp E83-E93),
2023. Date of Publication: 01 Feb 2023.
Author
Bongiovanni D.; Schreiner N.; Gosetti R.; Mayer K.; Angiolillo D.J.;
Sibbing D.; Holdenrieder S.; Anetsberger A.; Von Scheidt M.; Schunkert H.;
Laugwitz K.-L.; Schupke S.; Kastrati A.; Fegers-Wustrow I.; Bernlochner I.
Institution
(Bongiovanni, Schreiner, Gosetti, Laugwitz, Fegers-Wustrow, Bernlochner)
Department of Internal Medicine I, School of Medicine, University Hospital
Rechts der Isar, Technical University of Munich, Germany
(Mayer, Von Scheidt, Schunkert, Schupke, Kastrati) Department of
Cardiology, Deutsches Herzzentrum Munchen, Technical University of Munich,
Germany
(Anetsberger) Department of Anesthesiology, School of Medicine, University
Hospital Rechts der Isar, Technical University of Munich, Germany
(Bongiovanni) Division of Cardiology, Cardiocentro Ticino Institute, Ente
Ospedaliero Cantonale, Lugano, Switzerland
(Bongiovanni, Sibbing, Von Scheidt, Schunkert, Laugwitz, Schupke,
Kastrati, Bernlochner) German Center for Cardiovascular Research (DZHK),
Partner Site Munich Heart Alliance, Germany
(Bongiovanni) Department of Cardiovascular Medicine, Humanitas Clinical
and Research Center IRCCS, Humanitas University, Rozzano, Milan, Italy
(Angiolillo) Division of Cardiology, University of Florida, College of
Medicine, Jacksonville, United States
(Sibbing) Klinik der Universitat Munchen, Ludwig - Maximilians University
- Cardiology, Munich, Germany
(Holdenrieder) Deutsches Herzzentrum Munchen, Institute for Laboratory
Medicine, Technische Universitat Munchen, Munich, Germany
(Anetsberger) University of Applied Sciences Landshut, Faculty of
Interdisciplinary Studies, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Immature or reticulated platelets are associated with impaired
efficacy of antiplatelet drugs and adverse events in cardiovascular
patients. Their role as a predictive biomarker in patients with acute
coronary syndrome treated with potent P2Y12 receptor inhibitors is not
fully understood. We aimed to prospectively evaluate reticulated platelets
as a predictor of the primary end point of the ISAR-REACT 5 trial
consisting of death, myocardial infarction, or stroke at 1 year in
patients with acute coronary syndrome randomized to prasugrel or
ticagrelor. <br/>Method(s): Immature platelet fraction (IPF) was assessed
within 48 hours after randomization. Patients were divided based on the
IPF median values: the IPFhigh group included patients with IPF>median and
the IPFlow group included patients with IPF<=median. Platelet aggregation
was assessed using the Multiplate Analyzer and was correlated to IPF.
<br/>Result(s): Five hundred seventy-seven patients were included in the
study. IPF values in % (median [interquartile range]) within the first 48
hours did not differ between the two study groups: 3.6 (2.5-5.2)% in the
prasugrel group and 3.6 (2.5-5.4)% in the ticagrelor group (P=0.882). The
incidence of the primary end point was significantly higher in the IPFhigh
(IPF>3.6%) group compared with the IPFlow (IPF<=3.6%) group: 13.0% versus
7.2% (HRadj, 1.74 [1.02-3.00]; P=0.044), independently from the assigned
drug (Pint=0.159). No significant association between IPF and BARC 3 to 5
bleeding was observed. ADP-induced platelet aggregation correlated
significantly with IPF in patients treated with prasugrel (r=0.22;
P=0.005) while no correlation was detected in patients treated with
ticagrelor (r=0.09; P=0.257). <br/>Conclusion(s): Independently from drug
treatment, IPF was associated with the primary end point and therefore is
a promising biomarker for the prediction of adverse cardiovascular events
in patients with acute coronary syndrome treated with prasugrel or
ticagrelor. Registration: https://www.clinicaltrials.gov; Unique
identifier: NCT01944800.<br/>Copyright &#xa9; 2022 American Heart
Association, Inc.

<59>
Accession Number
2022304168
Title
Radiation dose to heart and cardiac substructures and risk of coronary
artery disease in early breast cancer patients: A DBCG study based on
modern radiation therapy techniques.
Source
Radiotherapy and Oncology. 180 (no pagination), 2023. Article Number:
109453. Date of Publication: March 2023.
Author
Holm Milo M.L.; Slot Moller D.; Bisballe Nyeng T.; Hoffmann L.; Dahl
Nissen H.; Jensen I.; Laugaard Lorenzen E.; Bech Jellesmark Thorsen L.;
Melgaard Nielsen K.; Paaske Johnsen S.; Brink Valentin J.; Alsner J.; Vrou
Offersen B.
Institution
(Holm Milo, Bech Jellesmark Thorsen, Alsner, Vrou Offersen) Department of
Experimental Clinical Oncology, Aarhus University Hospital, Denmark
(Holm Milo) Department of Oncology, Aalborg University Hospital, Denmark
(Slot Moller, Bisballe Nyeng, Hoffmann) Department of Medical Physics,
Aarhus, Denmark
(Slot Moller, Hoffmann) Department of Clinical Medicine, Faculty of Health
Sciences, Aarhus University, Aarhus, Denmark
(Dahl Nissen) Department of Medical Physics, Vejle Hospital, Denmark
(Jensen) Department of Medical Physics, Aalborg University Hospital,
Denmark
(Laugaard Lorenzen) Laboratory of Radiation Physics, Odense University
Hospital, Denmark
(Bech Jellesmark Thorsen, Vrou Offersen) Department of Oncology, Aarhus
University Hospital, Denmark
(Melgaard Nielsen) Department of Cardiology, Aarhus University Hospital,
Denmark
(Paaske Johnsen, Brink Valentin) Danish Center for Clinical Health
Services Research, Department of Clinical Medicine, Aalborg University
Hospital, Denmark
(Vrou Offersen) Danish Center for Particle Therapy, Aarhus, Denmark
Publisher
Elsevier Ireland Ltd
Abstract
Background: Coronary artery disease (CAD) has been reported as a late
effect following radiation therapy (RT) of early breast cancer (BC). This
study aims to report individual RT doses to the heart and cardiac
substructures in patients treated with CT-based RT and to investigate if a
dose-response relationship between RT dose and CAD exists using modern
radiation therapy techniques. <br/>Method(s): Patients registered in the
Danish Breast Cancer Group database from 2005 to 2016 with CT-based RT
were eligible. Among 15,765 patients, the study included 204 with CAD
after irradiation (cases) and 408 matched controls. Individual planning
CTs were retrieved, the heart and cardiac substructures were delineated
and dose-volume parameters were extracted. <br/>Result(s): The median
follow-up time was 7.3 years (IQR: 4.6-10.0). Among cases, the median mean
heart dose was 1.6 Gy (IQR 0.2-6.1) and 0.8 Gy (0.1-2.9) for left-sided
and right-sided patients, respectively (p < 0.001). The highest RT doses
were observed in the left ventricle and left anterior descending coronary
artery for left-sided RT and in the right atrium and the right coronary
artery after right-sided RT. The highest left-minus-right dose-difference
was located in the distal part of the left anterior descending coronary
artery where also the highest left-versus-right ratio of events was
observed. However, no significant difference in the distribution of CAD
was observed by laterality. Furthermore, no significant differences in the
dose-volume parameters were observed for cases versus controls.
<br/>Conclusion(s): CAD tended to occur in the part of the heart with the
highest left-minus- right dose difference, however, no significant risk of
CAD was observed at 7 years' median follow-up.<br/>Copyright &#xa9; 2023
Elsevier B.V.

<60>
Accession Number
2022255506
Title
Displaced medial clavicle fractures: a systematic review of outcomes after
nonoperative and operative management.
Source
JSES International. 7(1) (pp 79-85), 2023. Date of Publication: January
2023.
Author
Kang L.X.; Faulkner H.J.; Howard W.H.; Low A.K.
Institution
(Kang, Howard) Department of Orthopaedics, John Hunter Hospital,
Newcastle, NSW, Australia
(Faulkner) Faculty of Medicine, University of New South Wales, NSW,
Australia
(Low) Faculty of Medicine, University of Sydney, NSW, Australia
(Low) Department of Orthopaedic surgery, Sydney Adventist Hospital, NSW,
Australia
Publisher
Elsevier B.V.
Abstract
Background: Fractures of the medial clavicle are uncommon. There is no
consensus regarding the optimal treatment of displaced medial clavicle
fractures. <br/>Method(s): A systematic review using Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was
performed. PubMed, EMBASE, and the Cochrane Library were queried using the
terms medial clavicle and fracture to identify all studies reporting on
outcomes following either nonoperative or operative treatment of displaced
medial clavicle fractures. Data extracted included patient demographics,
fracture classification, surgical technique, patient-reported outcomes,
physical, and radiographic findings. Study quality was evaluated using the
Methodological Index for Non-Randomized Studies (MINORS) scoring system.
<br/>Result(s): The analysis included 15 studies (mean MINORS score, 10
+/- 1.5) with a total of 135 patients (85% male, mean age 47 +/- 10.9
years [range, 15-87 years]). Five studies (39 patients) reported outcomes
following nonoperative treatment. At a mean follow-up of 27 months, there
were 5 (13%) symptomatic nonunions, 2 (5%) malunions, and 2 (5%) delayed
unions. Eleven studies (96 patients) reported outcomes following surgical
treatment with a mean follow-up of 23 months. There were no reported
nonunions. Complications included plate prominence/ irritation (30%) and
additional surgery was performed for plate removal (27%), fixation failure
(3%), and wound debridement (1%). <br/>Conclusion(s): There is limited,
low-quality evidence in the literature to guide treatment of displaced
medial clavicle fractures. The available data suggest that surgical
treatment is associated with good functional outcomes and a lower risk of
nonunion and malunion, compared to nonoperative treatment but plate
irritation and further surgery to remove the plate was
common.<br/>Copyright &#xa9; 2022

<61>
Accession Number
2019980943
Title
Do Patients With Non-Viable Myocardium From Ischemic Cardiomyopathy
Benefit From Revascularization? A Systematic Review And Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 47 (pp 27-32), 2023. Date of
Publication: February 2023.
Author
Davoudi F.; Miyashita S.; Yoo T.K.; Imahira U.; Kimmelstiel C.; Huggins
G.S.; Downey B.C.
Institution
(Davoudi) Department of Medicine, Mass General Brigham-Salem Hospital, MA,
United States
(Miyashita, Kimmelstiel, Huggins, Downey) Cardiology Division, Tufts
Medical Center and Tufts University School of Medicine, MA, United States
(Yoo) Department of Medicine, MetroWest Medical Center, MA, United States
(Imahira) Inpatient Psychiatry, Tufts Medical Center, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Myocardial viability assessment is used to select patients who
will derive the greatest benefit from revascularization. It remains
controversial whether revascularization only benefits patients with
ischemic cardiomyopathy who have viable myocardium. The objective of this
meta-analysis was to compare mortality between patients with ischemic
cardiomyopathy and non-viable myocardium who underwent revascularization
and those who underwent medical therapy alone. <br/>Method(s): The MEDLINE
database was searched using PubMed to retrieve studies published up to
December 2021. Inclusion criteria were 1. studies that evaluated the
impact of revascularization (revascularization group) versus medical
therapy alone (control group) following myocardial viability assessment;
2. patients who had coronary artery disease that was amenable to coronary
artery bypass grafting or percutaneous coronary intervention; and 3.
patients who had non-viable myocardium. The main outcome measure was
all-cause mortality. <br/>Result(s): A total of 12 studies were included,
evaluating 1363 patients with non-viable myocardium, of whom 501 patients
underwent revascularization and 862 patients received medical therapy
alone. There was a significant reduction in all-cause mortality (RR 0.76,
95 % CI: 0.62-0.93, I² = 0) in the revascularization group
compared to the control group. There was no association between the type
of viability imaging modality and the risk of all-cause mortality
(P-interaction = 0.58). <br/>Conclusion(s): The findings of this
meta-analysis suggest a benefit from revascularization compared to medical
therapy in patients with ischemic cardiomyopathy despite the lack of
myocardial viability.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<62>
Accession Number
2020479974
Title
Justification of empiric methodology to determine dexmedetomidine dose for
the TREX study.
Source
Paediatric Anaesthesia. 33(3) (pp 236-242), 2023. Date of Publication:
March 2023.
Author
Disma N.; Goffredo B.M.; Cairoli S.; Cirillo G.; Morse J.; Anderson B.J.;
Bonfiglio R.; Cordani R.; Garrone M.; Patrone E.; Iengo A.; Bocca P.; Izzo
F.; Diotto V.; Lenares E.; Robino C.; Neri S.; Colantonio L.; Calderini
E.; Picardo S.; Tucci I.; Di Persio A.; Montagnini L.; Blesi L.; Pistone
B.; Kuppers B.; De Lorenzo B.; Caramelli F.; Pasini L.
Institution
(Disma, Cirillo) Unit for Research and Innovation, Department of
Anaesthesia, IRCCS Istituto Giannina Gaslini, Genova, Italy
(Goffredo, Cairoli) Division of Metabolic Disease and Drug Biology, IRCCS
Ospedale Bambino Gesu, Rome, Italy
(Morse, Anderson) Department Anesthesiology, Faculty Medicine and Health
Science, University of Auckland, Auckland, New Zealand
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Dexmedetomidine is the sedative agent administered in
combination with remifentanil and low dose of sevoflurane in the
interventional arm of the ongoing TREX trial (Trial Remifentanil
DExmedetomidine). The TREX pilot study (published in Paediatr Anaesth
2019;29:59-67) established infusion rates higher than those initially
proposed. This could be attributed to an inappropriate target
concentration for sedation or incorrect initial pharmacokinetic parameter
estimates. <br/>Method(s): The TREX study is a Phase III, randomized,
active controlled, parallel group, blinded evaluator, multicenter,
superiority trial comparing neurological outcome after standard
sevoflurane anesthesia with dexmedetomidine/remifentanil, and low dose
sevoflurane anesthesia in children aged less than 2 years undergoing
anesthesia of 2 h or longer. In this report, dexmedetomidine
pharmacokinetics were analyzed in the interventional arm of the Italian
population. <br/>Result(s): There were 162 blood samples from 32 infants
(22 male and 10 female). The median (IQR) age was 12 (5.2-15.5) months,
weight 9.9 (7.3-10.8) kg. Duration of anesthesia ranged from 2 to 6 h.
None of the children were born premature (median postnatal age 39 weeks,
IQR 38-40 weeks). A 3-compartment PK model that incorporated allometric
scaling and a maturation function demonstrated plasma concentration
observations from the current Italian arm of the TREX study were
consistent with those predicted by a "universal" model using pooled data
obtained from neonates to adults. <br/>Conclusion(s): This current PK
analysis from the Italian arm of the TREX study confirms that plasma
concentration of dexmedetomidine is predictable using known covariates
such as age and size. The initial target concentration (0.6
mug.L^-1) used to sedate children cared for in the intensive
care after cardiac surgery was inadequate for infants in the current TREX
study. A target concentration 1 mcg.L^-1, corresponding to a
loading dose of 1 mcg.kg^-1 followed by an infusion of 1
mcg.kg^-1.h^-1, provided adequate
sedation.<br/>Copyright &#xa9; 2022 The Authors. Pediatric Anesthesia
published by John Wiley & Sons Ltd.

<63>
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.

<64>
Accession Number
2022494478
Title
Efficacy of Auricular Acupuncture and Lavender Oil Aromatherapy in
Reducing Preinterventional Anxiety in Cardiovascular Patients: A
Randomized Single-Blind Placebo-Controlled Trial.
Source
Journal of Integrative and Complementary Medicine. 28(1) (pp 45-50), 2022.
Date of Publication: 01 Jan 2022.
Author
Patsalis P.C.; Malik-Patsalis A.B.; Rauscher H.G.; Schaefers C.; Useini
D.; Strauch J.T.; Zahn P.K.; Dobos G.J.; Mugge A.; Cramer H.
Institution
(Patsalis, Rauscher, Schaefers, Mugge) Department of Cardiology and
Angiology, University Hospital Bergmannsheil, Ruhr University Bochum,
Bochum, Germany
(Patsalis) Division of Cardiology and Emergency Medicine, Department of
Medicine, Knappschaft University Hospital, Ruhr University Bochum, Bochum,
Germany
(Malik-Patsalis, Dobos, Cramer) Department of Internal and Integrative
Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of
Duisburg-Essen, Essen, Germany
(Useini, Strauch) Department of Cardiothoracic Surgery, University
Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
(Zahn) Department of Anesthesiology, Intensive Care Medicine, Palliative
Care Medicine and Pain Management, University Hospital Bergmannsheil, Ruhr
University Bochum, Bochum, Germany
Publisher
Mary Ann Liebert Inc.
Abstract
Introduction: Auricular acupuncture at the "relaxation point"and lavender
oil aromatherapy can reduce preoperative anxiety associated with increased
mortality and morbidity. Data on the effect of combined auricular
acupuncture and lavender oil aromatherapy in patients undergoing
cardiovascular interventions with the use of local anesthesia or under
conscious sedation are sparse. The authors sought to evaluate the efficacy
of auricular acupuncture and lavender oil aromatherapy in reducing
preinterventional anxiety in cardiovascular patients. <br/>Material(s) and
Method(s): Data of 80 consecutive patients undergoing diagnostic coronary
angiography (n = 56) with or without percutaneous coronary intervention (n
= 9) and right heart catheterization (n = 6), transcatheter aortic valve
replacement (n = 17) and percutaneous mitral valve repair (MitraClip; n =
2) were analyzed. Patients were prospectively randomized to receive either
preinterventional auricular acupuncture and lavender oil (Lavandula
angustifolia) aromatherapy (verum group, n = 39) or combined sham
auricular acupuncture and placebo oil aromatherapy (placebo group, n =
41). For the verum group bilateral auricular acupuncture was performed at
the "relaxation point."State anxiety and blood pressure were assessed
before and at 30 min after acupuncture and presternal oil application.
State anxiety was defined as primary outcome measure and assessed using
the Spielberger State Anxiety Inventory (STAI) for Adults form Y6.
Intervention-specific anxiety was assessed by a 10-point numerical rating
scale, and perceived treatment success by a single dichotomous question.
Clinical blood pressure was further assessed. <br/>Result(s): After the
intervention, the verum group had significantly decreased anxiety on the
STAI compared with the placebo group (DELTA=-4.18; 95% confidence interval
=-8.31 to-0.05; p = 0.047). Significantly more patients reported
subjective treatment success in the verum group (87.2%) than in the
placebo group (65.9%, p = 0.035). No significant differences were observed
regarding intervention-specific anxiety and blood pressure between the two
groups. No serious adverse events occurred in any group.
<br/>Conclusion(s): Combined auricular acupuncture and lavender oil
aromatherapy can decrease preinterventional anxiety in cardiovascular
patients and requires further investigation. German Clinical Trials
Register (registration no. DRKS00023686).<br/>&#xa9; Copyright 2022, Mary
Ann Liebert, Inc., publishers 2022.

<65>
Accession Number
2019558212
Title
Identifying the Optimal Exercise Prescription for Patients with Coronary
Artery Disease Undergoing Cardiac Rehabilitation: Protocol for a
Systematic Review and Network Meta-Analysis of Randomized Control Trials.
Source
International Journal of Environmental Research and Public Health. 19(19)
(no pagination), 2022. Article Number: 12317. Date of Publication: October
2022.
Author
Shah S.; Dibben G.; Ketkar A.; Hare D.L.; Myers J.; Franklin B.; Babu
A.S.; Taylor R.S.
Institution
(Shah, Babu) Department of Physiotherapy, Manipal College of Health
Professions, Manipal Academy of Higher Education, Manipal 576104, India
(Dibben, Taylor) MRC/CSO Social and Public Health Sciences Unit &
Robertson Centre for Biostatistics, Institute of Health and Well Being,
University of Glasgow, Glasgow G12 8QQ, United Kingdom
(Ketkar) DES Institutes, Brijlal Jindal College of Physiotherapy, Pune
411004, India
(Hare, Babu) Department of Cardiology, Austin Health, University of
Melbourne, Melbourne, VIC 3084, Australia
(Myers) Department of Cardiology, Veterans Affairs Palo Alto Health Care
System/Stanford University, Palo Alto, CA 94304, United States
(Franklin) Department of Preventive Cardiology and Cardiac Rehabilitation,
William Beaumont Hospital, Royal Oak, MI 48073, United States
Publisher
MDPI
Abstract
Coronary artery disease (CAD) is one of the leading causes of mortality
and morbidity. Exercise-based cardiac rehabilitation (EBCR) has been shown
to improve clinical outcomes in these patients, and yet clinicians are
often challenged to prescribe the most effective type of exercise
training. Therefore, this systematic review and network meta-analysis
(NMA) aims to formally quantify the optimal dose of exercise training
interventions to improve exercise capacity and quality of life by
undertaking direct and indirect pooled comparisons of randomized
controlled trials. A detailed search will be conducted on PubMed/MEDLINE,
Cumulative Index to Nursing and Allied Health (CINAHL), EMBASE and Web of
Science. Two reviewers will screen the existing literature and assess the
quality of the studies. Disagreements will be resolved through consensus.
We anticipate that the analysis will include pairwise and Bayesian network
meta-analyses. Most of the trials have studied the impact of exercise
training comparing one or two modalities. As a result, little evidence
exists to support which interventions will be most effective. The current
NMA will address this gap in the literature and assist clinicians and
cardiac rehabilitation specialists in making an informed decision. Results
will be disseminated through peer-reviewed journals. Ethical approval is
not applicable, as no research participants will be involved. PROSPERO
Registration number: CRD42022262644.<br/>Copyright &#xa9; 2022 by the
authors.

<66>
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.

<67>
Accession Number
2020781834
Title
Intensive versus conservative glycemic control in patients undergoing
coronary artery bypass graft surgery: A protocol for systematic review of
randomised controlled trials.
Source
PLoS ONE. 17(10 October) (no pagination), 2022. Article Number: e0276228.
Date of Publication: October 2022.
Author
Liu Y.; Sun X.-X.; Du W.-Y.; Chen T.-T.; Lv M.
Institution
(Liu, Sun, Du, Chen, Lv) Department of Anesthesiology, The First
Affiliated Hospital of Shandong First Medical University, Shandong
Provincial Qianfoshan Hospital, Shandong Province, Ji'nan, China
Publisher
Public Library of Science
Abstract
Introduction Hyperglycemia and hypoglycemia are common during coronary
artery bypass graft (CABG) and are associated with a variety of
postoperative outcomes. Therefore, the strategy of intraoperative glycemic
control is an important issue for the patients undergoing CABG. This
systematic review aims to evaluate the effect of different intraoperative
glycemic control strategies on postoperative outcomes. Methods and
analyses We will perform this systematic review of randomised controlled
trials (RCTs) according to the recommendations of the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA). Relevant studies
will be searched in Medline, Embase, Cochrane Library and Web of Science.
Two independent reviewers will conduct study selection, data extraction,
risk of bias and quality assessment. The primary outcome is postoperative
mortality, and the secondary outcomes include the duration of mechanical
ventilation in the intensive care unit (ICU), the incidence of
postoperative myocardial infarction (MI), the incidence of postoperative
atrial fibrillation (AF), the type and volume of blood product
transfusion, the rate of rehospitalization, the rate of cerebrovascular
accident, the rate of significant postoperative bleeding, the rate of
infection, the incidence of acute kidney failure (AKF), hospital and ICU
lengths of stay (LOS). ReviewManager 5.4 will be used for data management
and statistical analysis. The Cochrane risk-of -bias tool 2.0 and GRADEpro
will be applied for risk of bias and quality assessment of the evidence.
Discussion There is no consensus that which strategy of glycemic control
is better for improving postoperative complications of patients undergoing
CABG. The results of our study might provide some evidence for the
relationship between intraoperative glycemic control strategies and
postoperative outcomes in patients undergoing CABG.<br/>Copyright &#xa9;
2022 Liu et al. This is an open access article distributed under the terms
of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original
author and source are credited.

<68>
Accession Number
2018804630
Title
Comparison of efficacy and safety between VKAs and DOACs in patients with
atrial fibrillation after transcatheter aortic valve replacement: A
systematic review and meta-analysis.
Source
Clinical Cardiology. 45(10) (pp 1002-1010), 2022. Date of Publication:
October 2022.
Author
Yan J.; Liu M.; Zhang Y.; Yang D.; An F.
Institution
(Yan, Liu, Zhang, Yang, An) 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 of
Shandong University, Jinan, China
Publisher
John Wiley and Sons Inc
Abstract
In the past decade, direct oral anticoagulants (DOACs) have proven to be
the best option for patients with nonvalvular atrial fibrillation.
Nevertheless, evidence for the use of DOACs for anticoagulation in
valvular atrial fibrillation, particularly after aortic valve replacement,
remains inadequate. Thus, we conducted a meta-analysis to compare the
efficacy and safety of vitamin K antagonists (VKAs) and DOACs in patients
with atrial fibrillation after transcatheter aortic valve replacement
(TAVR). We conducted a comprehensive search of online databases, and 11
studies were included in the final analysis. The primary endpoint was
all-cause mortality. Secondary endpoints included stroke and
cardiovascular death. The safe endpoint is major and/or life-threatening
bleeding. Subgroup analysis was conducted according to the different
follow-up time of each study. Random-effects models were used for all
outcomes. Statistical heterogeneity was assessed using chi²
tests and quantified using I² statistics. Patients in the DOACs
group had a significantly lower risk of all-cause mortality compared with
patients in the VKAs group (relative risk [RR]: 1.20, 95% confidence
interval [CI]: 1.01-1.43, p =.04). This benefit may be greater with longer
follow-up. In a subgroup analysis based on the length of follow-up, a
significantly lower risk of all-cause mortality was found in the DOACs
group in the subgroup with a follow-up time of >12 months (RR: 1.50, 95%
CI: 1.07-2.09, p =.001). There were no significant differences between the
two groups in cardiovascular death, stroke, and major and/or
life-threatening bleeding. For patients with atrial fibrillation after
TAVR, the use of DOACs may be superior to VKAs, and the benefit may be
greater with longer follow-up. The anticoagulant strategy for atrial
fibrillation after TAVR is a valuable direction for future
research.<br/>Copyright &#xa9; 2022 The Authors. Clinical Cardiology
published by Wiley Periodicals, LLC.

<69>
Accession Number
2021070893
Title
Early surgical intervention versus conservative management of asymptomatic
severe aortic stenosis: A systematic review and meta-analysis.
Source
Heart. 109(4) (pp 314-321), 2022. Date of Publication: 05 Oct 2022.
Author
Costa G.N.F.; Cardoso J.F.L.; Oliveiros B.; Goncalves L.; Teixeira R.
Institution
(Costa, Goncalves, Teixeira) Servico de Cardiologia, Centro Hospitalar e
Universitario de Coimbra, Coimbra, Portugal
(Costa, Oliveiros, Goncalves, Teixeira) Faculty of Medicine, University of
Coimbra, Coimbra, Portugal
(Cardoso) Centro Hospitalar de Vila Nova de Gaia, Servico de Cirurgia
Cardio-toracica, Vila Nova de Gaia, Portugal
Publisher
BMJ Publishing Group
Abstract
Objective Timing of intervention for patients with asymptomatic severe
aortic stenosis (AS) remains controversial. To compare the outcomes of
early aortic valve replacement (AVR) versus watchful waiting (WW) in
patients with asymptomatic severe AS. Methods We systematically searched
PubMed, Embase and Cochrane databases, in December 2021, for studies
comparing early AVR with WW in the treatment of asymptomatic severe AS.
Random-effects meta-analysis was performed. Results Twelve studies were
included in which two were randomised clinical trials. A total of 4130
patients were included, providing a 1092 pooled death events. Our
meta-analysis showed a significantly lower all-cause mortality for the
early AVR compared with WW group, although with a high amount of
heterogeneity between studies in the magnitude of the effect (pooled OR
0.40; 95% CI 0.35 to 0.45, p<0.01; I2=61%). An early surgery strategy
displayed a significantly lower cardiovascular mortality (pooled OR 0.33;
95% CI 0.19 to 0.56, p<0.01; I2=64%) and heart failure hospitalisation
(pooled OR 0.19; 95% CI 0.10 to 0.39, p<0.01, I2=7%). However, both groups
had similar rates of stroke (pooled OR 1.30; 95% CI 0.73 to 2.29, p=0.36,
I2=0%) and myocardial infarction (pooled OR 0.49; 95% CI 0.19 to 1.27,
p=0.14, I2= 0%). Conclusions This study suggests that for patients with
asymptomatic severe AS an early surgical intervention compared with a
conservative WW strategy was associated with a lower heart failure
hospitalisation and a similar rate of stroke or myocardial infarction,
although with significant risk of bias. PROSPERO registration number
CRD42021291144.<br/>Copyright &#xa9; 2022 Authors. All rights reserved.

<70>
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.

<71>
Accession Number
638983662
Title
Clinical factors affecting survival in patients with D-transposition of
the great arteries after atrial switch repair: A meta-analysis.
Source
Kardiologia polska. 81(1) (pp 38-47), 2023. Date of Publication: 2023.
Author
Nartowicz S.A.; Jakielska E.; Cieplucha A.; Ratajczak P.; Grajek S.;
Lesiak M.; Trojnarska O.
Institution
(Nartowicz, Jakielska, Grajek, Lesiak, Trojnarska) Poznan University of
Medical Sciences, Poznan, Poland
(Cieplucha) 1st Department of Cardiology, Poznan University of Medical
Sciences, Poznan, Poland
(Ratajczak) Department of Pharmacoeconomics and Social Pharmacy, Poznan
University of Medical Sciences, Poznan, Poland
Publisher
NLM (Medline)
Abstract
BACKGROUND: Atrial switch repair (AtrSR) was the initial operation method
in patients with D-transposition of the great arteries (D-TGA)
constituting the right ventricle as a systemic one. Currently, it has been
replaced with arterial switch operation (ASO), but the cohort of adults
after AtrSR is still large and requires strict cardiological management of
late complications. For this reason, we aimed to evaluate potential
long-term mortality risk factors in patients with D-TGA after AtrSR
(either Mustard or Senning procedures) Methods: We searched the MEDLINE
database for suitable trials. We included 22 retrospective and prospective
cohort studies of patients with D-TGA with at least 5 years mean/median
follow-up time after Mustard or Senning procedures, with an endpoint of
non-sudden cardiac death (n-SCD) and sudden cardiac death (SCD) after at
least 30 days following surgery. <br/>RESULT(S): A total of 2912 patients
were enrolled, of whom 351 met the combined endpoint of n-SCD/SCD. The
long-term mortality risk factors were New York Heart Association (NYHA)
class >=III/heart failure hospitalization (odds ratio [OR], 7.25; 95%
confidence interval [CI], 2.67-19.7), tricuspid valve regurgitation (OR,
4.64; 95% CI, 1.95-11.05), Mustard procedure (OR, 2.15; 95% CI,
1.37-3.35), complex D-TGA (OR, 2.41; 95% CI, 1.31-4.43), and right
ventricular dysfunction (OR, 1.94; 95% CI, 0.99-3.79). Supraventricular
arrhythmia (SVT; OR, 2.07; 95% CI, 0.88-4.85) and pacemaker implantation
(OR, 2.37; 95% CI, 0.48-11.69) did not affect long-term survival in this
group of patients. In an additional analysis, SVT showed a statistically
significant impact on SCD (OR, 2.74; 95% CI, 1.36-5.53) but not on n-SCD
(OR, 1.5; 95% CI, 0.37-6.0). <br/>CONCLUSION(S): This meta-analysis
demonstrated that at least moderate tricuspid valve regurgitation, NYHA
class >=III/heart failure hospitalization, right ventricular dysfunction,
complex D-TGA, and Mustard procedure are risk factors for long-term
mortality in patients after AtrSR.

<72>
Accession Number
639360214
Title
Usefulness of Analgesia Nociception Index for guiding intraoperative
opioid administration: a systematic review and meta-analysis.
Source
Minerva anestesiologica. 89(1-2) (pp 74-84), 2023. Date of Publication: 01
Jan 2023.
Author
Hung K.-C.; Chang P.-C.; Hsu C.-W.; Lan K.-M.; Liao S.-W.; Lin Y.-T.;
Huang P.-W.; Sun C.-K.
Institution
(Hung, Lan, Liao, Lin) Department of Anesthesiology, Chi Mei Medical
Center, Tainan, Taiwan (Republic of China)
(Chang) Division of Thoracic Surgery, Department of Surgery, Kaohsiung
Medical University Hospital/Kaohsiung Medical University, Kaohsiung,
Taiwan (Republic of China)
(Chang) Weight Management Center, Kaohsiung Medical University
Hospital/Kaohsiung Medical University, Kaohsiung, Taiwan (Republic of
China)
(Chang) Department of Sports Medicine, College of Medicine, Kaohsiung
Medical University, Kaohsiung, Taiwan (Republic of China)
(Chang) Program in Biomedical Engineering, College of Medicine, Kaohsiung
Medical University, Kaohsiung, Taiwan (Republic of China)
(Hsu) Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and
Chang Gung University College of Medicine, Kaohsiung, Taiwan (Republic of
China)
(Huang) Department of Emergency Medicine, Show Chwan Memorial Hospital,
Taiwan (Republic of China)
(Sun) Department of Emergency Medicine, E-Da Hospital, Kaohsiung, Taiwan
(Republic of China)
(Sun) College of Medicine, I-Shou University, Kaohsiung, Taiwan (Republic
of China)
Publisher
NLM (Medline)
Abstract
INTRODUCTION: This study primarily aimed at investigating the efficacy of
Analgesia Nociception Index (ANI) for guiding intraoperative opioid
administration in patients receiving surgery under general anesthesia.
EVIDENCE ACQUISITION: The Medline, Embase, Google scholar, and the
Cochrane Library databases were searched from inception to April 2022 for
randomized controlled trials. The primary outcome was intraoperative
opioid administration, while the secondary outcomes included postoperative
opioid consumption, pain score, emergency time, risk of nausea/vomiting
(PONV), and Postanesthesia Care Unit (PACU) stay. EVIDENCE SYNTHESIS: Six
studies including 399 participants (published from 2015 to 2022) focused
on non-cardiac surgery, including spine surgery (two trials), breast
surgery (two trials), gynecologic surgery (one trial), and laparoscopic
cholecystectomy (one trial) were included. Meta-analysis revealed no
difference in intraoperative opioid administration with the use of
ANI-guided analgesia compared to the control group that used conventional
clinical measurements (e.g., heart rate) to guide opioid use [standardized
mean difference (SMD)=-0.17, 95% CI: -0.56 to 0.22, P=0.39, I2=72%, six
trials, 399 participants]. Gender-based subgroup analysis showed
effectiveness of ANI for reducing opioid administration in female patients
(SMD=-0.53, P=0.02). There were no differences in postoperative recovery
characteristics including pain score [Mean difference (MD): -0.03,
P=0.79], opioid consumption (SMD: -0.34, P=0.08), emergence time (MD=1.12,
P=0.47), length of stay in the PACU (MD: -0.56, P=0.83), and risk of PONV
[risk ratio(RR): 0.75, P=0.46] between the two groups. <br/>CONCLUSION(S):
Analgesia nociception index-guided analgesia was unable to reduce
intraoperative opioid administration compared to monitoring using
conventional clinical parameters. Further studies are required to support
our findings.

<73>
Accession Number
2022079986
Title
Chiari network for the interventional cardiologist: A hidden enemy at the
heart gate - A systematic review of the literature.
Source
International Journal of Cardiology. 375 (pp 23-28), 2023. Date of
Publication: 15 Mar 2023.
Author
Ali H.; Lupo P.; Cristiano E.; Nicoli L.; Foresti S.; De Ambroggi G.;
Anderson R.H.; De Lucia C.; Turturiello D.; Paganini E.M.; Bessi R.;
Farghaly A.A.A.; Butera G.; Cappato R.
Institution
(Ali, Lupo, Cristiano, Nicoli, Foresti, De Ambroggi, De Lucia,
Turturiello, Paganini, Bessi, Farghaly, Cappato) Arrhythmia &
Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan,
Italy
(Anderson) Institute of Genetic Medicine, Newcastle University, Newcastle
Upon Tyne, United Kingdom
(Farghaly) Cardiovascular Department, Assiut University, Assiut, Egypt
(Butera) Department of Paediatric Cardiology, Cardiac Surgery and Heart
Lung Transplantation, ERN GUARD HEART: Bambin Gesu Hospital and Research
Institute, IRCCS, Rome, Italy
(Butera) Department of Paediatric and Adult Congenital Heart Disease,
Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation
Trust, London, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Background: This study aimed to collect and analyze the literature data
regarding Chiari network (CN) and other right atrium (RA) remnants
comprising the Eustachian and Thebesian valves (EV, ThV) as a potential
entrapment site during different percutaneous cardiac procedures (PCP).
<br/>Methods and Results: A systematic search was conducted using Pubmed
and Embase databases following the PRISMA guidelines to obtain available
data concerning PCP associated with entrapment of inserted materials
within CN-EV-ThV. The final analysis included 41 patients who underwent
PCP with reported material entrapment within these RA remnants. The PCP
was atrial septal defect (ASD)/patent foramen ovale (PFO) closure,
catheter ablation, and pacemaker/defibrillator implantation in 44%, 22%,
and 17% of patients, respectively. The entrapped materials were ASD/PFO
devices, multipolar electrophysiology catheters, passive-fixation pacing
leads, and J-guidewires in about 30%, 20%, 15%, and 10% of patients,
respectively. Intraprocedural transthoracic, transoesophageal and
intracardiac echocardiography showed sensitivity to reveal these
structures of 20%, ~95%, and 100%, respectively. A percutaneous approach
successfully managed 70% of patients, while cardiovascular surgery was
required in 20% and three patients died (7.3%). <br/>Conclusion(s): CN and
other RA remnants may cause entrapment of various devices or catheters
during PCP requiring right heart access. The percutaneous approach, guided
by intraprocedural imaging, appears safe and effective in managing most
patients. Prevention includes recognizing these anatomical structures at
baseline cardiac imaging and intraprocedural precautions. Further studies
are needed to analyze the actual incidence of this condition, its clinical
impact and appropriate management.<br/>Copyright &#xa9; 2022 Elsevier B.V.

<74>
Accession Number
2021993104
Title
External validation of the PROGRESS-CTO complication risk scores:
Individual patient data pooled analysis of 3 registries.
Source
International Journal of Cardiology. 375 (pp 14-20), 2023. Date of
Publication: 15 Mar 2023.
Author
Simsek B.; Tajti P.; Carlino M.; Ojeda S.; Pan M.; Rinfret S.; Vemmou E.;
Kostantinis S.; Nikolakopoulos I.; Karacsonyi J.; Dens J.A.; Agostoni P.;
Alaswad K.; Megaly M.; Avran A.; Choi J.W.; Jaffer F.A.; Doshi D.;
Karmpaliotis D.; Khatri J.J.; Knaapen P.; La Manna A.; Spratt J.C.; Tanabe
M.; Walsh S.; Mastrodemos O.C.; Allana S.; Rempakos A.; Rangan B.V.;
Goktekin O.; Gorgulu S.; Poommipanit P.; Kearney K.E.; Lombardi W.L.;
Grantham J.A.; Mashayekhi K.; Brilakis E.S.; Azzalini L.
Institution
(Simsek, Kostantinis, Karacsonyi, Mastrodemos, Allana, Rempakos, Rangan,
Brilakis) Minneapolis Heart Institute, Minneapolis Heart Institute
Foundation, Minneapolis, MN, United States
(Tajti) The Gottsegen National Cardiovascular Center, Budapest, Hungary
(Carlino) Interventional Cardiology Division, Cardio-Thoracic-Vascular
Department, San Raffaele Scientific Institute, Milan, Italy
(Ojeda, Pan) Division of Interventional Cardiology, Reina Sofia Hospital,
University of Cordoba, Maimonides Institute for Research in Biomedicine of
Cordoba (IMIBIC), Cordoba, Spain
(Rinfret) Emory Heart and Vascular Center, Emory University School of
Medicine, Atlanta, GA, United States
(Vemmou, Nikolakopoulos) Department of Internal Medicine, Yale University
School of Medicine, New Haven, CT, United States
(Dens) Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium
(Agostoni) Hartcentrum, Ziekenhuis Netwerk Antwerpen Middelheim, Antwerp,
Belgium
(Alaswad) Henry Ford Health System, Detroit, MI, United States
(Megaly) Division of Cardiology, Willis Knighton Heart Institute,
Shreveport, LA, United States
(Avran) Department of Interventional Cardiology, Clinique Pasteur,
Essey-les-Nancy, France
(Choi) Presbyterian Hospital, Dallas, TX, United States
(Jaffer, Doshi) Massachusetts General Hospital, Harvard Medical School,
Boston, MA, United States
(Karmpaliotis) Morristown Medical Center, Morristown, NJ, United States
(Khatri) Cleveland Clinic Foundation, Cleveland, OH, United States
(Knaapen) Department of Cardiology, VU University Medical Center,
Amsterdam, Netherlands
(La Manna) University of Catania, Catania, Italy
(Spratt) St. George's University Healthcare NHS Trust, London, United
Kingdom
(Tanabe) Department of Cardiology, Nozaki Tokushukai Hospital, Osaka,
Japan
(Walsh) Belfast Health, Belfast, United Kingdom
(Goktekin) Division of Cardiology, Memorial Bahcelievler Hospital,
Istanbul, Turkey
(Gorgulu) Division of Cardiology, Biruni University School of Medicine,
Istanbul, Turkey
(Poommipanit) University Hospitals, Cleveland, OH, United States
(Kearney, Lombardi, Azzalini) Division of Cardiology, Department of
Medicine, University of Washington, Seattle, WA, United States
(Grantham) Saint Luke's Mid America Heart Institute, Kansas City, MO,
United States
(Mashayekhi) Heart Center Lahr, Department for Internal Medicine and
Cardiology, Germany
Publisher
Elsevier Ireland Ltd
Abstract
Background: Chronic total occlusion (CTO) percutaneous coronary
intervention (PCI) is associated with a considerable risk of
complications, and risk stratification is of utmost importance.
<br/>Aim(s): To assess the clinical usefulness of the recently developed
PROGRESS-CTO (NCT02061436) complication risk scores in an independent
cohort. <br/>Method(s): Individual patient data pooled analysis of 3
registries was performed. <br/>Result(s): Of the 4569 patients who
underwent CTO PCI, 102 (2.2%) had major adverse cardiovascular events
(MACE). Patients with MACE were older (69 +/- 11 vs. 65 +/- 10, p <
0.001), more likely to have a history of prior coronary artery bypass
graft surgery, and unfavorable angiographic characteristics J-CTO score
(2.4 +/- 1.2 vs. 2.1 +/- 1.3, p = 0.007), including blunt stump (59% vs.
49%, p = 0.047). Technical success was lower in patients with MACE (59%
vs. 86%, p < 0.001). The area under the receiver operating characteristic
curve of the PROGRESS-CTO complication risk models were as follows: MACE
0.72 (95% confidence interval [CI], 0.67-0.76), mortality 0.73 (95% CI,
0.61-0.85), and pericardiocentesis 0.69 (95% CI, 0.62-0.77) in the
validation dataset. The observed complication rates increased with higher
PROGRESS-CTO complication scores. The PROGRESS-CTO MACE score showed good
calibration in this external cohort, with MACE rates similar to the
original study: 0.7% (score 0-1), 1.5% (score 2), 2.2% (score 3), 3.8%
(score 4), 4.9% (score 5), 5.8% (score 6-7). <br/>Conclusion(s): Given the
good discriminative performance, calibration, and ease of calculation, the
PROGRESS-CTO complication scores could help assess the risk of
complications in patients undergoing CTO PCI.<br/>Copyright &#xa9; 2022
Elsevier B.V.

<75>
Accession Number
640013624
Title
Comparison of meta-analytical estimates of outcomes after Alfieri or
neochordal repair in isolated anterior mitral prolapse.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 63(2) (no pagination),
2023. Date of Publication: 03 Feb 2023.
Author
Khairallah S.; Rahouma M.; Dabsha A.; Demetres M.; Gaudino M.F.; Mick S.L.
Institution
(Khairallah, Rahouma, Dabsha, Gaudino, Mick) Cardiothoracic Surgery
Department, Weill Cornell Medicine New York-Presbyterian Hospital (WCM),
New York, NY, USA
(Demetres) Scholarly Communications Librarian, Weill Cornell Medicine
(WCM), Samuel J. Wood Library & C.V. Starr Biomedical Information Center,
New York, NY, USA
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Repair of the isolated degenerative anterior mitral leaflet
has been considered more challenging and associated with compromised
durability compared with isolated posterior leaflet in major series.
Implantation of neochordae or Alfieri edge-to-edge is the most employed
repair technique for isolated anterior repair currently, but little data
exist comparing their relative durability. We sought to investigate this
issue with this meta-analysis. <br/>METHOD(S): A literature search was
performed (Ovid MEDLINE, Ovid Embase and The Cochrane Library). The
primary outcome was the incidence rate (IR) of reoperation, the secondary
outcomes were recurrent moderately severe/severe mitral regurgitation
(MR), in-hospital/30-day reoperation and mortality and follow-up
mortality. A random-effect model was used. Leave-one-out, subgroup
analysis (Alfieri versus neochordae) and meta-regression were done.
<br/>RESULT(S): Seventeen studies (including 1358 patients) were included.
At a weighted mean follow-up of 5.56+/-3.31years, the IR for reoperation
was 14.45 event per 1000 person-year and significantly lower in Alfieri
than neochordae repair (9.40 vs 18.61, P=0.04) on subgroup analysis. The
IR of follow-up moderately severe/severe MR was 19.89 event per 1000
person-year and significantly lower in Alfieri than neochordae repair
(10.68 and 28.63, P=0.01). In a sensitivity analysis comparing homogenous
studies, a significant difference in the recurrence of regurgitation in
favour of the Alfieri approach remained. There were no differences in
operative outcomes or survival. There were significant associations
between increased incidence of late reoperation and New York Heart
Association class III/IV and associated coronary artery bypass graft
procedure for whole cohort. <br/>CONCLUSION(S): Alfieri repair may be
associated with a lower incidence of recurrent MR compared with
neochordae-based repair in the setting of isolated degenerative anterior
mitral pathology. This is the first such meta-analysis and further inquiry
into this area is needed.<br/>Copyright &#xa9; The Author(s) 2023.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<76>
Accession Number
2021373528
Title
Levosimendan in patients undergoing extracorporeal membrane oxygenation
after cardiac surgery: an emulated target trial using observational data.
Source
Critical Care. 27(1) (no pagination), 2023. Article Number: 51. Date of
Publication: December 2023.
Author
Massol J.; Simon-Tillaux N.; Tohme J.; Hariri G.; Dureau P.; Duceau B.;
Belin L.; Hajage D.; De Rycke Y.; Charfeddine A.; Lebreton G.; Combes A.;
Bougle A.
Institution
(Massol, Simon-Tillaux, Tohme, Hariri, Dureau, Duceau, Belin, Hajage, De
Rycke, Charfeddine, Lebreton, Combes, Bougle) Department of Anesthesiology
and Critical Care Medicine, La Pitie-Salpetriere University Hospital,
47-83 Boulevard de L'Hopital, Paris 75013, France
Publisher
BioMed Central Ltd
Abstract
Background: Retrospective cohorts have suggested that levosimendan may
facilitate the weaning of veno-arterial extracorporeal membrane
oxygenation (VA-ECMO). We therefore studied this clinical question by
emulating a randomized trial with observational data. <br/>Method(s): All
patients with refractory postcardiotomy cardiogenic shock and assisted
with VA-ECMO, admitted to a surgical intensive care unit at La
Pitie-Salpetriere Hospital between 2016 and 2019, were eligible. To avoid
immortal-time bias, we emulated a target trial sequentially comparing
levosimendan administration versus no levosimendan administration in
patients treated with VA-ECMO. The primary outcome was time to successful
ECMO weaning. The secondary outcomes were 30-day and 1-year mortality. We
performed a multivariable analysis to adjust for confounding at baseline.
<br/>Result(s): Two hundred and thirty-nine patients were included in the
study allowing building a nested trials cohort of 1434 copies of patients.
No association of levosimendan treatment and VA-ECMO weaning was found (HR
= 0.91, [0.57; 1.45], p = 0.659 in multivariable analysis), or 30-day
mortality (OR = 1.03, [0.52; 2.03], p = 0.940) and 1-year mortality (OR =
1.00, [0.53; 1.89], p = 0.999). <br/>Conclusion(s): Using the emulated
target trial framework, this study did not find any association of
levosimendan treatment and ECMO weaning success after postcardiotomy
cardiogenic shock. However, the population of interest remains
heterogeneous and subgroups might benefit from levosimendan.<br/>Copyright
&#xa9; 2023, The Author(s).

<77>
Accession Number
2020023270
Title
Cognitive function and delirium following sevoflurane or propofol
anesthesia for valve replacement surgery: A multicenter randomized
controlled trial.
Source
Kaohsiung Journal of Medical Sciences. 39(2) (pp 166-174), 2023. Date of
Publication: February 2023.
Author
Duan G.-Y.; Duan Z.-X.; Chen H.; Chen F.; Du Z.-Y.; Chen L.-Y.; Lu K.-Z.;
Zuo Z.-Y.; Li H.
Institution
(Duan, Duan, Chen, Chen, Chen, Du, Li) Department of Anesthesiology,
Second Affiliated Hospital of Army Military Medical University, Chongqing,
China
(Chen) Department of Anesthesiology, Field Surgery Center, Army Medical
University, Chongqing, China
(Lu) Department of Anesthesiology, The First Affiliated Hospital of Army
Medical University, Chongqing, China
(Zuo) Department of Anesthesiology, University of Virginia,
Charlottesville, VA, United States
Publisher
John Wiley and Sons Inc
Abstract
Cognitive dysfunction is a common postoperative neurological complication
in patients undergoing valve replacement surgery. This study aimed to
compare the effects of sevoflurane versus propofol-based total intravenous
anesthesia on the incidence of cognitive dysfunction following valve
replacement surgery. This multicenter, randomized, controlled
double-blinded study was conducted in three teaching hospitals in China.
Patients receiving on-pump valve replacement surgery were enrolled.
Stratified block randomization was used to randomly assign patients 1:1 to
receive sevoflurane (1.0-1.5 MAC) or propofol (2.0-3.0 mg/kg/h) for
anesthesia maintenance. The primary outcome was the incidence of cognitive
dysfunction assessed by four cognitive tests before, as well as 7-14 days
after surgery. Patients were randomly assigned to receive sevoflurane
anesthesia (n = 144) or propofol-based total intravenous anesthesia (n =
145). The incidence of postoperative cognitive dysfunction in the
sevoflurane anesthesia group (31.9%) was significantly lower than that in
the total intravenous anesthesia group (43.4%; relative risk 0.61, 95%
confidence interval [CI]: 0.38-0.97, p = 0.044). There was no difference
in the incidence of delirium between patients receiving sevoflurane and
total intravenous anesthesia (27.8% [35/144] vs. 25.9% [35/145], 1.10, 95%
CI: 0.64 to 1.90, p = 0.736). There was a significant difference in the
Katz Index on day 3 after surgery (3 [0.9) vs. 3 (1.0], 0.095, 95% CI:
0.05 to 0.43, p = 0.012). No difference was observed in other outcomes
between the two groups. For patients undergoing on-pump valve replacement
surgery, sevoflurane anesthesia had a smaller effect on cognitive function
and independence in daily life activities compared with propofol
anesthesia.<br/>Copyright &#xa9; 2022 The Authors. The Kaohsiung Journal
of Medical Sciences published by John Wiley & Sons Australia, Ltd on
behalf of Kaohsiung Medical University.

<78>
Accession Number
640239352
Title
Effects of anesthetic depth on postoperative pain and delirium: a
meta-analysis of randomized controlled trials with trial sequential
analysis.
Source
Chinese medical journal. 135(23) (pp 2805-2814), 2022. Date of
Publication: 05 Dec 2022.
Author
Long Y.; Feng X.; Liu H.; Shan X.; Ji F.; Peng K.
Institution
(Long, Shan, Ji, Peng) Department of Anesthesiology, First Affiliated
Hospital of Soochow University, Suzhou, Jiangsu 215006, China
(Long, Shan, Ji, Peng) Institute of Anesthesiology, Soochow University,
Suzhou, Jiangsu 215006, China
(Feng) Department of Anesthesiology, University of Utah Health, Salt Lake
City, UT, United States
(Liu) Department of Anesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Whether anesthetic depth affects postoperative outcomes
remains controversial. This meta-analysis aimed to evaluate the effects of
deep vs. light anesthesia on postoperative pain, cognitive function,
recovery from anesthesia, complications, and mortality. <br/>METHOD(S):
PubMed, EMBASE, and Cochrane CENTRAL databases were searched until January
2022 for randomized controlled trials comparing deep and light anesthesia
in adult surgical patients. The co-primary outcomes were postoperative
pain and delirium (assessed using the confusion assessment method). We
conducted a meta-analysis using a random-effects model. We assessed
publication bias using the Begg's rank correlation test and Egger's linear
regression. We evaluated the evidence using the trial sequential analysis
and Grading of Recommendations Assessment, Development and Evaluation
(GRADE) methodology. We conducted subgroup analyses for pain scores at
different postoperative time points and delirium according to cardiac or
non-cardiac surgery. <br/>RESULT(S): A total of 26 trials with 10,743
patients were included. Deep anesthesia compared with light anesthesia (a
mean difference in bispectral index of -12 to -11) was associated with
lower pain scores at rest at 0 to 1 h postoperatively (weighted mean
difference = -0.72, 95% confidence interval [CI] = -1.25 to -0.18, P =
0.009; moderate-quality evidence) and an increased incidence of
postoperative delirium (24.95% vs. 15.92%; risk ratio = 1.57, 95% CI =
1.28-1.91, P < 0.0001; high-quality evidence). No publication bias was
detected. For the exploratory secondary outcomes, deep anesthesia was
associated with prolonged postoperative recovery, without affecting
neurocognitive outcomes, major complications, or mortality. In the
subgroup analyses, the deep anesthesia group had lower pain scores at rest
and on movement during 24 h postoperatively, without statistically
significant subgroup differences, and deep anesthesia was associated with
an increased incidence of delirium after non-cardiac and cardiac
surgeries, without statistically significant subgroup differences.
<br/>CONCLUSION(S): Deep anesthesia reduced early postoperative pain but
increased postoperative delirium. The current evidence does not support
the use of deep anesthesia in clinical practice.<br/>Copyright &#xa9; 2023
The Chinese Medical Association, produced by Wolters Kluwer, Inc. under
the CC-BY-NC-ND license.

<79>
Accession Number
640239136
Title
Perioperative dexmedetomidine administration does not reduce the risk of
acute kidney injury after non-cardiac surgery: a meta-analysis.
Source
Chinese medical journal. 135(23) (pp 2798-2804), 2022. Date of
Publication: 05 Dec 2022.
Author
Hu B.; Tian T.; Li X.; Liu W.; Chen Y.; Jiang T.; Chen P.; Xue F.
Institution
(Hu) Department of Anesthesiology, Beijing Friendship Hospital, Capital
Medical University, Beijing 100050, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Post-operative acute kidney injury (AKI) is one of the most
common and serious complications after major surgery and is significantly
associated with increased risks of morbidity and mortality. This
meta-analysis was conducted to evaluate the effects of perioperative
dexmedetomidine (Dex) administration on the occurrence of AKI and the
outcomes of recovery after non-cardiac surgery. <br/>METHOD(S): The
PubMed, Embase, Web of Science, and Cochrane Library databases were
systematically searched for studies comparing the effects of Dex vs.
placebo on kidney function after non-cardiac surgery, and a pooled
fixed-effect meta-analysis of the included studies was performed. The
primary outcome was the occurence of post-operative AKI. The secondary
outcomes included the occurence of intra-operative hypotension and
bradycardia, intensive care unit (ICU) admission, duration of ICU stay,
and hospital length of stay (LOS). <br/>RESULT(S): Six studies, including
four randomized controlled trials (RCTs) and two observational studies,
with a total of 2586 patients were selected. Compared with placebo, Dex
administration could not reduce the odds of post-operative AKI (odds ratio
[OR], 0.44; 95% confidence interval (CI), 0.18-1.06; P = 0.07; I2 =
0.00%, P = 0.72) in RCTs, but it showed a significant renoprotective
effect (OR, 0.67; 95% CI, 0.48-0.95; P = 0.02; I2 = 0.00%, P = 0.36) in
observational studies. Besides, Dex administration significantly increased
the odds of intra-operative bradycardia and shortened the duration of ICU
stay. However, there was no significant difference in the odds of
intra-operative hypotension, ICU admission, and hospital LOS.
<br/>CONCLUSION(S): This meta-analysis suggests that perioperative Dex
administration does not reduce the risk of AKI after non-cardiac surgery.
However, the quality of evidence for this result is low due to imprecision
and inconsistent types of non-cardiac operations. Thus, large and
high-quality RCTs are needed to verify the real effects of perioperative
Dex administration on the occurrence of AKI and the outcomes of recovery
after non-cardiac surgery.<br/>Copyright &#xa9; 2022 The Chinese Medical
Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND
license.

<80>
Accession Number
2021361931
Title
Comparison of transcatheter edge-to-edge and surgical repair in patients
with functional mitral regurgitation using a meta-analytic approach.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1063070. Date of Publication: 25 Jan 2023.
Author
Felbel D.; Paukovitsch M.; Forg R.; Stephan T.; Mayer B.; Kessler M.;
Tadic M.; Dahme T.; Rottbauer W.; Markovic S.; Schneider L.
Institution
(Felbel, Paukovitsch, Forg, Stephan, Kesler, Tadic, Dahme, Rottbauer,
Markovic, Schneider) Department of Cardiology, Angiology, Pneumology and
Intensive Care, University Hospital Ulm, Ulm, Germany
(Mayer) Institute of Epidemiology and Medical Biometry, Ulm University,
Ulm, Germany
Publisher
Frontiers Media S.A.
Abstract
Background: Evidence regarding favorable treatment of patients with
functional mitral regurgitation (FMR) using transcatheter edge-to-edge
repair (TEER) is constantly growing. However, there is only few data
directly comparing TEER and surgical mitral valve repair (SMVr).
<br/>Aim(s): To compare baseline characteristics, short-term and 1-year
outcomes in FMR patients undergoing mitral valve (MV) TEER or SMVr using a
meta-analytic approach. <br/>Method(s): Systematic database search
identified 1,703 studies reporting on TEER or SMVr for treatment of FMR
between January 2010 and December 2020. A meta-analytic approach was used
to compare outcomes from single-arm and randomized studies based on
measures by means of their corresponding 95% confidence intervals (CI).
Statistical significance was assumed if CIs did not overlap. A total of 21
TEER and 37 SMVr studies comprising 4,304 and 3,983 patients were
included. <br/>Result(s): Patients in the TEER cohort presented with
higher age (72.0 +/- 1.7 vs. 64.7 +/- 4.7 years, p < 0.001), greater
burden of comorbidities like hypertension (p < 0.001), atrial fibrillation
(p < 0.001), lung disease (p < 0.001) and chronic renal disease (p =
0.005) as well as poorer left ventricular ejection fraction (30.9 +/- 5.7
vs. 36.6 +/- 5.3%, p < 0.001). In-hospital mortality was significantly
lower with TEER [3% (95%-CI 0.02-0.03) vs. 5% (95%-CI 0.04-0.07)] and
1-year mortality did not differ significantly [18% (95%-CI 0.15-0.21) vs.
11% (0.07-0.18)]. NYHA [1.06 (95%-CI 0.87-1.26) vs. 1.15 (0.74-1.56)] and
MR reduction [1.74 (95%-CI 1.52-1.97) vs. 2.08 (1.57-2.59)] were
comparable between both cohorts. <br/>Conclusion(s): Despite considerably
higher age and comorbidity burden, in-hospital mortality was significantly
lower in FMR patients treated with TEER, whereas a tendency toward
increased 1-year mortality was observed in this high-risk population. In
terms of functional status and MR grade reduction, comparable 1-year
results were achieved.<br/>Copyright &#xa9; 2023 Felbel, Paukovitsch,
Forg, Stephan, Mayer, Kesler, Tadic, Dahme, Rottbauer, Markovic and
Schneider.

<81>
Accession Number
2022613680
Title
Dual or single antiplatelet therapy after coronary surgery for acute
coronary syndrome (TACSI trial): Rationale and design of an
investigator-initiated, prospective, multinational, registry-based
randomized clinical trial.
Source
American Heart Journal. 259 (pp 1-8), 2023. Date of Publication: May 2023.
Author
Malm C.J.; Alfredsson J.; Erlinge D.; Gudbjartsson T.; Gunn J.; James S.;
Moller C.H.; Nielsen S.J.; Sartipy U.; Tonnessen T.; Jeppsson A.
Institution
(Malm, Nielsen, Jeppsson) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Malm, Nielsen, Jeppsson) Department of Cardiothoracic Surgery,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Alfredsson) Department of Health, Medicine and Caring Sciences, Linkoping
University, Linkoping, Sweden
(Alfredsson) Department of Cardiology, Linkoping University Hospital,
Linkoping, Sweden
(Erlinge) Department of Cardiology, Clinical Sciences, Lund University,
Lund, Sweden
(Gudbjartsson) Department of Cardiothoracic Surgery, Landspitali
University Hospital, Reykjavik, Iceland
(Gudbjartsson) Faculty of Medicine, University of Iceland, Reykjavik,
Iceland
(Gunn) Heart Center, Turku University Hospital and University of Turku,
Turku, Finland
(James) Department of Medical Sciences, Cardiology, Uppsala University,
Uppsala, Sweden
(Moller) Department for Cardiothoracic Surgery, Rigshospitalet, Copenhagen
University Hospital, Copenhagen, Denmark
(Moller) Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
(Sartipy) Department of Molecular Medicine and Surgery, Karolinska
Institutet, Stockholm, Sweden
(Sartipy) Department of Cardiothoracic Surgery, Karolinska University
Hospital, Stockholm, Sweden
(Tonnessen) Department of Cardiothoracic Surgery, Oslo University
Hospital, Norway
(Tonnessen) University of Oslo, Oslo, Norway
Publisher
Elsevier Inc.
Abstract
The TACSI trial (ClinicalTrials.gov Identifier: NCT03560310) tests the
hypothesis that 1-year treatment with dual antiplatelet therapy with
acetylsalicylic acid (ASA) and ticagrelor is superior to only ASA after
isolated coronary artery bypass grafting (CABG) in patients with acute
coronary syndrome. The TACSI trial is an investor-initiated pragmatic,
prospective, multinational, multicenter, open-label, registry-based
randomized trial with 1:1 randomization to dual antiplatelet therapy with
ASA and ticagrelor or ASA only, in patients undergoing first isolated
CABG, with a planned enrollment of 2200 patients at Nordic cardiac surgery
centers. The primary efficacy end point is a composite of time to
all-cause death, myocardial infarction, stroke, or new coronary
revascularization within 12 months after randomization. The primary safety
end point is time to hospitalization due to major bleeding. Secondary
efficacy end points include time to the individual components of the
primary end point, cardiovascular death, and rehospitalization due to
cardiovascular causes. High-quality health care registries are used to
assess primary and secondary end points. The patients will be followed for
10 years. The TACSI trial will give important information useful for
guiding the antiplatelet strategy in acute coronary syndrome patients
treated with CABG.<br/>Copyright &#xa9; 2023 The Authors

<82>
Accession Number
2022613657
Title
Joint 2022 European Society of Thoracic Surgeons and The American
Association for Thoracic Surgery guidelines for the prevention of
cancer-associated venous thromboembolism in thoracic surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(3) (pp 794-824.e6),
2023. Date of Publication: March 2023.
Author
Shargall Y.; Wiercioch W.; Brunelli A.; Murthy S.; Hofstetter W.; Lin J.;
Li H.; Linkins L.-A.; Crowther M.; Davis R.; Rocco G.; Morgano G.P.;
Schunemann F.; Muti-Schunemann G.; Douketis J.; Schunemann H.J.; Litle
V.R.
Institution
(Shargall) Department of Surgery, McMaster University, Hamilton, ON,
Canada
(Wiercioch, Morgano, Muti-Schunemann, Schunemann) Department of Health
Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON,
Canada
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Murthy) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(Hofstetter) Department of Thoracic and Cardiovascular Surgery, The
University of Texas MD Anderson Cancer Center, Houston, Tex
(Lin) Section of Thoracic Surgery, University of Michigan, Ann Arbor,
Mich, United States
(Li) Department of Thoracic Surgery, Capital Medical University, Beijing,
China
(Linkins, Crowther, Douketis, Schunemann) Department of Medicine, McMaster
University, Hamilton, ON, Canada
(Davis) Patient Representative, Burlington, ON, Canada
(Rocco) Memorial Sloan Kettering Cancer Center, New York, NY, United
States
(Schunemann) Medizinische Fakultat, Albert-Ludwigs-Universitat Freiburg,
Freiburg, Germany
(Litle) Department of Surgery, Boston University School of Medicine,
Boston, Mass
Publisher
Elsevier Inc.
Abstract
Background: Venous thromboembolism (VTE), which includes deep vein
thrombosis and pulmonary embolism, is a potentially fatal but preventable
postoperative complication. Thoracic oncology patients undergoing surgical
resection, often after multimodality induction therapy, represent among
the highest risk groups for postoperative VTE. Currently there are no VTE
prophylaxis guidelines specific to these thoracic surgery patients.
Evidenced-based recommendations will help clinicians manage and mitigate
risk of VTE in the postoperative period and inform best practice.
<br/>Objective(s): These joint evidence-based guidelines from The American
Association for Thoracic Surgery and the European Society of Thoracic
Surgeons aim to inform clinicians and patients in decisions about
prophylaxis to prevent VTE in patients undergoing surgical resection for
lung or esophageal cancer. <br/>Method(s): The American Association for
Thoracic Surgery and the European Society of Thoracic Surgeons formed a
multidisciplinary guideline panel that included broad membership to
minimize potential bias when formulating recommendations. The McMaster
University GRADE Centre supported the guideline development process,
including updating or performing systematic evidence reviews. The panel
prioritized clinical questions and outcomes according to their importance
for clinicians and patients. The Grading of Recommendations Assessment,
Development and Evaluation (GRADE) approach was used, including GRADE
Evidence-to-Decision frameworks, which were subject to public comment.
<br/>Result(s): The panel agreed on 24 recommendations focused on
pharmacological and mechanical methods for prophylaxis in patients
undergoing lobectomy and segmentectomy, pneumonectomy, and esophagectomy,
as well as extended resections for lung cancer. <br/>Conclusion(s): The
certainty of the supporting evidence for the majority of recommendations
was judged as low or very low, largely due to a lack of direct evidence
for thoracic surgery. The panel made conditional recommendations for use
of parenteral anticoagulation for VTE prevention, in combination with
mechanical methods, over no prophylaxis for cancer patients undergoing
anatomic lung resection or esophagectomy. Other key recommendations
include: conditional recommendations for using parenteral anticoagulants
over direct oral anticoagulants, with use of direct oral anticoagulants
suggested only in the context of clinical trials; conditional
recommendation for using extended prophylaxis for 28 to 35 days over
in-hospital prophylaxis only for patients at moderate or high risk of
thrombosis; and conditional recommendations for VTE screening in patients
undergoing pneumonectomy and esophagectomy. Future research priorities
include the role of preoperative thromboprophylaxis and the role of risk
stratification to guide use of extended prophylaxis.<br/>Copyright &#xa9;
2022

<83>
Accession Number
640281936
Title
Percutaneous MitraClip Device or Surgical Mitral Valve Repair in Patients
With Primary Mitral Regurgitation Who Are Candidates for Surgery: Design
and Rationale of the REPAIR MR Trial.
Source
Journal of the American Heart Association. (pp e027504), 2023. Date of
Publication: 08 Feb 2023.
Author
McCarthy P.M.; Whisenant B.; Asgar A.W.; Ailawadi G.; Hermiller J.;
Williams M.; Morse A.; Rinaldi M.; Grayburn P.; Thomas J.D.; Martin R.;
Asch F.M.; Shu Y.; Sundareswaran K.; Moat N.; Kar S.
Institution
(McCarthy, Thomas) Northwestern Medicine Chicago IL
(Whisenant) Intermountain Healthcare Murray UT
(Asgar) Montreal Heart Institute Montreal QC Canada
(Ailawadi) University of Michigan Hospital Ann Arbor MI
(Hermiller) St. Vincent's Hospital Indianapolis IN
(Williams) New York University Medical Center New York NY
(Morse) St. Thomas Hospital Nashville TN
(Rinaldi) Sanger Heart and Vascular Institute Charlotte NC
(Grayburn) Baylor Scott and White Hospital Plano TX
(Martin) Emory University Atlanta GA
(Asch) Medstar Health Research Institute Washington DC
(Shu, Sundareswaran, Moat) Abbott Santa Clara CA
(Kar) Los Robles Medical Center Thousand Oaks CA
Publisher
NLM (Medline)
Abstract
Background The current standard of care for the treatment of patients with
primary mitral regurgitation (MR) is surgical mitral valve repair.
Transcatheter edge-to-edge repair with the MitraClip device provides a
less invasive treatment option for patients with both primary and
secondary MR. Worldwide, >150000 patients have been treated with the
MitraClip device. However, in the United States, MitraClip is approved for
use only in primary patients with MR who are at high or prohibitive risk
for mitral valve surgery. The REPAIR MR (Percutaneous MitraClip Device or
Surgical Mitral Valve Repair in Patients With Primary Mitral Regurgitation
Who Are Candidates for Surgery) trial is designed to compare early and
late outcomes associated with transcatheter edge-to-edge repair with the
MitraClip and surgical repair of primary MR in older or moderate surgical
risk patients. Methods and Results The REPAIR MR trial is a prospective,
randomized, parallel-controlled, open-label multicenter, noninferiority
trial for the treatment of severe primary MR (verified by an independent
echocardiographic core laboratory). Patients with severe MR and
indications for surgery because of symptoms (New York Heart Association
class II-IV), or without symptoms with left ventricular ejection fraction
<=60%, pulmonary artery systolic pressure >50mmHg, or left ventricular
end-systolic diameter >=40mm are eligible for the trial provided they meet
the moderate surgical risk criteria as follows: (1) >=75years of age, or
(2) if <75years of age, then the subject has a Society of Thoracic
Surgeons Predicted Risk Of Mortality score of >=2% for mitral repair (or
Society of Thoracic Surgeons replacement score of >=4%), or the presence
of a comorbidity that may introduce a surgery-specific risk. The local
surgeon must determine that the mitral valve can be surgically repaired.
Additionally, an independent eligibility committee will confirm that the
MR can be reduced to mild or less with both the MitraClip and surgical
mitral valve repair with a high degree of certainty. A total of 500
eligible subjects will be randomized in a 1:1 ratio to receive the
MitraClip device or to undergo surgical mitral valve repair (control
group). There are 2 co-primary end points for the trial, both of which
will be evaluated at 2years. Each subject will be followed for 10years
after enrollment. The study has received approval from both the Food and
Drug Administration and the Centers for Medicare and Medicaid Services,
and enrolled its first subject in July 2020. Conclusions The REPAIR MR
trial will determine the safety and effectiveness of transcatheter
edge-to-edge repair with the MitraClip in patients with primary MR who are
at moderate surgical risk and are candidates for surgical MV repair. The
trial will generate contemporary comparative clinical evidence for the
MitraClip device and surgical MV repair. Registration
https://clinicaltrials.gov/ct2/show/NCT04198870; NCT04198870.

<84>
Accession Number
640281621
Title
Impact of Peripheral Artery Disease in Patients With Heart Failure
Undergoing Transcatheter Mitral Valve Repair: The COAPT Trial.
Source
Journal of the American Heart Association. (pp e028444), 2023. Date of
Publication: 08 Feb 2023.
Author
Shahim B.; Cohen D.J.; Ben-Yehuda O.; Redfors B.; Kar S.; Lim D.S.; Arnold
S.V.; Li Y.; Lindenfeld J.; Abraham W.T.; Mack M.J.; Stone G.W.
Institution
(Shahim, Cohen, Ben-Yehuda, Redfors, Li) Clinical Trials Center
Cardiovascular Research Foundation New York NY
(Shahim) Division of Cardiology, Department of Medicine Solna, Karolinska
Institutet, Karolinska University Hospital Stockholm Sweden, Sweden
(Cohen) St. Francis Hospital Roslyn NY
(Ben-Yehuda, Redfors) New York-Presbyterian Hospital/Columbia University
Irving Medical Center NY New York
(Ben-Yehuda) Division of Cardiology University of California - San Diego
San Diego CA
(Redfors) Department of Cardiology Sahlgrenska University Hospital
Gothenburg Sweden, Sweden
(Kar) Los Robles Regional Medical Center Thousand Oaks CA
(Kar) Bakersfield Heart Hospital Bakersfield CA
(Lim) Division of Cardiology University of Virginia Charlottesville VA
(Arnold) University of Missouri-Kansas City School of Medicine Kansas City
MO
(Arnold) Saint Luke's Mid America Heart Institute Kansas City MO, United
States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section
Vanderbilt Heart and Vascular Institute Nashville TN
(Abraham) Division of Cardiovascular Medicine The Ohio State University
Columbus OH
(Mack) Baylor Scott & White Health Plano TX
(Stone) Zena and Michael A. Wiener Cardiovascular Institute Icahn School
of Medicine at Mount Sinai New York NY
Publisher
NLM (Medline)
Abstract
Background Peripheral artery disease (PAD) and heart failure (HF) often
coexist. Whether PAD influences outcomes of transcatheter mitral valve
repair (TMVr) in patients with HF and severe secondary mitral
regurgitation is unknown. The objectives are to assess the impact of PAD
on outcomes of TMVr plus guideline-directed medical therapy (GDMT) versus
GDMT alone in patients with HF and secondary mitral regurgitation. Methods
and Results The COAPT trial (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients with Functional
Mitral Regurgitation) randomized patients with HF with
>=moderate-to-severe secondary mitral regurgitation to TMVr with MitraClip
implant plus GDMT versus GDMT alone. We evaluated the relationship between
PAD and 2-year outcomes in the COAPT trial and examined whether PAD
modified the benefits of TMVr. Among 614 patients enrolled, 109 (17.8%)
had PAD. By multivariable analysis, PAD was independently associated with
2-year mortality (adjusted hazard ratio [adjHR], 1.51 [95% CI, 1.07-2.15])
but not HF hospitalizations. Compared with GDMT alone, TMVr reduced the
2-year risk of death in patients without PAD (adjHR, 0.42 [95% CI,
0.30-0.60]) but not those with PAD (adjHR, 1.27 [95% CI, 0.72-2.27];
Pinteraction=0.001). In contrast, TMVr reduced HF hospitalizations
consistently in patients with (adjHR, 0.65 [95% CI, 0.35-1.23]) and
without (adjHR, 0.42 [95% CI, 0.31-0.57]) PAD (Pinteraction=0.22).
Improvements in health status and exercise capacity at 2years with TMVr
compared with GDMT alone were similar in degree, irrespective of PAD
status (Pinteraction=0.76 and 0.64, respectively). Conclusions In patients
with HF and severe secondary mitral regurgitation, the reduced mortality
with TMVr in the overall COAPT study population was not observed in the
subgroup of patients with PAD. However, TMVr reduced HF hospitalizations
and improved health status and exercise capacity consistently in patients
with and without PAD. Registration Clinical Trial Name: Cardiovascular
Outocmes Assessment of the MitraClip Percutaneous Therapy for Heart
Failure Patients with Functional Mitral Regurgitation (The COAPT Trial);
URL: https://www.clinicaltrials.gov/; Unique identifier: NCT01626079.
https://clinicaltrials.gov/ct2/show/NCT01626079.

<85>
Accession Number
2022619849
Title
Robotic vs other surgery techniques for mitral valve repair and/or
replacement: A systematic review and meta-analysis.
Source
Hellenic Journal of Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Husen T.F.; Kohar K.; Angelica R.; Saputro B.I.L.
Institution
(Husen, Kohar, Angelica, Saputro) Faculty of Medicine, University of
Indonesia, Pondok Cina, Beji, West Java, Depok City 16424, Indonesia
Publisher
Hellenic Cardiological Society
Abstract
Objective: Mitral valve repair or replacement (MVr/R) are procedures that
aim to correct mitral regurgitation. The three techniques, namely
conventional, minimally invasive, and robotic each present their
advantages and setbacks. Previous studies had compared each technique with
the other but mostly focused on two techniques. In this systematic review
and meta-analysis, we attempt to compare all three techniques, to provide
a reference for the clinical selection of the best surgical scheme.
<br/>Method(s): The literature search was performed in databases including
PubMed, Scopus, Google Scholar, EBSCOHost, Wiley, ProQuest, and Embase, up
to June 1^st, 2022. Critical appraisal of studies was performed
using Newcastle Ottawa Scale converted by Agency for Healthcare Research
and Quality (AHRQ). We used bayesian network meta-analysis and
conventional meta-analysis (random effects model) to rank and analyze
pooled odds ratios (OR) and mean differences (MD) with 95% confidence
intervals (CI). Forest plots of pooled effect estimates comparing each
treatment and ranking panel using Surface Under the Cumulative Ranking
(SUCRA) were used for the intervention measures. <br/>Result(s): A total
of 18 studies with 60,331 patients were included in this systematic review
and meta-analysis. Hospital stay was significantly lower in the group with
robotic procedure compared to the conventional interventions in terms of
ICU stay and overall length of stay. The mean difference of length of
hospital stay days of the conventional group was 2.27 (1.31-3.30) days and
of the minimally invasive -0.364 (-2.31-1.53) days compared to the robotic
group. The robotic procedure was associated with longer cross-clamp and
cardiopulmonary bypass (CPB) times. Nevertheless, the robotic procedure
was associated with lower infection (OR = 0.60 [95% CI 0.50-0.73)] rates
and in-hospital mortality compared to conventional techniques (OR=0.53
[95% CI 0.40-0.70)] but not the minimally invasive techniques (OR = 1.74
[95% CI 0.48-6.31]). <br/>Conclusion(s): Robotic surgery showed more
favorable surgical outcomes, including hospital stay, post-operational
complications and in-hospital mortality, although it was associated with
longer cross-clamp time and CPB time compared to other interventions.
However, its high cost is a difficult consideration for its widespread
clinical implementation.<br/>Copyright &#xa9; 2022 Hellenic Society of
Cardiology

<86>
Accession Number
2022551314
Title
The Role of Insulin-Like Growth Factor 1 in Delirium: A Systematic Review
and Meta-Analysis.
Source
Dementia and Geriatric Cognitive Disorders. (no pagination), 2023. Date
of Publication: 2023.
Author
Adamis D.; Eikelenboom P.
Institution
(Adamis) Sligo Mental Health Services, Sligo, Ireland
(Eikelenboom) GGZinGeest, Amsterdam, Netherlands
(Eikelenboom) Department of Neurology, Academic Medical Center, Amsterdam,
Netherlands
Publisher
S. Karger AG
Abstract
Background: The relationship between delirium and low levels of
insulin-like growth factor 1 (IGF-1) is contradictory and uncertain. We
hypothesised that low levels of IGF-1 are a predisposing factor for
delirium in medical and abdominal surgical cohorts, in contrast to other
surgical cohorts. <br/>Aim(s): Systematic review and meta-analysis
investigating the association between peripheral levels of IGF-1 and
delirium in medical and surgical patients to explore if there are distinct
patterns of associations by using subgroup meta-analysis. <br/>Method(s):
PubMed, Scopus, CINAHL, Cochrane, and Embase databases were searched.
Inclusion criteria were prospective studies in medical and surgical
populations and available data. The following were collected: the setting
(surgical/medical), the type (orthopaedic surgery, abdominal,
cardiovascular, or medical), the number of participants, mean age, the
number of delirious patients, scale/criteria for delirium, IGF-1 levels,
and MMSE. <br/>Result(s): Thirteen studies were included and analysed. Low
levels of IGF-1 are significantly associated with delirium in abdominal
surgical samples and medical samples but not in the other surgical
samples. Age, cognition, and the setting (medical vs. surgical) do not
have any significant effect on the differences in IGF-1 levels between
those with and without delirium. <br/>Discussion(s): Delirium in acute
medical and abdominal surgery is triggered by low IGF-1 which may reflect
chronic conditions like frailty/cachexia/sarcopenia, while in other
surgeries perhaps from an inflammatory process. <br/>Conclusion(s): Low
peripheral levels of IGF-1 are a predisposing factor for delirium only in
acute medical and abdominal surgery. More studies are needed to confirm
and to explore further this finding. <br/>Copyright &#xa9; 2023 S. Karger
AG. All rights reserved.

<87>
Accession Number
640281181
Title
Hybrid Ablation Versus Repeated Catheter Ablation in Persistent Atrial
Fibrillation: A Randomized Controlled Trial.
Source
JACC. Clinical electrophysiology. (no pagination), 2023. Date of
Publication: 10 Jan 2023.
Author
van der Heijden C.A.J.; Weberndorfer V.; Vroomen M.; Luermans J.G.;
Chaldoupi S.-M.; Bidar E.; Vernooy K.; Maessen J.G.; Pison L.; van Kuijk
S.M.J.; La Meir M.; Crijns H.J.G.M.; Maesen B.
Institution
(van der Heijden) Department of Cardiothoracic Surgery, Maastricht
University Medical Center, Maastricht, Netherlands
(Weberndorfer, Luermans, Chaldoupi, Vernooy, Crijns) Department of
Cardiology, Maastricht University Medical Center, Maastricht, the
Netherlands; Cardiovascular Research Institute Maastricht, Maastricht, the
Netherlands
(Vroomen) Department of Cardiology, Maastricht University Medical Center,
Maastricht, the Netherlands; Department of Cardiac Surgery, Robert Bosch
Hospital, Stuttgart, Germany
(Bidar, Maessen, Maesen) Department of Cardiothoracic Surgery, Maastricht
University Medical Center, Maastricht, the Netherlands; Cardiovascular
Research Institute Maastricht, Maastricht, the Netherlands
(Pison) Department of Cardiology, Hospital Oost Limburg, Genk, Belgium
(van Kuijk) Department of Clinical Epidemiology and Medical Technology
Assessment, Maastricht University Medical Centre, Maastricht, Netherlands
(La Meir) Department of Cardiothoracic Surgery, Maastricht University
Medical Center, Maastricht, the Netherlands; Department of Cardiac
Surgery, UZ Brussel, Brussels, Belgium
Publisher
NLM (Medline)
Abstract
BACKGROUND: Although catheter ablation (CA) is successful for the
treatment of paroxysmal atrial fibrillation (AF), results are less
satisfactory in persistent AF. Hybrid ablation (HA) results in better
outcomes in patients with persistent atrial fibrillation (persAF), as it
combines a thoracoscopic epicardial and transvenous endocardial approach
in a single procedure. <br/>OBJECTIVE(S): The purpose of this study was to
compare the effectiveness and safety of HA with CA in a prospective,
superiority, unblinded, randomized controlled trial. <br/>METHOD(S):
Forty-one ablation-naive patients with (long-standing)-persAF were
randomized to HA (n = 19) or CA (n = 22) and received pulmonary vein
isolation, posterior left atrial wall isolation and, if needed, a
cavotricuspid isthmus ablation. The primary efficacy endpoint was freedom
from any atrial tachyarrhythmia >5 minutes off antiarrhythmic drugs after
12 months. The primary and secondary safety endpoints included major and
minor complications and the total number of serious adverse events.
<br/>RESULT(S): After 12 months, the freedom of atrial tachyarrhythmias
off antiarrhythmic drugs was higher in the HA group compared with the CA
group (89% vs 41%, P = 0.002). There was 1 pericarditis requiring
pericardiocentesis and 1 femoral arteriovenous-fistula in the HA group. In
the CA arm, 1 bleeding from the femoral artery occurred. There were no
deaths, strokes, need for pacemaker implantation, or conversions to
sternotomy, and the number of (serious) adverse events was comparable
between groups (21% vs 14%, P = 0.685). <br/>CONCLUSION(S): Hybrid AF
ablation is an efficacious and safe procedure and results in better
outcomes than catheter ablation for the treatment of patients with
persistent AF. (Hybrid Versus Catheter Ablation in Persistent AF
[HARTCAP-AF]; NCT02441738).<br/>Copyright &#xa9; 2023 The Authors.
Published by Elsevier Inc. All rights reserved.

<88>
Accession Number
640280089
Title
Predictors of mitral valve haemodynamics after mitral valve repair for
degenerative mitral regurgitation.
Source
Heart (British Cardiac Society). (no pagination), 2023. Date of
Publication: 07 Feb 2023.
Author
Rumman R.K.; Verma S.; Chan V.; Mazer D.; Quan A.; Hibino M.; De Varennes
B.; Chu M.W.A.; Latter D.; Teoh H.; Yanagawa B.; Leong-Poi H.; Connelly
K.A.
Institution
(Rumman, Leong-Poi, Connelly) Department of Medicine, University of
Toronto, Toronto, ON, Canada
(Rumman, Leong-Poi, Connelly) Division of Cardiology, Li Ka Shing
Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
(Verma, Quan, Latter, Teoh, Yanagawa) Division of Cardiac Surgery, Li Ka
Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
(Verma, Latter, Yanagawa) Department of Surgery, University of Toronto,
Toronto, ON, Canada
(Verma, Yanagawa) Department of Pharmacology & Toxicology, University of
Toronto, Toronto, ON, Canada
(Chan) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Chan) School of Epidemiology, Public Health and Preventive Medicine,
University of Ottawa, Ottawa, ON, Canada
(Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute of St.
Michael's Hospital, Toronto, ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Hibino) Division of Cardiothoracic Surgery, Emory University School of
Medicine, Atlanta, GA, United States
(De Varennes) Division of Cardiac Surgery, Royal Victoria Hospital, McGill
University Health Center, Montreal, Quebec, Canada
(Chu) Division of Cardiac Surgery, London Health Sciences Centre, Western
University, London, ON, Canada
(Teoh) Division of Endocrinology and Metabolism, Li Ka Shing Knowledge
Institute of St. Michael's Hospital, Toronto, ON, Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Intraoperative predictors of functional mitral valve (MV)
stenosis after surgical repair of mitral regurgitation (MR) caused by
prolapse remain poorly characterised. This study evaluated the effect of
annuloplasty size on postoperative MV haemodynamics during exercise and
evaluated predictors of MV hemodynamics. <br/>METHOD(S): 104 patients were
randomly assigned to leaflet resection or preservation for surgical repair
of MR in the Canadian Mitral Research Alliance CardioLink-2 study. In this
post hoc analysis, we compared MV haemodynamics between the two surgical
groups and examined the relationship between annuloplasty size and MV
haemodynamics 1year after repair in the combined groups. Echocardiograms
were performed at baseline and intraoperatively. Exercise transthoracic
echocardiography was performed 1year postoperatively. Multivariable linear
regression analysis was used to identify predictors of exercise MV
gradients at follow-up. <br/>RESULT(S): Mean age of participants was
65+/-10 years, and 83% were male. Median annuloplasty size was 34 (IQR
32-36). Dividing by the median, 48 (46%) had annuloplasty size of <34mm
and 56 (54%) had >=34mm. Mean and peak exercise gradients at 1year were
11+/-5mm Hg and 22+/-9mm Hg in <34, and 6+/-3mm Hg and 14+/-5mm Hg in >=34
(p<0.001). Rate of residual MR was similar in both groups. In
multivariable analyses, annuloplasty size of >=34mm was associated with
lower mean and peak exercise gradients at 12months, after adjustment for
repair type, age, sex, heart rate and body surface area (beta -4.1, 95% CI
-6 to -3, p<0.001,and beta -7 95% CI -10 to -4, p<0.001, respectively).
Intraoperative mean and peak MV gradients by transesophageal
echocardiography independently predicted mean and peak resting and
exercise gradients at follow-up (p<0.001). Similar results were obtained
in both leaflet resection and preservation. <br/>CONCLUSION(S):
Annuloplasty size of >=34mm is associated with a 4 and 7mm Hg reduction in
mean and peak exercise MV gradients, respectively, 1year post MV repair
regardless of the repair strategy used. Intraoperative TEE MV gradients
predict exercise MV gradients 1year post repair. TRIAL REGISTRATION
NUMBER: NCT02552771.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<89>
Accession Number
640274808
Title
Risk Prediction Models for Long-Term Survival after Cardiac Surgery: A
Systematic Review.
Source
The Thoracic and cardiovascular surgeon. (no pagination), 2023. Date of
Publication: 07 Feb 2023.
Author
Argus L.; Taylor M.; Ouzounian M.; Venkateswaran R.; Grant S.W.
Institution
(Argus) University of Manchester, Manchester, United Kingdom
(Taylor, Venkateswaran) Department of Cardiothoracic Surgery, Manchester
University NHS Foundation Trust, Manchester, United Kingdom
(Ouzounian) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
University Health Network, Toronto, ON, Canada
(Grant) Division of Cardiovascular Sciences, University of Manchester,
Manchester, United Kingdom
(Grant) Academic Cardiovascular Unit, South Tees Hospitals NHS Foundation
Trust, Middlesborough, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: The reporting of alternative postoperative measures of
quality after cardiac surgery is becoming increasingly important as
in-hospital mortality rates continue to decline. This study aims to
systematically review and assess risk models designed to predict long-term
outcomes after cardiac surgery. <br/>METHOD(S): The MEDLINE and Embase
databases were searched for articles published between 1990 and 2020.
Studies developing or validating risk prediction models for long-term
outcomes after cardiac surgery were included. Data were extracted using
checklists for critical appraisal and systematic review of prediction
modeling studies. <br/>RESULT(S): Eleven studies were identified for
inclusion in the review, of which nine studies described the development
of long-term risk prediction models after cardiac surgery and two were
external validation studies. A total of 70 predictors were included across
the nine models. The most frequently used predictors were age (n=9),
peripheral vascular disease (n=8), renal disease (n=8), and pulmonary
disease (n=8). Despite all models demonstrating acceptable performance on
internal validation, only two models underwent external validation, both
of which performed poorly. <br/>CONCLUSION(S): Nine risk prediction
models predicting long-term mortality after cardiac surgery have been
identified in this review. Statistical issues with model development,
limited inclusion of outcomes beyond 5 years of follow-up, and a lack of
external validation studies means that none of the models identified can
be recommended for use in contemporary cardiac surgery. Further work is
needed either to successfully externally validate existing models or to
develop new models. Newly developed models should aim to use standardized
long-term specific reproducible outcome measures.<br/>Copyright Thieme.
All rights reserved.

<90>
Accession Number
2021354240
Title
Thoracic paravertebral versus interpleural catheter for post-thoracotomy
pain control in minimally invasive cardiac surgery.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2023. Date of
Publication: 2023.
Author
Pujara J.; Singh G.; Prajapati M.; Ninama S.; Rajesh V.S.P.; Trivedi V.;
Pandya H.
Institution
(Pujara, Singh, Prajapati, Ninama, Rajesh, Trivedi) Department of Cardiac
Anesthesia, U. N. Mehta Institute of Cardiology and Research Centre,
Affiliated to B. J. Medical College Ahmedabad, Gujarat, Ahmedabad, India
(Pandya) Department of Research, U. N. Mehta Institute of Cardiology and
Research Centre, Affiliated to B. J. Medical College Ahmedabad, Gujarat,
Ahmedabad, India
Publisher
SAGE Publications Inc.
Abstract
Objective: The aim of this study was to compare efficacy and safety of
paravertebral block (PVB) and interpleural analgesia (IPA) after minimally
invasive cardiac surgery through thoracotomy in terms of quality of
analgesia, post-operative mechanical ventilation time, intensive care unit
(ICU) and hospital length of stay (LOS) and complications. <br/>Design(s):
A randomized, prospective study. <br/>Participant(s): A total of 50 adult
patients (18-50 years old) undergoing minimally invasive cardiac surgery
via thoracotomy. <br/>Intervention(s): Patients were randomized for group
A: paravertebral epidural catheter (n = 25), group B: interpleural
catheter (n = 25). All patients were given Inj. Bupivacaine 0.125%, 8 ml
and Inj. Tramadol 100 mg as an adjuvant, total volume 10 ml.
<br/>Result(s): After obtaining institutional review board approval, data
collected and analysed - visual analogue score (VAS) at rest and on
coughing, haemodynamic and respiratory parameters, time to extubation,
supplementary analgesia requirement, LOS and complications. VAS was
recorded at 0, 2, 3, 4, 8, 12 and 24 h post-extubation, while blood gases
at-after shifting, 4, 8, 12 and 24 h. There were no significant
differences in haemodynamic or respiratory parameters, VAS at rest and on
coughing, ventilation duration, ICU and hospital LOS between two groups.
The requirement of rescue analgesia was in one patient of mini coronary
artery bypass in group B, while one patient in group A required
reintubation due to respiratory acidosis and got successfully extubated on
next day morning. <br/>Conclusion(s): PVB and IPA both are safe and
effective techniques for minimally invasive cardiac surgery with
thoracotomy. It allows optimal pain control and safe ICU fast-track
post-operative course.<br/>Copyright &#xa9; The Author(s) 2023.

<91>
Accession Number
640280943
Title
Randomized Comparison of a Radiofrequency Wire Versus a Radiofrequency
Needle System for Transseptal Puncture.
Source
JACC. Clinical electrophysiology. (no pagination), 2022. Date of
Publication: 03 Nov 2022.
Author
Dewland T.A.; Gerstenfeld E.P.; Moss J.D.; Lee A.C.; Vedantham V.; Lee
R.J.; Tseng Z.H.; Hsia H.H.; Lee B.K.; Wall G.C.; Chang K.R.; Yang M.H.;
Marcus G.M.
Institution
(Dewland, Gerstenfeld, Moss, Lee, Vedantham, Lee, Tseng, Hsia, Lee, Wall,
Chang, Yang, Marcus) Department of Medicine, Division of Cardiology,
Electrophysiology Section, University of California-San Francisco, San
Francisco, CA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transseptal puncture is a necessary component of many
electrophysiology and structural heart procedures. Improving this
technique has broad ramifications for the overall efficiency and safety of
these interventions. A new technology uses a specialized introducer wire
to cross the septum with radiofrequency (RF) energy, eliminating the need
for a transseptal needle and wire/needle exchanges. <br/>OBJECTIVE(S):
This study sought to compare the efficacy and safety of an RF needle
versus RF wire approach for transseptal puncture. <br/>METHOD(S):
Individuals >=18 years of age undergoing double transseptal puncture for
atrial fibrillation or left atrial flutter ablation were randomized to a
transseptal approach with either an RF needle or RF wire. The primary
outcome was time to achieve first transseptal puncture. Secondary outcomes
included second and combined transseptal puncture time, fluoroscopy time,
number of equipment exchanges, and complications. <br/>RESULT(S): A total
of 75 participants were enrolled (36 RF needle, 39 RF wire). No crossovers
occurred. Randomization to the RF wire resulted in a significant reduction
in first transseptal time compared with the RF needle (median 9.2 [IQR:
5.7-11.2] minutes vs 6.9 [IQR: 5.2-8.4] minutes, P = 0.03). Second and
combined transseptal times, and number of equipment exchanges, were also
reduced with the RF wire. One participant in the RF needle group
experienced transient atrioventricular block due to mechanical trauma from
the sheath/dilator assembly. There were no complications in the RF wire
group. <br/>CONCLUSION(S): The RF wire technique resulted in faster time
to transseptal puncture and fewer equipment exchanges compared with an RF
needle with no difference in complications.<br/>Copyright &#xa9; 2022
American College of Cardiology Foundation. Published by Elsevier Inc. All
rights reserved.

<92>
Accession Number
2018028699
Title
Surgery for Anomalous Aortic Origin of a Coronary Artery (AAOCA) in
Children and Adolescents: A Meta-Analysis.
Source
World Journal for Pediatric and Congenital Heart Surgery. 13(4) (pp
485-494), 2022. Date of Publication: July 2022.
Author
Ponzoni M.; Frigo A.C.; Padalino M.A.
Institution
(Ponzoni, Padalino) Pediatric and Congenital Cardiac Surgery Unit, Veneto,
Padova, Italy
(Frigo) Unit of Biostatistics, Department of Cardiac, Vascular Sciences,
and Public Health, University of Padova Medical School, Thoracic, Italy
Publisher
SAGE Publications Inc.
Abstract
We conducted a systematic review and meta-analysis of the literature to
assess the outcomes of surgery for the anomalous aortic origin of a
coronary artery in children and young adults (<30 years). Thirteen
publications were selected, including a total of 384 patients. Unroofing
of the intramural segment was adopted in 92% (95% CI: 81%-98%) of cases,
with pooled early and late mortality of 0% (95% CI: 0%-0.3%) and 0.1% (95%
CI: 0%-1%), respectively. Reoperation for aortic regurgitation was
anecdotal. Surgical management of anomalous aortic origin of coronary
arteries can be achieved with excellent results in pediatric patients, but
concerns remain about the durability of surgery.<br/>Copyright &#xa9; The
Author(s) 2022.

<93>
Accession Number
2015843007
Title
Quality of Life of Mothers of Infants Subjected to Neonatal Cardiac
Surgery: The Importance of Psychosocial Factors.
Source
World Journal for Pediatric and Congenital Heart Surgery. 13(3) (pp
324-331), 2022. Date of Publication: May 2022.
Author
Lisanti A.J.; Golfenshtein N.; Marino B.S.; Huang L.; Hanlon A.L.; Lozano
A.J.; Curley M.A.Q.; Medoff-Cooper B.
Institution
(Lisanti, Curley, Medoff-Cooper) Research Institute, Children's Hospital
of Philadelphia, Philadelphia, PA, United States
(Lisanti, Golfenshtein, Huang, Medoff-Cooper) Department of Family and
Community Health, School of Nursing, University of Pennsylvania,
Philadelphia, PA, United States
(Golfenshtein) Haifa University, Haifa, Israel
(Marino) Department of Pediatric Cardiology, Cleveland Clinic Children's,
Cleveland, OH, United States
(Hanlon, Lozano) Center for Biostatistics and Health Data Science,
Department of Statistics, Virginia Tech, Blacksburg, VA, United States
(Curley) Nursing and Clinical Care Services, Children's Hospital of
Philadelphia, Philadelphia, PA, United States
Publisher
SAGE Publications Inc.
Abstract
Background: The World Health Organization acknowledges quality of life
(QOL) as subjectively perceived overall well-being by the individual and
recognizes it as an essential construct for overall health and wellness.
The purpose of this study was to examine the association of infant,
environmental, and parental factors with the QOL of mothers of infants at
four months post-hospital discharge from cardiac surgery. <br/>Method(s):
Secondary analysis of prospectively collected data from the REACH
randomized clinical trial of telehealth home monitoring. The sample
included mothers (n = 148) of infants with congenital heart disease who
provided data at four months post-discharge. Ten imputations were
generated using fully conditional specification methods to address missing
data and were combined. All analyses were performed on the imputed data.
Mothers' QOL was the main outcome of the analysis, as measured by the Ulm
Quality of Life Inventory for Parents. Predictors on QOL were identified
based on the World Health Organization QOL framework which recognizes the
multidimensional domains influencing QOL that include personal factors,
environmental factors, and physical factors related to disease and
functioning. <br/>Result(s): The treatment and control groups did not
differ on any study variable, thus data were collapsed and analyzed
together. Final multivariable model found that the combination of dyadic
adjustment, social support, parenting stress, and post-traumatic stress
symptoms explained approximately three-quarters of the variance in QOL
scores. <br/>Conclusion(s): QOL for mothers of infants with congenital
heart disease is largely influenced by psychosocial factors. Future
research targeted toward improving maternal QOL should include
psychosocial interventions that address social networks and
stress.<br/>Copyright &#xa9; The Author(s) 2022.

<94>
Accession Number
2015211525
Title
Major Aortopulmonary Collateral Arteries Requiring Percutaneous
Intervention Following the Arterial Switch Operation: A Case Series and
Systematic Review.
Source
World Journal for Pediatric and Congenital Heart Surgery. 13(2) (pp
146-154), 2022. Date of Publication: March 2022.
Author
Doulamis I.P.; Marathe S.P.; Oh N.A.; Saeed M.Y.; Muter A.; del Nido P.J.;
Nathan M.
Institution
(Doulamis, Marathe, Oh, Saeed, Muter, del Nido, Nathan) Department of
Cardiac Surgery, Boston Children's Hospital, Harvard Medical School,
Boston, MA, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Dextro transposition of the great arteries (d-TGA) is the most
common critical congenital cardiac defect surgically treated in the
neonatal period by arterial switch operation (ASO). Major aortopulmonary
collaterals (MAPCAs) can be present in this population and may complicate
the early postoperative period. Our aim was to review our institutional
data and systematically review the available literature to provide further
insight on the clinical significance of MAPCAs during the early
postoperative course after ASO. <br/>Method(s): This is a retrospective
study of patients with simple d-TGA who underwent ASO between March 1998
and September 2020 at Boston Children's Hospital. The MEDLINE, Embase, and
Cochrane databases were searched from inception to June 2020.
<br/>Result(s): Of the 671 d-TGA patients who underwent ASO at our center,
13 (1.9%) were diagnosed with MAPCAs. Five were diagnosed before ASO,
while eight were diagnosed after ASO. Of these, two patients required
catheterization for MAPCAs coiling during the same hospitalization on the
2nd and 11th postoperative days. The systematic review retrieved a total
of 34 articles after duplicates were removed. Finally, nine studies
reporting on 23 patients were deemed eligible for our analysis. The
average time to MAPCAs coiling was 12 days, while the mean hospital stay
was 36 days. <br/>Conclusion(s): MAPCAs should be included in the
differential diagnosis of ASO complicated by cardiac or respiratory
failure, or pulmonary hemorrhage acutely postoperatively. Once managed,
recovery of these patients is predictable, and mortality is low. Further
studies investigating the diagnostic value of echocardiography and the
long-term outcomes of these MAPCAs are necessary.<br/>Copyright &#xa9; The
Author(s) 2021.

<95>
Accession Number
2015211515
Title
Plasmalyte-A Based del Nido Cardioplegia Versus Plain Ringer Based del
Nido Cardioplegia: Double-Blind Randomized Trial.
Source
World Journal for Pediatric and Congenital Heart Surgery. 13(2) (pp
187-195), 2022. Date of Publication: March 2022.
Author
Talwar S.; Harshavardhan N.; Kapoor P.M.; Makhija N.; Rajashekar P.;
Sreenivas V.; Upadhyay A.D.; Sahu M.K.; Choudhary S.K.
Institution
(Talwar, Harshavardhan, Sahu, Choudhary) All India Institute of Medical
Sciences Cardio-Thoracic Sciences Centre, New Delhi, India
(Kapoor, Makhija, Rajashekar, Sreenivas, Upadhyay) All India Institute of
Medical Sciences, New Delhi, India
Publisher
SAGE Publications Inc.
Abstract
Background: In this prospective randomized controlled trial, we compared
the standard del Nido cardioplegia solution (SDN) with the modified del
Nido cardioplegia solution (MDN) in which the base solution was the plain
Ringer solution. <br/>Method(s): A total of 80 patients aged < 12 years
undergoing intracardiac repair of Tetralogy of Fallot were randomized into
SDN (n = 39) or MDN (n = 41) groups. The primary outcome was a change in
cardiac index (CI). Secondary outcomes were ventricular arrhythmias after
the release of aortic-cross clamp, postoperative inotropic score (IS),
time to peripheral rewarming, duration of mechanical ventilation,
intensive care unit (ICU) length of stay, and hospital length of stay, and
electron microscopic differences between the 2 groups. Cardiac Troponin-I,
inflammatory markers tumor necrosis factor-alpha (TNF-alpha), and
interleukin-L (IL-6) were measured. <br/>Result(s): Applying the
noninferiority confidence interval approach, the difference between the
changes in CI between the 2 groups was -0.093 L/min/m2 (95% CI: -0.46-0.27
L/min/m2) which was within the noninferiority threshold of -0.5 indicating
that CI was similar in both SDN and MDN. Ventricular arrhythmias postclamp
release (P =.91), IS (P =.09), duration of mechanical ventilation (P
=.27), ICU length of stay (P =.50), hospital length of stay (P =.57), IL-6
(P =.19), TNF-alpha (P =.17), Troponin-I (P =.15), electron microscopy
changes (P >.05) were not different between groups. <br/>Conclusion(s):
MDN was shown to be noninferior to the SDN cardioplegia in terms of
preservation of cardiac index. In addition, other metrics indicative of
myocardial protection were similar between groups. In developing nations
where SDN is not available or is expensive, MDN cardioplegia is an
acceptable alternative.<br/>Copyright &#xa9; The Author(s) 2022.

<96>
Accession Number
2014571986
Title
Double Jeopardy: Prematurity and Congenital Heart Disease-What's Known and
Why It's Important.
Source
World Journal for Pediatric and Congenital Heart Surgery. 13(1) (pp
65-71), 2022. Date of Publication: January 2022.
Author
Costello J.M.; Kim F.; Polin R.; Krishnamurthy G.
Institution
(Costello) Department of Pediatrics, Medical University of South Carolina,
Charleston, SC, United States
(Kim, Polin, Krishnamurthy) Department of Pediatrics, Columbia University
Irving Medical Center, New York, NY, United States
Publisher
SAGE Publications Inc.
Abstract
This article is based on a composite of talks presented during the Double
Jeopardy: Prematurity and Congenital Heart Disease Plenary Session at
NeoHeart 2020, a global virtual conference. Prematurity and low weight
remain significant risk factors for mortality after neonatal cardiac
surgery despite a steady increase in survival. Newer and lower weight
thresholds for operability are constantly generated as surgeons gather
proficiency, technical mastery, and experience in performing complex
procedures on extremely small infants. The relationship between birth
weight and survival after cardiac surgery is nonlinear with 2 kilograms
(kg) being an inflection point below which marked decline in survival
occurs. The prevalence of congenital heart disease (CHD) in premature
infants is more than twice that in term born infants. Increased risk of
preterm birth in infants with CHD is most commonly due to spontaneous
preterm birth and remains poorly understood. Advances in
Neonatal-Perinatal medicine have led to a marked improvement in survival
of neonates born prematurely over the last several decades. However, the
risk of severe morbidities including retinopathy of prematurity,
intraventricular hemorrhage, bronchopulmonary dysplasia and necrotizing
enterocolitis remains significant in extremely low birth weight infants.
Premature infants with CHD are at a greater risk of prematurity related
morbidities than premature infants without CHD. Interventions that have
been successful in decreasing the risk of these morbidities are
addressed.<br/>Copyright &#xa9; The Author(s) 2021.

<97>
Accession Number
2013401149
Title
Comparison between bicycle ergometric interval and continuous training in
patients early after coronary artery bypass grafting: A prospective,
randomized study.
Source
SAGE Open Medicine. 9 (no pagination), 2021. Date of Publication: 2021.
Author
Reer M.; Rauschenberg S.; Hottenrott K.; Schwesig R.; Heinze V.; Huta D.;
Schwark N.; Schlitt A.
Institution
(Reer, Heinze, Huta, Schlitt) Paracelsus-Harz Clinic, Quedlinburg, Germany
(Rauschenberg, Schwark, Schlitt) Martin-Luther University
Halle-Wittenberg, Halle (Saale), Germany
(Hottenrott) Institute of Sports Science, Martin-Luther-University
Halle-Wittenberg, Halle (Saale), Germany
(Schwesig) Department of Orthopedic and Trauma Surgery,
Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
Publisher
SAGE Publications Ltd
Abstract
Objectives: Continuous and interval training have previously been compared
in patients with cardiac diseases. However, data comparing the safety and
effectiveness of the two exercise methods are lacking in patients early
after coronary artery bypass grafting. <br/>Method(s): In all, 120
patients were prospectively randomized in a 1:1 fashion approximately 17
days after coronary artery bypass grafting to an interval group or
continuous group. All patients participated in bicycle ergometric training
six times/week for 20 min each during a 3-week inpatient rehabilitation
program. The combined primary endpoint was safety as defined by incidence
of scar pain and cardiac events related to the exercise intervention.
Secondary outcomes included the effect of the interventions on parameters
such as heart rate and peak power output. <br/>Result(s): Four patients
(12.1%) in the interval group reported pain on the saphenectomy scar as a
result of the training intervention in comparison to six patients (20.0%)
in the continuous group (chi² (1, n = 63) = 0.73, p = 0.393).
No cardiac events were related to exercise intervention. No effect on
heart rate was found during the intervention, nor was a difference
observed between the groups. Peak power output, as one of the analyzed
markers, improved significantly in both groups, but no differences were
found between groups. <br/>Conclusion(s): Ergometry training performed as
interval or continuous training was safe and effective regarding increase
in physical fitness early after coronary artery bypass grafting in an
inpatient rehabilitation setting, with no differences observed between the
groups.<br/>Copyright &#xa9; The Author(s) 2021.

<98>
Accession Number
2011030719
Title
Closure or medical therapy of patent foramen ovale in cryptogenic stroke:
prospective case series.
Source
Neurological Research and Practice. 3(1) (no pagination), 2021. Article
Number: 16. Date of Publication: December 2021.
Author
Poli S.; Siebert E.; Mbroh J.; Poli K.; Krumbholz M.; Mengel A.; Greulich
S.; Hartig F.; Muller K.A.L.; Bocksch W.; Gawaz M.; Ziemann U.; Zuern C.S.
Institution
(Poli, Mbroh, Poli, Krumbholz, Mengel, Hartig, Ziemann, Zuern) Department
of Neurology & Stroke, Eberhard-Karls University, Hoppe-Seyler-Str. 3,
Tubingen 72076, Germany
(Poli, Mbroh, Poli, Krumbholz, Mengel, Hartig, Ziemann) Hertie Institute
for Clinical Brain Research, Eberhard-Karls University, Tuebingen, Germany
(Siebert, Greulich, Muller, Bocksch, Gawaz, Zuern) Department of
Cardiology, Eberhard-Karls University, Tuebingen, Germany
(Zuern) Cardiology Division, Department of Medicine, University Hospital,
and Cardiovascular Research Institute, Basel, Switzerland
Publisher
BioMed Central Ltd
Abstract
Background: Results of randomized controlled trials (RCT) do not provide
definite guidance for secondary prevention after ischemic stroke
(IS)/transient ischemic attack (TIA) attributed to patent foramen ovale
(PFO). No recommendations can be made for patients > 60 years. We aimed to
compare interventional and medical PFO-management in cryptogenic IS/TIA
patients, including patients > 60 years. <br/>Method(s): Prospective case
series including consecutive cryptogenic IS/TIA patients with PFO at
Tuebingen university stroke unit, Germany. 'PFO-closure' was recommended
in patients <=70 years when featuring high-risk PFO (i.e., with atrial
septal aneurysm, spontaneous, or high-grade right-to-left shunt during
Valsalva). Primary (recurrent IS/intracranial hemorrhage) and secondary
endpoints (e.g., disability) were assessed during >=1-year follow-up;
planned subgroup analyses of patients <=60/> 60 years. <br/>Result(s):
Among 236 patients with median age of 58 (range 18-88) years, 38.6% were
females and median presenting National Institutes of Health Stroke Scale
score was 1 (IQR 0-4). Mean follow-up was 2.8 +/- 1.3 years. No
intracranial hemorrhage was observed. Recurrent IS rate after
'PFO-closure' was 2.9% (95%CI 0-6.8%) and 7% (4-16.4) in high-risk PFO
patients <=60 (n = 103) and > 60 years (n = 43), respectively, versus 4%
(0-11.5) during 'medical therapy alone' MTA (n = 28). 42 low-risk PFO
patients treated with MTA experienced no recurrent IS/TIA.
<br/>Conclusion(s): In our real-world study, IS recurrence rate in
'PFO-closure' high-risk PFO patients <=60 years was comparable to that
observed in recent RCT. High-risk PFO patients > 60 years who underwent
PFO-closure had similar IS recurrence rates than those who received MTA.
MTA seems the appropriate treatment for low-risk PFO. Trial registration:
ClinicalTrials.gov, registration number: NCT04352790, registered on: April
20, 2020 - retrospectively registered.<br/>Copyright &#xa9; 2021, The
Author(s).

<99>
Accession Number
2007027352
Title
Effect of Albumin Addition to Cardiopulmonary Bypass Prime on Outcomes in
Children Undergoing Open-Heart Surgery (EACPO Study)-A Randomized
Controlled Trial.
Source
World Journal for Pediatric and Congenital Heart Surgery. 12(1) (pp
61-69), 2021. Date of Publication: January 2021.
Author
Rauf A.; Joshi R.K.; Aggarwal N.; Agarwal M.; Kumar M.; Dinand V.; Joshi
R.
Institution
(Rauf, Joshi) Department of Pediatric Intensive Care, Sir Ganga Ram
Hospital, New Delhi, Delhi, India
(Joshi, Aggarwal, Agarwal, Kumar) Department of Pediatric Cardiac
Sciences, Sir Ganga Ram Hospital, New Delhi, Delhi, India
(Dinand) Department of Research, Sir Ganga Ram Hospital, New Delhi, Delhi,
India
Publisher
SAGE Publications Inc.
Abstract
Background: There is a paucity of literature regarding the association of
high oncotic priming solutions for pediatric cardiopulmonary bypass (CPB)
and outcomes, and no consensus exists regarding the composition of optimal
CPB priming solution. This study aimed to examine the impact of high
oncotic pressure priming by the addition of 20% human albumin on outcomes.
<br/>Method(s): Double-blinded, randomized controlled study was done in
the pediatric cardiac intensive care unit of a tertiary care hospital.
Consecutive children with congenital heart diseases admitted for
open-heart surgery were randomized into two groups, where the study group
received an additional 20% albumin to conventional blood prime before CPB
initiation. <br/>Result(s): We enrolled 39 children in the high oncotic
prime (added albumin) group and 37 children in the conventional prime
group. In the first 24-hour postoperative period, children in the albumin
group had significantly lower occurrence of hypotension (28.2% vs 54%, P
=.02), requirement of fluid boluses (25.6% vs 54%, P =.006), and lactate
clearance time (6 vs 9 hours, P <.001). Albumin group also had
significantly higher platelet count (x10³/microL) at 24 hours
(112 vs 91, P =.02). There was no significant difference in intra-CPB
hemodynamic parameters and incidence of acute kidney injury. In subgroup
analysis based on risk category, significantly decreased intensive care
unit stay (4 vs 5 days, P =.04) and hospital stay (5 vs 7 days, P =.002)
were found in the albumin group in low-risk category. <br/>Conclusion(s):
High oncotic pressure CPB prime using albumin addition might be beneficial
over conventional blood prime, and our study does provide a rationale for
further studies.<br/>Copyright &#xa9; The Author(s) 2020.

<100>
Accession Number
2005851225
Title
A Systematic Review of Antibiotic Prophylaxis for Delayed Sternal Closure
in Children.
Source
World Journal for Pediatric and Congenital Heart Surgery. 12(1) (pp
93-102), 2021. Date of Publication: January 2021.
Author
Kennedy J.T.; DiLeonardo O.; Hurtado C.G.; Nelson J.S.
Institution
(Kennedy, Hurtado, Nelson) University of Central Florida College of
Medicine, Orlando, FL, United States
(Kennedy) Department of Surgery, University of Cincinnati College of
Medicine, Cincinnati, OH, United States
(DiLeonardo) Department of Medical Education, Nemours Children's Hospital,
Orlando, FL, United States
(DiLeonardo) Nemours Children's Hospital Medical Library, Orlando, FL,
United States
(Nelson) Department of Cardiovascular Services, Nemours Children's
Hospital, Orlando, FL, United States
Publisher
SAGE Publications Inc.
Abstract
Antibiotic prophylaxis following delayed sternal closure in pediatric
cardiac surgery is not standardized. We systematically reviewed relevant
literature published between 1990 and 2019 to aid future trial design.
Patient characteristics, antimicrobial prophylaxis regimens, and
postoperative incidence of infection were collected. Twenty-eight studies
described 36 different regimens in over 3,000 patients. There were 11
single-drug regimens and 25 multidrug regimens. Cefazolin-only was the
most common regimen (9/36, 25%). The overall incidence of surgical site
infection was 7.5% (217/2,910 patients) and bloodstream infection was 7.4%
(123/1,667 patients). In the 2010s, multidrug regimens were associated
with a significantly lower incidence of both surgical site infections
(4.6% vs. 20%, P <.001) and bloodstream infections (6.0% vs. 50%, P <.001)
compared to single-drug regimens.<br/>Copyright &#xa9; The Author(s) 2020.

<101>
Accession Number
2006003911
Title
Aortic Valve Intervention During Aortic Root Surgery in Children: A
Systematic Review.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11(5) (pp
611-618), 2020. Date of Publication: 01 Sep 2020.
Author
Rodriguez M.; Malvea A.; McNally D.; Bijelic V.; Guo M.; Momoli F.;
Boodhwani M.
Institution
(Rodriguez) Division of Cardiovascular Surgery, Children's Hospital of
Eastern Ontario, Ottawa, ON, Canada
(Rodriguez, Malvea, Guo, Momoli, Boodhwani) University of Ottawa, Ottawa,
ON, Canada
(McNally) Pediatric Intensive Care Unit, Children's Hospital of Eastern
Ontario, Ottawa, ON, Canada
(Bijelic) Clinical Research Unit, Children's Hospital of Eastern Ontario,
Ottawa, ON, Canada
(Guo, Boodhwani) Division of Cardiac Surgery, University of Ottawa Heart
Institute, Ottawa, ON, Canada
Publisher
SAGE Publications Inc.
Abstract
Background: Pediatric aortic root dilatation is a life-threatening
condition that lacks guidelines for surgical management. We aimed to
analyze the data on aortic valve interventions during root surgery to
guide decision-making. <br/>Method(s): A search was performed of MEDLINE,
Embase, CENTRAL, ClinicalTrials.gov, and WHO ICTRP. Citations were
screened in duplicate and independently to identify randomized controlled
trials, cohorts, and case series involving populations aged 0 to 18 years,
who received valve-sparing and valve-replacing aortic root surgeries
between 1999 and 2019. Outcomes considered included mortality
(perioperative, one year, five year), reintervention rates.
<br/>Result(s): After duplicate removal, 689 citations were screened
through abstract and full text review, identifying five eligible studies.
All five were observational studies evaluating valve-sparing procedures.
There were 81 patients with a mean study age range of 9.9 to 13.9 years.
Both reimplantation (74%) and remodeling (26%) subtypes were done. Range
of mean duration of follow-up was 1.2 to 4.4 years. There was no mortality
reported until the one-year follow-up period. The long-term mortality rate
was calculated as 0.02 per patient-year (95% CI: 0.01-0.05). The long-term
reintervention rate was 0.08 per patient-year (95% CI: 0.05-0.13).
<br/>Conclusion(s): There is limited experience on aortic valve
intervention during aortic root surgery in children. Single-arm studies on
valve-sparing surgeries show excellent survival up to one year. Mortality
and reintervention rates increase in the longer term. The small sample
size and lack of controlled studies do not allow for direct comparisons
between procedure types.<br/>Copyright &#xa9; The Author(s) 2020.

<102>
Accession Number
2006003902
Title
Monocusp Valves Do Not Improve Early Operative Mortality in Tetralogy of
Fallot: A Meta-Analysis.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11(5) (pp
619-624), 2020. Date of Publication: 01 Sep 2020.
Author
Awori M.N.; Awori J.A.; Mehta N.P.; Makori O.
Institution
(Awori, Mehta, Makori) Department of Surgery, School of Medicine,
University of Nairobi, Kenyatta National Hospital, Nairobi, Kenya
(Awori) Department of Pediatrics, Seattle Children's Hospital, Seattle,
WA, United States
Publisher
SAGE Publications Inc.
Abstract
Monocusp valves are thought to reduce early operative mortality and
morbidity associated with pediatric tetralogy of Fallot repair. As there
are no published randomized clinical trials comparing outcomes with and
without a monocusp valve, we performed a meta-analysis of observational
studies in accordance with established protocols. After systematically
searching PubMed, the Cochrane Library, and Google Scholar, 12 studies
were included. The operative mortality was compared in 695 patients, and
we found no difference between patients with and patients without a
monocusp valve. Monocusp valves may not improve operative mortality of
tetralogy of Fallot repair in pediatric patients.<br/>Copyright &#xa9; The
Author(s) 2020.

<103>
Accession Number
2005518661
Title
Efficacy of Nitric Oxide Administration in Attenuating
Ischemia/Reperfusion Injury During Neonatal Cardiopulmonary Bypass.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11(4) (pp
417-423), 2020. Date of Publication: 01 Jul 2020.
Author
Elzein C.; Urbas C.; Hughes B.; Li Y.; Lefaiver C.; Ilbawi M.; Vricella L.
Institution
(Elzein, Ilbawi, Vricella) Division of Pediatric Cardiothoracic Surgery,
Advocate Children's Hospital Heart Institute, Advocate Children's
Hospital, Oak Lawn, IL, United States
(Urbas) Advocate Children's Hospital Heart Institute, Advocate Children's
Hospital, Oak Lawn, IL, United States
(Hughes) Advocate Center for Pediatric Research, Advocate Children's
Hospital Heart Institute, Advocate Children's Hospital, Oak Lawn, IL,
United States
(Li) Patient-Centered Outcomes Research, Advocate Center for Pediatric
Research, Research Institute, Advocate Children's Hospital, Oak Lawn, IL,
United States
(Lefaiver) Advocate Center for Pediatric Research, Advocate Children's
Hospital, Oak Lawn, IL, United States
Publisher
SAGE Publications Inc.
Abstract
Objective: Nitric oxide (NO) plays several protective roles in
ischemia/reperfusion (I/R) injury. Neonates undergoing the Norwood
procedure are subject to develop I/R injury due to the immaturity of their
organs and the potential need to interrupt or decrease systemic flow
during surgery. We hypothesized that NO administration during
cardiopulmonary bypass (CPB) ameliorates the I/R and could help the
postoperative recovery after the Norwood procedure. <br/>Method(s):
Twenty-four neonates who underwent a Norwood procedure were enrolled in a
prospective randomized blinded controlled trial to receive NO (12
patients) or placebo (12 patients) into the oxygenator of the CPB circuit
during the Norwood procedure. Markers of I/R injury were collected at
baseline (T0), after weaning from CPB before modified ultrafiltration
(T1), after modified ultrafiltration (T2), and at 12 hours (T3) and 24
hours (T4) after surgery, and they were compared between both groups, as
well as other postoperative clinical variables. <br/>Result(s): There was
no difference in age, weight, anatomical diagnosis, CPB, and aortic
cross-clamp time between both groups. Troponin levels were lower in the
study group at T1 (0.62 +/- 58 ng/mL vs 0.87 +/- 0.58 ng/mL, P =.31) and
became significantly lower at T2 (0.36 +/- 0.32 ng/mL vs 0.97 +/- 0.48
ng/mL, P =.009).There were no significant differences between both groups
for all other markers. Despite a lower troponin level, there was no
difference in inotropic scores or ventricular function between both
groups. Time to start diuresis, time to sternal closure and extubation,
and intensive care unit and hospital stay were not different between both
groups. <br/>Conclusion(s): Systemic administration of NO during the
Norwood procedure has myocardial protective effects (lower Troponin
levels) but we observed no effect on postoperative recovery. Larger sample
size may be needed to show clinical differences.<br/>Copyright &#xa9; The
Author(s) 2020.

<104>
Accession Number
2005518659
Title
Randomized Pilot Trial of Acute Normovolemic Hemodilution in Pediatric
Cardiac Surgery Patients.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11(4) (pp
452-458), 2020. Date of Publication: 01 Jul 2020.
Author
Harris W.M.; Treggiari M.M.; LeBlanc A.; Giacomuzzi C.; You J.J.;
Muralidaran A.; Shen I.
Institution
(Harris, Treggiari) Department of Anesthesiology and Perioperative
Medicine, Oregon Health Science University, Portland, OR, United States
(Treggiari) Department of Anesthesiology, Yale University, New Haven, CT,
United States
(LeBlanc, Giacomuzzi, You) Department of Pediatric Perfusion and ECMO
Services, Oregon Health Science University, Portland, OR, United States
(Muralidaran, Shen) Department of Cardiothoracic Surgery, Oregon Health
Science University, Portland, OR, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Due to the substantial improvement in survival among pediatric
patients undergoing congenital heart surgery, reducing early and long-term
morbidity is becoming the major focus of care. Blood transfusion is
associated with worse postoperative outcomes after cardiac surgery. Acute
normovolemic hemodilution (ANH) is a blood conservation strategy that aims
to reduce allogenic blood transfusion during cardiac surgery. However,
there are scant data regarding its efficacy for pediatric cardiac surgery
patients. <br/>Method(s): We designed a single-center, controlled,
randomized, pilot trial in patients between 6 and 36 months old undergoing
pediatric heart surgery. Patients were equally assigned to undergo ANH
prior to initiation of cardiopulmonary bypass or to be managed per usual
care. The primary end point was the amount of blood product transfused
perioperatively. Secondary end points were markers of morbidity:
postoperative bleeding, hematocrit, inotropic agents use, intensive care
unit, and hospital stay. The analysis was by intention-to-treat. Estimates
of differences between groups are presented with 95% CIs. <br/>Result(s):
Twelve pediatric heart surgery patients were randomized to each group, ANH
and usual care. Baseline characteristics were similar between groups.
Acute normovolemic hemodilution implementation did not result in a
reduction in the administration of blood product transfused (difference
between ANH and usual care among patients transfused = -1.4 mL [-29.4 to
26.6], P =.92). Secondary end points were not different between groups.
<br/>Conclusion(s): In this small trial of pediatric cardiac surgery
patients, ANH as a strategy to reduce blood component therapy was safe;
however, the study failed to show a reduction in perioperative transfusion
or other postoperative outcomes.<br/>Copyright &#xa9; The Author(s) 2020.

<105>
Accession Number
2004397409
Title
Passive Peritoneal Drainage Impact on Fluid Balance and Inflammatory
Mediators: A Randomized Pilot Study.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11(2) (pp
150-158), 2020. Date of Publication: 01 Mar 2020.
Author
Pourmoghadam K.K.; Kubovec S.; DeCampli W.M.; Khallouq B.B.; Piggott K.;
Blanco C.; Fakioglu H.; Kube A.; Narasimhulu S.S.
Institution
(Pourmoghadam, DeCampli, Kube) Section of Pediatric Cardiovascular
Surgery, Arnold Palmer Hospital for Children, Orlando, FL, United States
(Pourmoghadam, Kubovec, DeCampli, Khallouq, Narasimhulu) University of
Central Florida College of Medicine, Orlando, FL, United States
(Piggott, Blanco, Fakioglu, Narasimhulu) Pediatric Cardiac Intensive Care,
Orlando, FL, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Infants after cardiopulmonary bypass are exposed to increasing
inflammatory mediator release and are at risk of developing fluid
overload. The aim of this pilot study was to evaluate the impact of
passive peritoneal drainage on achieving negative fluid balance and its
ability to dispose of inflammatory cytokines. <br/>Method(s): From
September 2014 to November 2016, infants undergoing STAT category 3, 4,
and 5 operations were randomized to receive or not receive intraoperative
prophylactic peritoneal drain. We analyzed time to negative fluid balance
and perioperative variables for each group. Pro- and anti-inflammatory
cytokines were measured from serum and peritoneal fluid in the passive
peritoneal drainage group and serum in the control group postoperatively.
<br/>Result(s): Infants were randomized to prophylactic passive peritoneal
drain group (n = 13) and control (n = 12). The groups were not
significantly different in pre- and postoperative peak lactate levels,
postoperative length of stay, and mortality. Peritoneal drain patients
reached time to negative fluid balance at a median of 1.42 days
(interquartile range [IQR]: 1.00-2.91), whereas the control at 3.08 (IQR:
1.67-3.88; P =.043). Peritoneal drain patients had lower diuretic index at
72 hours, median of 2.86 (IQR: 1.21-4.94) versus 6.27 (IQR: 4.75-11.11; P
=.006). Consistently, tumor necrosis factor-alpha, interleukin (IL)-4,
IL-6, IL-8, IL-10, and interferon-gamma were present at higher levels in
peritoneal fluid than serum at 24 and 72 hours. However, serum cytokine
levels in peritoneal drain and control group, at 24 and 72 hours
postoperatively, did not differ significantly. <br/>Conclusion(s): The
prophylactic passive peritoneal drain patients reached negative fluid
balance earlier and used less diuretic in early postoperative period. The
serum cytokine levels did not differ significantly between groups at 24
and 72 hours postoperatively. However, there was no significant difference
in mortality and postoperative length of stay.<br/>Copyright &#xa9; The
Author(s) 2020.

<106>
Accession Number
2003963263
Title
Transfusing Platelets During Bypass Rewarming in Neonates Improves
Postoperative Outcomes: A Randomized Controlled Trial.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11(1) (pp
71-76), 2020. Date of Publication: 01 Jan 2020.
Author
Gautam N.K.; Pierre J.; Edmonds K.; Pawelek O.; Griffin E.; Xu Z.;
Dodge-Khatami A.; Salazar J.
Institution
(Gautam, Pierre, Edmonds, Pawelek, Griffin, Xu) Department of
Anesthesiology, McGovern Medical School, University of Texas Health
Science Center at Houston, TX, United States
(Dodge-Khatami, Salazar) Division of Pediatric Congenital Heart Surgery,
McGovern Medical School, University of Texas Health Science Center at
Houston, TX, United States
Publisher
SAGE Publications Inc.
Abstract
Background: In neonates, transfusion of platelets after hemodilution from
cardiopulmonary bypass (CPB) has been standard. We hypothesize that
platelet administration during the rewarming phase before termination of
CPB would reduce coagulopathy, enhance hemostasis, reduce transfusion, and
improve postoperative outcomes after neonatal cardiac surgery.
<br/>Method(s): A prospective, randomized trial was performed in 46
neonates. Controls received platelets only at the end of bypass with other
blood products to assist in hemostasis. The treatment group received 10
mL/kg of platelets during the rewarming phase of bypass after cross-clamp
release. After protamine, transfusion and perioperative management
protocols were identical and constant among groups. <br/>Result(s): Two
neonates in each group were excluded secondary to postoperative need for
extracorporeal support. Controls (n = 21) and treatment patients (n = 21)
were similar in age, weight, case complexity, associated syndromes, single
ventricle status, and CPB times. Compared to controls, the treatment group
required 40% less postbypass blood products (58 +/- 29 vs 103 +/- 80
mL/kg, P =.04), and case completion time after protamine administration
was 28 minutes faster (P =.016). The treatment group required fewer
postoperative mediastinal explorations for bleeding (P =.045) and had a
lower fluid balance (P =.04). The treatment group had shorter mechanical
ventilation (P =.016) and length of intensive care unit times (P =.033).
There were no 30-day mortalities in either group. <br/>Conclusion(s):
Platelet transfusion during the rewarming phase of neonatal cardiac
surgery was associated with reduced bleeding and improved postoperative
outcomes, compared to platelets given after coming off bypass. Further
studies are necessary to understand mechanisms and benefits of this
strategy.<br/>Copyright &#xa9; The Author(s) 2019.

<107>
Accession Number
2003963260
Title
Budesonide for Protein Losing Enteropathy in Patients with Fontan
Circulation: A Systematic Review and Meta-Analysis.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11(1) (pp
85-91), 2020. Date of Publication: 01 Jan 2020.
Author
Kewcharoen J.; Mekraksakit P.; Limpruttidham N.; Kanitsoraphan C.;
Charoenpoonsiri N.; Poonsombudlert K.; Pattison R.J.; Rattanawong P.
Institution
(Kewcharoen, Limpruttidham, Kanitsoraphan, Poonsombudlert, Pattison,
Rattanawong) University of Hawaii Internal Medicine Residency Program,
Honolulu, HI, United States
(Mekraksakit) Department of Medicine, Phramongkutklao College of Medicine,
Bangkok, Thailand
(Charoenpoonsiri) Faculty of Medicine, Chulalongkorn University Hospital,
Bangkok, Thailand
(Rattanawong) Faculty of Medicine, Ramathibodi Hospital, Mahidol
University, Bangkok, Thailand
Publisher
SAGE Publications Inc.
Abstract
Background: Recent studies have shown that oral budesonide can be used to
improve albumin level in patients with protein-losing enteropathy (PLE)
following Fontan procedure. However, there has never been a systematic
review and meta-analysis to confirm this finding. We performed a
systematic review and meta-analysis to explore the therapeutic effect of
budesonide in patients with PLE post-Fontan procedure. <br/>Method(s): We
searched the databases of MEDLINE and EMBASE from inception to January
2019. Included studies were published studies that evaluate albumin level
before and after budesonide therapy in patients with PLE following Fontan
procedure. Data from each study were combined using the random-effects
model. <br/>Result(s): Five studies with 36 post-Fontan operation patients
with PLE were included. In random-effects model, there was a statistically
significant difference in albumin level between before and after
budesonide treatment (weighted mean difference = 1.28, 95% confidence
interval: 0.76-1.79). No publication bias was observed on a funnel plot
and Egger test with a P value of.676. <br/>Conclusion(s): The results of
this systematic review and meta-analysis show that budesonide can be used
to increase albumin level in patients with PLE following Fontan operation.
Further studies may focus on the impact of outcome of budesonide in this
population.<br/>Copyright &#xa9; The Author(s) 2019.

<108>
Accession Number
2007174470
Title
Safety and Effectiveness of Del Nido Cardioplegia in Comparison to
Blood-Based St. Thomas Cardioplegia in Congenital Heart Surgeries: A
Prospective Randomized Controlled Study.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11(6) (pp
720-726), 2020. Date of Publication: November 2020.
Author
Haranal M.; Chin H.C.; Sivalingam S.; Raja N.; Mohammad Shaffie M.S.;
Namasiwayam T.K.; Fadleen M.; Fakhri N.
Institution
(Haranal, Chin, Sivalingam) Department of Pediatric Cardiac Surgery,
National Heart Institute, Kuala Lumpur, Malaysia
(Raja, Mohammad Shaffie, Namasiwayam) Department of Cardiac Anesthesia,
National Heart Institute, Kuala Lumpur, Malaysia
(Fadleen) Department of Perfusion Sciences, National Heart Institute,
Kuala Lumpur, Malaysia
(Fakhri) Department of Clinical Research, National Heart Institute, Kuala
Lumpur, Malaysia
Publisher
SAGE Publications Inc.
Abstract
Background: To compare the safety and effectiveness of del Nido
cardioplegia with blood-based St Thomas Hospital (BSTH) cardioplegia in
myocardial protection in congenital heart surgery. <br/>Method(s): It is a
prospective, open-labeled, randomized controlled study conducted at
National Heart Institute, Kuala Lumpur from July 2018 to July 2019. All
patients with simple and complex congenital heart diseases (CHD) with good
left ventricular function (left ventricular ejection fraction [LVEF] >50%)
were included while those with LVEF <50% were excluded. A total of 100
patients were randomized into two groups of 50 each receiving either del
Nido or BSTH cardioplegia. Primary end points were the spontaneous return
of activity following aortic cross-clamp release and ventricular function
between two groups. Secondary end point was myocardial injury as assessed
by troponin T levels. <br/>Result(s): Cardiopulmonary bypass and aortic
cross-clamp time, return of spontaneous cardiac activity following the
aortic cross-clamp release, the duration of mechanical ventilation, and
intensive care unit stay were comparable between two groups. Statistically
significant difference was seen in the amount and number of cardioplegia
doses delivered (P <.001). The hemodilution was significantly less in the
del Nido complex CHD group compared to BSTH cardioplegia (P =.001) but no
difference in blood usage (P =.36). The myocardial injury was lesser
(lower troponin T release) with del Nido compared to BSTH cardioplegia (P
=.6). <br/>Conclusion(s): Our study showed that both del Nido and BSTH
cardioplegia are comparable in terms of myocardial protection. However,
single, less frequent, and lesser volume of del Nido cardioplegia makes it
more suitable for complex repair.<br/>Copyright &#xa9; The Author(s) 2020.

<109>
Accession Number
2002867702
Title
Modified Single-Patch versus Two-Patch Repair for Atrioventricular Septal
Defect: A Systematic Review and Meta-Analysis.
Source
World Journal for Pediatric and Congenital Heart Surgery. 10(5) (pp
616-623), 2019. Date of Publication: 01 Sep 2019.
Author
Loomba R.S.; Flores S.; Villarreal E.G.; Bronicki R.A.; Anderson R.H.
Institution
(Loomba) Cardiology, Pediatrics, Advocate Children's Hospital, Oak Lawn,
IL, United States
(Flores, Villarreal, Bronicki) Critical Care and Cardiology, Pediatrics,
Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United
States
(Anderson) Institute of Genetics, Newcastle University, Newcastle Upon
Tyne, United Kingdom
Publisher
SAGE Publications Inc.
Abstract
Background: We performed a meta-analysis of studies to determine whether
the modified single-patch technique offers benefits when compared to the
two-patch repair. The postoperative outcomes examined in this study were
cardiopulmonary bypass time, cross-clamp time, duration of mechanical
ventilation, intensive care unit length of stay, total hospital length of
stay, need for reoperation, need for reoperation for left ventricular
outflow tract obstruction or left atrioventricular valve regurgitation,
need for pacemaker implantation, and mortality during follow-up.
<br/>Method(s): A review was conducted to identify studies comparing a
modified single-patch repair versus two-patch repair. A fixed-effects
model was utilized for end points with low heterogeneity and a
random-effects model for end points with significant heterogeneity.
Meta-regression was also performed to determine the influence of other
factors on the variables of interest. <br/>Result(s): A total of 964
unique manuscripts were screened, with 10 being included in the final
analyses. There were a total of 724 patients, with 353 (49%) having
undergone repair utilizing a modified single-patch repair. Mean age at
repair for modified single-patch repair and two-patch repair was 8.81 and
9.03 months, respectively. Significant differences were noted in
cardiopulmonary bypass time and cross-clamp time with mean difference of
-28.53 and -22.69 minutes, respectively. In comparison to the two-patch
repair, both times were decreased in modified single-patch repair. No
significant difference was noted in any other variables.
<br/>Conclusion(s): Modified single-patch repair for atrioventricular
septal defects requires less cardiopulmonary bypass and cross-clamp time
but does not significantly impact the examined postoperative
outcomes.<br/>Copyright &#xa9; The Author(s) 2019.

<110>
Accession Number
624459567
Title
Antiplatelet Effect of Ketorolac in Children After Congenital Cardiac
Surgery.
Source
World Journal for Pediatric and Congenital Heart Surgery. 9(6) (pp
651-658), 2018. Date of Publication: 01 Nov 2018.
Author
Kim J.S.; Kaufman J.; Patel S.S.; Manco-Johnson M.; Di Paola J.; da Cruz
E.M.
Institution
(Kim, Kaufman, Patel, da Cruz) Department of Pediatrics, Heart Institute,
Children's Hospital Colorado, University of Colorado Denver School of
Medicine, Aurora, CO, United States
(Manco-Johnson, Di Paola) Department of Pediatrics, Hemophilia and
Thrombosis Center, Children's Hospital Colorado, University of Colorado
Denver School of Medicine, Aurora, CO, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Ketorolac is used for pediatric analgesia after surgery
despite its known platelet inhibition via the arachidonic acid (AA)
pathway. The degree of platelet inhibitory effect after cardiac surgery is
not well characterized. Thromboelastography with platelet mapping (TEG-PM)
is emerging as a frequently used test to evaluate platelet inhibition via
the AA pathway. <br/>Method(s): Post hoc analysis of a data set collected
in a prospective observational cohort study evaluating platelet inhibition
in children after congenital heart surgery with cardiopulmonary bypass
(CPB). Categorization into two groups: (1) received ketorolac and (2) did
not receive ketorolac for analgesia after surgery. The TEG-PM was
evaluated at two time points (prior to surgery and 12-48 hours after CPB).
<br/>Result(s): Fifty-three children were studied; mean age was 6.6
(range: 0.07-16.7) years and 45% (n = 24) were female. Participants were
distributed into two groups by ketorolac use, 41 within the ketorolac
group and 12 in the no ketorolac group. All 41 participants who received
ketorolac had platelet inhibition and 11 (91.7%) of 12 participants who
did not receive ketorolac had normal platelet function after surgery (P
<.0001). There was no difference in patient characteristics or clinical
data between the two groups. <br/>Conclusion(s): Ketorolac use in a cohort
of children after congenital cardiac surgery was associated with platelet
inhibition via the AA pathway when evaluated by TEG-PM.<br/>Copyright
&#xa9; The Author(s) 2018.

<111>
Accession Number
621323224
Title
Early Outcomes of Hypoplastic Left Heart Syndrome Infants: Meta-Analysis
of Studies Comparing the Hybrid and Norwood Procedures.
Source
World Journal for Pediatric and Congenital Heart Surgery. 9(2) (pp
224-233), 2018. Date of Publication: 01 Mar 2018.
Author
Cao J.Y.; Lee S.Y.; Phan K.; Ayer J.; Celermajer D.S.; Winlaw D.S.
Institution
(Cao, Lee, Phan, Ayer, Celermajer, Winlaw) Sydney Medical School,
University of Sydney, Sydney, NSW, Australia
(Phan) NeuroSpine Surgery Research Group (NSURG), Prince of Wales Private
Hospital, Sydney, NSW, Australia
(Ayer, Winlaw) Heart Centre for Children, The Children's Hospital at
Westmead, Sydney, NSW, Australia
(Celermajer) Cardiology, Royal Prince Alfred Hospital, Sydney, NSW,
Australia
Publisher
SAGE Publications Inc.
Abstract
The hybrid strategy is an alternative to the traditional Norwood procedure
for initial palliation of infants with hypoplastic left heart syndrome
(HLHS) who are deemed to be at high surgical risk. Numerous single-center
studies have compared the two procedures, showing similar early outcomes,
although the cohort sizes are likely insufficiently powered to detect
significant differences. The current meta-analysis aims to explore the
early morbidity and mortality associated with the hybrid compared to the
Norwood procedure. MEDLINE, Cochrane Libraries, and Embase were
systematically searched, and 14 studies were included for statistical
synthesis, comprising 263 hybrid and 426 Norwood patients. Early mortality
was significantly higher in the hybrid patients (relative risk [RR] =
1.54, P <.05, 95% confidence interval [CI]: 1.02-2.34), whereas interstage
mortality was comparable between the two groups (RR = 0.88, P >.05, 95%
CI: 0.46-1.70). Six-month (RR = 0.89, P <.05, 95% CI: 0.80-1.00) and
one-year (RR = 0.88, P <.05, 95% CI: 0.78-1.00) transplant-free survival
was also inferior among the hybrid patients. Furthermore, the hybrid
patients required more reinterventions following initial surgical
palliation (RR = 1.48, P <.05, 95% CI: 1.09-2.01), although the two groups
had comparable length of hospital and intensive care unit stay
postoperatively. In conclusion, our results suggest that the hybrid
procedure is associated with worse early survival compared to the
traditional Norwood when used for initial palliation of infants with HLHS.
However, due to the hybrid being used preferentially for high-risk
patients, definitive conclusions regarding the efficacy of the procedure
cannot be drawn.<br/>Copyright &#xa9; 2018, &#xa9; The Author(s) 2018.

<112>
Accession Number
620193774
Title
The Perspective of the Intensivist on Inotropes and Postoperative Care
Following Pediatric Heart Surgery: An International Survey and Systematic
Review of the Literature.
Source
World Journal for Pediatric and Congenital Heart Surgery. 9(1) (pp 10-21),
2018. Date of Publication: 01 Jan 2018.
Author
Roeleveld P.P.; de Klerk J.C.A.
Institution
(Roeleveld) Department of Pediatric Intensive Care, Leiden University
Medical center, Leiden, Netherlands
(de Klerk) Department of Neonatal Intensive Care, Erasmus MC-Sophia
Children's Hospital, Rotterdam, Netherlands
Publisher
SAGE Publications Inc.
Abstract
Introduction: Inotropes are frequently being used in children undergoing
heart surgery to prevent or treat low cardiac output syndrome (LCOS).
There is only limited evidence that inotropes actually positively
influence postoperative outcome. Our aim was to describe the current
international practice variation in the use of inotropes following
congenital heart surgery. <br/>Method(s): We developed an online survey
regarding the postoperative use of inotropes. We sent an invitation to all
197 registered members of the Pediatric Cardiac Intensive Care Society
(PCICS) to participate in the survey. We also performed a systematic
review of the literature. <br/>Result(s): Ninety-eight people (50%)
responded, representing 62 international centers. Milrinone is routinely
used perioperatively by 90 respondents (97%). Adrenaline/epinephrine is
routinely used by 43%, dopamine by 36%, dobutamine by 11%, and
levosimendan by 6%. Steroids are used routinely by 54% before initiating
cardiopulmonary bypass. Vasopressin is used by 44% of respondents. The
development of LCOS is monitored with lactate in 99% of respondents,
physical examination (98%), intermittent mixed venous saturation (76%),
continuous mixed venous saturation (13%), echocardiography (53%),
core-peripheral temperature gap (29%), near-infrared spectrometry (25%),
and 4% use cardiac output monitors (PiCCO, USCOM). To improve cardiac
output, 42% add/increase milrinone, 37% add adrenaline, and 15% add
dopamine. Rescue therapy is titrated individually, based on the patients'
pathophysiology. A systematic review of the literature failed to show
compelling evidence with regard to the benefit of inotropes.
<br/>Conclusion(s): Despite the lack of sufficient evidence, milrinone is
used by the vast majority of caregivers following congenital heart
surgery.<br/>Copyright &#xa9; 2017, &#xa9; The Author(s) 2017.

<113>
Accession Number
618308563
Title
Cardiac Tumors in Pediatric Patients: A Systematic Review.
Source
World Journal for Pediatric and Congenital Heart Surgery. 8(5) (pp
624-632), 2017. Date of Publication: 01 Sep 2017.
Author
Tzani A.; Doulamis I.P.; Mylonas K.S.; Avgerinos D.V.; Nasioudis D.
Institution
(Tzani, Doulamis, Mylonas, Avgerinos, Nasioudis) Surgery Working Group,
Society of Junior Doctors, Athens, Greece
(Mylonas) Division of Pediatric Surgery, Department of Surgery,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United
States
(Avgerinos) Department of Cardiothoracic Surgery, New York Presbyterian
Medical Center, Weill Cornell College of Medicine, New York, NY, United
States
(Nasioudis) Department of Obstetrics and Gynecology, Hospital of the
University of Pennsylvania, Philadelphia, PA, United States
Publisher
SAGE Publications Inc.
Abstract
This systematic review sought to investigate the current evidence
regarding surgical management of primary cardiac tumors in children and
adolescents. Twenty-eight studies were deemed eligible, reporting on 745
pediatric patients. Rhabdomyoma was the most prevalent histologic type and
echocardiography was the most common diagnostic tool. Cumulative 30-day
mortality rate was 6.7%. Rhabdomyomas and teratomas had the highest 30-day
mortality. The higher percentage of tumor relapse was noted for myxoma and
teratoma. Although cardiac tumors are rare, their atypical clinical
presentation, potential for recurrence, and the poor prognosis associated
with recurrence elucidate the need for reliable diagnostic and therapeutic
management.<br/>Copyright &#xa9; 2017, &#xa9; The Author(s) 2017.

<114>
Accession Number
614028466
Title
Clinical Databases and Registries in Congenital and Pediatric Cardiac
Surgery, Cardiology, Critical Care, and Anesthesiology Worldwide.
Source
World Journal for Pediatric and Congenital Heart Surgery. 8(1) (pp 77-87),
2017. Date of Publication: 01 Jan 2017.
Author
Vener D.F.; Gaies M.; Jacobs J.P.; Pasquali S.K.
Institution
(Vener) Department of Anesthesiology, Perioperative and Pain Medicine,
Pediatric Cardiovascular Anesthesia, Texas Children's Hospital, Baylor
College of Medicine, Houston, TX, United States
(Gaies, Pasquali) Department of Pediatric Cardiology, C. S. Mott
Children's Hospital, University of Michigan, Ann Arbor, MI, United States
(Jacobs) Cardiovascular Surgery, Johns Hopkins All Children's Hospital, St
Petersburg, FL, United States
Publisher
SAGE Publications Inc.
Abstract
The growth in large-scale data management capabilities and the successful
care of patients with congenital heart defects have coincidentally
paralleled each other for the last three decades, and participation in
multicenter congenital heart disease databases and registries is now a
fundamental component of cardiac care. This manuscript attempts for the
first time to consolidate in one location all of the relevant databases
worldwide, including target populations, specialties, Web sites, and
participation information. Since at least 1,992 cardiac surgeons and
cardiologists began leveraging this burgeoning technology to create
multi-institutional data collections addressing a variety of specialties
within this field. Pediatric heart diseases are particularly well suited
to this methodology because each individual care location has access to
only a relatively limited number of diagnoses and procedures in any given
calendar year. Combining multiple institutions data therefore allows for a
far more accurate contemporaneous assessment of treatment modalities and
adverse outcomes. Additionally, the data can be used to develop outcome
benchmarks by which individual institutions can measure their progress
against the field as a whole and focus quality improvement efforts in a
more directed fashion, and there is increasing utilization combining
clinical research efforts within existing data structures. Efforts are
ongoing to support better collaboration and integration across data sets,
to improve efficiency, further the utility of the data collection
infrastructure and information collected, and to enhance return on
investment for participating institutions.<br/>Copyright &#xa9; 2016,
&#xa9; The Author(s) 2016.

<115>
Accession Number
611155490
Title
Comparison of Feeding Strategies for Infants With Hypoplastic Left Heart
Syndrome: A Randomized Controlled Trial.
Source
World Journal for Pediatric and Congenital Heart Surgery. 7(4) (pp
446-453), 2016. Date of Publication: 01 Jul 2016.
Author
Spillane N.T.; Kashyap S.; Bateman D.; Weindler M.; Krishnamurthy G.
Institution
(Spillane) Department of Pediatrics, Hackensack UMC, Rutgers University
New Jersey Medical School, Hackensack, NJ, United States
(Kashyap, Bateman, Weindler, Krishnamurthy) Department of Pediatrics,
Columbia University Medical Center, New York, NY, United States
Publisher
SAGE Publications Inc.
Abstract
Introduction: Infants with hypoplastic left heart syndrome are at risk for
growth failure, particularly after stage 1 procedures. The effect of
continuous enteral feedings on weight gain has not been previously
investigated. <br/>Method(s): A randomized controlled trial was performed
in infants with hypoplastic left heart syndrome and single ventricle
variants after stage 1 procedures. Eligible infants were randomized to a
continuous and intermittent feeding regimen or an exclusive intermittent
feeding regimen after stage 1 procedures and continued until hospital
discharge. Anthropometric measures and markers of nutritional status were
assessed throughout hospitalization. <br/>Result(s): Twenty-six infants
completed the study. There were no significant differences in weight gain,
growth, or nutritional status. Weight gain on full enteral feedings was
24.3 versus 23.6 g/d (P =.88) for the combination (continuous and
intermittent) versus intermittent feeding groups. Weight-for-age Z scores
at discharge were -1.37 versus -1.2 (P =.59) for the combination versus
intermittent groups. <br/>Conclusion(s): No significant differences in
weight gain, growth, or nutritional status were observed at hospital
discharge between the two feeding strategies. Despite both groups
achieving target daily weight gain after attaining full feeds, growth
failure continued to be a problem after stage 1 procedures. Further
strategies to improve growth during initial hospitalization are
needed.<br/>Copyright &#xa9; The Author(s) 2016.

<116>
Accession Number
614975153
Title
Effectiveness of an early mobilization program on functional capacity
after coronary artery bypass surgery: A randomized controlled trial
protocol.
Source
SAGE Open Medicine. 4 (no pagination), 2016. Date of Publication: 2016.
Author
da Costa Torres D.; dos Santos P.M.R.; Reis H.J.L.; Paisani D.M.;
Chiavegato L.D.
Institution
(da Costa Torres, dos Santos, Chiavegato) Universidade Cidade de Sao
Paulo, Sao Paulo, Brazil
(Reis) Hospital de Clinicas Gaspar Vianna, Belem, Brazil
(Paisani) Hospital do Coracao, Sao Paulo, Brazil
Publisher
SAGE Publications Ltd
Abstract
Background: Muscle atrophy and prolonged inactivity are associated with an
increased sensation of fatigue and reduced functional capacity in the
postoperative period in patients undergoing coronary artery bypass
grafting. Cardiac rehabilitation after hospital discharge is highly
recommended and contributes to improvement in functional capacity and
quality of life. However, few studies have evaluated the effectiveness of
early mobilization protocols during hospitalization on the patterns of
physical activity and functional capacity after coronary artery bypass
grafting. <br/>Objective(s): To investigate the effectiveness of an early
mobilization program on the functional capacity of patients undergoing
coronary artery bypass grafting in the short and long term.
<br/>Method(s): This is a prospective, randomized, controlled,
single-blind trial protocol that will evaluate 66 consecutive patients
undergoing coronary artery bypass grafting. Patients will be randomized
into two training groups: the control group (N = 33), which will perform
breathing exercises and the intervention group (N = 33), which will
perform breathing exercises and aerobic exercises. The groups will receive
treatment from first to the seventh postoperative day, twice daily. In the
preoperative period, the following outcomes will be assessed: physical
activity level (Baecke Questionnaire), Functional Independence Measure,
and functional capacity (6-min walking test). Functional capacity will be
reassessed after the 7th and 60th postoperative day. Pulmonary
complications and length of hospital stay will also be evaluated.
Statistical analysis will be calculated using linear mixed models and will
be based on intention-to-treat. The level of significance will be set at
alpha = 5%.<br/>Copyright &#xa9; The Author(s) 2016.

<117>
Accession Number
604704698
Title
The Expanding Indications for the Lecompte Maneuver.
Source
World Journal for Pediatric and Congenital Heart Surgery. 5(2) (pp
291-296), 2014. Date of Publication: 2014.
Author
Talwar S.; Muthukkumaran S.; Choudhary S.K.; Airan B.
Institution
(Talwar, Muthukkumaran, Choudhary, Airan) Department of Cardiothoracic &
Vascular Surgery, All India Institute of Medical Sciences, New Delhi,
India
Publisher
SAGE Publications Inc.
Abstract
Since the anterior translocation of the pulmonary arteries in relation to
the aorta (Lecompte maneuver) was first described in 1981, its indications
have continued to expand. In this review, we discuss the physiological
basis and the expanding indications for this maneuver.<br/>Copyright
&#xa9; The Author(s) 2013

<118>
Accession Number
604281647
Title
Comparison of Cardioprotective Effects of Volatile Anesthetics in Children
Undergoing Ventricular Septal Defect Closure.
Source
World Journal for Pediatric and Congenital Heart Surgery. 4(1) (pp 24-29),
2013. Date of Publication: 2013.
Author
Singh P.; Chauhan S.; Jain G.; Talwar S.; Makhija N.; Kiran U.
Institution
(Singh, Chauhan, Makhija, Kiran) Department of Cardiac Anaesthesia, All
India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
(Jain) Department of Anesthesia and Intensive care, Teerthankar Mahaveer
Medical College, Moradabad, UP, India
(Talwar) Department of Cardiothoracic and Vascular Surgery, All India
Institute of Medical Sciences, Ansari Nagar, New Delhi, India
Publisher
SAGE Publications Inc.
Abstract
Background: Volatile anesthetic agents may precondition the myocardium and
protect against ischemia and infarction. Preconditioning by volatile
anesthetic agents is well documented in adults but is underinvestigated in
children. The present study compares the effect of preconditioning in
children by three volatile anesthetic agents along with several other
variables associated with cardioprotection. <br/>Method(s): Eighty
children scheduled for ventricular septal defect closure under
cardioplegic arrest were assigned to preconditioning for five minutes
after commencement of cardiopulmonary bypass (CPB) with one minimum
alveolar concentration (MAC) of one of the following agents: isoflurane,
sevoflurane, desflurane, or placebo (oxygen-air mixture). The plasma
concentration of creatine kinase MB (CK-MB) was determined after
initiation of CPB, and again 6 and 24 hours after admission to the
intensive care unit (ICU) after surgery. Duration of inotropic support,
mechanical ventilation, and length of ICU stay in all the groups were also
recorded. <br/>Result(s): Preconditioning with isoflurane, sevoflurane,
and desflurane was associated with significantly decreased postoperative
release of CK-MB as compared to placebo group at 6 (group 1: 237.2 +/-
189, group 2: 69.8 +/- 15.8, group 3: 64.7 +/- 37.8, and group 4: 70.4 +/-
26.7) and 24 hours (group 1: 192.4 +/- 158.2, group 2: 67.7 +/- 25.0,
group 3: 85.7 +/- 66.8, and group 4: 50.4 +/- 31.6) after admission to
ICU. No significant differences were observed in the CK-MB levels among
the three volatile anesthetic agents. Duration of inotropic support,
mechanical ventilation, and length of ICU stay were greater in placebo
group as compared to other groups without reaching statistical
significance. <br/>Conclusion(s): Volatile anesthetic appear to provide
definite cardioprotection to pediatric myocardium. No conclusion can be
drawn regarding the best preconditioning agent among isoflurane,
sevoflurane, and desflurane.<br/>Copyright &#xa9; The Author(s) 2012

<119>
Accession Number
368408847
Title
Comparison of Cardioprotective Effects of Volatile Anesthetics in Children
Undergoing Ventricular Septal Defect Closure.
Source
World Journal for Pediatric and Congenital Heart Surgery. 4(1) (pp 24-29),
2013. Date of Publication: January 2013.
Author
Singh P.; Chauhan S.; Jain G.; Talwar S.; Makhija N.; Kiran U.
Institution
(Singh, Chauhan, Makhija, Kiran) Department of Cardiac Anaesthesia, All
India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
(Jain) Department of Cardiac Anaesthesia, All India Institute of Medical
Sciences, Ansari Nagar, New Delhi, India
(Talwar) Department of Cardiothoracic and Vascular Surgery, All India
Institute of Medical Sciences, Ansari Nagar, New Delhi, India
Publisher
SAGE Publications Inc.
Abstract
Background: Volatile anesthetic agents may precondition the myocardium and
protect against ischemia and infarction. Preconditioning by volatile
anesthetic agents is well documented in adults but is underinvestigated in
children. The present study compares the effect of preconditioning in
children by three volatile anesthetic agents alongwith several other
variables associated with cardioprotection. <br/>Method(s): Eighty
children scheduled for ventricular septal defect closure under
cardioplegic arrest were assigned to preconditioning for five minutes
after commencement of cardiopulmonary bypass (CPB) with one minimum
alveolar concentration (MAC)of oneof the following agents: isoflurane,
sevoflurane, desflurane, or placebo(oxygen-air mixture).The plasma
concentration of creatine kinaseMB(CK-MB) was determined after initiation
ofCPB, and again 6 and 24 hours after admission to the intensive care unit
(ICU) after surgery. Duration of inotropic support, mechanical
ventilation, and length of ICUstay in all the groups were also recorded.
<br/>Result(s): Preconditioning with isoflurane, sevoflurane, and
desflurane was associated with significantly decreased postoperative
release of CK-MB as compared to placebo group at 6 (group 1: 237.2+/-189,
group 2: 69.8+/-15.8, group 3: 64.7+/-37.8, and group 4: 70.4+/-26.7) and
24 hours (group 1: 192.4+/-158.2, group 2: 67.7+/-25.0, group 3:
85.7+/-66.8, and group 4: 50.4+/-31.6) after admission toICU. No
significant differenceswereobserved in theCK-MBlevels among the three
volatile anesthetic agents.Duration of inotropic support, mechanical
ventilation, and length of ICU stay were greater in placebo group as
compared to other groups without reaching statistical significance.
<br/>Conclusion(s): Volatile anesthetic appear to provide definite
cardioprotection to pediatricmyocardium. No conclusion can be drawn
regarding the best preconditioning agent among isoflurane, sevoflurane,
and desflurane. &#xa9; The Author(s) 2012.

<120>
Accession Number
368408895
Title
Controlling Oxygenation During Initiation of Cardiopulmonary Bypass: Can
It Improve Immediate Postoperative Outcomes in Cyanotic Children
Undergoing Cardiac Surgery? A Prospective Randomized Study.
Source
World Journal for Pediatric and Congenital Heart Surgery. 3(3) (pp
310-316), 2012. Date of Publication: July 2012.
Author
Babu B.; Bhat S.; Prabuswamy H.P.; Kamalapurkar G.; Kumar H.V.J.; Libu
G.K.; Shilpa S.; Lokesh B.K.
Institution
(Babu) Department of Cardiothoracic Surgery, Apollo Hospitals, 154/11,
Bannerghatta Road, Bangalore 560076, India
(Babu, Bhat, Prabuswamy, Kamalapurkar, Kumar, Shilpa) Department of
Cardiothoracic Surgery, Sri Jayadeva Institute of Cardiovascular Sciences
and Research, Bangalore, India
(Libu) Department of Community Medicine and Statistics, Karakonam Medical
College, Trivandrum, India
(Lokesh) Department of Perfusion, Sri Jayadeva Institute of Cardiovascular
Sciences and Research, Bangalore, India
Publisher
SAGE Publications Inc.
Abstract
Objective: Cardiopulmonary bypass (CPB) initiated with high oxygen levels
may expose cyanotic children to reoxygenation injury. The ideal method of
initiation of bypass to prevent this phenomenon still remains largely
unproven. This study tested the hypothesis that controlling oxygenation
during initiation of CPB improves early postoperative outcomes.
<br/>Method(s): Thirty-one cyanotic children were randomized to two
treatment arms of the study. In group A (intervention), CPB was initiated
with fraction of inspired oxygen (Fio2) 0.21, and after one minute of full
bypass, Fio2 was increased at increments of 0.1 per minute to reach 0.6.
In group B (hyperoxemic), CPB was initiated using Fio2 > 0.6. Aortic cross
clamp time (minutes), CPB time (minutes), creatine phosphokinase-MB
(CPK-MB) levels (U/L), lactate levels (mmol/L), duration of ventilator
support (hours), inotropic support (hours), and intensive care unit (ICU)
stay (hours) as well as hospital mortality were measured. <br/>Result(s):
Levels of CPK-MB (group A mean = 59.6 U/L, 95% confidence interval [CI]:
45.9-73.3; group B mean = 82.6 U/L, 95% CI: 66.1-99.1, P = .016) and
ventilation time (group A median = 16.5 hours; interquartile range [IQR] =
11.25-23; group B median = 27.5 hours; IQR = 17-54, P = .045) were
significantly lower in the intervention group. Other parameters showed no
significant differences: CPB time (group A median = 71.5 minutes, IQR =
64-100; group B median = 95.5 minutes, IQR = 58-145, P = .71), cross clamp
time (group A mean = 59.2 minutes, 95% CI: 47.6-70.8; group B mean = 66.57
minutes, 95% CI: 47.6-88.5, P =.57), lactate levels (mmol/L; group A
median = 1.8, IQR = 1.48-2.59; group B median = 2.1, IQR = 1.29-2.62, P =
1), inotropic support (group A median = 47.5 hours, IQR = 36-73.75; group
B median = 59.5 hours, IQR = 41.75-92.5, P = .27), ICU stay (group A
median = 59.5 hours, IQR = 48.25-118.5; group B median = 85 hours, IQR =
47.75-137.50, P = .21), and mortality (group A n = 2, group B n = 2).
<br/>Conclusion(s): A controlled oxygenation protocol was associated with
significantly lower postoperative CPK-MB levels. Evaluation of other end
points including ventilation times requires a study with larger sample
size for validation. &#xa9; The Author(s) 2012.

<121>
Accession Number
368408871
Title
The Effects of Multiple Doses of Glucocorticoids on the Inflammatory
Response to Cardiopulmonary Bypass in Children.
Source
World Journal for Pediatric and Congenital Heart Surgery. 3(4) (pp
439-445), 2012. Date of Publication: October 2012.
Author
Bronicki R.A.; Checchia P.A.; Stuart-Killion R.B.; Dixon D.J.; Backer C.L.
Institution
(Bronicki) Department of Pediatric Critical Care Medicine, Children's
Hospital of Orange County, Orange, CA, United States
(Checchia) Division of Critical Care Medicine, St Louis Children's
Hospital, Washington University, St Louis, MO, United States
(Stuart-Killion) Division of Pediatric Cardiology, Lucile Packard
Children's Hospital, Stanford University, Stanford, CA, United States
(Dixon) Division of Biostatistics, Washington University School of
Medicine, St Louis, MO, United States
(Backer) Division of Cardiovascular-Thoracic Surgery Ann and Robert H.
Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., mc 22, Chicago,
IL 60611-2605, United States
Publisher
SAGE Publications Inc.
Abstract
Background: We previously demonstrated that a dose of glucocorticoids
(GCs) administered prior to cardiopulmonary bypass (CPB) is effective at
suppressing the inflammatory response to CPB and leads to an improved
postoperative course. We evaluated whether an additional dose of GC
administered eight hours prior to CPB would lead to further clinical
benefit. <br/>Method(s): We conducted a prospective study in which
patients were randomized to receive placebo or GC eight hours prior to
CPB, in addition to a dose of GC administered following induction of
anesthesia. We measured serum inflammatory mediator levels and
postoperative clinical parameters. <br/>Result(s): Thirty-one patients
were included in the study. Eighteen patients received two doses of GC and
13 patients received a single does of GC. Complement C3a levels were
significantly lower at 24 hours following surgery in those patients who
received two doses of GC (3136 +/- 1650 vs 1779 +/- 1616 ng/mL, P = .04).
There was no significant difference in tumor necrosis factor (TNF)-alpha
or interleukin (IL)-6 levels at any time between groups. There was no
significant difference in core body temperature or renal function (based
on serum creatinine levels) between groups. There was no significant
difference between groups in duration of mechanical ventilation (2.4 +/-
1.5 vs 3.6 +/- 3.7 days, two vs one dose, respectively, P = .33) or length
of stay in the intensive care unit ([ICU]; 3.4 +/- 1.4 vs 4.9 +/- 3.6
days, 2 vs 1 dose, respectively, P = .15). <br/>Conclusion(s): While those
patients who received two doses of GC prior to surgery had significantly
less complement activation postoperatively, clinical outcomes did not
differ between groups. We conclude that the practice of administering an
additional dose of GC prior to CPB is not supported. However, a large
randomized study is needed to conclusively discount the potential benefit
of this strategy. &#xa9; The Author(s) 2012.

<122>
Accession Number
2018413834
Title
Validation of donor fraction cell-free DNA with biopsy-proven cardiac
allograft rejection in children and adults.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(2) (pp 460-468.e2),
2023. Date of Publication: February 2023.
Author
Richmond M.E.; Deshpande S.R.; Zangwill S.D.; Bichell D.P.; Kindel S.J.;
Mahle W.T.; Schroder J.N.; Wigger M.A.; Knecht K.R.; Pahl E.; Gaglianello
N.A.; Goetsch M.A.; Simpson P.; Dasgupta M.; Zhang L.; North P.E.;
Tomita-Mitchell A.; Mitchell M.E.
Institution
(Richmond) Division of Pediatric Cardiology, Department of Pediatrics,
Vagelos College of Physicians and Surgeons, Columbia University, New York,
NY, United States
(Deshpande) Division of Pediatric Cardiology, Children's National Heart
Institute, Children's National Hospital, Washington, DC, United States
(Zangwill) Division of Cardiology, Phoenix Children's Hospital, Phoenix,
Ariz
(Bichell) Division of Pediatric Cardiac Surgery, Department of Surgery,
Vanderbilt University, Nashville, Tenn, United States
(Kindel) Division of Pediatric Cardiology, Department of Pediatrics,
Medical College of Wisconsin, Herma Heart Institute, Children's Wisconsin,
Milwaukee, Wis, United States
(Mahle) Division of Cardiology, Department of Pediatrics, Emory
University, Children's Healthcare of Atlanta, Atlanta, Ga
(Schroder) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University, Durham, NC
(Wigger) Division of Cardiovascular Medicine, Department of Medicine,
Vanderbilt University, Nashville, Tenn, United States
(Knecht) Department of Pediatrics, Arkansas Children's Hospital, Little
Rock, Ark, United States
(Pahl) Cardiology, Lurie Children's Hospital, Chicago, Ill
(Gaglianello) Department of Medicine, Medical College of Wisconsin,
Milwaukee, Wis, United States
(Goetsch) Department of Surgery, Medical College of Wisconsin, Milwaukee,
Wis, United States
(Simpson, Dasgupta, Zhang) Department of Pediatrics, Medical College of
Wisconsin, Milwaukee, Wis, United States
(North) Department of Pathology, Medical College of Wisconsin, Children's
Wisconsin, Milwaukee, Wis, United States
(Tomita-Mitchell, Mitchell) Division of Pediatric Cardiothoracic Surgery,
Department of Surgery, Medical College of Wisconsin, Herma Heart
Institute, Milwaukee, Wis, United States
Publisher
Elsevier Inc.
Abstract
Objectives: Donor-specific cell-free DNA shows promise as a noninvasive
marker for allograft rejection, but as yet has not been validated in both
adult and pediatric recipients. The study objective was to validate donor
fraction cell-free DNA as a noninvasive test to assess for risk of acute
cellular rejection and antibody-mediated rejection after heart
transplantation in pediatric and adult recipients. <br/>Method(s):
Pediatric and adult heart transplant recipients were enrolled from 7
participating sites and followed for 12 months or more with plasma samples
collected immediately before all endomyocardial biopsies. Donor fraction
cell-free DNA was extracted, and quantitative genotyping was performed.
Blinded donor fraction cell-free DNA and clinical data were analyzed and
compared with a previously determined threshold of 0.14%. Sensitivity,
specificity, negative predictive value, positive predictive value, and
receiver operating characteristic curves were calculated. <br/>Result(s):
A total of 987 samples from 144 subjects were collected. After applying
predefined clinical and technical exclusions, 745 samples from 130
subjects produced 54 rejection samples associated with the composite
outcome of acute cellular rejection grade 2R or greater and pathologic
antibody-mediated rejection 2 or greater and 323 healthy samples. For all
participants, donor fraction cell-free DNA at a threshold of 0.14% had a
sensitivity of 67%, a specificity of 79%, a positive predictive value of
34%, and a negative predictive value of 94% with an area under the curve
of 0.78 for detecting rejection. When analyzed independently, these
results held true for both pediatric and adult cohorts at the same
threshold of 0.14% (negative predictive value 92% and 95%, respectively).
<br/>Conclusion(s): Donor fraction cell-free DNA at a threshold of 0.14%
can be used to assess for risk of rejection after heart transplantation in
both pediatric and adult patients with excellent negative predictive
value.<br/>Copyright &#xa9; 2022 The American Association for Thoracic
Surgery

<123>
Accession Number
2021929825
Title
Percutaneous coronary intervention of native coronary artery versus
saphenous vein graft in patients with prior coronary artery bypass graft
surgery: Rationale and design of the multicenter, randomized PROCTOR
trial.
Source
American Heart Journal. 257 (pp 20-29), 2023. Date of Publication: March
2023.
Author
de Winter R.W.; Walsh S.J.; Hanratty C.G.; Spratt J.C.; Sprengers R.W.;
Twisk J.W.; Vegting I.; Schumacher S.P.; Bom M.J.; Hoek R.; Verouden N.J.;
Delewi R.; Nap A.; Knaapen P.
Institution
(de Winter, Vegting, Schumacher, Bom, Hoek, Verouden, Delewi, Nap,
Knaapen) Department of Cardiology, Heart Center Amsterdam, Amsterdam UMC,
Amsterdam, Netherlands
(Walsh) Department of Cardiology, Belfast Health and Social Care Trust,
Royal Victoria Hospital, Belfast, United Kingdom
(Hanratty) Heart & Vascular Centre, Mater Private Day Hospital, Dublin,
Ireland
(Spratt) Department of Cardiology, St George's University Hospital NHS
Trust, London, United Kingdom
(Sprengers) Department of Radiology & Nuclear Medicine, Amsterdam UMC,
Amsterdam, Netherlands
(Twisk) Department of Epidemiology & Data Science, Amsterdam UMC,
Amsterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Patients with prior coronary artery bypass grafting (CABG)
frequently require repeat percutaneous revascularization due to advanced
age, progressive coronary artery disease and bypass graft failure.
Percutaneous coronary intervention (PCI) of either the bypass graft or the
native coronary artery may be performed. Randomized trials comparing
native vessel PCI with bypass graft PCI are lacking and long-term outcomes
have not been reported. <br/>Method(s): PROCTOR (NCT03805048) is a
prospective, multicenter, randomized controlled trial, that will include
584 patients presenting with saphenous vein graft (SVG) failure and a
clinical indication for revascularization, as determined by the local
Heart Team. The trial is designed to compare the clinical and angiographic
outcomes in patients randomly allocated in a 1:1 fashion to either a
strategy of native vessel PCI or SVG PCI. The primary study endpoint is a
3-year composite of major adverse cardiac events (MACE: all-cause
mortality, non-fatal target coronary territory myocardial infarction [MI],
or clinically driven target coronary territory revascularization). At
3-years, after evaluation of the primary endpoint, follow-up invasive
coronary angiography will be performed. Secondary endpoints comprise
individual components of MACE at 1, 3 and 5 years follow-up, PCI-related
MI, MI >48 hours after index PCI, target vessel failure, target lesion
revascularization, renal failure requiring renal-replacement therapy,
angiographic outcomes at 3-years and quality of life (delta Seattle Angina
Questionnaire, Canadian Cardiovascular Society Grading Scale and Rose
Dyspnea Scale). <br/>Conclusion(s): PROCTOR is the first randomized trial
comparing an invasive strategy of native coronary artery PCI with SVG PCI
in post-CABG patients presenting with SVG failure.<br/>Copyright &#xa9;
2022 The Author(s)

<124>
Accession Number
2021321045
Title
Prognostic value of remnant cholesterol in patients with coronary heart
disease: A systematic review and meta-analysis of cohort studies.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 951523. Date of Publication: 19 Jan 2023.
Author
Tian Y.; Wu W.; Qin L.; Yu X.; Cai L.; Wang H.; Zhang Z.
Institution
(Tian, Wu, Qin, Yu, Cai, Wang, Zhang) Department of Cardiology, The
Affiliated Hospital of Southwest Jiaotong University, The Third People's
Hospital of Chengdu, Sichuan, Chengdu, China
Publisher
Frontiers Media S.A.
Abstract
Background: The relationship between abnormal lipid levels and
atherosclerotic cardiovascular diseases is well established, but the
association between remnant cholesterol (RC) and coronary heart disease
(CHD) remains uncertain. The aim of this meta-analysis is to
systematically evaluate the prognostic value of RC concentration in
patients with CHD. <br/>Method(s): PubMed, EMBASE, Cochrane, and Web of
Science databases were reviewed to identify relevant observational cohort
studies published in English up to December 2021. Random-effects
meta-analysis compared the highest and lowest RC concentration. The
primary outcome was a composite of major adverse cardiovascular events
(MACEs) and all-cause mortality in patients with CHD. <br/>Result(s): A
total of 10 studies recruiting 30,605 patients with CHD were selected to
be included in this meta-analysis. Patients with CHD with elevated RC
concentration had an increased risk of the composite endpoint events (RR =
1.54, 95% CI: 1.26-1.87) and MACEs (RR = 1.70, 95% CI: 1.54-1.88), but the
risk of all-cause mortality was not statistically significant (RR = 1.16,
95% CI: 0.79-1.69, P = 0.44). Subgroup analysis showed consistent results.
<br/>Conclusion(s): Our results suggest that elevated concentration RC may
independently predict MACEs in patients with CHD. Determination of RC
concentration may improve risk stratification of prognosis in patients
with CHD. However, more high-quality studies are necessary to confirm this
association.<br/>Copyright &#xa9; 2023 Tian, Wu, Qin, Yu, Cai, Wang and
Zhang.

<125>
Accession Number
2021034501
Title
Meta-Analysis on Invasive Versus Conservative Strategy in Patients Older
Than Seventy Years With Non-ST Elevation Myocardial Infarction.
Source
American Journal of Cardiology. 186 (pp 66-70), 2023. Date of Publication:
01 Jan 2023.
Author
Khalil M.; Maqsood M.H.; Basir M.B.; Saad M.; Yassa G.; Hakam L.; Abraham
J.; Hennawy B.S.; Etriby S.E.; Ribeiro M.H.; Ong K.; Garcia S.; Brilakis
E.S.; Alaswad K.; Megaly M.
Institution
(Khalil, Maqsood) Departments of Medicine
(Ong) Cardiovascular Medicine, Lincoln Medical Center, New York City, New
York, United States
(Basir, Alaswad, Megaly) Division of Cardiology, Henry Ford Hospital,
Detroit, MI, United States
(Saad) Department of Cardiology, Brown University, Providence, Rhode
Island
(Yassa) Ascension Macomb-Oakland, Warren, Michigan
(Hakam) Internal Medicine Department, Mayo Clinic, Jacksonville, Florida,
United States
(Abraham) Unity Health White County Medical Center, Searcy, AR, United
States
(Hennawy, Etriby) Cardiology Department, Ain Shams University, Cairo,
Egypt
(Ribeiro) Heart institute, Sao Paulo, Brazil
(Garcia, Brilakis) Minneapolis Heart Institute at Abbott Northwestern
Hospital, Minneapolis, MN, United States
Publisher
Elsevier Inc.
Abstract
Management of non-ST elevation myocardial infarction (NSTEMI) has evolved
over the years, but most published data are from younger patients. Data on
the NSTEMI management in older patients remain limited. We performed a
meta-analysis of randomized controlled trials to evaluate the long-term
outcomes of invasive versus conservative strategies in older patients (>70
years old) with NSTEMI. Of 1,550 reports searched, 4 randomized controlled
trials (1,126 patients) were included in the analysis, with a median
follow-up of 1.25 years (range: 1 to 2.5 years). The median age of
included patients was 83.6 (interquartile range: 2.8 years). The invasive
strategy was associated with significantly lower risk of major adverse
cardiac and cerebrovascular event (odds ratio [OR] 0.60, 95% confidence
interval [CI] 0.40 to 0.91, I² = 54%; 3 trials] and unplanned
revascularization (OR 0.31, 95% CI 0.15 to 0.64, I² = 1.7%; 3
trials] than was the conservative strategy. There was no difference in
all-cause mortality (OR 0.88, 95% CI 0.65 to 1.18, I² = 0%; 4
trials], myocardial infarction (OR 0.70, 95% CI 0.42 to 1.19,
I² = 54.7%; 4 trials], or bleeding (OR 0.87, 95% CI 0.39 to
1.93, I² = 0%; 3 trials] between the strategies. In conclusion,
the use of initial invasive strategy in older patients presenting with
NSTEMI was associated with a significantly lower risk of major adverse
cardiac and cerebrovascular event and unplanned revascularization than
that of the initial conservative strategy without increased
bleeding.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<126>
Accession Number
2019626577
Title
Postoperative analgesia efficacy of erector spinae plane block in adult
abdominal surgery: A systematic review and meta-analysis of randomized
trials.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 934866.
Date of Publication: 04 Oct 2022.
Author
Gao Y.; Liu L.; Cui Y.; Zhang J.; Wu X.
Institution
(Gao, Liu, Cui, Zhang, Wu) Department of Anesthesiology, Shengjing
Hospital, China Medical University, Shenyang, China
Publisher
Frontiers Media S.A.
Abstract
Objectives: Erector spinae plane block (ESPB) has been used for many
thoracic and abdominal surgeries. However, evidence of its analgesic
efficacy following abdominal surgery, compared with that of thoracic
analgesia, is insufficient. Our study explored the analgesic effect of
ESPB after abdominal surgery. <br/>Method(s): We searched PubMed, Embase,
Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov.
Primary outcomes were pain scores at 6, 12 and 24 h and 24-h opioid
consumption. Secondary outcomes included time to first rescue analgesia,
length of hospital stay, and incidence of postoperative nausea and
vomiting (PONV). We calculated standardized mean differences (SMDs) with
95% confidence intervals (CIs) for primary outcomes and mean differences
(MDs) and risk ratios (RRs) with 95% CIs for secondary outcomes.
<br/>Result(s): We systematically included 1,502 cases in 24 trials.
Compared with placebo, ESPB significantly reduced pain scores at 6 h (SMD
-1.25; 95% CI -1.79 to -0.71), 12 h (SMD -0.85; 95% CI -1.33 to -0.37) and
24 h (SMD -0.84; 95% CI -1.30 to -0.37) and 24-h opioid consumption (SMD
-0.62; 95% CI -1.19 to -0.06) post-surgery. ESPB prolonged the time to
first rescue analgesia and decreased the incidence of PONV. Compared with
transversus abdominal plane block (TAPB), ESPB significantly reduced pain
scores at 6, 12, and 24 h and 24-h opioid consumption and prolonged the
time to first rescue analgesia postsurgically. Furthermore, subgroup
analysis showed that ESPB significantly reduced pain scores at various
time points and opioid consumption within 24 h after laparoscopic
cholecystectomy, percutaneous nephrolithotomy and bariatric surgery.
<br/>Conclusion(s): Compared with placebo, ESPB improves the postoperative
analgesic efficacy after abdominal surgery. Furthermore, our meta-analysis
confirmed that ESPB provides more beneficial analgesic efficacy than TAPB.
Systematic review registration:
[https://www.crd.york.ac.uk/PROSPEROFILES/301491_STRATEGY_20220104.pdf],
identifier [CRD42022301491].<br/>Copyright &#xa9; 2022 Gao, Liu, Cui,
Zhang and Wu.

<127>
Accession Number
2020202635
Title
Long-Term Efficacy and Safety of ARRY-371797 (PF-07265803) in Patients
With Lamin A/C-Related Dilated Cardiomyopathy.
Source
American Journal of Cardiology. 183 (pp 93-98), 2022. Date of Publication:
15 Nov 2022.
Author
Judge D.P.; Lakdawala N.K.; Taylor M.R.G.; Mestroni L.; Li H.; Oliver C.;
Angeli F.S.; Lee P.A.; MacRae C.A.
Institution
(Judge) Cardiovascular Genetics, Medical University of South Carolina,
Charleston, South Carolina
(Lakdawala, MacRae) Cardiovascular Medicine, Brigham and Women's Hospital,
Boston, Massachusetts, United States
(Taylor, Mestroni) Department of Medicine, Adult Medical Genetics Program,
University of Colorado, AuroraColorado
(Li, Angeli) Pfizer Inc., Collegeville, PA, United States
(Oliver, Lee) Pfizer Inc., Boulder, Colorado
Publisher
Elsevier Inc.
Abstract
Dilated cardiomyopathy associated with lamin A/C (LMNA) gene variants
(LMNA-related dilated cardiomyopathy [DCM]) is a life-threatening
condition with a high unmet need, accounting for approximately 6% of
idiopathic DCM cases. Currently, no disease-specific treatments target the
underlying disease mechanism. ARRY-371797 (PF-07265803), a potent,
selective, oral, small-molecule inhibitor of the p38alpha
mitogen-activated protein kinase pathway, improved 6-minute walk test
(6MWT) distance in 12 patients with symptomatic LMNA-related DCM in a
48-week, open-label, phase 2 study. This long-term extension study
examined the safety and efficacy of ARRY-371797 in patients from the phase
2 study. 6MWT, N-terminal pro-B-type natriuretic peptide concentration,
and 12-item Kansas City Cardiomyopathy Questionnaire score were assessed
at weeks 48, 72, 96, 120, and 144 from phase 2 study baseline. Eight
patients enrolled (mean [SD] age, 51 [10] years, 4 male). Mean 6MWT
increased by >30 m (>10%) from phase 2 study baseline up to week 120. The
decrease in N-terminal pro-B-type natriuretic peptide observed in the
phase 2 study was maintained throughout the present study. Twelve-item
Kansas City Cardiomyopathy Questionnaire Physical Limitation increased
from baseline at all visits except week 96 (range: -0.8 [week 96] to 13.8
[week 120]); results for other domains were variable. Treatment was
generally well tolerated; 2 patients discontinued because of causes not
considered treatment-related. There were no deaths. ARRY-371797 was
generally well tolerated over median (range) 155.7 (61 to 327)-week
exposure; evidence suggested preserved exercise capacity over the study
period. The ongoing, pivotal, phase 3, randomized, placebo-controlled
study REALM-DCM investigates the efficacy and safety of ARRY-371797
(PF-07265803) in LMNA-related DCM. (ClinicalTrials.gov Identifier:
NCT02351856)<br/>Copyright &#xa9; 2022 The Author(s)

<128>
Accession Number
2022471538
Title
Assessment of the effect of two regimens of milrinone infusion in
paediatric patients with pulmonary artery hypertension undergoing
corrective cardiac procedure: A prospective observational study.
Source
Annals of Pediatric Cardiology. 15(4) (pp 358-363), 2022. Date of
Publication: July 2022.
Author
Prajapati M.; Patel J.; Patel H.; Gandhi H.; Singh G.; Patel P.
Institution
(Prajapati, Patel, Patel, Gandhi, Singh, Patel) Department of Cardiac
Anesthesia, U.N. Mehta Institute of Cardiology and Research Center
(Affiliated to B. J. Medical College), Gujarat, Ahmadabad, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: The aim of the study was to compare the effect of two
different regimens of milrinone in pediatric patients with pulmonary
artery hypertension (PAH) undergoing corrective procedure.
<br/>Material(s) and Method(s): This randomized prospective study included
100 pediatric patients undergoing corrective cardiac surgeries. Group E:
Milrinone was started as infusion 0.5 mug/kg/min without a loading dose
after induction of anesthesia and continued as infusion 0.5-0.75
mug/kg/min in the pediatric cardiac surgical intensive care unit (PSICU).
Group L: Milrinone was started as a loading dose 50 mug/kg over 10 min
before weaning from cardiopulmonary bypass (CPB) followed by infusion
0.5-0.75 mug/kg/min in the PSICU. We compared heart rate, mean arterial
blood pressure, central venous pressure, cardiac index (CI), mean
pulmonary arterial pressure (MPAP), serum lactate level, urine output,
vasoactive inotropic score, mechanical ventilation duration, and intensive
care unit (ICU)- and hospital length of stay between the groups.
<br/>Result(s): There was an increase in mean arterial blood pressure, CI,
and urine output in Group E compared to Group L (P < 0.05). MPAP, serum
lactate level, and requirement of inotropes and vasopressors were lower in
Group E compared to Group L (P < 0.05). Mechanical ventilation duration,
ICU, and hospital length of stay were shorter in Group E than Group L (P <
0.05). <br/>Conclusion(s): Early use of milrinone in patients with PAH
undergoing corrective cardiac surgeries improved CI and mean arterial
pressure, decreased MPAP, improved urine output, decreased serum lactate
level, and decreased requirement of inotropes and vasopressors after
weaning from CPB compared to the milrinone bolus group.<br/>Copyright
&#xa9; 2022 Wolters Kluwer Medknow Publications. All rights reserved.

<129>
Accession Number
2019840043
Title
Ross Procedure in Neonate and Infant Populations: A Meta-Analysis Review.
Source
World Journal for Pediatric and Congenital Heart Surgery. 13(6) (pp
759-769), 2022. Date of Publication: November 2022.
Author
Tohme S.; Jiang S.; Farooqi K.; Crystal M.A.; Blitzer D.; Ferrari G.;
Bacha E.; Kalfa D.
Institution
(Tohme, Bacha, Kalfa) Section of Congenital and Pediatric Cardiac Surgery,
Division of Cardiac, Thoracic and Vascular Surgery, Morgan Stanley
Children's Hospital, NewYork -Presbyterian Hospital, Columbia University
Irving Medical Center, New York, NY, United States
(Jiang) Department of Epidemiology, Columbia University Mailman School of
Public Health, New York, NY, United States
(Farooqi, Crystal) Division of Pediatric Cardiology, Morgan Stanley
Children's Hospital, NewYork -Presbyterian Hospital, Columbia University
Irving Medical Center, New York, NY, United States
(Blitzer, Ferrari) Division of Cardiothoracic and Vascular Surgery,
Department of Surgery, Columbia University Irving Medical Center, New
York, NY, United States
Publisher
SAGE Publications Inc.
Abstract
Objective: This study aims to perform a meta-analysis of early and late
outcomes of the Ross/Ross-Konno procedures in neonates/infants.
<br/>Method(s): A meta-analysis was performed in accordance with PRISMA
guidelines. We used Ovid versions of MEDLINE/PubMed for relevant studies
and included those that reported Ross/Ross-Konno operations in
neonates/infants and at least one of the predetermined clinical outcomes.
I² and double arcsine methods assessed the heterogeneity
between pooled estimates. We used a random-effect model to account for
heterogeneity with MetaXL. We calculated point estimates of a pooled
estimates along with its 95% CI. <br/>Result(s): 587 neonate/infant
patients were included with median age of 87.5 days old. The follow-up
range was five days to 23 years. Early mortality reported in 25 studies
with pooled estimates of 18.3% (95% CI: 13.6%-23.5%). Estimates ranged
from 0% to 50% with relatively substantial heterogeneity (P =.01,
I² = 48.6%). Late mortality reported in 22 studies with pooled
incidence of 9.7% (95% CI: 5.9%-14.3%). Estimates ranged from 0% to 53%
with relatively substantial heterogeneity (P =.01, I² = 46.1%).
Autograft reintervention reported in 18 studies with pooled estimate of
19.2% (95% CI: 7.3%-34.5%). Estimates ranged from 0% to 81.8% with high
heterogeneity (P <.001, I² = 90.5%). Right
ventricle-to-pulmonary artery conduit reintervention reported in 16
studies with pooled estimates of 32.0% (95% CI: 20.9%-44.12%). Estimates
ranged from 0% to 92.3% with high heterogeneity (P <.001, I² =
75.9%). <br/>Conclusion(s): The data suggest that the Ross/Ross-Konno
procedure in neonates/infants still carries significant risk of early/late
mortality and autograft/conduit reintervention. The high variability of
results among centers confirms the need for surgical expertise and good
patient selection. Prospective multicenter studies are warranted to
investigate the rate of autograft reintervention and the impact on
long-term survival in this specific population.<br/>Copyright &#xa9; The
Author(s) 2022.

<130>
Accession Number
627905355
Title
Children's Heart Assessment Tool for Transplantation (CHAT) Score: A Novel
Risk Score Predicts Survival After Pediatric Heart Transplantation.
Source
World Journal for Pediatric and Congenital Heart Surgery. 10(3) (pp
296-303), 2019. Date of Publication: 01 May 2019.
Author
Fraser C.D.; Grimm J.C.; Zhou X.; Lui C.; Giuliano K.; Suarez-Pierre A.;
Crawford T.C.; Magruder J.T.; Hibino N.; Vricella L.A.
Institution
(Fraser, Grimm, Zhou, Lui, Giuliano, Suarez-Pierre, Crawford, Magruder,
Hibino, Vricella) Division of Cardiac Surgery, The Johns Hopkins Hospital,
Baltimore, MD, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Given the shortage of donor organs in pediatric heart
transplantation (HTx), pretransplant risk stratification may assist in
organ allocation and recipient optimization. We sought to construct a
scoring system to preoperatively stratify a patient's risk of one-year
mortality after HTx. <br/>Method(s): The United Network for Organ Sharing
database was queried for pediatric (<18 years) patients undergoing HTx
between 2000 and 2016. The population was randomly divided in a 4:1
fashion into derivation and validation cohorts. A multivariable logistic
regression model for one-year mortality was constructed within the
derivation cohort. Points were then assigned to independent predictors (P
<.05) based on relative odds ratios (ORs). Risk groups were established
based on easily applicable, whole-integer score cutoffs. <br/>Result(s): A
total of 5,700 patients underwent HTx; one-year mortality was 10.7%. There
was a similar distribution of variables between derivation (n = 4,560) and
validation (n = 1,140) cohorts. Of the 12 covariates included in the final
model, nine were allotted point values. The low-risk (score 0-9),
intermediate-risk (10-20), and high-risk (>20) groups had a 5.18%, 10%,
and 28% risk of one-year mortality (P <.001), respectively. Both
intermediate-risk (OR = 2.46, 95% confidence interval [95% CI]: 1.93-3.15;
P <.001) and high-risk (OR = 9.24, 95% CI: 6.92-12.35; P <.001) scores
were associated with an increased risk of one-year mortality when compared
to the low-risk group. <br/>Conclusion(s): The Children's Heart Assessment
Tool for Transplantation score represents a pediatric-specific,
recipient-based system to predict one-year mortality after HTx. Its use
could assist providers in identification of patients at highest risk of
poor outcomes and may aid in pretransplant optimization of these
children.<br/>Copyright &#xa9; The Author(s) 2019.

<131>
[Use Link to view the full text]
Accession Number
640261803
Title
PROGNOSTIC VALUE OF COMPUTED TOMOGRAPHY PSOAS MUSCLE SIZE IN PREDICTING
MAJOR ADVERSE CARDIOVASCULAR EVENTS IN THE ELDERLY: A META-ANALYSIS.
Source
Journal of Hypertension. Conference: 29th Scientific Meeting of the
International Society of Hypertension, ISH 2022. Kyoto Japan.
41(Supplement 1) (pp e412), 2023. Date of Publication: January 2023.
Author
Sanchez A.J.T.; Bandong I.
Institution
(Sanchez, Bandong) Philippine Heart Center, Philippines
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Cardiovascular diseases (CVD) are the leading cause of death
globally (WHO). It accounts for > 17 million deaths each year (30% of all
deaths) (WONG, 2014). Aging is associated with body composition changes
such as a reduction in the muscle mass and an increase in visceral fat
that shift the metabolism to an unfavorable state which increases the risk
of CVD (EVANS, 2021). Psoas muscle mass index (PMI) has been growing
recognition as an objective and quantitative marker to assess muscle
wasting and has been suggested as a useful predictive marker for long-term
outcome after cardiovascular surgery (MATSUMOTO, 2020). The aim of this
study is to determine the prognostic value of psoas muscle size for
development of major adverse cardiovascular events. Methodology: We
searched PubMed and Google scholar. The Newcastle-Ottawa Scale assessment
was used for quality assessment. Two investigators independently extracted
patient baseline characteristics, CT psoas muscle size, and research
endpoint such as all-cause mortality, myocardial infarction, and stroke.
The hazard ratio (95% CI) and relative risk (95% CI) was calculated using
a generic inverse variance approach. The overall effects was determined by
Z-test and P-value < 0.05 were considered as statistically significant.
<br/>Result(s):Out of 37 articles, 10 citations fulfilled the inclusion
criteria. Sarcopenia was not associated with MACE (HR 14.6, 95% CI:5.69 -
37.48, p value < 0.00001, I2 0%) and all cause mortality (RR 2.04, 95%
CI:1.55 - 2.69, p value of < 0.00001, I2 0%). The sub-group analysis shows
no association between sarcopenia and MACE among patients > 60 years (HR
15.36, 95% CI: 5.54 - 42.53, p value < 0.0001, I2 0%), myocardial
infarction (RR 1.96, 95% CI: 0.63 - 6.10, p value of < 0.24, I2 0%), and
stroke (RR 1.62, 95% CI: 0.84 - 3.15, p value of < 0.15, I2 0%).
<br/>Conclusion(s):Sarcopenia is not associated with MACE and all cause
mortality. Among patients > 60 years, sarcopenia shows no association
between myocardial infarction and stroke. Further studies should be done
to determine the cut-off value for psoas muscle size for sarcopenia and
sarcopenic obesity among elderly patients.

<132>
Accession Number
640264641
Title
Direct oral anticoagulants in patients with a left-sided bioprosthetic
heart valve: a systematic review and meta-analysis.
Source
Internal and emergency medicine. (no pagination), 2023. Date of
Publication: 07 Feb 2023.
Author
Silvia G.; Valentina P.; Leonardo C.; Daniela P.; Alessandro S.
Institution
(Silvia) Internal Medicine, Ospedale San Valentino-AULSS 2 Marca
Trevigiana, Via Palmiro Togliatti, 1, 31044, Montebelluna, Treviso, Italy
(Valentina) Internal Medicine Residency Program, School of Medicine,
University of Insubria, Italy
(Leonardo) Department of Medicine and Surgery, University of Insubria,
Varese, Italy
(Daniela) Thrombosis Center, Azienda Ospedaliero-Universitaria Careggi,
Florence, Italy
(Alessandro) Research Center On Thromboembolic Disorders and
Antithrombotic Therapies, ASST Lariana, University of Insubria, Como,
Italy
Publisher
NLM (Medline)
Abstract
To compare the efficacy/effectiveness and safety of DOACs versus VKAs in
patients with a previously and newly surgically implanted BHV with or
without AF. A systematic search on MEDLINE and EMBASE was performed till
November 2022. Treatment effects were estimated with relative risk (RR)
and 95% confidence intervals (CIs). Statistical heterogeneity was assessed
with the I2 statistic. Four randomized controlled trials (RCTs), 2
subgroup analysis from ARISTOTLE and ENGAGE-AF-TIMI 48 and 4 observational
studies were included for a total of 5808 patients, 1893 on DOACs and 3915
on VKAs. AF prevalence was 98.28%. In the overall analysis, DOACs vs VKAs
were associated with a RR for stroke/transient ischemic attack
(TIA)/systemic embolism (SE) of 0.63 (95% CI 0.51-0.79; I2=0%) and a RR of
major bleeding of 0.50 (95% CI 0.39-0.63; I2=0%) in a median follow-up of
19 months (IQR 4.5-33.4). In the 3 RCTs (DAWA, RIVER, ENAVLE), DOACs vs
VKAs were associated with a RR of stroke/TIA/SE and major bleeding of 0.38
(95% CI 0.13-1.58, I2=0%) and of 0.68 (95% CI 0.32-1.44; I2=5%)
respectively. In patients randomized during the first three months from
valve surgery, DOACs vs VKAs were associated with a RR of stroke/TIA/SE
and major bleeding of 0.54 (95% CI 0.14-2.08; I2=0%) and of 0.76 (95% CI
0.05-10.72; I2=66%). In previously implanted BHV patients with AF, DOACs
showed a risk-benefit profile at least comparable to VKAs. DOACs showed a
similar, even if underpowered, risk-benefit profile during the first three
months after BHV implantation prevalently in patients with
AF.<br/>Copyright &#xa9; 2023. The Author(s), under exclusive licence to
Societa Italiana di Medicina Interna (SIMI).