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<1>
Accession Number
2019427222
Title
Infarct Size and Long-Term Clinical Outcomes of Prasugrel versus
Clopidogrel in Patients with Acute Coronary Syndrome Undergoing Coronary
Artery Stenting: A Prospective Randomized Study.
Source
International Journal of Angiology. 32(1) (pp 56-65), 2023. Date of
Publication: March 2023.
Author
Yabe T.; Noike R.; Okubo R.; Amano H.; Ikeda T.
Institution
(Yabe, Noike, Okubo, Amano, Ikeda) Department of Cardiovascular Medicine,
Toho University Faculty of Medicine, Tokyo, Japan
Publisher
Thieme Medical Publishers, Inc.
Abstract
The antiplatelet drug prasugrel inhibits platelet aggregation early after
oral administration. This study examined whether prasugrel is effective in
inhibiting infarct size and can reduce the incidence of major adverse
cardiovascular events (MACE) in patients with acute coronary syndrome
(ACS). This study was a single-center, prospective, randomized pilot
study. Among 80 ACS patients treated at our institution between August
2014 and September 2015, 76 ACS patients who underwent stenting and
achieved thrombolysis in myocardial infarction flow grade 3 were assigned
to receive aspirin plus prasugrel (prasugrel group; n = 37) or aspirin
plus clopidogrel (clopidogrel group; n = 39). The primary endpoint was
survival free of MACE. The secondary endpoint was the evaluation of
infarct size defined as the area under the curve (AUC) of troponin I,
calculated using the linear trapezoidal method. During follow-up (mean,
1262.4 +/- 599.6 days), 14 patients showed MACE. No significant
differences in CYP2C19 genotype were seen between groups. AUC of troponin
I up to 72 hours after intervention tended to be smaller in the prasugrel
group (1,927.1 +/- 2,189.3 ng/mL) than in the clopidogrel group (3,186.0
+/- 3,760.1 ng/mL, p = 0.08). Cumulative incidence of MACE was
significantly higher in the clopidogrel group (log-rank test; p = 0.02).
Compared with clopidogrel, prasugrel was associated with reduced infarct
size and lower frequency of long-term outcomes among ACS patients
undergoing stenting. Copyright © 2021. Thieme. All rights
reserved.

<2>
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. 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. 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. 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. Copyright © 2023 by the authors.

<3>
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. 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. 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).
 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. Copyright © 2023 Authors. All rights reserved.

<4>
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. 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. 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. 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. 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. Copyright © 2023 American College of
Cardiology Foundation

<5>
Accession Number
2022624507
Title
Comparison of Remimazolam Tosilate and Etomidate on Hemodynamics in
Cardiac Surgery: A Randomised Controlled Trial.
Source
Drug Design, Development and Therapy. 17 (pp 381-388), 2023. Date of
Publication: 01 Feb 2023.
Author
Hu B.; Zhang M.; Wu Z.; Zhang X.; Zou X.; Tan L.; Song T.; Li X.
Institution
(Hu, Zou, Tan, Song, Li) Department of Anesthesiology, The Affiliated
Hospital of Guizhou Medical University, Guizhou Province, Guiyang, China
(Hu, Zhang, Wu, Zhang, Zou) College of Anesthesiology, Guizhou Medical
University, Guizhou Province, Guiyang, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Remimazolam tosilate (RT) is a new ultrashort-acting
gamma-aminobutyric acid subtype A (GABA<inf>A</inf>) agonist, with the
characteristics of rapid onset and offset, minimal cardiorespiratory
depression. Currently, few studies have compared the effect of RT and
etomidate on hemodynamics during anesthesia induction. Here, we aimed to
compare the hemodynamic effects of different doses of RT and etomidate for
anesthesia induction in patients undergoing cardiac surgeries.
 Method(s): Patients were recruited from January to September 2022 in
this single-center, prospective, randomized, double-blind trial. A total
of 117 patients undergoing selective valve replacement surgery were
randomly divided into low-dose RT (0.2 mg/kg) group (group LR), high-dose
RT (0.3 mg/kg) group (group HR), or etomidate (1.5 mg/kg) group (group E),
respectively. The primary outcome was hemodynamic fluctuations (mean
arterial pressure fluctuation value [MAP]; heart rate fluctuation value
[HR]) during anesthesia induction. Secondary outcomes included the
incidence of adverse drug reactions (injection pain and myoclonus) and
adverse cardiovascular events, vital signs at different time points and
the cumulative doses of vasoactive drugs. Result(s): The hemodynamic
fluctuations (MAP) in group LR and group E were significantly lower than
that in group HR. In addition, the incidence of hypotension and the
cumulative norepinephrine doses in group E and group LR were also
significantly lower than that in group HR. Furthermore, the incidence of
injection pain and myoclonus in group LR and group HR were less frequently
recorded compared with group E. There were no significant differences in
terms of HR, tachycardia, hypertension, severe bradycardia, vital signs at
different time points, lactic acid and blood glucose between both groups.
 Conclusion(s): Compared with etomidate, low-dose RT (0.2mg/kg) can
not only provide stable hemodynamic parameters but also cause fewer
adverse reactions when used for anesthesia induction in patients with
cardiac disease. Copyright © 2023 Hu et al.

<6>
Accession Number
2022699507
Title
Evaluation of the Effect of Del Nido and Cold Blood Cardioplegia on Renal
Functions in the Surgery of Congenital Heart Diseases.
Source
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi. 28(2) (pp
135-143), 2022. Date of Publication: 2022.
Author
Isildak F.U.; Yavuz Y.; Arisut S.; Yilmaz A.A.
Institution
(Isildak, Yavuz, Arisut) Department of Anesthesia and Reanimation,
Istanbul Provincial Health Directorate, Kartal Kosuyolu High Speciality
Training and Research Hospital, Istanbul, Turkey
(Yilmaz) Department of Cardiovascular Surgery, Istanbul Provincial Health
Directorate, Kartal Kosuyolu High Speciality Training and Research
Hospital, Istanbul, Turkey
Publisher
Turkish Anaesthesiology and Intensive Care Society
Abstract
Objectives: We aimed to evaluate the effect of del Nido (DN) and cold
blood (CB) cardioplegia on renal functions in children undergoing cardiac
surgery for congenital heart disease (CHD). Method(s): This study was
conducted prospectively. One hundred and nineteen pediatric patients with
Risk Adjustment for Congenital Heart Surgery (RACHS) scores below 3 were
randomly assigned using allocation software to two groups (CB and DN
cardioplegia) according to the type of cardioplegia solution used. The
change of urea, creatinine, estimated glomerular filtration rate (eGFR),
and renal near-infrared spectroscopy (NIRS) values before and after
cardioplegia were the primary outcome measures of this study.
 Result(s): Cardiopulmonary bypass (CPB) duration (p<0.001), ACC
duration (p<0.001), and extubation time (p=0.032) were longer and the VIS-
48th h (p=0.048) value was higher in the DN group. The pre-operative
versus 48th h increase in urea were higher in the DN group (p=0.028). The
increase in CPB duration was predictive for the increase in urea (p=0.009)
and creatinine (p=0.004), and younger age was a predictor for the increase
in urea (p=0.014) and decrease in eGFR (p=0.044). Conclusion(s):
Although CPB duration, aortic cross-clamp times, and extubation times are
longer in DN cardioplegia recipients, it is as safe as blood cardioplegia
in terms of ICU LOS, mortality rates, VIS-initial and VIS-24th h values,
and changing renal NIRS, creatinine, eGFR, and urea values during surgery.
There is a need for more extensive research on the use of DN cardioplegia
in CHD surgery. Copyright © 2022 by The Cardiovascular Thoracic
Anaesthesia and Intensive Care.

<7>
Accession Number
2020060656
Title
Congenital coronary artery-left ventricular multiple micro-fistulas and
hypertrophic cardiomyopathy: a case report and literature review.
Source
BMC Cardiovascular Disorders. 22(1) (no pagination), 2022. Article Number:
483. Date of Publication: December 2022.
Author
Liu Y.; Wang Z.; Zeng H.; Yang S.; Li X.
Institution
(Liu, Zeng, Yang, Li) Cardiology department, China-Japan Union Hospital of
Jilin University, Changchun 130033, China
(Liu, Zeng, Yang, Li) Jilin Provincial Key Laboratory for Genetic
Diagnosis of Cardiovascular Disease, Changchun 130033, China
(Liu, Zeng, Yang, Li) Jilin Provincial Cardiovascular Research Institute,
126 Xiantai Street, Jilin Province, Changchun 130033, China
(Wang) Ultrasound Department, China-Japan Union Hospital of Jilin
University, Changchun 130033, China
Publisher
BioMed Central Ltd
Abstract
Background: Coronary artery-left ventricular multiple micro-fistulas
(CA-LVMMFs) is a rare congenital vascular anomaly that may present with no
obvious clinical symptoms or a typical angina attack. CA-LVMMFs is usually
found unexpectedly during coronary angiography (CAG). Case presentation:
We report a case of a 65-year-old man admitted to the hospital with acute
coronary syndrome. CA-LVMMFs was found during coronary angiography.
Echocardiography showed apical hypertrophy and blood flow signals were
seen in the apical myocardium, connected with the left ventricle. We
searched the MEDLINE database and found 39 relevant reports. We made
statistics on the clinical characteristics of these patients and found
half involved hypertrophy or perfusion defects in the ventricular septum
or apex. Conclusion(s): As a rare congenital anomaly, the effect of
CA-LVMMFs on patients is unclear. By reporting a case and summarizing
literature reports, we found that CA-LVMMFs may be associated with
myocardial hypertrophy, especially ventricular septal and apical
hypertrophy. Copyright © 2022, The Author(s).

<8>
Accession Number
640361548
Title
Clear cell "sugar" tumor of the lung: Diagnostic characteristics of a rare
pulmonary tumor: A case report and review of literature.
Source
Medicine. 102(7) (pp e33035), 2023. Date of Publication: 17 Feb 2023.
Author
Wang B.; Xu X.; Zhao Z.
Institution
(Wang) Department of Pathology, Xingtai People's Hospital Affiliated to
Hebei Medical University, Xingtai, Hebei, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Clear cell tumors of the lung (CCTLs), also known as "sugar
tumors" for an abundant cellular glycogen concentration, are an extremely
rare type pulmonary neoplasm. Often, they are incidentally found on chest
roentgenogram or computed tomography scan during routine examination.
CCTLs usually present with nonspecific symptoms that pose a diagnostic
challenge to clinicians. Accordingly, histopathology remains the gold
standard for diagnosing. Moreover, some of them can present with either
appearances or histopathological features similar to other pulmonary
neoplasms under the light microscope, including pulmonary malignancy,
thereby causing misdiagnosis prior to or after surgery. Accordingly,
herein, we describe a rare case of CCTL, review the literature has been
published, and then discuss the benign versus malignant nature of this
rare tumor. PATIENT CONCERNS: A 59-year-old man presented due to a
high-density chest nodule in the left diaphragm. The patient's medical
history was unremarkable and he also denied smoking in the past.
DIAGNOSIS: Physical examination, there were no noted signs. A new chest
contrast-enhanced computed tomography revealed a 3.2x2.5cm, solitary,
circular nodule with a smooth edge located in the beside of the left
thoracic aorta. Postoperative pathological and immunohistochemical
examinations of the surgical specimens revealed a final diagnosis of
CCTLs. INTERVENTIONS: The patient underwent video-assisted thoracoscopic
surgery. A wedge resection of left lower lung lobe was carried out and the
tumor node was successfully removed alongside normal surrounding
parenchyma. OUTCOME(S): The operation was successful. Then the
patient recovered completely and continued to do well on postsurgical
thoracic surgical clinic visits. The tumor was a benign tumor, and the
patient did not require any additional treatment. The patient had been
followed-up regularly for 4 years after surgery; she did not experience
any complications and remained disease-free. CONCLUSION(S): CCTLs
should be considered in the differential diagnosis if a patient shows a
solitary, circular chest nodule with a smooth edge. They are extremely
rare lung tumors that must be differentiated from other lung tumors,
especially the malignant tumors. Although pathological and
immunohistochemical findings are important for making the diagnosis, the
varying histopathological features on microscope make diagnosis difficult.
The current case highlights the importance of physicians being aware of
and suspecting CCTLs in similar cases, along with knowing the
characteristics of CCTLs for the diagnosis and differential
diagnosis. Copyright © 2023 the Author(s). Published by Wolters
Kluwer Health, Inc.

<9>
Accession Number
640364113
Title
ANTICOAGULATION OF MECHANICAL HEART VALVES IN PREGNANCY.
Source
American Journal of Hematology. Conference: Biennial Summit of the
Thrombosis and Hemostasis Societies of North America, THSNA 2022. Chicago,
IL United States. 98(Supplement 1) (pp E25), 2023. Date of Publication:
February 2023.
Author
D'Souza R.
Institution
(D'Souza) McMaster University, Canada
Publisher
John Wiley and Sons Inc
Abstract
Pregnant individuals with mechanical heart valves are at an increased risk
for thromboembolic complications and death. Three anticoagulant regmiens
are used in contemporary clinical practice - vitamin-K antagonists
throughout pregnancy, low molecular weight heparin throughout pregnancy
and sequential treatment involving heparins in the first trimester and
vitamin-K antagonists thereafter. None of these regimens are completely
safe for both, mother and baby. Decision-making regarding the choice of
anticoagulant regimen during pregnancy is complex, requiring
multidisciplinary input and the consideration of the family's values and
preferences with regard to trade-offs between maternal and fetal health.
Other considerations in this population include controversies around the
optimal dosing and monitoring strategies, general surveillance of maternal
and fetal health during pregnancy, peripartum considerations in a
fully-anticoagulated pregnant person, prevention and treatment of major
bleeding during pregnancy and childbirth and modifications to care in
lower resource settings. This presentation will systematically review the
above areas and provide directions for clinical practice and future
research.

<10>
Accession Number
640364046
Title
PATIENT-CENTRED CARE FOR WARFARIN MANAGEMENT: A PILOT STUDY TO TRANSITION
CARE TO HIGH RISK PATIENTS.
Source
American Journal of Hematology. Conference: Biennial Summit of the
Thrombosis and Hemostasis Societies of North America, THSNA 2022. Chicago,
IL United States. 98(Supplement 1) (pp E15-E16), 2023. Date of
Publication: February 2023.
Author
Bungard T.J.; McMurtry M.S.; Meyer S.R.; Ritchie B.; Tsuyuki R.T.
Institution
(Bungard, McMurtry, Meyer, Ritchie, Tsuyuki) University of Alberta,
Edmonton, AB, Canada
Publisher
John Wiley and Sons Inc
Abstract
BACKGROUND: Warfarin remains the mainstay for patients with mechanical
heart valves (MHV). Management occurs via primary care physician offices
or anticoagulant clinics (AC) in Canada, while in Europe patient
self-management (PSM) wherein patients test their own INRs and adjust
their own warfarin dosing is implemented amongst highly selected, capable
patients. PSM trials report better INR control and better long-term
survival relative to traditional management. No funding/program models
exist in Alberta for PSM, and as such, our purpose was to study a PSM
approach within our AC. OBJECTIVE(S): Primarily, to determine change
in quality of life from baseline to study completion between PSM and AC
care using 2 validated instruments (DASS and Sawicki). Secondarily, to
assess proportion of patients completing PSM, time in INR range,
ER/hospitalizations and healthcare time for PSM to be neutral relative to
AC care. METHOD(S): A pilot randomized controlled trial of PSM vs AC
care amongst adult patients with MHVs. Patients had to be managed by the
AC for a minimum of 6 months, consent by mail, be adherent and stable with
warfarin/INR testing, have internet access and lack cognitive impairment.
From a master list of MHVs we randomly selected patients and mailed
consent packages targeting 25 in each group. Upon receipt of consent, a
general overview of warfarin was offered and patients had to pass a
foundational quiz. Thereafter, they were randomized to continue AC care vs
PSM. For PSM, a preparatory phase (comprehension of warfarin dosing chart,
access INRs, track care) and practical training phase occurred (3 months
of patient reported and reviewed plans) until independent PSM x 6 months.
 RESULT(S): 211 were approached for consent, 53 (25.1%) were
randomized, most common exclusion (45.8%) was not returning consent. For
PSM and AC care, median age was 54.0 and 57.8 years, the majority were
aortic MHVs (69.6% and 73.1%) using standard INR venipuncture (82.6% and
84.6%) and managed by the AC for 5.5 and 7.0 years, respectively. Overall
quality of life scores were positive, with no difference between groups
for the DASS (P=0.57) or Sawicki (P=0.41). Confidence with anticoagulation
treatment was greater amongst PSM vs AC care (P=0.01). Of the 27
randomized to PSM, 23 (85.2%) completed the study. Time in INR range was
similar between PSM (75.0%) and AC care (74.1%) (P=0.86) as were events.
Total healthcare time for PSM (97 minutes) was neutral in relation to AC
care (103.5 minutes) at 6 months. Preference for ongoing care was to
continue with PSM for the majority (95.7%), while 70.0% in AC care still
wanted to pursue PSM. CONCLUSION(S): We observed no difference in
quality of life between PSM and ongoing AC care. PSM was feasible for
almost all patients and there was no difference in time in INR range.
Health care resource time was similar between PSM and AC care, making this
a feasible option for the future.

<11>
Accession Number
2022839566
Title
Efficacy of erector spinae plane block for minimally invasive mitral valve
surgery: Results of a double-blind, prospective randomized
placebo-controlled trial.
Source
Journal of Clinical Anesthesia. 86 (no pagination), 2023. Article Number:
111072. Date of Publication: June 2023.
Author
Hoogma D.F.; Van den Eynde R.; Al Tmimi L.; Verbrugghe P.; Tournoy J.;
Fieuws S.; Coppens S.; Rex S.
Institution
(Hoogma, Van den Eynde, Al Tmimi, Coppens, Rex) Department of
Anesthesiology, University Hospitals of Leuven, Leuven, Belgium
(Hoogma, Al Tmimi, Verbrugghe, Coppens, Rex) Department of Cardiovascular
Sciences, Biomedical Sciences Group, University of Leuven, Leuven, Belgium
(Verbrugghe) Department of Cardiac Surgery, University Hospitals of
Leuven, Leuven, Belgium
(Tournoy) Department of Public Health and Primary Care, Geriatric
Medicine, University Hospitals Leuven, Leuven, Belgium
(Fieuws) Leuven Biostatistics and Statistical Bioinformatics Centre
(L-BioStat), Biomedical Sciences Group, University of Leuven, Leuven,
Belgium
Publisher
Elsevier Inc.
Abstract
Study objective: To investigate if an erector spinae plane (ESP) block
decreases postoperative opioid consumption, pain and postoperative nausea
and vomiting in patients undergoing minimally invasive mitral valve
surgery (MIMVS). Design(s): A single-center, double-blind,
prospective, randomized, placebo-controlled trial. Setting(s):
Postoperative period; operating room, post-anesthesia care unit (PACU) and
hospital ward in a university hospital. Patient(s): Seventy-two
patients undergoing video-assisted thoracoscopic MIMVS via right-sided
mini-thoracotomy and enrolled in the institutional enhanced recovery after
cardiac surgery program. Intervention(s): At the end of surgery, all
patients received an ESP catheter at vertebra T5 under ultrasound guidance
and were randomized to the administration of either ropivacaine 0.5%
(loading of dose 30 ml and three additional doses of 20 ml with a 6 h
interval) or normal saline 0.9% (with an identical administration scheme).
In addition, patients received multimodal postoperative analgesia
including dexamethasone, acetaminophen and patient-controlled intravenous
analgesia with morphine. Following the final ESP bolus and before catheter
removal, the position of the catheter was re-evaluated by ultrasound.
Patients, investigators and medical personnel were blinded for the group
allocation during the entire trial. Measurements: Primary outcome was
cumulative morphine consumption during the first 24 h after extubation.
Secondary outcomes included severity of pain, presence/extent of sensory
block, duration of postoperative ventilation and hospital length of stay.
Safety outcomes comprised the incidence of adverse events. Main
Result(s): Median (IQR) 24-h morphine consumption was not different
between the intervention- and control-group, 41 mg (30-55) versus 37 mg
(29-50) (p = 0.70), respectively. Likewise, no differences were detected
for secondary and safety endpoints. Conclusion(s): Following MIMVS,
adding an ESP block to a standard multimodal analgesia regimen did not
reduce opioid consumption and pain scores. Copyright © 2023
Elsevier Inc.

<12>
Accession Number
2021649111
Title
Non-pharmacological prevention of postoperative delirium by occupational
therapy teams: A randomized clinical trial.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1099594.
Date of Publication: 02 Feb 2023.
Author
Alvarez E.A.; Rojas V.A.; Caipo L.I.; Galaz M.M.; Ponce D.P.; Gutierrez
R.G.; Salech F.; Tobar E.; Reyes F.I.; Vergara R.C.; Egana J.I.; Briceno
C.A.; Penna A.
Institution
(Alvarez) Terapia Ocupacional, Universidad Central de Chile, Santiago,
Chile
(Alvarez, Briceno) Departamento de Terapia Ocupacional y Ciencia de la
Ocupacion, Universidad de Chile, Santiago, Chile
(Rojas, Tobar) Critical Care Unit, Department of Medicine, Hospital
Clinico de la Universidad de Chile, Santiago, Chile
(Rojas, Caipo, Galaz, Ponce, Gutierrez, Salech, Egana, Penna) Centro de
Investigacion Clinica Avanzada (CICA), Hospital Clinico y Facultad de
Medicina de la Universidad de Chile, Santiago, Chile
(Gutierrez, Egana, Penna) Departamento de Anestesiologia y Medicina
Perioperatoria, Hospital Clinico de la Universidad de Chile, Santiago,
Chile
(Salech) Seccion de Geriatria, Departamento de Medicina, Hospital Clinico
de la Universidad de Chile, Santiago, Chile
(Reyes) Servicio de Anestesiologia, Hospital Santiago Oriente Doctor Luis
Tisne Brousse, Santiago, Chile
(Vergara) Nucleo de Bienestar y Desarrollo Humano (NUBIDEH), Centro de
Investigacion en Educacion (CIE-UMCE), Universidad Metropolitana de
Ciencias de la Educacion, Santiago, Chile
(Vergara) Facultad de Artes y Educacion Fisica, Departamento de
Kinesiologia, Universidad Metropolitana de Ciencias de la Educacion,
Santiago, Chile
(Vergara) Centro Nacional de Inteligencia Artificial (CENIA), Santiago,
Chile
Publisher
Frontiers Media S.A.
Abstract
Background: Patients who develop postoperative delirium (POD) have several
clinical complications, such as increased morbidity, increased hospital
stays, higher hospital costs, cognitive and functional impairment, and
higher mortality. POD is a clinical condition preventable by standard
non-pharmacological measures An intensive Occupational Therapy (OT)
intervention has been shown to be highly effective in preventing delirium
in critically ill medical patients, but it is unknown the effect in
surgical patients. Thus, we designed a prospective clinical study with the
aim to determine whether patients undergoing intervention by the OT team
have a lower incidence of POD compared to the group treated only with
standard measures. Method(s): A multicenter, single-blind, randomized
clinical trial was conducted between October 2018 and April 2021, in
Santiago of Chile, at a university hospital and at a public hospital.
Patients older than 75 years undergoing elective major surgery were
eligible for the trial inclusion. Patients with cognitive impairment,
severe communication disorder and cultural language limitation, delirium
at admission or before surgery, and enrolled in another study were
excluded. The intervention consisted of OT therapy twice a day plus
standard internationally recommended non-pharmacological prevention
intervention during 5 days after surgery. Our primary outcome was
development of delirium and postoperative subsyndromal delirium.
 Result(s): In total 160 patients were studied. In the interventional
group, treated with an intensive prevention by OT, nine patients (12.9%)
developed delirium after surgery and in the control group four patients
(5.5%) [p = 0.125, RR 2.34 CI 95 (0.75-7.27)]. Whereas subsyndromal POD
was present in 38 patients in the control group (52.1%) and in 34 (48.6%)
in the intervention group [p = 0.4, RR 0.93 CI95 (0.67-1.29)]. A post hoc
analysis determined that the patient's comorbidity and cognitive status
prior to hospitalization were the main risk factors to develop delirium
after surgery. Discussion(s): Patients undergoing intervention by the
OT team did not have a lower incidence of POD compared to the group
treated only with standard non-pharmacological measures in adults older
than 75 years who went for major surgery. Clinical trial registration:
www.ClinicalTrials.gov, identifier NCT03704090. Copyright © 2023
Alvarez, Rojas, Caipo, Galaz, Ponce, Gutierrez, Salech, Tobar, Reyes,
Vergara, Egana, Briceno and Penna.

<13>
Accession Number
2021621329
Title
Transcutaneous electrical acupoint stimulation for the prevention of
postoperative delirium in elderly surgical patients: A systematic review
and meta-analysis.
Source
Frontiers in Aging Neuroscience. 15 (no pagination), 2023. Article Number:
1046754. Date of Publication: 31 Jan 2023.
Author
Huang K.-Y.; Liang S.; Chen L.; Xu Y.-Y.; Grellet A.
Institution
(Huang, Liang, Chen, Xu) Department of Acupuncture, Ningbo Hospital of
Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese
Medical University, Ningbo, China
(Grellet) The First Clinical Medical College, Nanjing University of
Chinese Medicine, Nanjing, China
Publisher
Frontiers Media S.A.
Abstract
Objective: This systematic review and meta-analysis aimed to evaluate the
preventive effect of transcutaneous electrical acupoint stimulation on
postoperative delirium in elderly surgical patients. Method(s):
PubMed, CENTRAL, China National Knowledge Infrastructure, and WanFang
databases were searched for randomized controlled trials regarding the
effect of transcutaneous electrical acupoint stimulation on preventing
postoperative delirium in elderly patients undergoing any type of surgery.
The primary outcome was the incidence of postoperative delirium. The
secondary outcome was the duration of postoperative delirium. All analyses
were conducted using RevMan 5.3 and Stata 13.0 software. Result(s):
Twelve trials with 991 participants were included, and most of them were
at high/unclear risk of bias. Meta-analysis showed transcutaneous
electrical acupoint stimulation could reduce the incidence of
postoperative delirium (RR = 0.40, 95%CI = 0.29 to 0.55, p < 0.00001) and
shorten the duration of postoperative delirium (MD = -0.97 days, 95%CI =
-1.72 to -0.22, p = 0.01). Subgroup analyses demonstrated that
transcutaneous electrical acupoint stimulation reduced the incidence of
postoperative delirium in elderly patients undergoing orthopedic surgery
and thoracic surgery, but not digestive surgery; transcutaneous electrical
acupoint stimulation with dilatational wave and with continuous wave were
both beneficial; and transcutaneous electrical acupoint stimulation was
favored when compared to blank and sham control. Conclusion(s):
Transcutaneous electrical acupoint stimulation could reduce the incidence
of postoperative delirium and shorten the duration of postoperative
delirium in elderly surgical patients. The findings should be interpreted
with caution due to weak evidence. High-quality, large sample, and
multi-center trials are needed to further confirm the preliminary
findings. Systematic review registration:
https://inplasy.com/inplasy-2022-7-0096/, identifier:
INPLASY202270096. Copyright © 2023 Huang, Liang, Chen, Xu and
Grellet.

<14>
Accession Number
2022850260
Title
Influenza vaccination strategy in acute coronary syndromes: the VIP-ACS
trial.
Source
European Heart Journal. 43(41) (pp 4378-4388), 2022. Date of Publication:
01 Nov 2022.
Author
Fonseca H.A.R.; Furtado R.H.M.; Zimerman A.; Lemos P.A.; Franken M.;
Monfardini F.; Pedrosa R.P.; De Lemos S. Patriota R.; Passos L.C.S.;
Dall'Orto F.T.C.; Hoffmann Filho C.R.; Nascimento B.R.; Baldissera F.A.;
Pereira C.A.C.; Caramori P.R.A.; de Andrade P.B.; Esteves C.; Salim E.F.;
Da Silva J.H.; Pedro I.C.; Silva M.C.R.; De Pedri E.H.; Carioca A.C.R.D.;
De Piano L.P.A.; Albuquerque C.S.N.; Moia D.D.F.; Momesso R.G.R.A.P.;
Machado F.P.; Damiani L.P.; Soares R.V.P.; Schettino G.P.; Rizzo L.V.;
Nicolau J.C.; Berwanger O.
Institution
(Fonseca, Furtado, Monfardini, Esteves, Salim, Da Silva, Pedro, Silva, De
Pedri, Carioca, De Piano, Albuquerque, Moia, Momesso, Machado, Damiani,
Soares, Berwanger) Academic Research Organization, Hospital Israelita
Albert Einstein, Rua Comendador Elias Jafet, 755, Sao Paulo 05652-900,
Brazil
(Furtado, Lemos, Franken) Cardiology Division, Hospital Israelita Albert
Einstein, Av. Albert Einstein, Sao Paulo 627/701, Brazil
(Furtado, Pereira, Nicolau) Instituto do Coracao (InCor), Hospital das
Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av.
Dr. Eneas Carvalho de Aguiar, 44, Sao Paulo, Brazil
(Zimerman) Hospital de Clinicas de Porto Alegre, Universidade Federal do
Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Av. Protasio Alves, 211, Rio
Grande do Sul, Porto Alegre, Brazil
(Pedrosa, De Lemos S. Patriota) Pronto Socorro Cardiologico de Pernambuco,
PROCAPE, Rua dos Palmares, SN, Pernambuco, Recife, Brazil
(Passos) Hospital Ana Nery, R. Saldanha Marinho, s/ n, Bahia, Salvador,
Brazil
(Dall'Orto) Hospital Santa Lucia, Avenida Vereador Edmundo Cardillo, 3003,
Minas Gerais, Pocos de Caldas, Brazil
(Hoffmann Filho) Hospital Regional Hans Dieter Schmidt, R. Xavier Arp, s/n
- Boa Vista, Santa Catarina, Joinville, Brazil
(Nascimento) Hospital Universitario Ciencias Medicas, Rua dos Aimores,
2896 - Santo Agostinho, Minas Gerais, Belo Horizonte, Brazil
(Baldissera) Instituto de Pesquisas Medicas de Itajai, Avenida Coronel
Marcos Konder, 1111, Santa Catarina, Itajai, Brazil
(Caramori) Hospital Sao Lucas da PUCRS, Av Ipiranga, 6690, Rio Grande do
Sul, Porto Alegre, Brazil
(de Andrade) Irmandade da Santa Casa de Misericordia de Marilia, Av.
Vicente Ferreira, 828, Sao Paulo, Marilia, Brazil
(Schettino, Rizzo) Instituto de Ensino e Pesquisa, Hospital Israelita
Albert Einstein, Rua Comendador Elias Jafet, Sao Paulo 755, Brazil
Publisher
Oxford University Press
Abstract
Aims: To evaluate whether a strategy of double-dose influenza vaccination
during hospitalization for an acute coronary syndrome (ACS) compared with
standard-dose outpatient vaccination (as recommended by current
guidelines) would further reduce the risk of major cardiopulmonary events.
 Methods and Results: Vaccination against Influenza to Prevent
cardiovascular events after Acute Coronary Syndromes (VIP-ACS) was a
pragmatic, randomized, multicentre, active-comparator, open-label trial
with blinded outcome adjudication comparing two strategies of influenza
vaccination following an ACS: double-dose quadrivalent inactivated vaccine
before hospital discharge vs. standard-dose quadrivalent inactivated
vaccine administered in the outpatient setting 30 days after
randomization. The primary outcome was a hierarchical composite of
all-cause death, myocardial infarction, stroke, unstable angina,
hospitalization for heart failure, urgent coronary revascularization, and
hospitalization for respiratory causes, analysed by the win ratio method.
Patients were followed for 12 months. During two influenza seasons, 1801
participants were included at 25 centres in Brazil. The primary outcome
was not different between groups, with 12.7% wins in-hospital double-dose
vaccine group and 12.3% wins in the standard-dose vaccine group {win
ratio: 1.02 [95% confidence interval (CI): 0.79-1.32], P = 0.84}. Results
were consistent for the key secondary outcome, a hierarchical composite of
cardiovascular death, myocardial infarction and stroke [win ratio: 0.94
(95% CI: 0.66-1.33), P = 0.72]. Time-to-first event analysis for the
primary outcome showed results similar to those of the main analysis
[hazard ratio 0.97 (95% CI: 0.75-1.24), P = 0.79]. Adverse events were
infrequent and did not differ between groups. Conclusion(s): Among
patients hospitalized with an ACS, double-dose influenza vaccination
before discharge did not reduce cardiopulmonary outcomes compared with
standard-dose vaccination in the outpatient setting. Copyright ©
2022 The Author(s). Published by Oxford University Press on behalf of
European Society of Cardiology. All rights reserved.

<15>
Accession Number
2022850173
Title
Immunosuppressive therapy in virus-negative inflammatory cardiomyopathy:
20-year follow-up of the TIMIC trial.
Source
European Heart Journal. 43(36) (pp 3463-3473), 2022. Date of Publication:
21 Sep 2022.
Author
Chimenti C.; Russo M.A.; Frustaci A.
Institution
(Chimenti, Frustaci) Department of Clinical Internal, Anesthesiology and
Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
(Chimenti, Frustaci) Molecular and Cellular Cardiology Lab, IRCCS 'L.
Spallanzani', Rome, Italy
(Russo) MEBIC Consortium, San Raffaele 21 University, Rome, Italy
Publisher
Oxford University Press
Abstract
Aims: Long-Term results of the Tailored IMmunosuppression in
virus-negative Inflammatory Cardiomyopathy (TIMIC) trial protocol have
been evaluated. Methods and Results: Eighty-five patients with
endomyocardial biopsy-proven virus-negative chronic inflammatory
cardiomyopathy were enrolled in the randomized, double-blind,
placebo-controlled TIMIC trial and received prednisone and azathioprine (n
= 43) vs. placebo (n = 42) for 6 months. Immunosuppressive treatment
promoted an improvement in cardiac function in 88% of the cases compared
with none of the patients in the placebo group, which were switched to a
6-month immunosuppressive therapy at the end of the 6-month study period.
Long-Term (up to 20 years) clinical outcomes of the whole cohort of 85
patients originally enrolled in the TIMIC trial (Group A) were compared
with those of a 1:2 propensity score-matched control cohort of patients
untreated with the TIMIC protocol (Group B) and followed for a comparable
period of time. The primary outcome was a composite of cardiovascular
death and heart transplantation. At long-Term follow-up, the risk of
cardiovascular death [hazard ratio (HR) 6.77; 95% confidence interval (CI)
2.36-19.45] and heart transplantation (HR 7.92; 95% CI 1.80-34.88) was
significantly higher in Group B patients. Group A showed a persistent
improvement in the left ventricular ejection fraction compared with Group
B (HR 7.24; 95% CI 3.05-17.18). A higher number of Group B patients
underwent implantable cardioverter defibrillator implantation. The
incidence of recurrent myocarditis was similar between groups, and
patients with evidence of a recurrent cardiac inflammatory process
promptly responded to a TIMIC protocol application. Conclusion(s):
Virus-negative inflammatory cardiomyopathy benefits from immunosuppressive
therapy even after long-Term follow-up. Recurrence appears to respond to a
new TIMIC protocol application. Copyright © 2022 The Author(s).
Published by Oxford University Press on behalf of European Society of
Cardiology.

<16>
Accession Number
2022850096
Title
Impact of baseline renal dysfunction on cardiac outcomes and end-stage
renal disease in heart failure patients with mitral regurgitation: The
COAPT trial.
Source
European Heart Journal. 43(17) (pp 1639-1648), 2022. Date of Publication:
01 May 2022.
Author
Beohar N.; Ailawadi G.; Kotinkaduwa L.N.; Redfors B.; Simonato M.; Zhang
Z.; Morgan L.G.; Escolar E.; Kar S.; Lim D.S.; Mishell J.M.; Whisenant
B.K.; Abraham W.T.; Lindenfeld J.; Mack M.J.; Stone G.W.
Institution
(Beohar) Columbia University Medical Center, Columbia University Division
of Cardiology at Mount Sinai Medical Center, Miami Beach, FL 33140, United
States
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Kotinkaduwa, Redfors, Simonato, Zhang, Stone) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Redfors) NewYork-Presbyterian Hospital/Columbia University Medical
Center, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Morgan) Division of Cardiology, Medical University of South Carolina,
Columbia, SC, United States
(Escolar) Columbia University Medical Center, Columbia University Division
of Cardiology at Mount Sinai Medical Center, Miami Beach, FL 33140, United
States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kar) Bakersfield Heart Hospital, Bakersfield, CA, United States
(Lim) Division of Cardiology, University of Virginia, Charlottesville, VA,
United States
(Mishell) Kaiser Permanente-San Francisco Hospital, San Francisco, CA,
United States
(Whisenant) Intermountain Heart Center, Salt Lake City, UT, United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
Columbus, OH, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Mack) Baylor Scott and White Health, Plano, TX, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Oxford University Press
Abstract
Aims: Baseline renal dysfunction (RD) adversely impacts outcomes among
patients with heart failure (HF) and severe secondary mitral regurgitation
(MR). Heart failure and MR, in turn, accelerate progression to end-stage
renal disease (ESRD), worsening prognosis. We sought to determine the
impact of RD in HF patients with severe MR and the impact of transcatheter
mitral valve repair (TMVr) on new-onset ESRD and the need for renal
replacement therapy (RRT). Methods and Results: The COAPT trial
randomized 614 patients with HF and severe MR to MitraClip plus
guideline-directed medical therapy (GDMT) vs. GDMT alone. Patients were
stratified into three RD subgroups based on baseline estimated glomerular
filtration rate (eGFR, mL/min/1.73 m2): none (>=60), moderate (30-60), and
severe (<30). End-stage renal disease was defined as eGFR <15 mL/min/1.73
m2 or RRT. The 2-year rates of all-cause death or HF hospitalization
(HFH), new-onset ESRD, and RRT according to RD and treatment were
assessed. Baseline RD was present in 77.0% of patients, including 23.8%
severe RD, 6.0% ESRD, and 5.2% RRT. Worse RD was associated with greater
2-year risk of death or HFH (none 45.3%; moderate 53.9%; severe 69.2%; P <
0.0001). MitraClip vs. GDMT alone improved outcomes regardless of RD (P
interaction = 0.62) and reduced new-onset ESRD [2.9 vs. 8.1%, hazard ratio
(HR) 0.34, 95% confidence interval (CI) 0.15-0.76, P = 0.008] and the need
for new RRT (2.5 vs. 7.4%, HR 0.33, 95% CI 0.14-0.78, P = 0.011).
 Conclusion(s): Baseline RD was common in the HF patients with severe
MR enrolled in COAPT and strongly predicted 2-year death and HFH.
MitraClip treatment reduced new-onset ESRD and the need for RRT,
contributing to the improved prognosis after TMVr. Copyright ©
2022 The Author(s). Published by Oxford University Press on behalf of
European Society of Cardiology. All rights reserved.

<17>
Accession Number
2020247424
Title
Outcomes of catheter ablation of ventricular tachycardia in non-ischemic
idiopathic dilated cardiomyopathy: A systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 1007392. Date of Publication: 11 Nov 2022.
Author
Ammar A.; Sharief M.; Abouelmagd K.; Riad O.; Ibrahim M.
Institution
(Ammar, Riad, Ibrahim) Department of Cardiology, Ain Shams University,
Cairo, Egypt
(Ammar) Department of Cardiology, Worcestershire Acute Hospitals NHS
Trust, Worcester, United Kingdom
(Sharief) Department of Cardiology, Specialized Medical Hospital, Mansoura
University, Mansoura, Egypt
(Sharief) Lancashire Teaching Hospitals NHS Foundation Trust, Preston,
United Kingdom
(Abouelmagd) Department of Cardiology, Dr. Mohammad Alfagih Hospital,
Riyadh, Saudi Arabia
(Riad) Department of Cardiology, Royal Brompton & Harefield NHS Trust,
London, United Kingdom
(Ibrahim) University Hospitals of Leicester NHS Trust, Leicester, United
Kingdom
Publisher
Frontiers Media S.A.
Abstract
Objective: To perform a systematic review and meta-analysis of available
trials regarding the outcomes of ventricular tachycardia (VT) ablation in
patients with non-ischemic dilated cardiomyopathy (NIDCM). Method(s):
A comprehensive database search of large four electronic databases,
including PubMed, Cochrane, Scopus, and Institute for Scientific
Information network meta-analysis, identified five studies enrolling 666
patients for patients with idiopathic dilated cardiomyopathy (IDCM)
underwent catheter ablation (CA) for VT. The short-term outcomes assessed
included procedural success, VT non-inducibility and procedural
complications, whereas the long-term outcomes assessed included VT
recurrence, heart transplantation, antiarrhythmic drugs (AAD) use after
ablation and death. Result(s): A total of 5 observational studies
reported outcomes in 666 patients with NIDCM undergoing VT CA. The
complete procedural success was moderately high; 65.5% of the patients
(95% CI 0.402- 0.857, p < 0.001) and the procedural complications occurred
in 5.8% of the patients (95% CI 0.040-0.076, P = 0.685). Epicardial
mapping and ablation were performed among 61.5% and 37% of patients with
NIDCM respectively. During a follow up period of 12 to 45 months, there
were VT recurrence in 34.2% of the patients (95% CI 0.301-0.465, p <
0.080), death in 20.2% of the patients (95% CI 0.059-0.283, p < 0.017) and
heart transplantation in 12.9% of the patients (95% CI -0.026-0.245, P <
0.012). Conclusion(s): Ventricular tachycardia CA is effective and
safe approach for management of patients with NIDCM with the epicardial
approach to be considered as initial strategy especially in presence of
ECG and CMR findings suggestive of epicardial substrate. A multicenter
randomized trial is crucial to look at the short- and long-term outcomes
of VT ablation in NIDCM especially with the advances in mapping and
ablation techniques and predictors of success. Copyright © 2022
Ammar, Sharief, Abouelmagd, Riad and Ibrahim.

<18>
Accession Number
2018754055
Title
The clinical outcomes of reni-angiotensin system inhibitors for patients
after transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 963731. Date of Publication: 11 Aug 2022.
Author
Wang S.; Lin X.; Guan Y.; Huang J.
Institution
(Wang) Department of Translation Medicine Center, Affiliated Hangzhou
First People's Hospital, Zhejiang University School of Medicine, Hangzhou,
China
(Wang, Huang) Department of Cardiology, Affiliated Hangzhou First People's
Hospital, Zhejiang University School of Medicine, Hangzhou, China
(Lin, Guan) The Fourth School of Clinical Medicine, Zhejiang Chinese
Medical University, Hangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Aims: The objective of our systematic reviews and meta-analysis is to
evaluate the clinical outcomes of RAS inhibitors for patients after TAVR.
 Methods and Results: We performed a comprehensive search for Embase,
Pubmed, and Cochrane databases from inception to May 1, 2022. The analysis
of all outcomes was performed using the random-effects model. In total, 7
articles with a total of 32,585 patients (RAS inhibitor, N = 14,871;
Controls, N = 17,714) were included in our study. There was a
significantly lower rates of all-cause mortality (RR = 0.76, 95%Cl = 0.68
to 0.86, P < 0.01), cardiovascular death (RR = 0.66, 95%Cl = 0.59-0.74, P
< 0.01) and HF readmission (RR = 0.87, 95%Cl = 0.80-0.94, P < 0.01) in
patients with RAS inhibitors compared with controls. Patients with RAS
inhibitors also had lower rates of all-cause mortality (RR = 0.82, 95%Cl =
0.76-0.89, P < 0.01) and cardiovascular death (RR = 0.73, 95%Cl,
0.62-0.85, P < 0.01) after propensity matching. Conclusion(s): In
conclusion, our systematic reviews and meta-analysis demonstrated that RAS
inhibitors could improve the clinical outcomes for patients after TAVR.
Further large and high-quality trials should be conducted to support the
use of RAS inhibitors for patients after TAVR. Copyright © 2022
Wang, Lin, Guan and Huang.

<19>
Accession Number
2017317059
Title
The efficacy of the use of heparin in the emergency room in patients with
acute ST-segment elevation myocardial infarction.
Source
Journal of Radiation Research and Applied Sciences. 15(1) (pp 187-192),
2022. Date of Publication: March 2022.
Author
Zuo G.; Li Y.; Hu S.; Wang K.; Zhao H.; Wang D.; Qian X.; Du X.
Institution
(Zuo, Li, Hu, Wang, Zhao, Wang, Qian, Du) Department of Cardiology,
Tianjin Fifth Central Hospital, Tianjin 300450, China
Publisher
Egyptian Society of Radiation Science and Applications (ESRSA)
Abstract
Aim: To investigate the efficacy of the use of heparin in the emergency
room in patients with acute ST-segment elevation myocardial infarction
(STEMI). Method(s): 200 STEMI patients undergoing primary
percutaneous coronary intervention (PCI) were randomly divided into the
research and control groups (heparin administration in emergency room and
catheterization laboratory, respectively). Result(s): The rate of
thrombolysis in myocardial infarction (TIMI) grade 2 flow in the research
participants was significantly higher than that in the controls (P <
0.05). The stent diameter in the research patients was smaller than that
in the control participants (P < 0.05); while the stent length in the
research patients was shorter than that in the controls (P < 0.05). The
slow flow rate in the research patients was similar to that in the control
participants (P > 0.05). There were no differences between the groups in
the corrected TIMI frame counts or intraoperative complications (P >
0.05). The ST-segment resolution rate within 2 h post-PCI was 90.0% in the
research patients and 83.8% in the controls (P > 0.05). There was no
significant difference in the cardiac troponin and N terminal prohormone
of brain natriuretic peptide (NT-proBNP) levels between the two groups
post-PCI (P > 0.05). The left ventricular end-diastolic volume and left
ventricular ejection fraction (LVEF) during hospitalization were similar
between the groups (P > 0.05). Conclusion(s): Administering heparin
to STEMI patients in the emergency room can increase the rate of coronary
artery revascularization. Copyright © 2022 The Authors

<20>
Accession Number
2022876342
Title
Low-Dose vs Standard Warfarin After Mechanical Mitral Valve Replacement: A
Randomized Trial.
Source
Annals of Thoracic Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Chu M.W.A.; Ruel M.; Gerdisch M.W.; Damiano R.J.; Smith R.L.; Keeling
W.B.; Wait M.A.; Hagberg R.C.; Quinn R.D.; Sethi G.K.; Floridia R.;
Barreiro C.J.; Pruitt A.L.; Accola K.D.; Dagenais F.; Markowitz A.H.; Ye
J.; Sekela M.E.; Tsuda R.Y.; Duncan D.A.; Swistel D.G.; Harville L.E.;
DeRose J.J.; Lehr E.J.; Alexander J.H.; Puskas J.D.; Choi C..; Pettersson
G.; Gerdisch M.; Frazier O.H.; Askew J.; Damiano R.; Pruitt A.; Duncan D.;
Segurola R.; Shoukfeh M.F.; Gregoric I.; Meyer S.; Chu M.; Chu D.; Hagberg
R.; Tsuda R.; Kirker E.; Swistel D.; Landvater L.; Barreiro C.; Castlemain
B.; Tutuska P.; Quinn R.; Beaver T.; Accola K.; Sethi G.; Graeve A.; Liu
D.; Wait M.; Whitson B.; Harville L.; DeRose J.; Lehr E.; Markowitz A.;
Sekela M.; Smith R.; Shults C.; Shekar P.; Badhwar V.
Institution
(Chu) London Health Sciences Centre, Western University, London, ON,
Canada
(Ruel) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Graeve) MultiCare Health System, Tacoma, WA, United States
(Gerdisch) Franciscan St. Francis Health, Indianapolis, IN, United States
(Damiano) Washington University in St. Louis, St. Louis, MO, United States
(Smith) The Heart Hospital Baylor Plano, Plano, TX, United States
(Keeling) Emory University Hospital Midtown, Atlanta, Georgia, United
States
(Wait) University of Texas Southwestern Medical Center (St. Paul's),
Dallas, TX, United States
(Hagberg) Hartford Hospital, Hartford, CT, United States
(Quinn) Maine Medical Center, Portland, ME, United States
(Sethi) Tucson Heart Center, University of Arizona, Tucson, AZ, United
States
(Floridia) Loma Linda University Medical Center, Loma Linda, CA, United
States
(Barreiro) Sentara Norfolk General Hospital, Norfolk, VA, United States
(Pruitt) St. Joseph Mercy Hospital, Ann Arbor, MI, United States
(Accola) Florida Hospital, Orlando, FL, United States
(Dagenais) Institut universitaire de cardiologie et de pneumologie de
Quebec (IUCPQ), Quebec City, QC, Canada
(Markowitz) University Hospitals-Cleveland, Cleveland, OH, United States
(Ye) St. Paul's and Vancouver General Hospital, Vancouver, BC, Canada
(Sekela) University of Kentucky, Lexington, KY, United States
(Tsuda) Southern Arizona Veterans Affairs Medical Center, Tucson, AZ,
United States
(Duncan) Novant Clinical Research Institute, Winston-Salem, NC, United
States
(Swistel) New York University Langone Hospitals, New York, NY, United
States
(Harville) University of Oklahoma Health Sciences Center, Oklahoma City,
OK, United States
(DeRose) Montefiore Medical Center, Bronx, NY, United States
(Lehr) Swedish Medical Center, Seattle, WA, United States
(Alexander) Duke University Medical Center, Durham, NC, United States
(Puskas) Mount Sinai Saint Luke's, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Current guidelines recommend a target international normalized
ratio (INR) range of 2.5 to 3.5 in patients with a mechanical mitral
prosthesis. The Prospective Randomized On-X Anticoagulation Clinical Trial
(PROACT) Mitral randomized controlled noninferiority trial assessed safety
and efficacy of warfarin at doses lower than currently recommended in
patients with an On-X (Artivion, Inc) mechanical mitral valve.
 Method(s): After On-X mechanical mitral valve replacement, followed
by at least 3 months of standard anticoagulation, 401 patients at 44 North
American centers were randomized to low-dose warfarin (target INR,
2.0-2.5) or standard-dose warfarin (target INR, 2.5-3.5). All patients
were prescribed aspirin, 81 mg daily, and encouraged to use home INR
testing. The primary end point was the sum of the linearized rates of
thromboembolism, valve thrombosis, and bleeding events. The design was
based on an expected 7.3% event rate and 1.5% noninferiority margin.
 Result(s): Mean patient follow-up was 4.1 years. Mean INR was 2.47
and 2.92 (P <.001) in the low-dose and standard-dose warfarin groups,
respectively. Primary end point rates were 11.9% per patient-year in the
low-dose group and 12.0% per patient-year in the standard-dose group
(difference, -0.07%; 95% CI, -3.40% to 3.26%). The CI >1.5%, thus
noninferiority was not achieved. Rates (percentage per patient-year) of
the individual components of the primary end point were 2.3% vs 2.5% for
thromboembolism, 0.5% vs 0.5% for valve thrombosis, and 9.13% vs 9.04% for
bleeding. Conclusion(s): Compared with standard-dose warfarin,
low-dose warfarin did not achieve noninferiority for the composite primary
end point. (PROACT Clinicaltrials.gov number, NCT00291525). Copyright
© 2023 The Society of Thoracic Surgeons

<21>
Accession Number
2022790430
Title
Gender Disparities in Cardiac Surgery Trials: Leadership, Authorship, and
Patient Enrollment.
Source
Annals of Thoracic Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Soletti G.J.; Perezgrovas-Olaria R.; Dimagli A.; Harik L.; Rong L.Q.;
Bairey Merz C.N.; Rahouma M.; Sandner S.E.; Gelijns A.C.; Gaudino M.
Institution
(Soletti, Perezgrovas-Olaria, Dimagli, Harik, Rahouma, Gaudino) Department
of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United
States
(Rong) Department of Anesthesiology, Weill Cornell
Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
(Bairey Merz) Barbra Streisand Women's Heart Center, Smidt Heart
Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Gelijns) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Studies have highlighted the paucity of women-led randomized
controlled trials (RCTs) in cardiovascular medicine. Whether this finding
also applies to cardiac surgery has not been evaluated. In this study, we
evaluate women authorship, leadership, and women enrollment in cardiac
surgery RCTs. Method(s): A systematic literature search was conducted
to identify RCTs comparing 2 or more adult cardiac surgical procedures
published from 2000 to 2022. Women-led RCTs were defined as those with a
woman as either a first or last author. Linear regression and correlation
analyses were used. Result(s): Of 58 RCTs, 8 (13.8%) were women-led;
17 (29.3%) RCTs had no women authors. Overall, 17.9% of all authors were
women, but only 1.2% of all authors were women cardiac surgeons and only
19% of the RCTs had a women cardiac surgeon among the authors. The median
proportion of women authors was 14.3% by RCT, which was significantly
higher in women-led compared with men-led RCTs (28.6% vs 11.8%; P =.01).
No significant change in the proportion of women authors was observed
during the study period. North American RCTs had a higher proportion of
women authors compared with other geographic regions (28.6% vs 12.5%; P
=.01). No correlation was found between the proportion of women authors
and the proportion of women participants enrolled in individual RCTs.
 Conclusion(s): During the last 2 decades, only a minority of cardiac
surgery RCTs were women-led, and no significant increase in women
authorship occurred. There are important geographic differences in women
authorship. Copyright © 2023 The Society of Thoracic Surgeons

<22>
Accession Number
2021649405
Title
A randomised controlled trial of dexmedetomidine for delirium in adults
undergoing heart valve surgery.
Source
Anaesthesia. (no pagination), 2023. Date of Publication: 2023.
Author
Wang H.-B.; Jia Y.; Zhang C.-B.; Zhang L.; Li Y.-N.; Ding J.; Wu X.; Zhang
Z.; Wang J.-H.; Wang Y.; Yan F.-X.; Yuan S.; Sessler D.I.
Institution
(Wang, Jia, Li, Ding, Wu, Zhang, Wang, Yan, Yuan) Department of
Anaesthesiology, Fuwai Hospital, National Centre for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(Zhang) Department of Anaesthesiology, Fuwai Hospital, Chinese Academy of
Medical Sciences, Shenzhen (Sun Yat-sen Cardiovascular Hospital,
Shenzhen), Shenzhen, China
(Zhang) Department of Anaesthesiology, Chongqing Hospital of Traditional
Chinese Medicine, Chongqing, China
(Wang) Department of Medical Research & Biometrics Centre, Fuwai Hospital,
National Centre for Cardiovascular Diseases, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
(Sessler) Department of Outcomes Research, Cleveland Clinic, Cleveland,
OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Dexmedetomidine might reduce delirium after cardiac surgery. We allocated
326 participants to an infusion of dexmedetomidine at a rate of 0.6 mug
kg-1 for 10 min and then at 0.4
mug.kg-1.h-1 until the end of surgery; 326 control
participants received comparable volumes of saline. We detected delirium
in 98/652 (15%) participants during the first seven postoperative days:
47/326 after dexmedetomidine vs. 51/326 after placebo, p = 0.62, adjusted
relative risk (95%CI) 0.86 (0.56-1.33), p = 0.51. Postoperative renal
impairment (Kidney Disease Improving Global Outcomes stages 1, 2 and 3)
was detected in 46, 9 and 2 participants after dexmedetomidine and 25, 7
and 4 control participants, p = 0.040. Intra-operative dexmedetomidine
infusion did not reduce the incidence of delirium after cardiac valve
surgery but might impair renal function. Copyright © 2023
Association of Anaesthetists.

<23>
Accession Number
2021842140
Title
Comparative efficacy of quadratus lumborum type-II and erector spinae
plane block in patients undergoing caesarean section under spinal
anaesthesia: a randomised controlled trial.
Source
International Journal of Obstetric Anesthesia. 53 (no pagination), 2023.
Article Number: 103614. Date of Publication: February 2023.
Author
Priya T.K.; Singla D.; Talawar P.; Sharma R.S.; Goyal S.; Purohit G.
Institution
(Priya, Singla, Talawar, Sharma, Goyal, Purohit) Department of
Anaesthesiology, AIIMS, Uttarakhand, Rishikesh, India
Publisher
Churchill Livingstone
Abstract
Background: Quadratus lumborum and erector spinae plane blocks have been
used to provide analgesia in patients undergoing thoracic or abdominal
surgeries. Our study compared the analgesic efficacy of the quadratus
lumborum type-II block (QLB-II) and the erector spinae plane block (ESPB)
in parturients who underwent caesarean section under spinal anaesthesia.
 Method(s): Fifty-two patients with comparable demographic profiles
were randomised into two groups, QLB-II (n = 26) and ESPB (n = 26). After
the surgery, patients received either ultrasound-guided QLB-II or ESPB
using 0.25% bupivacaine 0.3 mL/kg. Comparison of analgesic efficacy was in
terms of fentanyl consumption (primary outcome), pain scores, incidence of
complications in the 24-h postoperative period, and quality of recovery
(QoR-15) on postoperative days one and two, and day of discharge.
 Result(s): There was no significant difference in cumulative number
of fentanyl doses (W = 349.000, P = 0.840), numerical rating score at rest
(P = 0.648) or with movement (P = 0.520), QoR-15 scores on postoperative
day one (P = 0.549), day two (P = 0.927) or day of discharge (P = 0.676).
 Conclusion(s): We concluded that patients who underwent QLB-II or
ESPB reported similar analgesic efficacy, complications, and quality of
recovery in the postoperative period. Copyright © 2022 Elsevier
Ltd

<24>
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).
 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%). 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. Copyright © 2022 Elsevier B.V.

<25>
Accession Number
2021126744
Title
Causes and Determinants of Heart Failure Readmissions Post Transcutaneous
Aortic Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(1) (no pagination), 2023. Article
Number: 101428. Date of Publication: January 2023.
Author
Yasmin F.; Aamir M.; Moeed A.; Iqbal K.; Iqbal A.; Asghar M.S.; Ullah W.;
Rajapreyar I.; Brailovsky Y.
Institution
(Yasmin, Moeed, Iqbal, Iqbal) Department of Medicine, Dow Medical College,
Dow University of Health Sciences, Karachi, Pakistan
(Aamir) Division of Cardiology, Lehigh Valley Heart and Vascular
Institute, Allentown, PA, United States
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
MN
(Ullah, Rajapreyar, Brailovsky) Division of Cardiology, Thomas Jefferson
University Hospitals, Philadelphia, PA
(Brailovsky) Department of Advanced Heart Failure, Mechanical Circulatory
Support, Heart Transplant, Jefferson Heart Institute, Sidney Kimmel School
of Medicine at Thomas Jefferson University, 833 Chestnut Street, Suite
640, Philadelphia, PA
Publisher
Elsevier Inc.
Abstract
Transcutaneous aortic valve implantation (TAVI) has transformed the
management of aortic stenosis (AS) and is increasingly being used for
patients with symptomatic, severe aortic stenosis who are ineligible or at
high risk for conventional cardiac surgery. PUBMED, Google Scholar, and
SCOPUS databases were searched to identify studies reporting heart failure
hospitalization after TAVI. Major factors evaluated for HF hospitalization
were age, comorbidities such as hypertension, atrial fibrillation (AF),
chronic pulmonary disease including COPD, chronic kidney disease, baseline
LVEF before the procedure, NYHA symptom class, and society of thoracic
surgeons (STS) score. Hazard ratio (HR) with a 95% confidence interval
were computed using random-effects models. A total of eight studies were
included comprising 77,745 patients who underwent TAVI for severe aortic
stenosis. The presence of diabetes mellitus (HR: 1.39, 95% CI [1.17,
1.66], chronic kidney disease (CKD) (HR: 1.39, 95% CI [1.31, 1.48], atrial
fibrillation (HR: 1.69, 95% CI [1.42, 2.01], chronic pulmonary disease
(HR: 1.33, 95% CI [1.12, 1.58], and a high STS score (HR: 1.07, 95% CI
[1.03, 1.11] were positive predictors of 1-year HF hospitalization after
TAVI. Patients with diabetes mellitus, AF, CKD, chronic pulmonary disease,
and a high STS score are at an increased risk of heart failure
hospitalization at 1-year of TAVI, whereas increasing age, hypertension,
LVEF <50%, and NYHA class III/IV symptoms did not predict HF
hospitalization. Careful follow-up after TAVI in high-risk patients, with
closer surveillance for HF particularly, is key to preventing HF
hospitalizations and death. Copyright © 2022

<26>
Accession Number
2020551543
Title
Effect of high-energy and/or high-protein feeding in children with
congenital heart disease after cardiac surgery: a systematic review and
meta-analysis.
Source
European Journal of Pediatrics. 182(2) (pp 513-524), 2023. Date of
Publication: February 2023.
Author
Ni P.; Wang X.L.; Xu Z.M.; Luo W.
Institution
(Ni, Xu) Department of Thoracic and Cardiovascular Surgery, Shanghai
Children's Medical Center, School of Medicine, Shanghai Jiao Tong
University, Shanghai, China
(Wang) Department of Cardiology, Shanghai Children's Medical Center,
School of Medicine, Shanghai Jiao Tong University, Shanghai, China
(Luo) Nursing Department, Shanghai Children's Medical Center, School of
Medicine, Shanghai Jiao Tong University, 1678 Dong-fang Road, Shanghai
200127, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
High-energy or high-protein feeding offers a promising approach to
improving malnutrition in children after congenital heart surgery.
However, the effect of high-energy or high-protein feeding in this
population has not yet been systematically reviewed. Therefore, we aimed
to assess the safety and effectiveness of high-energy or high-protein
feeding in children after congenital heart surgery. Five electronic
databases (PubMed, Embase, CENTRAL, CINAHL, and Scopus) were searched from
inception to April 23, 2022. After screening the literature according to
inclusion and exclusion criteria, a risk of bias assessment was performed
using version 2 of the Cochrane risk-of-bias tool for randomized trials,
and the certainty of the evidence was assessed using the Grading of
Recommendations, Assessment, Development and Evaluations system. Finally,
the random effects model was used to perform a meta-analysis of all data.
A total of 609 subjects from 9 studies were included for qualitative
analysis, and meta-analyses were performed on data from 8 of these
studies. The results showed that high-energy and/or high-protein feeding
did not increase feeding intolerance (RR = 1.09, 95% CI: 0.80, 1.48) or
fluid intake (MD = - 12.50 ml/kg/d, 95% CI: - 36.10, 11.10); however, the
intervention was beneficial in increasing weight (MD = 0.5 kg, 95% CI:
0.23, 0.77) and reducing the duration of mechanical ventilation (MD = -
17.45 h, 95% CI: - 27.30, - 7.60), intensive care unit (ICU) stay (MD = -
1.45 days, 95% CI: - 2.36, - 0.54) and hospital stay (MD = - 2.82 days,
95% CI: - 5.22, - 0.43). However, high-energy and/or protein feeding did
not reduce the infection rate (RR = 0.68, 95% CI: 0.25, 1.87) or mortality
(RR = 1.50, 95% CI: 0.47, 4.82). Conclusion(s): The certainty of the
evidence was graded as moderate to high, which suggests that high-energy
and/or high-protein feeding may be safe in children after congenital heart
surgery. Furthermore, this intervention improves nutrition and reduces the
duration of mechanical ventilation, length of ICU stay, and length of
hospital stay. However, the overall conclusion of this meta-analysis will
need to be confirmed in a cohort of patients with different cardiac
physiologies.What is Known:* Malnutrition is highly prevalent in children
with congenital heart disease (CHD) and can negatively affect the
prognosis of these children.* High-energy and/or high-protein feeding can
improve nutrition status and facilitate recovery; however, evidence on its
safety and efficacy is lacking. What is New:* Pooled data suggest that
high-energy and/or high-protein feeding does not increase fluid intake or
feeding intolerance in children with CHD.* High-energy and/or high-protein
feeding may reduce the duration of mechanical ventilation, length of
intensive care unit stay, and length of hospital stay. Copyright
© 2022, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<27>
Accession Number
2020996019
Title
Comparative Efficacy of Local and General Anesthesia for Transcatheter
Aortic Valve Implantation: A Meta-Analysis and Systematic Review.
Source
Heart Surgery Forum. 25(3) (pp E364-E373), 2022. Date of Publication:
2022.
Author
Gao L.; Jin B.; Chao C.; Wang B.; Zhang X.; Shen J.
Institution
(Gao, Shen) Department of Anesthesiology, The Third Affiliated Hospital of
Soochow University, Changzhou 213000, China
(Jin) NO.971 Hospital of The People's Liberation Army Navy, China
(Chao, Wang, Zhang) Department of Cardiothoracic Surgery, The Third
Affiliated Hospital of Soochow University, Changzhou 213000, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: This meta-analysis aimed to compare the potential effects of
local anesthesia (LA) and general anesthesia (GA) for transcatheter aortic
valve implantation (TAVI). Measurements: All relevant studies were
searched from Pubmed, EMbase, Web of Science, and the Cochrane Library
(January 1, 2016, to June 1, 2021). The main outcomes of this literature
meta-analysis were 30-day mortality, procedural time, new pacemaker
implantation, total stay in the hospital, use of the vasoactive drug, and
intra-and postoperative complications and emergencies, including
conversion to open, myocardial infarction, pulmonary complication,
vascular complication, renal injury/failure, stroke, transesophageal
echocardiography, life-threatening/major bleeding, cardiac tamponade, and
emergency PCI. Pooled risk ratio (RR) and mean difference (MD) together
with a 95% confidence interval (CI) were calculated. Result(s): A
total of 17 studies, including 20938 patients, in the final analysis,
fulfilled the inclusion criteria. Intra-and postoperative complications
(myocardial infarction, vascular complication, renal injury/failure,
stroke, and cardiac tamponade) undergoing TAVI in severe AS patients under
GA do not offer a significant difference compared with LA. No differences
were observed between LA and GA for new pacemaker implantation, total stay
in the hospital, transesophageal echocardiography, and emergency PCI. LA
has lower mortality compared with GA (RR 0.69, P = 0.600), pulmonary
complications (RR 0.54, P = 0.278), life-threatening/major bleeding (RR
0.85, P = 0.855), and lower times of conversion to open (RR 0.22, P =
0.746). LA has many advantages, including a shorter procedure duration
(MD=-0.38, P = 0.000) and reduction of the use of the vasoactive drug (RR
0.57, P = 0.000). Conclusion(s): For TAVI, both LA with or without
sedation and GA are feasible and safe. LA appears a feasible alternative
to GA for AS patients undergoing TAVI. Copyright © 2022 Forum
Multimedia Publishing, LLC.

<28>
Accession Number
2018992582
Title
Infective Endocarditis by Pasteurella Species: A Systematic Review.
Source
Journal of Clinical Medicine. 11(17) (no pagination), 2022. Article
Number: 5037. Date of Publication: September 2022.
Author
Alifragki A.; Kontogianni A.; Protopapa I.; Baliou S.; Ioannou P.
Institution
(Alifragki, Kontogianni, Protopapa) School of Medicine, University of
Crete, Voutes 70013, Greece
(Baliou, Ioannou) Internal Medicine Department, University Hospital of
Heraklion, Voutes 71500, Greece
Publisher
MDPI
Abstract
Pasteurella spp. are non-motile, facultative anaerobic, Gram-negative
coccobacilli that are commonly found in the oral cavity and the
gastrointestinal tract of some animals and are known to be the cause of
infections. Usually, infections by Pasteurella spp. in humans is more
common in the context of an animal bite leading to a skin and soft tissue
infection (SSTI). Infective endocarditis (IE) is rarely caused by
Pasteurella spp.; however, it can pose diagnostic and therapeutic dilemmas
due to its rarity. The aim of the present study was to systematically
review all cases of IE by Pasteurella spp. in the literature. A systematic
review was performed of PubMed, Scopus and the Cochrane Library (through
20 December 2021) for studies providing data on epidemiology and clinical
and microbiological characteristics as well as data on treatment and
outcomes of IE by Pasteurella spp. A total of 28 studies containing data
for 28 patients were included. Prosthetic valve was present in 21.4% of
patients. The aorta was the most commonly involved intracardiac site.
Fever, sepsis, septic shock and heart failure were the most common
clinical presentations. Cephalosporins, aminopenicillins and penicillin
were the antimicrobials used most commonly. Overall mortality was
17.9%. Copyright © 2022 by the authors.

<29>
Accession Number
2011408958
Title
European Association of Urology Section of Urolithiasis and International
Alliance of Urolithiasis Joint Consensus on Percutaneous Nephrolithotomy.
Source
European Urology Focus. 8(2) (pp 588-597), 2022. Date of Publication:
March 2022.
Author
Zeng G.; Zhong W.; Pearle M.; Choong S.; Chew B.; Skolarikos A.; Liatsikos
E.; Pal S.K.; Lahme S.; Durutovic O.; Farahat Y.; Khadgi S.; Desai M.; Chi
T.; Smith D.; Hoznek A.; Papatsoris A.; Desai J.; Mazzon G.; Somani B.;
Eisner B.; Scoffone C.M.; Nguyen D.; Ferretti S.; Giusti G.; Saltirov I.;
Maroccolo M.V.; Gokce M.I.; Straub M.; Bernardo N.; Lantin P.L.; Saulat
S.; Gamal W.; Denstedt J.; Ye Z.; Sarica K.
Institution
(Zeng, Zhong) Department of Urology and Guangdong Key Laboratory of
Urology, The First Affiliated Hospital of Guangzhou Medical University,
Guangzhou, China
(Pearle) Department of Urology, University of Texas Southwestern Medical
Center, Dallas, TX, United States
(Choong, Smith) Institute of Urology, University College Hospital, UK,
London, United Kingdom
(Chew) Department of Urologic Sciences, University of British Columbia,
Vancouver, BC, Canada
(Skolarikos) 2nd Department of Urology, Sismanoglio General Hospital,
Athens, Greece
(Liatsikos) Department of Urology, University Hospital of Patras,
University of Patras, Patras, Greece
(Pal) Department of Urology, Holy Family Hospital, New Delhi, India
(Lahme) Department of Urology, Siloah St. Trudpert Hospital, Pforzheim,
Germany
(Durutovic) Department of Urology, Clinic of Urology, University of
Belgrade, Belgrade, Serbia
(Farahat) Department of Urology, Sheikh Khalifa General Hospital, Umm Al
Quwain, United Arab Emirates
(Khadgi) Department of Urology, Vayodha Hospital, Kathmandu, Nepal
(Desai) Department of Urology, Muljibhai Patel Urological Hospital,
Nadiad, India
(Chi) Department of Urology, University of California, San Francisco, CA,
United States
(Hoznek) Department of Urology, Mondor Hospital, Creteil, France
(Papatsoris) Department of Urology, Sismanoglio General Hospital, Athens,
Greece
(Desai) Department of Urology, Samved Hospital, Ahmedabad, India
(Mazzon) Department of Urology, San Bassiano Hospital, Vicenza, Italy
(Somani) Department of Urology, University Hospital Southampton, UK,
Southampton, United Kingdom
(Eisner) Deparment of Urology, Massachusetts General Hospital, Boston, MA,
United States
(Scoffone) Department of Urology, Cottolengo Hospital of Torino, Torino,
Italy
(Nguyen) Binh Dan Hospital, SaiGon, Vietnam
(Ferretti) Department of Urology, Hospital and University of Parma, Parma,
Italy
(Giusti) Department of Urology, IRCCS San Raffaele Hospital, Milan, Italy
(Saltirov) Department of Urology and Nephrology, Military Medical Academy,
Sofia, Bulgaria
(Maroccolo) Hospital de Base of the Federal District, Brasilia, Brazil
(Gokce) Department of Urology, Ankara University School of Medicine,
Ankara, Turkey
(Straub) Department of Urology, Technical University Munich, Munich,
Germany
(Bernardo) Department of Urology, Hospital de Clinicas Jose de San Martin,
Buenos Aires, Argentina
(Lantin) Urology Center of the Philippines, Quezon City, Philippines
(Saulat) Department of Urology, Sindh Institution of Urology and
Transplantation, Karachi, Pakistan
(Gamal) Department of Urology, Sohag University Hospital, Sohag, Egypt
(Denstedt) Division of Urology, Western University, London, ON, Canada
(Ye) Department of Urology, Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, China
(Sarica) Department of Urology, Biruni University, Medical School,
Istanbul, Turkey
Publisher
Elsevier B.V.
Abstract
Context: Although percutaneous nephrolithotomy (PCNL) has been performed
for decades and has gone through many refinements, there are still
concerns regarding its more widespread utilization because of the long
learning curve and the potential risk of severe complications. Many
technical details are not included in the guidelines because of their
nature and research protocol. Objective(s): To achieve an expert
consensus viewpoint on PCNL indications, preoperative patient preparation,
surgical strategy, management and prevention of severe complications,
postoperative management, and follow-up. Evidence Acquisition: An
international panel of experts from the Urolithiasis Section of the
European Association of Urology, International Alliance of Urolithiasis,
and other urology associations was enrolled, and a prospectively conducted
study, incorporating literature review, discussion on research gaps (RGs),
and questionnaires and following data analysis, was performed to reach a
consensus on PCNL. Evidence Synthesis: The expert panel consisted of
36 specialists in PCNL from 20 countries all around the world. A consensus
on PCNL was developed. The expert panel was not as large as expected, and
the discussion on RGs did not bring in more supportive evidence in the
present consensus. Conclusion(s): Adequate preoperative preparation,
especially elimination of urinary tract infection prior to PCNL, accurate
puncture with guidance of fluoroscopy and/or ultrasonography or a
combination, keeping a low intrarenal pressure, and shortening of
operation time during PCNL are important technical requirements to ensure
safety and efficiency in PCNL. Patient Summary: Percutaneous
nephrolithotomy (PCNL) has been a well-established procedure for the
management of upper urinary tract stones. However, according to an expert
panel consensus, core technical aspects, as well as the urologist's
experience, are critical to the safety and effectiveness of
PCNL. Copyright © 2021

<30>
Accession Number
2021046934
Title
Both Sides of a Coin: Having Open Heart Surgery While Researching in
Cardiology.
Source
JACC: Case Reports. 4(22) (pp 1556-1558), 2022. Date of Publication: 16
Nov 2022.
Author
Edwards J.J.
Institution
(Edwards) School of Psychology and Life Sciences, Canterbury Christ Church
University, Kent, United Kingdom
Publisher
Elsevier Inc.

<31>
Accession Number
2019217456
Title
Can Quality Improvement Methodologies Derived from Manufacturing Industry
Improve Care in Cardiac Surgery? A Systematic Review.
Source
Journal of Clinical Medicine. 11(18) (no pagination), 2022. Article
Number: 5350. Date of Publication: September 2022.
Author
Hoefsmit P.C.; Schretlen S.; Burchell G.; van den Heuvel J.; Bonjer J.;
Dahele M.; Zandbergen R.
Institution
(Hoefsmit, Zandbergen) Department of Cardiothoracic Surgery, Amsterdam
University Medical Centre, Amsterdam 1081 HV, Netherlands
(Schretlen) Integrated Health Solutions, Medtronic Inc, Eindhoven 5616 VB,
Netherlands
(Burchell) Medical Library, Vrije Universiteit, Amsterdam 1081 HV,
Netherlands
(van den Heuvel) Department of Healthcare Management, University of
Amsterdam Business School, Amsterdam 1018 TV, Netherlands
(Bonjer, Zandbergen) Department of Surgery, Amsterdam University Medical
Centre, Amsterdam 1081 HV, Netherlands
(Dahele) Department of Radiation Oncology, Amsterdam University Medical
Centre, Amsterdam 1081 HV, Netherlands
Publisher
MDPI
Abstract
Objectives: Healthcare is required to be effectively organised to ensure
that growing, aging and medically more complex populations have timely
access to high-quality, affordable care. Cardiac surgery is no exception
to this, especially due to the competition for and demand on hospital
resources, such as operating rooms and intensive care capacity. This is
challenged more since the COVID-19 pandemic led to postponed care and
prolonged waiting lists. In other sectors, Quality Improvement
Methodologies (QIM) derived from the manufacturing industry have proven
effective in enabling more efficient utilisation of existing capacity and
resources and in improving the quality of care. We performed a systematic
review to evaluate the ability of such QIM to improve care in cardiac
surgery. Method(s): A literature search was performed in PubMed,
Embase, Clarivate Analytics/Web of Science Core Collection and Wiley/the
Cochrane Library according to the Preferred Reporting Items for Systematic
Reviews and Meta-Analysis methodology. Result(s): Ten articles were
identified. The following QIM were used: Lean, Toyota Production System,
Six Sigma, Lean Six Sigma, Root Cause Analysis, Kaizen and
Plan-Do-Study-Act. All reported one or more relevant improvements in
patient-related (e.g., infection rates, ventilation time, mortality,
adverse events, glycaemic control) and process-related outcomes (e.g.,
shorter waiting times, shorter transfer time and productivity). Elements
to enhance the success included: multidisciplinary team engagement, a
patient-oriented, data-driven approach, a sense of urgency and a focus on
sustainability. Conclusion(s): In all ten papers describing the
application of QIM initiatives to cardiac surgery, positive results, of
varying magnitude, were reported. While the consistency of the available
data is encouraging, the limited quantity and heterogenous quality of the
evidence base highlights that more rigorous evaluation, including how best
to employ manufacturing industry-derived QIM in cardiac surgery is
warranted. Copyright © 2022 by the authors.

<32>
Accession Number
2020025156
Title
Use of Transversus Abdominis Plane and Intercostal Blocks in Bitches
Undergoing Laparoscopic Ovariectomy: A Randomized Controlled Trial.
Source
Veterinary Sciences. 9(11) (no pagination), 2022. Article Number: 604.
Date of Publication: November 2022.
Author
Paolini A.; Santoro F.; Bianchi A.; Collivignarelli F.; Vignoli M.;
Scialanca S.; Parrillo S.; Falerno I.; De Bonis A.; Rosto M.; Tamburro R.
Institution
(Paolini, Bianchi, Collivignarelli, Vignoli, Scialanca, Parrillo, Falerno,
De Bonis, Rosto, Tamburro) Faculty of Veterinary Medicine, University of
Teramo, Teramo 64100, Italy
(Santoro) Department of Clinical Sciences and Services, The Royal
Veterinary College, Hatfield AL9 7TA, United Kingdom
Publisher
MDPI
Abstract
In humans and dogs, loco-regional anesthesia is associated with lower
peri-operative opioid consumption and less related side effects. The
combination of transversus abdominis plane (TAP) and intercostal blocks
can be used to desensitize the entire abdominal wall in dogs. The aim of
this study was to evaluate the effectiveness of TAP and intercostal blocks
in bitches undergoing laparoscopic ovariectomy. Twenty client-owned
bitches were enrolled in this double-blinded randomized controlled trial.
After premedication with dexmedetomidine, methadone and ketamine, the
animals were randomized into two groups. Dogs in the TAP group received
intercostal blocks from T8 to T10 and a TAP block with ropivacaine. Dogs
in the FEN group received a fentanyl bolus and a constant rate infusion
for the entire duration of the procedure. Intra-operative cardiovascular
stability, post-operative pain scores, rescue opioid requirement,
dysphoria during recovery, time to attain sternal recumbency and interest
in food at 6 h post-extubation were compared. Bitches in the TAP group
received a statistically significant lower amount of rescue fentanyl
intra-operatively and methadone post-operatively. Pain scores were lower
in the TAP group until 6 h post-extubation. No difference was found for
dysphoric recoveries, time to attain sternal recumbency and appetite at 6
h post-extubation. No adverse event was recorded for any of the dogs. The
combination of TAP and intercostal blocks can be part of an effective
multi-modal analgesic strategy in bitches undergoing laparoscopic
ovariectomy. Copyright © 2022 by the authors.

<33>
Accession Number
2020017983
Title
Pulmonary hemorrhage after cardiac resynchronization therapy device
implantation - A systematic review.
Source
American Journal of the Medical Sciences. 364(6) (pp 796-802), 2022. Date
of Publication: December 2022.
Author
Jafry A.H.; Raza S.M.; Bajwa A.; Hassan A.; Akhtar K.H.; Salat H.; Abdo T.
Institution
(Jafry, Bajwa, Akhtar) Department of Medicine, University of Oklahoma
Health Sciences Center, Oklahoma City, OK, United States
(Raza) Department of Medicine, Allama Iqbal Medical College, Lahore,
Pakistan
(Hassan) Department of Medicine-Pediatrics, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, United States
(Salat, Abdo) Department of Medicine, Section of Pulmonary, Critical Care
and Sleep Medicine, University of Oklahoma Health Sciences Center and
Oklahoma City VA Health Care System, Oklahoma City, OK, United States
Publisher
Elsevier B.V.
Abstract
Cardiac implantable electronic devices are being increasingly used for a
variety of cardiovascular diseases. We describe a rare case of massive
hemoptysis after device implantation. The patient was managed
conservatively with reversal of anticoagulation and inhaled tranexamic
acid and had a successful recovery. A systematic review accompanies the
case presentation. The modality and difficulty of access appear to play a
significant role in precipitating bleeding, believed to be the result of
direct injury to the pulmonary parenchyma and vasculature. The condition
is often self-limiting; however, anticoagulation reversal, intubation,
endobronchial intervention, and transarterial embolization may be
indicated in more severe pulmonary hemorrhage. Copyright © 2022
Southern Society for Clinical Investigation

<34>
Accession Number
639898457
Title
Testing for EGFR Variants in Pleural and Pericardial Effusion Cell-Free
DNA in Patients With Non-Small Cell Lung Cancer.
Source
JAMA oncology. 9(2) (pp 261-265), 2023. Date of Publication: 01 Feb 2023.
Author
Lee K.W.C.; Li M.S.C.; Gai W.; Lau Y.M.; Chan A.K.C.; Chan O.S.H.; Lee
C.K.; Yeung R.M.W.; Fung S.Y.H.; Cheung W.F.; Chan V.W.; Leung L.; Kam
K.N.P.; Mok T.S.K.
Institution
(Lee, Li, Chan, Mok) Department of Clinical Oncology, Chinese University
of Hong Kong, Hong Kong
(Li, Mok) State Key Laboratory of Translational Oncology, Chinese
University of Hong Kong, Hong Kong
(Gai, Chan, Fung, Cheung) Department of Chemical Pathology, Chinese
University of Hong Kong, Hong Kong
(Lau, Leung, Kam) Department of Clinical Oncology, Prince of Wales
Hospital, Hong Kong
(Chan, Yeung) Department of Clinical Oncology, Pamela Youde Nethersole
Eastern Hospital, Hong Kong
(Lee) National Health and Medical Research Council (NHMRC) Clinical Trials
Centre, University of Sydney, Sydney, NSW, Australia
Publisher
NLM (Medline)
Abstract
Importance: Molecular testing in non-small cell lung cancer (NSCLC) is
commonly limited by inadequate tumor sample. Plasma cell-free DNA (cfDNA)
genotyping as a complementary test is specific but only moderately
sensitive. Genotyping of cfDNA in pleural and pericardial effusion
(PE-cfDNA) can further optimize molecular diagnostic yield and reduce the
need for repeated biopsies. Objective(s): To prospectively validate
droplet digital polymerase chain reaction (ddPCR) for detection of
sensitizing EGFR variants and acquired Thr790Met variant (T790M) from
PE-cfDNA in patients with NSCLC. Design, Setting, and Participant(s):
This prospective diagnostic validation study was conducted between
September 6, 2016, and January 21, 2021 at 2 major Hong Kong cancer
centers. Patients with advanced NSCLC with both wild-type and variant EGFR
status and exudative PE who underwent thoracocentesis or
pericardiocentesis were randomly enrolled. Patients were either
EGFR-tyrosine kinase inhibitor (TKI) naive (cohort 1) or EGFR-TKI treated
but osimertinib naive (cohort 2). Enrolled patients underwent pleural- or
pericardial-fluid and blood sampling for ddPCR EGFR testing. EGFR status
results with ddPCR testing of PE-cfDNA and blood were compared with EGFR
status in matched tumor biopsy or PE cell block samples. Main
Outcomes and Measures: Specificity, sensitivity, and concordance of
PE-cfDNA for detection of sensitizing EGFR variants and acquired T790M
variation. Result(s): Among 171 patients (54% female) enrolled, there
were 104 in cohort 1 and 67 in cohort 2. In cohort 1, 37% (38/102) were
EGFR-variant positive; PE-cfDNA showed 97% sensitivity (95% CI, 92%-100%),
97% specificity (95% CI, 93%-100%), and 97% concordance (k=0.94, P<.001)
for the detection of sensitizing EGFR variants. It was more sensitive than
plasma in detecting sensitizing EGFR variants (97% vs 74%, P<.001). In
cohort 2, 38% (15 of 40) were positive for the EGFR T790M variant;
PE-cfDNA showed 87% sensitivity (95% CI, 69%-100%), 60% specificity (95%
CI, 41%-79%), and 70% concordance (k=0.42, P=.004) for acquired T790M. The
EGFR T790M variant was detected in 51% of PE-cfDNA vs 25% of PE cell block
samples. Conclusions and Relevance: In this diagnostic study, EGFR
variants could be accurately detected from PE-cfDNA in patients with
NSCLC. More EGFR T790M was detected in PE-cfDNA than in
guideline-recommended PE cell block preparations. These results suggest
that PE-cfDNA can complement plasma and tumor genotyping for detecting
EGFR variants in patients with advanced NSCLC.

<35>
Accession Number
640352431
Title
Five-Year Results of Coronary Artery Bypass Grafting with or without
Carotid Endarterectomy in Patients with Asymptomatic Carotid Artery
Stenosis: CABACS RCT.
Source
Thoracic and Cardiovascular Surgeon. Conference: 52nd Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Hamburg
Germany. 71(Supplement 1) (no pagination), 2023. Date of Publication:
January 2023.
Author
Knipp S.C.; Holst T.; Bilbilis K.; Diener H.C.; Jockel K.H.; Jakob H.;
Ruhparwar A.; Weimar C.
Institution
(Knipp, Holst, Bilbilis, Diener, Jockel, Jakob, Ruhparwar) Essen
University Hospital, Essen, Germany
(Weimar) BDH Clinic Elzach GmbH, Elzach, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: In patients with coronary artery disease and concomitant
asymptomatic severe carotid stenosis, combination of simultaneous coronary
artery bypass grafting (CABG) and carotid endarterectomy (CEA) has been
widely performed despite lack of evidence from randomized trials. We
recently showed that the risk of stroke or death within 30 days was higher
following CABG + CEA compared with CABG alone. Here, we report long-term
outcomes following CABG with versus without CEA. Method(s): The
CABACS (Coronary Artery Bypass Graft Surgery in Patients With Asymptomatic
Carotid Stenosis Study) is a randomized, controlled, multicenter, open
trial. Patients with asymptomatic severe (>=70%) carotid stenosis
undergoing CABG were allocated with either CABG + CEA or CABG alone, and
follow-up was 5 years. Major secondary end points included nonfatal stroke
or death, any death, and any nonfatal stroke. Due to low recruitment, the
study was stopped prematurely after randomization of 127 patients in 17
centers. Result(s): By 5 years, the rate of stroke or death did not
significantly differ between groups (CABG + CEA: 40.6% [95% CI,
0.285-0.536], CABG alone: 35.0% [95% CI, 0.231-0.484]; p = 0.58). Higher
albeit statistically nonsignificant rates of nonfatal strokes occurred at
any time following CABG + CEA versus CABG alone (1 year: 19.3 vs. 7.1%, p
= 0.09; 5 years: 29.4 vs. 18.8%, p = 0.25). All-cause mortality up to 5
years was similar in both groups (CABG + CEA: 25.4% vs. CABG alone: 23.3%,
hazard ratio, 1.148 [95% CI, 0.560-2.353]; p = 0.71). Subgroup analyses
did not reveal any significant effect of age, sex, preoperative-modified
Rankin scale and center on outcome events. Conclusion(s): During
5-year follow-up, combined simultaneous CABG + CEA was associated with a
higher albeit statistically nonsignificant rate of stroke or death
compared with CABG alone. This was mainly due to a nonsignificantly higher
perioperative risk following CABG + CEA. Since the power of our study was
not sufficient, no significant effect of either procedure could be
observed at any time during follow-up.

<36>
Accession Number
640352372
Title
Pre-surgery Optimization of Patients' Expectations to Improve Outcome in
Heart Surgery: Study Protocol of the Randomized Controlled Multicenter
PSY-HEART-II Trial.
Source
Thoracic and Cardiovascular Surgeon. Conference: 52nd Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Hamburg
Germany. 71(Supplement 1) (no pagination), 2023. Date of Publication:
January 2023.
Author
Salzmann S.; Laferton J.; Shedden-Mora M.; Horn N.; Gartner L.; Schroder
L.; Rau J.; Schade-Brittinger C.; Murmann K.; Rastan A.; Andrasi T.;
Boning A.; Salzmann-Djufri M.; Lowe B.; Brickwedel J.; Albus C.; Wahlers
T.; Hamm A.; Hilker L.; Albert W.; Zimmermann T.; Ismail I.; Strauss B.;
Doenst T.; Schedlowski M.; Moosdorf R.; Rief W.
Institution
(Salzmann, Horn, Gartner, Schroder, Rief) Division of Clinical Psychology
and Psychotherapy, Philipps University of Marburg, Marburg, Germany
(Laferton) Department of Medicine, Health and Medical University, Potsdam,
Germany
(Shedden-Mora) Department of Psychology, Medical School Hamburg, Hamburg,
Germany
(Rau, Schade-Brittinger, Murmann) Coordination Center for Clinical Trials
(KKS), University of Marburg, Marburg, Germany
(Rastan, Andrasi, Moosdorf) Department for Cardiovascular Surgery, Heart
Center, Philipps University of Marburg, Marburg, Germany
(Boning, Salzmann-Djufri) Department of Cardiovascular Surgery, University
Hospital Giessen, Giessen, Germany
(Lowe) Department of Psychosomatic Medicine and Psychotherapy, University
Medical Center Hamburg, Hamburg, Germany
(Brickwedel) Department of Cardiovascular Surgery, University Heart and
Vascular Center Hamburg, Hamburg, Germany
(Albus) Department of Psychosomatics and Psychotherapy, Medical Faculty
and University Hospital, Cologne, Germany
(Wahlers) Department of Cardiothoracic Surgery, University Hospital of
Cologne, Cologne, Germany
(Hamm) Department of Physiological and Clinical Psychology/ Psychotherapy,
University of Greifswald, Greifswald, Germany
(Hilker) Department of Cardiovascular Surgery, Clinic Karlsburg, Heart and
Diabetes Center, Karlsburg, Germany
(Albert) Psychosomatics,German Heart Center Berlin, Berlin, Germany
(Zimmermann) Department of Psychosomatic Medicine and Psychotherapy,
Hannover Medical School, Hanover, Germany
(Ismail) Division of Cardiac,Thoracic,Transplantation and Vascular
Surgery, Hannover Medical School, Hanover, Germany
(Straus) Institute of Psychosocial Medicine,Psychotherapy,and
Psychooncology, University Hospital Jena, Jena, Germany
(Doenst) Jena University Hospital, Friedrich-Schiller-University of Jena,
Jena, Germany
(Schedlowski) Institute of Medical Psychology and Behavioral
Immunobiology, University Clinic Essen, Essen, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: Preoperative psychological preparation is gaining importance
for cardiac surgery. The PSY-HEART-I trial indicated that a brief
psychological intervention optimizing patients' expectations before heart
surgery improves disability and quality of life 6 months after coronary
artery bypass graft surgery (CABG). However, to investigate the clinical
utility of such an intervention, a large multi-center trial is needed to
generalize the results and their implications for the health care system.
The PSY-HEART-II study aims to examine whether a preoperative
psychological intervention targeting patients' expectations (EXPECT) can
improve outcomes 6 months after CABG (with or without heart valve
replacement). Method(s): EXPECT will be compared with Standard of
Care (SOC) and an intervention providing emotional support without
targeting expectations (SUPPORT). In a 3-arm multicenter randomized,
controlled, prospective trial (RCT), N = 567 patients scheduled for CABG
surgery will be randomized to either SOC alone or SOC and EXPECT or SOC
and SUPPORT. Patients will be randomized with a fixed unbalanced ratio of
3:3:1 (EXPECT: SUPPORT: SOC) to compare EXPECT to SOC and EXPECT to
SUPPORT. Both psychological interventions consist of 2 in-person sessions
(50 minutes), 2 phone consultations (20 minutes) during the week prior to
surgery, and one booster phone consultation post-surgery 6 weeks later.
Assessment will occur at baseline approximately 3 to 10 days before
surgery, preoperatively the day before surgery, 4 to 6 days later, and 6
months after surgery. This trial is funded by the DFG (German Research
Foundation; PI W. Rief, DFG Ri-574/29-1 and Ri574/29-2). Result(s):
The study's primary endpoint will be patients' illness-related disability
6 months after surgery. Secondary outcomes will be patients' expectations,
subjective illness beliefs, quality of life, anxiety, depression, length
of hospital stay and blood sample parameters (e.g., biomarkers such as
IL-6, IL-8, CRP, NT-proBNP). Conclusion(s): This large multicenter
trial has the potential to corroborate and generalize the promising
results of the PSYHEART-I trial for routine care of cardiac surgery
patients, strengthen the importance of a multi-professional team, and
stimulate revisions of treatment guidelines in heart surgery.

<37>
Accession Number
640352307
Title
Association of Liver Dysfunction with Outcomes after Cardiac Surgery: A
Systematic Review and Meta-analysis.
Source
Thoracic and Cardiovascular Surgeon. Conference: 52nd Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Hamburg
Germany. 71(Supplement 1) (no pagination), 2023. Date of Publication:
January 2023.
Author
Kirov H.; Caldonazo T.; Diab M.; Farber G.; Doenst T.
Institution
(Kirov, Caldonazo, Diab, Farber, Doenst) Friedrich-Schiller-University,
Jena, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: To perform a meta-analysis of studies reporting outcomes in
patients with liver dysfunction addressed by the model of end-stage liver
disease (MELD) and Child-Turcotte-Pugh (CTP) scores undergoing cardiac
surgery. Method(s): A systematic literature search was conducted to
identify contemporary studies reporting short- and long-term outcomes in
patients with liver dysfunction compared with patients with no or mild
liver dysfunction undergoing cardiac surgery (stratified in high and low
score group based on the study cutoffs). Primary outcome was perioperative
mortality. Secondary outcomes were perioperative neurological events,
prolonged ventilation, sepsis, bleeding and/or need for transfusion, acute
kidney injury, and long-term mortality. Result(s): A total of 33
studies with 48,891 patients were included. Compared with the low score
group, being in the high score group was associated with significantly
higher risk of perioperative mortality (OR: 3.72, 95% CI: 2.75-5.03, p <
0.001). High score group was also associated with a significantly higher
rate of perioperative neurological events (OR: 1.49, 95% CI: 1.30-1.71, p
< 0.001), prolonged ventilation (OR: 2.45, 95% CI: 1.94-3.09, p < 0.001),
sepsis (OR: 3.88, 95% CI: 2.07-7.26, p < 0.001), bleeding and/or need for
transfusion (OR: 1.95, 95% CI: 1.43-2.64, p < 0.001), acute kidney injury
(OR: 3.84, 95% CI: 2.12-6.98, p < 0.001), and long-term mortality (IRR:
0.78, 95% CI: 0.69-0.88, p < 0.001). At meta-regression, the assessed
variables did not show any significant association with the pooled
estimate for perioperative mortality. Conclusion(s): The analysis
suggests that liver dysfunction in patients undergoing cardiac surgery is
independently associated with higher risk of short and long-term mortality
and also with an increased occurrence of various perioperative adverse
events.

<38>
Accession Number
640352254
Title
Surgeons Learning Curve in Acute Type A Aortic Dissection.
Source
Thoracic and Cardiovascular Surgeon. Conference: 52nd Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Hamburg
Germany. 71(Supplement 1) (no pagination), 2023. Date of Publication:
January 2023.
Author
Von Aspern K.; Valencia-Nunez D.M.; Roeschner C.; Schneider M.; Otto K.;
Becker V.; Schmidt T.; Lehmann S.; Garbade J.
Institution
(Von Aspern, Valencia-Nunez, Roeschner, Schneider, Otto, Becker, Schmidt,
Lehmann, Garbade) Klinikum Links der Weser-Herzzentrum Bremen, Bremen,
Germany
Publisher
Georg Thieme Verlag
Abstract
Background: Type A aortic dissection is one of the main emergency
indications for cardiovascular surgery oftentimes operated on after
regular working hours by the on-call surgeon. Due to its heterogeneity in
presentation and surgical strategy involved it is regarded as a challenge
especially for surgeons with less operative experience. The aim of this
study is to investigate the influence of operative experience on outcome.
 Method(s): All emergency surgeries for acute type A aortic dissection
between January 2010 and December 2020 at a single institution were
included. Operative details and outcomes of 12 surgeons (with specialty in
cardiac surgery and at least 1 year of working period in the centers'
operating team) were analyzed. Analyses were stratified according to the
surgeons' operative experience (surgeons' allocation were blinded and
randomized for all analyses). Outcomes included early mortality (30 days
or in-house), early complications, and aortic reoperations during
follow-up. Result(s): A total of 250 patients were operated on.
Surgeons were stratified according to their operative experience at the
time of the operation. Surgeons with up to 5 years of operative experience
did not perform any extended arch procedures compared with 26% (N = 11) of
surgeons with more than 20 years of operative experience (p < 0.05
inter-group significance). Time on cardiopulmonary bypass and aortic
cross-clamp periods gradually decreased for surgeons in their first year
up to 20 years of experience (from 184 +/- 34 and 115 +/- 37 minutes to
129 +/- 35 and 69 +/- 24 minutes, respectively; p < 0.05). No early deaths
were observed for patients operated by surgeons in their first year. A
peak in early mortality was observed for surgeons between their second to
fifth year (20.8%, N = 5), reaching a plateau thereafter at 15.3% (N = 33;
p < 0.05). Conclusion(s): Surgeons in their first year of type A
aortic dissection surgery did not negatively influence outcome. The second
to fifth years seem to be the most vulnerable time frame with regard to
operative complications. Individual attributes might also have an
important effect on outcome irrespective of mere operative experience.
These results might indicate the importance of a functioning aortic team
supervising the early operative learning curve.

<39>
Accession Number
640352235
Title
Procedural Success in Transaxillary Transcatheter Aortic Valve
Implantation According to Type of Transcatheter Heart Valve: Results from
the Multicenter TAXI Registry.
Source
Thoracic and Cardiovascular Surgeon. Conference: 52nd Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Hamburg
Germany. 71(Supplement 1) (no pagination), 2023. Date of Publication:
January 2023.
Author
Schafer A.; Bhadra O.D.; Conradi L.; Westermann D.; Reichenspurner H.; De
Backer O.; Sondergaard L.; Qureshi W.T.; Kakouros N.; Amat-Santos I.;
Kaneko T.; Teles R.; Nolasco T.; Abecasis M.; Werner N.; Sacha J.; Trani
C.; Mangieri A.; Regueiro A.; Biancari F.; Niemela M.; Giannini F.; Buono
A.; Bruno F.; Savontaus M.; Ielasi A.; Ferraro P.; Biondi-Zoccai G.;
Morello A.; Giordano A.
Institution
(Schafer, Bhadra, Conradi, Westermann, Reichenspurner) University Heart
and Vascular Center Hamburg, Hamburg, Germany
(De Backer) Heart Center - Rigshospitalet, Copenhagen, Denmark
(Sondergaard) Heart Center-Rigshospitalet, Copenhagen, Denmark
(Qureshi, Kakouros) University of Massachusetts, School of Medicine,
Worcester, United States
(Amat-Santos) Hospital Clinico Universitario de Valladolid, Valladolid,
Spain
(Kaneko) Brigham and Women's Hospital, Boston, United States
(Teles, Nolasco, Abecasis) Hospital de Santa Cruz, Lisbon, Portugal
(Werner) Barmherzige Bruder Hospital, Trier, Germany
(Sacha) University of Opole, Opole, Poland
(Trani) Gemelli University Polyclinic Foundation, Rome, Italy
(Mangieri) Humanitas Research Hospital IRCCS, Milan, Italy
(Regueiro) University of Barcelona, Barcelona, Spain
(Biancari) Helsinki University Hospital, Helsinki, Finland
(Niemela) Oulu University Hospital, Oulu, Finland
(Giannini) GVM Care and Research Maria Cecilia Hospital, Cotignola, Italy
(Buono) Fondazione Poliambulanza Institute, Brescia, Italy
(Bruno) Citta Della Salute e della Scienza, Turin, Italy
(Savontaus) Turku University Hospital, Turku, Finland
(Ielasi) Istituto Clinico Sant'Ambrogio, Milan, Italy
(Ferraro) Santa Lucia Clinic, San Giuseppe, Italy
(Biondi-Zoccai) Sapienza University of Rome, Rome, Italy
(Morello, Giordano) Pineta Grande Hospital, Castel Volturno, Italy
Publisher
Georg Thieme Verlag
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is an
established therapy. To maintain transvascular access in patients not
eligible for the transfemoral approach, transaxillary (TAx)-TAVI is
increasingly performed. The multicenter retrospective observational TAXI
(Trans-AXillary Intervention) international registry showed that
percutaneous axillary access is superior to surgical access in TAx-TAVI.
In this subanalysis of the TAXI registry, we aimed to compare procedural
success in TAx-TAVI according to different types of transcatheter heart
valves (THV) with a special emphasis on anatomical conditions.
 Method(s): For the TAXI international registry (clinicaltrials.gov
NCT02713932) anonymized data from 18 centers were collected. Follow-up was
based on direct patient visits and echocardiographic controls. Acute
procedural, early clinical and 1-month outcomes were adjudicated in
accordance with standardized VARC-3 definitions. Result(s): From a
total of 432 patients, 368 patients (85.3%, SE group) received a
self-expanding (SE) THV and 64 patients (14.8%, BE group) a
balloon-expandable (BE) THV. Preprocedural imaging revealed lower axillary
artery diameters in SE group (max/min diameter in mm: 8.4/6.6 vs. 9.4/6.8
mm; p < 0.001/p = 0.04) but a higher proportion of axillary tortuosity in
BE group (62/368, 23.6% vs. 26/64, 42.6%; p = 0.004) with steeper
aorta-left ventricle (LV) inflow (55 vs. 51degree; p = 0.002) and left
ventricular outflow tract-LV inflow angle (40.0 vs. 24.5degree; 0.002).
TAx-TAVI was significantly more often conducted by the right sided
axillary artery in BE group (33/368, 9.0% vs. 17/64, 26.6%; p < 0.001).
Device success was higher in SE group (353/368, 95.9% vs. 44/64, 68.8%, p
< 0.001). No significant differences were found regarding other outcomes.
However, in logistic regression analysis, BE THV was a risk factor for
vascular complications and axillary stent implantation.
 Conclusion(s): TAx-TAVI using SE THV leads to a significant higher
rate of device success. However, patients receiving BE THV presented with
significantly more axillary tortuosity, steeper inflow angles and were
more often provided with a right sided access. Advantage of the flexible
delivery catheter of BE THV may be the leading consideration when
utilizing BE THV in more complex anatomy in TAx-TAVI, conversely the
obligatory sheath may adversely impact steerability in hostile vascular
conditions. Based on the herein presented data of this large multicenter
registry, TAx-TAVI with SE-THV should be preferred over utilization of
BE-THV unless specific anatomical considerations occur.

<40>
Accession Number
640352209
Title
In-Hospital Outcome of Acute Myocardial Infarction: Culprit PCI and
Consecutive CABG versus Emergent Complete Surgical Revascularization.
Source
Thoracic and Cardiovascular Surgeon. Conference: 52nd Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Hamburg
Germany. 71(Supplement 1) (no pagination), 2023. Date of Publication:
January 2023.
Author
Macius E.; Naito S.; Sobik F.; Reichenspurner H.; Sill B.
Institution
(Macius, Naito, Sobik, Reichenspurner, Sill) University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: Coronary artery bypass grafting (CABG) and percutaneous
coronary intervention (PCI) are standard therapeutic approaches for
cardiac revascularization. The selection of therapy depends primarily on
the complexity of coronary artery disease and urgency of treatment.
Surgical revascularization guaranties excellent long-term outcomes in
patients with advanced multivessel disease, whereas percutaneous coronary
intervention of the culprit lesion is recommended in the setting of ST
elevation myocardial infarction (STEMI). Still, the outcome of CABG when
compared with PCI in an emergency setting is unclear. Method(s): Data
from January 2010 to February 2020 were used for this survey. A total of
1,062 patients with an acute myocardial infarction (STEMI: n = 229,
NSTEMI: n = 883) were surgically treated (<48 hours after diagnosis) and
retrospectively analyzed. In-hospital outcome (MACCE: myocardial
infarction, surgical revision, stroke, and all causes of death) was
compared between patients with a culprit PCI and consecutive CABG (group
1: n = 138) to patients with emergent complete surgical revascularization
(group 2: n = 924). Outcome parameters were adjusted using regression
analysis. Result(s): There was no significant difference in terms of
MACCE events between the two groups. Patient cohorts were comparable in
terms of 30-day mortality (OR: 0.612, 95% CI: 0.989-1.909; p = 0.379),
rate of prolonged ventilation (>24 hours); (OR: 1.161, 95% CI: 0.507-
2.660; p = 0.724), prolonged catecholamine requirement (>24 hours), (OR:
1.001, 95% CI: 0.427-2.347; p = 0.998), and secondary myocardial
infarctions (OR: 1.537, 95% CI: 0.334-7.073; p = 0.581).
 Conclusion(s): Emergent surgical revascularization is a valid and
safe alternative for patients with an acute myocardial infarction. The
surgical treatment offers complete revascularization with well documented
long-term benefit. Whether or not this is particularly applicable for this
cohort needs to be determined in a longer follow-up period and in
prospective, randomized trials.

<41>
Accession Number
640352191
Title
Type of Cardioplegia and Its Application May Not Explain Improvements in
Cardiac Surgery Outcomes during the Last Two Decades.
Source
Thoracic and Cardiovascular Surgeon. Conference: 52nd Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Hamburg
Germany. 71(Supplement 1) (no pagination), 2023. Date of Publication:
January 2023.
Author
Schneider U.; Mukharyamov M.; Farber G.; Kirov H.; Caldonazo T.; Doenst T.
Institution
(Schneider, Mukharyamov, Farber, Kirov, Caldonazo, Doenst)
Friedrich-Schiller University, Jena, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: Cardiac surgery has made tremendous achievements once
cardiopulmonary bypass (CPB) was able to support circulation and
cardioplegia was able to protect the arrested heart during the operative
procedure. Continuous improvements made surgery better and safer until
today, despite significant changes in today's patient profiles (i.e.,
advanced age, higher likelihood of comorbidities). With cardioplegic
arrest being a key component of avoiding ischemic damage to the heart from
the operative procedure, we aimed to assess the role of cardioplegia in
most recent outcomes. Method(s): A systematic literature search was
performed for studies correlating specific cofactors with patient
survival. We searched PubMed, SCOPUS, Embase, Cochrane Database, Google
Scholar, and Ovid for the keywords "cardioplegia," "myocardial
protection," "aortic cross-clamp time," and "mortality." Search terms were
used as key words and in combination as Medical Subject Headings (MeSH)
terms. Result(s): Academic interest in cardioplegia declined in the
past two decades. The number of publications in the time frames of 1990 to
2000 (n = 1,106) and 2010 to 2020 (n = 611) has been cut in half. The
relative percentage of cardioplegia studies related to all cardiac
surgical publications has been reduced to one-fifth (1.3-0.25%). The
youngest cardioplegia solution has been introduced to the market 28 years
ago (del Nido's); the oldest (Bretschneider's) had already been developed
in the 1960s and 1970s. The search for duration of cardioplegic arrest
times and mortality revealed a significant correlation with higher
mortality at higher clamp-times, which was independent of cardioplegia
type or delivery details. Age was qualified as a strong independent risk
factor for mortality. Conclusion(s): Given the results of this
analysis, improved outcomes in cardiac surgery in the past two decades
cannot be attributed to changes in our way to use cardioplegia. However,
there is still a significant relationship between cardioplegic cross-clamp
time and mortality making the field attractive for further investigations
specifically for a changing and often older and sicker patient population.

<42>
Accession Number
640356926
Title
Efficacy and safety of transcutaneous electrical acupoints stimulation for
preoperative anxiety in thoracoscopic surgery: study protocol for a
randomised controlled trial.
Source
BMJ open. 13(2) (pp e067082), 2023. Date of Publication: 16 Feb 2023.
Author
Wu X.; Chen T.; Wang K.; Wei X.; Feng J.; Zhou J.
Institution
(Wu) Yueyang Hospital of Integrated Traditional Chinese and Western
Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai,
China
(Wu, Chen, Feng, Zhou) Cardiothoracic Surgery Department, Yueyang Hospital
of Integrated Traditional Chinese and Western Medicine Affiliated to
Shanghai University of Traditional Chinese Medicine, Shanghai, China
(Wang, Wei) Clinical Research Institute of Acupuncture and Anaesthetic,
Yueyang Hospital of Integrated Traditional Chinese and Western Medicine
Affiliated to Shanghai University of Traditional Chinese Medicine,
Shanghai, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Preoperative anxiety occurs at a very high rate in patients
undergoing video-assisted thoracoscopic surgery (VATS). Moreover, it will
result in poor mental state, more analgesic consumptions, rehabilitation
delay and extra hospitalisation costs. Transcutaneous electrical acupoints
stimulation (TEAS) is a convenient intervention for pain control and
anxiety reduction. Nevertheless, TEAS efficacy of preoperative anxiety in
VATS is unknown. METHODS AND ANALYSIS: This single-centre randomised
sham-controlled trial will be conducted in cardiothoracic surgery
department of the Yueyang Hospital of Integrated Traditional Chinese and
Western Medicine in China. A total of 92 eligible participants with
pulmonary nodules (size >=8mm) who are arranged for VATS will be randomly
assigned to a TEAS group and a sham TEAS (STEAS) group in a 1:1 ratio.
Daily TEAS/STEAS intervention will be administered starting on 3days
before the VATS and continued once per day for three consecutive days. The
primary outcome will be the generalised anxiety disorder scale score
change between the day before surgery with the baseline. The secondary
outcomes will include serum concentrations of 5-hydroxytryptamine,
norepinephrine and gamma-aminobutyric acid, intraoperative anaesthetic
consumption, time to postoperative chest tube removal, postoperative pain,
and length of postoperative hospital stay. The adverse events will be
recorded for safety evaluation. All data in this trial will be analysed by
the SPSS V.21.0 statistical software package. ETHICS AND DISSEMINATION:
Ethics approval was obtained from the Ethics Committee of the Yueyang
Hospital of Integrated Traditional Chinese and Western Medicine affiliated
to Shanghai University of Traditional Chinese Medicine (approval number:
2021-023). The results of this study will be distributed through
peer-reviewed journals. TRIAL REGISTRATION NUMBER:
NCT04895852. Copyright © 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.

<43>
Accession Number
2022680091
Title
Effectiveness of precise and quantitative rapid pulmonary rehabilitation
nursing program for elderly patients with lung cancer during the
perioperative period: A randomized controlled trial.
Source
Pakistan Journal of Medical Sciences. 39(2) (pp 572-577), 2023. Date of
Publication: March-April 2023.
Author
Chen B.; Yan X.; Wang X.; Mao Y.
Institution
(Chen, Yan) Department of Thoracic Surgery, Shanghai Pulmonary Hospital,
Tongji University School of Medicine, Shanghai 200433, China
(Wang) Department of Operating Room, Shanghai Pulmonary Hospital, Tongji
University School of Medicine, Shanghai 200433, China
(Mao) Department of Nursing, Shanghai Pulmonary Hospital, Tongji
University School of Medicine, Shanghai 200433, China
Publisher
Professional Medical Publications
Abstract
Objective: Preoperative rehabilitation should improve the functional
condition of patients. Improvements in metabolism, lung mechanics,
cardiovascular function, and muscle-function can be achieved by pulmonary
rehabilitation. Hence, we focused on elderly patients with lung cancer
undergoing surgery, and assessed the effectiveness of a rapid and precise
pulmonary rehabilitation nursing program during the perioperative period.
 Method(s): This randomized controlled trial at the department of
thoracic surgery; Shanghai pulmonary hospital, China during 2021 was
conducted amongst 218 elderly patients with lung cancer treated by
surgical operation into either a precision quantitative nursing model
nursing group (experimental group) or a perioperative routine nursing
group (control group). After individual planning of the pulmonary
rehabilitation nursing outpatient clinic, nurses distributed breathing
trainers, instructed the patients in breathing training, and supervised
the patients after the operation. For our evaluation we considered
pulmonary function tests, postoperative thoracic drainage tube indwelling
times, postoperative hospital stays, postoperative complication rates, and
postoperative quality of life results. Result(s): The experimental
group showed better pulmonary function, length of hospital stay, and
quality of life outcomes than the control group, but the differences were
not statistically significant. However, we found a significantly higher
postoperative complications rate in the control group (11.9%) than in the
experimental group (3.7%; p=0.02). Conclusion(s): Strengthening
pulmonary rehabilitation nursing interventions for elderly patients with
lung cancer during the perioperative period can reduce their postoperative
complications and promote their rapid recovery. Copyright © 2023,
Professional Medical Publications. All rights reserved.

<44>
Accession Number
2022818430
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:
January 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,
Chang Gung University College Of Medicine, Kaohsiung, Taiwan (Republic of
China)
(Huang) Department Of Emergency Medicine, Show Chwan Memorial Hospital,
Changhua City, 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
Edizioni Minerva Medica
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 adminis-tration, 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.
conclUsions: analgesia nociception index-guided analgesia was unable to
reduce intraoperative opioid administra-tion compared to monitoring using
conventional clinical parameters. Further studies are required to support
our findings. Copyright © 2023 Edizioni Minerva Medica. All
rights reserved.

<45>
Accession Number
2022679028
Title
Clinical Outcome of Revascularization Deferral With Instantaneous
Wave-Free Ratio and Fractional Flow Reserve: A 5-Year Follow-Up Substudy
From the iFR-SWEDEHEART Trial.
Source
Journal of the American Heart Association. 12(3) (no pagination), 2023.
Article Number: e028423. Date of Publication: 07 Feb 2023.
Author
Berntorp K.; Rylance R.; Yndigegn T.; Koul S.; Frobert O.; Christiansen
E.H.; Erlinge D.; Gotberg M.
Institution
(Berntorp, Rylance, Yndigegn, Koul, Erlinge, Gotberg) Department of
Cardiology, Skane University Hospital, Clinical Sciences, Lund University,
Lund, Sweden
(Frobert) Faculty of Health, Department of Cardiology, Orebro University
Hospital, Orebro, Sweden
(Christiansen) Department of Cardiology, Aarhus University Hospital,
Skejby, Denmark
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Although physiology-based assessment of coronary artery
stenosis using instantaneous wave-free ratio (iFR) and fractional flow
reserve (FFR) are established methods of guiding coronary
revascularization, its clinical outcome in long-term deferral needs
further evaluation, especially with acute coronary syndrome as a clinical
presentation. The aim was to evaluate the long-term clinical outcome of
deferral of revascularization based on iFR or FFR. METHODS AND RESULTS:
This is a substudy of the iFR-SWEDEHEART (Instantaneous Wave-Free Ratio
Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or
Acute Coronary Syndrome) randomized clinical trial, where patients
deferred from revascularization from each study arm were selected. Nine
hundred eight patients deferred from coronary re-vascularization with iFR
(n=473) and FFR (n=435) were followed for 5 years. The national quality
registry, SWEDEHEART (Swedish Web-System for Enhancement and Development
of Evidence-Based Care in Heart Disease Evaluated According to Recommended
Therapies), was used for patient data collection and clinical follow-up.
The end point was major adverse cardiac events and their individual
components all-cause death, cardiovascular death, noncardiovascular death,
nonfatal myocardial infarction, and unplanned revascularization. No
significant difference was found in major adverse cardiac events (iFR
18.6% versus FFR 16.8%; adjusted hazard ratio, 1.08 [95% CI, 0.79-1.48];
P=0.63) or their individual components. CONCLUSION(S): No differences
in clinical outcomes after 5-year follow-up were noted when comparing iFR
versus FFR as methods for deferral of coronary revascularization in
patients presenting with stable angina pectoris and acute coronary
syndrome. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT02166736. Copyright © 2023 The Authors. Published
on behalf of the American Heart Association, Inc., by Wiley.

<46>
Accession Number
2022678952
Title
New Cerebral Microbleeds After Catheter-Based Structural Heart
Interventions: An Exploratory Analysis.
Source
Journal of the American Heart Association. 12(3) (no pagination), 2023.
Article Number: e8189. Date of Publication: 07 Feb 2023.
Author
Braemswig T.B.; Kusserow M.; Bellmann B.; Beckhoff F.; Reinthaler M.; von
Rennenberg R.; Erdur H.; Scheitz J.F.; Galinovic I.; Villringer K.;
Leistner D.M.; Audebert H.J.; Endres M.; Landmesser U.; Haeusler K.G.;
Fiebach J.B.; Lauten A.; Rillig A.; Nolte C.H.
Institution
(Braemswig, von Rennenberg, Erdur, Scheitz, Audebert, Endres, Nolte)
Klinik und Hochschulambulanz fur Neurologie, Charite - Universitatsmedizin
Berlin, corporate member of Freie Universitat Berlin and
Humboldt-Universitat zu Berlin, Berlin, Germany
(Braemswig, Scheitz, Leistner, Landmesser, Nolte) Berlin Institute of
Health (BIH) at Charite - Universitatsmedizin Berlin, Berlin, Germany
(Braemswig, von Rennenberg, Erdur, Scheitz, Galinovic, Villringer,
Audebert, Endres, Fiebach, Nolte) Center for Stroke Research Berlin (CSB),
Charite - Universitatsmedizin Berlin, corporate member of Freie
Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany
(Braemswig, Scheitz, Leistner, Endres, Landmesser, Nolte) German Centre
for Cardiovascular Research (DZHK), partner site Berlin, Berlin, Germany
(Kusserow) Klinik fur Innere Medizin, Bundeswehrkrankenhaus Berlin,
Berlin, Germany
(Kusserow) Charite - Universitatsmedizin Berlin, corporate member of Freie
Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany
(Bellmann) MEDIAN Klinik AGZ Dusseldorf, Dusseldorf, Germany
(Bellmann, Beckhoff, Reinthaler, Leistner, Landmesser, Lauten, Rillig)
Department of Cardiology, Charite - Universitatsmedizin Berlin, corporate
member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin,
Campus Benjamin Franklin, Berlin, Germany
(Reinthaler) Institute of Active Polymers and Berlin-Brandenburg Center
for Regenerative Therapies, Helmholtz-Zentrum Hereon, Teltow, Germany
(Reinthaler, Landmesser) Deutsches Herzzentrum der Charite, Klinik fur
Kardiologie, Angiologie und Intensivmedizin, Berlin, Germany
(von Rennenberg, Endres, Nolte) German Center for Neurodegenerative
Diseases (DZNE), partner site Berlin, Berlin, Germany
(Leistner) Department of Medicine III, Cardiology, Goethe University,
Frankfurt am Main, Germany
(Leistner) German Centre for Cardiovascular Research (DZHK), partner site
Rhine-Main, Frankfurt, Germany
(Endres) ExcellenceCluster NeuroCure, Berlin, Germany
(Haeusler) Department of Neurology, Universitatsklinikum Wurzburg,
Wurzburg, Germany
(Lauten) Department of General and Interventional Cardiology, Helios
Klinikum Erfurt, Erfurt, Germany
(Rillig) Universitares Herz-und Gefasszentrum Hamburg-Eppendorf, Hamburg,
Germany
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Cerebral microbleeds (CMBs) are increasingly recognized as
"covert" brain lesions indicating increased risk of future neurological
events. However, data on CMBs in patients undergoing catheter-based
structural heart interventions are scarce. Therefore, we assessed
occurrence and predictors of new CMBs in patients undergoing
catheter-based left atrial appendage closure and percutaneous mitral valve
repair using the MitraClip System. METHODS AND RESULTS: We conducted an
exploratory analysis using data derived from 2 prospective, observational
studies. Eligible patients underwent cerebral magnetic resonance imaging
(3 Tesla) examinations and cognitive tests (using the Montreal Cognitive
Assessment) before and after catheter-based left atrial appendage closure
and percutaneous mitral valve repair. Forty-seven patients (53% men;
median age, 77 years) were included. New CMBs occurred in 17 of 47
patients (36%) following catheter-based structural heart interventions.
Occurrences of new CMBs did not differ significantly between patients
undergoing catheter-based left atrial appendage closure and percutaneous
mitral valve repair (7/25 versus 10/22; P=0.348). In univariable analysis,
longer procedure time was significantly associated with new CMBs.
Adjustment for heparin attenuated this association (adjusted odds ratio
[per 30 minutes]: 1.77 [95% CI, 0.92-3.83]; P=0.090). CONCLUSION(S):
New CMBs occur in approximately one-third of patients after catheter-based
left atrial appendage closure and percutaneous mitral valve repair using
the MitraClip System. Our data suggest that longer duration of the
procedure may be a risk factor for new CMBs. Future studies in larger
populations are needed to further investigate their clinical relevance.
CLINICAL TRIAL REGISTRATION: German Clinical Trials Register: DRKS00010300
(https://drks.de/search/en/trial/DRKS00010300); ClinicalTrials.gov:
NCT03104556
(https://clinicaltrials.gov/ct2/show/NCT03104556?term=NCT03104556&draw=2&r
ank=1). Copyright © 2023 The Authors.

<47>
Accession Number
640334464
Title
Drugs to reduce bleeding and transfusion in major open vascular or
endovascular surgery: a systematic review and network meta-analysis.
Source
Cochrane Database of Systematic Reviews. 2023(2) (no pagination), 2023.
Article Number: CD013649. Date of Publication: 17 Feb 2023.
Author
Beverly A.; Ong G.; Kimber C.; Sandercock J.; Doree C.; Welton N.J.; Wicks
P.; Estcourt L.J.
Institution
(Beverly, Ong, Kimber, Sandercock, Doree) Systematic Review Initiative,
NHS Blood and Transplant, Oxford, United Kingdom
(Welton) Population Health Sciences, Bristol Medical School, University of
Bristol, Bristol, United Kingdom
(Wicks) Cardiac Anaesthesia and Intensive Care, University Hospital
Southampton, Southampton, United Kingdom
(Estcourt) Haematology/Transfusion Medicine, NHS Blood and Transplant,
Oxford, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: Vascular surgery may be followed by internal bleeding due to
inadequate surgical haemostasis, abnormal clotting, or surgical
complications. Bleeding ranges from minor, with no transfusion
requirement, to massive, requiring multiple blood product transfusions.
There are a number of drugs, given systemically or applied locally, which
may reduce the need for blood transfusion. Objective(s): To assess
the effectiveness and safety of anti-fibrinolytic and haemostatic drugs
and agents in reducing bleeding and the need for blood transfusion in
people undergoing major vascular surgery or vascular procedures with a
risk of moderate or severe (> 500 mL) blood loss. Search Method(s):
We searched: Cochrane Central Register of Controlled Trials; MEDLINE;
Embase; CINAHL, and Transfusion Evidence Library. We also searched the WHO
ICTRP and ClinicalTrials.gov trial registries for ongoing and unpublished
trials. Searches used a combination of MeSH and free text terms from
database inception to 31 March 2022, without restriction on language or
publication status. Selection Criteria: We included randomised
controlled trials (RCTs) in adults of drug treatments to reduce bleeding
due to major vascular surgery or vascular procedures with a risk of
moderate or severe blood loss, which used placebo, usual care or another
drug regimen as control. Data Collection and Analysis: We used
standard Cochrane methods. Our primary outcomes were units of red cells
transfused and all-cause mortality. Our secondary outcomes included risk
of receiving an allogeneic blood product, risk of reoperation or repeat
procedure due to bleeding, risk of a thromboembolic event, risk of a
serious adverse event and length of hospital stay. We used GRADE to assess
certainty of evidence. Main Result(s): We included 22 RCTs with 3393
participants analysed, of which one RCT with 69 participants was reported
only in abstract form, with no usable data. Seven RCTs evaluated systemic
drug treatments (three aprotinin, two desmopressin, two tranexamic acid)
and 15 RCTs evaluated topical drug treatments (drug-containing
bioabsorbable dressings or glues), including fibrin, thrombin, collagen,
gelatin, synthetic sealants and one investigational new agent. Most trials
were conducted in high-income countries and the majority of the trials
only included participants undergoing elective surgery. We also identified
two ongoing RCTs. We were unable to perform the planned network
meta-analysis due to the sparse reporting of outcomes relevant to this
review. Systemic drug treatments. We identified seven trials of three
systemic drugs: aprotinin, desmopressin and tranexamic acid, all with
placebo controls. The trials of aprotinin and desmopressin were small with
very low-certainty evidence for all of our outcomes. Tranexamic acid
versus placebo was the systemic drug comparison with the largest number of
participants (2 trials; 1460 participants), both at low risk of bias. The
largest of these included a total of 9535 individuals undergoing a number
of different higher risk surgeries and reported limited information on the
vascular subgroup (1399 participants). Neither trial reported the number
of units of red cells transfused per participant up to 30 days. Three
outcomes were associated with very low-certainty evidence due to the very
wide confidence intervals (CIs) resulting from small study sizes and low
number of events. These were: all-cause mortality up to 30 days; number of
participants requiring an allogeneic blood transfusion up to 30 days; and
risk of requiring a repeat procedure or operation due to bleeding.
Tranexamic acid may have no effect on the risk of thromboembolic events up
to 30 days (risk ratio (RR) 1.10, 95% CI 0.88 to 1.36; 1 trial, 1360
participants; low-certainty evidence due to imprecision). There is one
large ongoing trial (8320 participants) comparing tranexamic acid versus
placebo in people undergoing non-cardiac surgery who are at high risk of
requiring a red cell transfusion. This aims to complete recruitment in
April 2023. This trial has primary outcomes of proportion of participants
transfused with red blood cells and incidence of venous thromboembolism
(DVT or PE). Topical drug treatments. Most trials of topical drug
treatments were at high risk of bias due to their open-label design
(compared with usual care, or liquids were compared with sponges). All of
the trials were small, most were very small, and few reported clinically
relevant outcomes in the postoperative period. Fibrin sealant versus usual
care was the topical drug comparison with the largest number of
participants (5 trials, 784 participants). The five trials that compared
fibrin sealant with usual care were all at high risk of bias, due to the
open-label trial design with no measures put in place to minimise
reporting bias. All of the trials were funded by pharmaceutical companies.
None of the five trials reported the number of red cells transfused per
participant up to 30 days or the number of participants requiring an
allogeneic blood transfusion up to 30 days. The other three outcomes were
associated with very low-certainty evidence with wide confidence intervals
due to small sample sizes and the low number of events, these were:
all-cause mortality up to 30 days; risk of requiring a repeat procedure
due to bleeding; and risk of thromboembolic disease up to 30 days. We
identified one large trial (500 participants) comparing fibrin sealant
versus usual care in participants undergoing abdominal aortic aneurysm
repair, which has not yet started recruitment. This trial lists death due
to arterial disease and reintervention rates as primary outcomes. Authors'
conclusions: Because of a lack of data, we are uncertain whether any
systemic or topical treatments used to reduce bleeding due to major
vascular surgery have an effect on: all-cause mortality up to 30 days;
risk of requiring a repeat procedure or operation due to bleeding; number
of red cells transfused per participant up to 30 days or the number of
participants requiring an allogeneic blood transfusion up to 30 days.
There may be no effect of tranexamic acid on the risk of thromboembolic
events up to 30 days, this is important as there has been concern that
this risk may be increased. Trials with sample size targets of thousands
of participants and clinically relevant outcomes are needed, and we look
forward to seeing the results of the ongoing trials in the
future. Copyright © 2023 The Authors. Cochrane Database of
Systematic Reviews published by John Wiley & Sons, Ltd. on behalf of The
Cochrane Collaboration.

<48>
Accession Number
640357998
Title
Warm versus cold-blood cardioplegia in paediatric congenital heart
surgery: a randomized trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2023.
Date of Publication: 17 Feb 2023.
Author
Stoica S.; Smartt H.; Heys R.; Sheehan K.; Walker-Smith T.; Parry A.;
Beringer R.; Ttofi I.; Evans R.; Dabner L.; Ghorbel M.T.; Lansdowne W.;
Reeves B.C.; Angelini G.D.; Rogers C.A.; Caputo M.
Institution
(Stoica, Sheehan, Parry, Beringer, Ttofi, Lansdowne, Caputo) Bristol Royal
Hospital for Children, University Hospitals Bristol and Weston NHS
Foundation Trust, Bristol, United Kingdom
(Smartt, Heys, Walker-Smith, Evans, Dabner, Reeves, Rogers) Bristol Trials
Centre, Bristol Medical School, University of Bristol, Bristol, United
Kingdom
(Smartt, Heys, Sheehan, Walker-Smith, Evans, Dabner, Reeves, Angelini,
Rogers) National Institute for Health Research Bristol Biomedical Research
Centre, University Hospitals Bristol and Weston NHS Foundation Trust and
University of Bristol, Bristol, United Kingdom
(Ghorbel, Angelini, Caputo) Bristol Heart Institute, University of
Bristol, Bristol, United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Intermittent cold blood cardioplegia is commonly used in
children whereas intermittent warm blood cardioplegia is widely used in
adults. We aimed to compare clinical and biochemical outcomes with these
two methods. METHOD(S): A single centre, randomized controlled trial
was conducted to compare the effectiveness of warm (>=34degreeC) versus
cold (4-6degreeC) antegrade cardioplegia in children. The primary outcome
was cardiac troponin T over the first 48 postoperative hours. Intensive
care teams were blinded to group allocation. Outcomes were compared by
intention-to-treat using linear mixed-effects, logistic, or Cox
regression. RESULT(S): 97 participants with median age of 1.2years
were randomized (49 to warm, 48 to cold cardioplegia); 59 participants
(61%) had a risk-adjusted congenital heart surgery score of 3 or above.
There were no deaths and 92 participants were followed to 3-months.
Troponin release was similar in both groups (geometric mean ratio 1.07;
95% confidence interval [CI], 0.79-1.44; P=0.66), as were other cardiac
function measures (echocardiography, arterial and venous blood gases,
vasoactive-inotrope score, arrhythmias). Intensive care stay was on
average 14.6hours longer in the warm group (hazard ratio 0.52; 95% CI,
0.34-0.79; P=0.003), with a trend towards longer overall hospital stays
(hazard ratio 0.66; 95% CI, 0.43-1.02; P=0.060) compared with the cold
group. This could be related to more unplanned reoperations on bypass in
the warm group compared to cold group (3 vs 1). CONCLUSION(S): Warm
blood cardioplegia is a safe and reproducible technique but does not
provide superior myocardial protection in paediatric heart surgery.
CLINICAL TRIAL REGISTRY NUMBER: ISRCTN13467772. Copyright © The
Author(s) 2023. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery.

<49>
Accession Number
640356893
Title
Design and Rationale of RE-ENERGIZE FONTAN: RandomizEd Exercise
iNtERvention desiGned to maximIZE fitness in FONTAN patients.
Source
American heart journal. (no pagination), 2023. Date of Publication: 14
Feb 2023.
Author
Tierney E.S.S.; Palaniappan L.; Leonard M.; Long J.; Myers J.; Davila T.;
Lui M.C.; Kogan F.; Olson I.; Punn R.; Desai M.; Schneider L.M.; Wang
C.-H.; Cooke J.P.; Bernstein D.
Institution
(Tierney, Davila, Lui, Olson, Punn, Bernstein) Department of Pediatrics,
Division of Pediatric Cardiology, Stanford University, School of Medicine
(Palaniappan) Department of Medicine, Stanford University, School of
Medicine
(Leonard, Long) Department of Pediatrics, Division of Pediatric
Nephrology, Stanford University, School of Medicine
(Myers) Department of Medicine, Health Research Science, Palo Alto VA
Health Care System
(Kogan) Department of Radiology, Stanford University, School of Medicine
(Desai) Department of Biomedical Data Science, Stanford University, School
of Medicine
(Schneider) Psychiatry and Behavioral Sciences - Child & Adolescent
Psychiatry and Child Development
(Wang) Department of Pediatrics, Health Policy, Stanford University,
School of Medicine
(Cooke) Houston Methodist Research Institute Houston Methodist Hospital &
Research Institute
Publisher
NLM (Medline)
Abstract
In this manuscript, we describe the design and rationale of a randomized
controlled trial in pediatric Fontan patients to test the hypothesis that
a live-video-supervised exercise (aerobic+resistance) intervention will
improve cardiac and physical capacity; muscle mass, strength, and
function; and endothelial function. Survival of children with single
ventricles beyond the neonatal period has increased dramatically with the
staged Fontan palliation. Yet, long-term morbidity remains high. By age
40, 50% of Fontan patients will have died or undergone heart
transplantation. Factors that contribute to onset and progression of heart
failure in Fontan patients remain incompletely understood. However, it is
established that Fontan patients have poor exercise capacity which is
associated with a greater risk of morbidity and mortality. Furthermore,
decreased muscle mass, abnormal muscle function, and endothelial
dysfunction in this patient population is known to contribute to disease
progression. In adult patients with two ventricles and heart failure,
reduced exercise capacity, muscle mass, and muscle strength are powerful
predictors of poor outcomes, and exercise interventions can not only
improve exercise capacity and muscle mass, but also reverse endothelial
dysfunction. Despite these known benefits of exercise, pediatric Fontan
patients do not exercise routinely due to their chronic condition,
perceived restrictions to exercise, and parental overprotection. Limited
exercise interventions in children with congenital heart disease have
demonstrated that exercise is safe and effective; however, these studies
have been conducted in small, heterogeneous groups, and most had few
Fontan patients. Critically, adherence is a major limitation in pediatric
exercise interventions delivered on-site, with adherence rates as low as
10%, due to distance from site, transportation difficulties, and missed
school or workdays. To overcome these challenges, we utilize live-video
conferencing to deliver the supervised exercise sessions. Our
multidisciplinary team of experts will assess the effectiveness of a
live-video-supervised exercise intervention, rigorously designed to
maximize adherence, and improve key and novel measures of health in
pediatric Fontan patients associated with poor long-term outcomes. Our
ultimate goal is the translation of this model to clinical application as
an "exercise prescription" to intervene early in pediatric Fontan patients
and decrease long-term morbidity and mortality. Copyright © 2023.
Published by Elsevier Inc.

<50>
Accession Number
640356790
Title
Fractional Flow Reserve or 3D-Quantitative-Coronary-Angiography Based
Vessel-FFR guided revascularization. Rationale and study design of the
prospective randomized FAST III Trial.
Source
American heart journal. (no pagination), 2023. Date of Publication: 14
Feb 2023.
Author
Scoccia A.; Byrne R.A.; Banning A.P.; Landmesser U.; Van Belle E.;
Amat-Santos I.J.; Sabate M.; Tijssen J.G.P.; Spitzer E.; Daemen J.
Institution
(Scoccia, Daemen) Department of Cardiology, Thoraxcenter, Erasmus
University Medical Center, Rotterdam, Netherlands
(Byrne) Dept. of Cardiology and Cardiovascular Research Institute (CVRI)
Dublin, Ireland. School of Pharmacy and Biomolecular Sciences, RCSI
University of Medicine and Health Sciences, Mater Private Network, Dublin,
Ireland
(Banning) Department of Cardiology, John Radcliffe Hospital Oxford, United
Kingdom
(Landmesser) Department of Cardiology, Charite Universitatsmedizin Berlin,
German Center of Cardiovascular Research (DZHK) - Partner Site Berlin;
Germany
(Van Belle) Department of Cardiology, France and Department of
Interventional Cardiology for Coronary Valves and Structural Heart
Diseases, Inserm, Institut Pasteur de Lille, EGID, Universite de Lille,
CHU Lille, Lille U1011, France
(Amat-Santos) Cardiology Department, Hospital Clinico Universitario de
Valladolid, Valladolid, Spain
(Sabate) Cardiology Department, Cardiovascular Institute (ICCV), Hospital
Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
(Tijssen) Cardialysis BV, Rotterdam, Netherlands
(Spitzer) Department of Cardiology, Thoraxcenter, Erasmus University
Medical Center, Rotterdam, The Netherlands; European Cardiovascular
Research Institute, Rotterdam, The Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: Physiological assessment of intermediate coronary lesions to
guide coronary revascularization is currently recommended by international
guidelines. Vessel fractional flow reserve (vFFR) has emerged as a new
approach to derive fractional flow reserve (FFR) from 3D-quantitative
coronary angiography (3D-QCA) without the need for hyperemic agents or
pressure wires. METHODS/DESIGN: The FAST III is an investigator-initiated,
open label, multicenter randomized trial comparing vFFR guided versus FFR
guided coronary revascularization in approximately 2228 patients with
intermediate coronary lesions (defined as 30-80% stenosis by visual
assessment or QCA). Intermediate lesions are physiologically assessed
using on-line vFFR or FFR and treated if vFFR or FFR <=0.80. The primary
endpoint is a composite of all-cause death, any myocardial infarction, or
any revascularization at 1-year post-randomization. Secondary endpoints
include the individual components of the primary endpoint and
cost-effectiveness will be investigated. SUMMARY: FAST III is the first
randomized trial to explore whether a vFFR guided revascularization
strategy is non-inferior to an FFR guided strategy in terms of clinical
outcomes at 1-year follow-up in patients with intermediate coronary artery
lesions. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, Unique
Identifier: NCT04931771. Copyright © 2023. Published by Elsevier
Inc.

<51>
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. 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. 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. 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. Copyright © 2022, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature.

<52>
[Use Link to view the full text]
Accession Number
2022653577
Title
Efficacy and Safety of Clopidogrel Versus Ticagrelor for Stabilized
Patients with Acute Coronary Syndromes after Percutaneous Coronary
Intervention: Results from a Real-World Registry in China.
Source
Journal of Cardiovascular Pharmacology. 81(2) (pp 134-140), 2023. Date of
Publication: 25 Feb 2023.
Author
Peng W.; Zhang Y.; Li X.; Lin Y.
Institution
(Peng, Zhang, Li, Lin) Department of Pharmacy, Beijing Anzhen Hospital,
Capital Medical University, Beijing, China
(Zhang, Li) College of Pharmacy, Capital Medical University, Beijing,
China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:The first 3 months after percutaneous coronary intervention
(PCI) in patients with acute coronary syndrome (ACS) is a high-risk period
for adverse events, including ischemic and bleeding events, which decrease
greatly with time. It is worth investigating whether the use of potent
P2Y12 inhibitors is necessary after the early stage. The purpose of this
study was to investigate the differences in clinical outcomes between
clopidogrel and ticagrelor in stable patients without ischemic or major
bleeding events during the first 3 months after PCI. Method(s):Data
for this study were obtained from the PHARM-ACS registry (NCT04184583).
Patients who were free from ischemic and major bleeding events in the
first 3 months after PCI were enrolled. Inverse probability of treatment
weighting (IPTW) and Cox proportional hazards model were applied to
compare the differences in clinical outcomes between the 2 groups. Major
adverse cardiovascular and cerebrovascular events (MACCE) were considered
the primary end point, and major bleeding was considered the secondary end
point. Result(s):A total of 6662 patients were included in this
study. Of these, 3465 were treated with clopidogrel plus aspirin
(clopidogrel group) and 3197 with ticagrelor plus aspirin (ticagrelor
group). There were no significant differences in MACCE after IPTW
adjustment for baseline variables (IPTW-adjusted HR, 1.06; 95% CI,
0.90-1.25) or major bleeding events (IPTW-adjusted HR, 0.97; 95% CI,
0.67-1.41) between the 2 groups. However, the incidence of minor bleeding
in the clopidogrel group was significantly lower than that in the
ticagrelor group (IPTW-adjusted HR, 0.65; 95% CI, 0.59-0.71).
 Conclusion(s):In patients with ACS who were free from ischemic or
major bleeding events during the first 3 months after PCI, the subsequent
clopidogrel treatment might reduce minor bleeding events without
increasing the risk of MACCE compared with ticagrelor. However, the
results still need to be confirmed by large randomized controlled studies
in the future. Copyright © Lippincott Williams & Wilkins.

<53>
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. 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. 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. 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. Copyright © 2021 The American Association for Thoracic
Surgery

<54>
Accession Number
2022622002
Title
Cardiovascular Statistics - Brazil 2021.
Source
Arquivos Brasileiros de Cardiologia. 118(1) (pp 115), 2022. Date of
Publication: 2022.
Author
de Oliveira G.M.M.; Brant L.C.C.; Polanczyk C.A.; Malta D.C.; Biolo A.;
Nascimento B.R.; de Fatima Marinho de Souza M.; De Lorenzo A.R.; de Paiva
Fagundes Junior A.A.; Schaan B.D.; de Castilho F.M.; Cesena F.H.Y.; Soares
G.P.; Junior G.F.X.; Barreto-Filho J.A.S.; Passaglia L.G.; Pinto-Filho
M.M.; Machline-Carrion M.J.; Bittencourt M.S.; Pontes-Neto O.M.; Villela
P.B.; Teixeira R.A.; Sampaio R.O.; Gaziano T.A.; Perel P.; Roth G.A.;
Ribeiro A.L.P.
Institution
(de Oliveira, Soares, Villela) Instituto do Coracao Edson Saad,
Universidade Federal do Rio de Janeiro (UFRJ), RJ, Rio de Janeiro, Brazil
(de Oliveira, De Lorenzo, Villela) Universidade Federal do Rio de Janeiro
(UFRJ), RJ, Rio de Janeiro, Brazil
(Brant, Malta, Nascimento, de Fatima Marinho de Souza, Junior, Passaglia,
Pinto-Filho, Teixeira, Ribeiro) Universidade Federal de Minas Gerais
(UFMG), MG, Belo Horizonte, Brazil
(Brant, Nascimento, de Castilho, Ribeiro) Hospital das Clinicas,
Universidade Federal de Minas Gerais (UFMG), MG, Belo Horizonte, Brazil
(Polanczyk, Biolo, Schaan) Universidade Federal do Rio Grande do Sul
(UFRS), RS, Porto Alegre, Brazil
(Polanczyk, Biolo) Hospital Moinhos de Vento, RS, Porto Alegre, Brazil
(Polanczyk, Biolo, Schaan) Hospital de Clinicas de Porto Alegre (HCPA),
RS, Porto Alegre, Brazil
(de Fatima Marinho de Souza) Vital Strategies, NY, United States
(De Lorenzo) Instituto Nacional de Cardiologia, RJ, Rio de Janeiro, Brazil
(de Paiva Fagundes Junior, Gaziano) Brigham and Women's Hospital, Boston,
United States
(Cesena) Hospital Israelita Albert Einstein, SP, Sao Paulo, Brazil
(Soares) Curso de Medicina da Universidade de Vassouras, RJ, Vassouras,
Brazil
(Barreto-Filho) Universidade Federal de Sergipe, SE, Aracaju, Brazil
(Barreto-Filho) Hospital Sao Lucas Rede Sao Luiz D'Or, SE, Aracaju, Brazil
(Machline-Carrion) ePHealth Primary Care Solutions, SC, Santo Antonio,
Brazil
(Bittencourt) Department of Medicine and Radiology, University of
Pittsburgh, Pittsburgh, United States
(Pontes-Neto) Faculdade de Medicina de Ribeirao Preto, Universidade de Sao
Paulo (USP), SP, Sao Paulo, Brazil
(Sampaio) Faculdade de Medicina, Universidade de Sao Paulo (USP), SP, Sao
Paulo, Brazil
(Sampaio) Instituto do Coracao (Incor), Hospital das Clinicas da Faculdade
de Medicina da Universidade de Sao Paulo (HCFMUSP), SP, Sao Paulo, Brazil
(Gaziano) Department of Medicine, Cardiovascular, Harvard Medical School,
Boston, United States
(Perel) World Heart Federation, Geneva, Switzerland
(Perel) Centre for Global Chronic Conditions, London School of Hygiene &
Tropical Medicine, London, United Kingdom
(Roth) Division of Cardiology, Department of Medicine, University of
Washington, WA, United States
Publisher
Sociedade Brasileira de Cardiologia

<55>
Accession Number
2017546072
Title
Dexmedetomidine vs other sedatives in critically ill mechanically
ventilated adults: a systematic review and meta-analysis of randomized
trials.
Source
Intensive Care Medicine. 48(7) (pp 811-840), 2022. Date of Publication:
July 2022.
Author
Lewis K.; Alshamsi F.; Carayannopoulos K.L.; Granholm A.; Piticaru J.; Al
Duhailib Z.; Chaudhuri D.; Spatafora L.; Yuan Y.; Centofanti J.; Spence
J.; Rochwerg B.; Perri D.; Needham D.M.; Holbrook A.; Devlin J.W.; Nishida
O.; Honarmand K.; Ergan B.; Khorochkov E.; Pandharipande P.; Alshahrani
M.; Karachi T.; Soth M.; Shehabi Y.; Moller M.H.; Alhazzani W.
Institution
(Lewis, Carayannopoulos, Piticaru, Chaudhuri, Spatafora, Centofanti,
Spence, Rochwerg, Perri, Karachi, Soth, Alhazzani) Division of Critical
Care, Intensive Care Unit, Department of Medicine, McMaster University, St
Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON L8N 4A,
Canada
(Lewis, Chaudhuri, Spence, Rochwerg, Holbrook, Alhazzani) Department of
Health Research Methods, Evidence and Impact, McMaster University,
Hamilton, Canada
(Alshamsi) Department of Internal Medicine, College of Medicine and Health
Sciences, United Arab Emirates University, Alain, United Arab Emirates
(Granholm, Moller) Department of Intensive Care, Copenhagen University
Hospital, Copenhagen, Rigshospitalet, Denmark
(Al Duhailib) Department of Critical Care Medicine, King Faisal Specialist
Hospital & Research Centre, Riyadh, Saudi Arabia
(Yuan) Division of Gastroenterology, Department of Medicine, McMaster
University, Hamilton, Canada
(Centofanti, Spence) Department of Anesthesia, McMaster University,
Hamilton, Canada
(Spence) Population Health Research Institute, McMaster University,
Hamilton, Canada
(Perri, Holbrook) Division of Clinical Pharmacology and Toxicology,
McMaster University, Hamilton, Canada
(Needham) Division of Pulmonary and Critical Care Medicine, Department of
Medicine, Johns Hopkins University, Baltimore, United States
(Needham) Armstrong Institute for Patient Safety and Quality, John Hopkins
University, Baltimore, United States
(Needham) Outcomes After Critical Illness and Surgery (OACIS) Group, Johns
Hopkins University, Baltimore, United States
(Needham) Department of Physical Medicine and Rehabilitation, School of
Medicine, Johns Hopkins University, Baltimore, United States
(Devlin) School of Pharmacy, Division of Pulmonary and Critical Care
Medicine, Brigham and Women's Hospital, Northeastern University, Boston,
MA, United States
(Nishida) Department of Anesthesiology and Critical Care Medicine, Fujita
Health University School of Medicine, Aichi, Japan
(Honarmand) Division of Critical Care Medicine, Department of Medicine,
Western University, London, Canada
(Ergan) Department of Pulmonary and Critical Care, Dokuz Eylul University
School of Medicine, Izmir, Turkey
(Khorochkov) Department of Medical Imaging, Memorial University of
Newfoundland, St. John's, Canada
(Pandharipande) Division of Anesthesiology Critical Care Medicine,
Department of Anesthesiology, Vanderbilt University Medical Center,
Nashville, United States
(Alshahrani) Department of Emergency and Critical Care, College of
Medicine, Imam Abdulrahman Ben Faisal University, Al Khobar, Saudi Arabia
(Shehabi) Department of Intensive Care, Monash Health School of Clinical
Sciences, The School of Clinical Medicine, University of New South Wales,
3168, Randwick, Clayton, VIC 2031, Australia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Conventional gabaminergic sedatives such as benzodiazepines and propofol
are commonly used in mechanically ventilated patients in the intensive
care unit (ICU). Dexmedetomidine is an alternative sedative that may
achieve lighter sedation, reduce delirium, and provide analgesia. Our
objective was to perform a comprehensive systematic review summarizing the
large body of evidence, determining if dexmedetomidine reduces delirium
compared to conventional sedatives. We searched MEDLINE, EMBASE, CENTRAL,
ClinicalTrials.gov and the WHO ICTRP from inception to October 2021.
Independent pairs of reviewers identified randomized clinical trials
comparing dexmedetomidine to other sedatives for mechanically ventilated
adults in the ICU. We conducted meta-analyses using random-effects models.
The results were reported as relative risks (RRs) for binary outcomes and
mean differences (MDs) for continuous outcomes, with corresponding 95%
confidence intervals (CIs). In total, 77 randomized trials (n = 11,997)
were included. Compared to other sedatives, dexmedetomidine reduced the
risk of delirium (RR 0.67, 95% CI 0.55 to 0.81; moderate certainty), the
duration of mechanical ventilation (MD - 1.8 h, 95% CI - 2.89 to - 0.71;
low certainty), and ICU length of stay (MD - 0.32 days, 95% CI - 0.42 to -
0.22; low certainty). Dexmedetomidine use increased the risk of
bradycardia (RR 2.39, 95% CI 1.82 to 3.13; moderate certainty) and
hypotension (RR 1.32, 95% CI 1.07 to 1.63; low certainty). In mechanically
ventilated adults, the use of dexmedetomidine compared to other sedatives,
resulted in a lower risk of delirium, and a modest reduction in duration
of mechanical ventilation and ICU stay, but increased the risks of
bradycardia and hypotension. Copyright © 2022, Springer-Verlag
GmbH Germany, part of Springer Nature.

<56>
Accession Number
2019072338
Title
The intraoperative use of augmented and mixed reality technology to
improve surgical outcomes: A systematic review.
Source
International Journal of Medical Robotics and Computer Assisted Surgery.
18(6) (no pagination), 2022. Article Number: e2450. Date of Publication:
December 2022.
Author
Bollen E.; Awad L.; Langridge B.; Butler P.E.M.
Institution
(Bollen, Awad, Langridge, Butler) Charles Wolfson Centre for
Reconstructive Surgery, Royal Free Hospital, London, United Kingdom
(Langridge, Butler) Department of Plastic Surgery, Royal Free Hospital,
London, United Kingdom
(Langridge, Butler) Division of Surgery and Interventional Science,
University College London, London, United Kingdom
(Langridge, Butler) Department of Plastic and Reconstructive Surgery,
Royal Free Hospital, London, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: This systematic review aims to critically appraise the
intraoperative use of augmented and mixed reality technology to improve
surgical outcomes. Method(s): A literature search of PubMed, Scopus,
Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and WHO
ICTRP was performed in accordance with Cochrane Handbook for Systematic
Reviews of Interventions. Result(s): This review included 94 studies
on 2473 patients, comprising 78 studies on augmented reality and 16 on
mixed reality. This technology has seen broad intraoperative application.
Augmented and mixed reality can reduce operative duration, blood loss, and
the duration of inpatient care. Current evidence shows that they achieve
this most in percutaneous surgery. Conclusion(s): Augmented and mixed
reality technology improve surgical outcomes by increasing navigational
speed and reducing navigational error intraoperatively. However, they have
technical limitations which are the subject of ongoing research. Further
studies are necessary to define how this technology is best applied
intraoperatively. Systematic Review Registration: PROSPERO
CRD42020205892. Copyright © 2022 John Wiley & Sons Ltd.

<57>
Accession Number
2018987079
Title
A systematic review of the use of 3D printing in left atrial appendage
occlusion procedures.
Source
Journal of Cardiovascular Electrophysiology. 33(11) (pp 2367-2374), 2022.
Date of Publication: November 2022.
Author
Tarabanis C.; Klapholz J.; Zahid S.; Jankelson L.
Institution
(Tarabanis, Klapholz, Zahid, Jankelson) Leon H. Charney Division of
Cardiology, NYU Langone Health, New York University Grossman School of
Medicine, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
The placement of a left atrial appendage occlusion (LAAO) device can be a
technically challenging transcatheter-based procedure. Key challenges
include accurate pre-procedural device sizing and proper device
positioning at the LAA ostium to ensure sufficient device anchoring and
avoid peri-device leaks. To address these challenges, 3D printing (3DP) of
LAA models has recently emerged in the literature, first being described
in 2015. We present a review of the benefits and drawbacks of employing
this technology for LAAO procedures. Pre-procedurally the use of 3DP can
consistently and accurately determine LAAO device size over standard of
care approaches. Intra-procedurally 3DP's impact entailed a statistically
significant decrease in the number of devices used per procedure, as well
as in the fluoroscopic time and dose. Post-procedurally, there is some
evidence that 3DP could reduce the rate of peri-device leaks, with limited
data on its effect on complication rates. Based on existing evidence, we
recommend the focused application of 3DP to cases of complex LAA anatomy
and for the training of proceduralists. Lastly, we address the emergence
of next generation LAAO devices and AR/VR systems that could limit even
this narrow window of clinical benefit afforded by 3DP. Copyright
© 2022 Wiley Periodicals LLC.

<58>
Accession Number
2015500472
Title
The effect of peripheral regional analgesia in thoracic surgery: a
systematic review and a meta-analysis of randomized-controlled trials.
Source
Tumori. 109(1) (pp 6-18), 2023. Date of Publication: February 2023.
Author
Balzani E.; Rosboch G.L.; Ceraolo E.; Lyberis P.; Filippini C.; Piccioni
F.; Guerrera F.; Ruffini E.; Pedoto A.; Brazzi L.
Institution
(Balzani, Guerrera, Ruffini, Brazzi) Department of Surgical Science,
University of Turin, Torino, Italy
(Rosboch, Ceraolo, Brazzi) Department of Anesthesia, Intensive Care and
Emergency, 'Citta della Salute e della Scienza di Torino' Hospital,
Torino, Italy
(Lyberis, Guerrera, Ruffini) Department of Cardiovascular and Thoracic
Surgery, 'Citta della Salute e della Scienza di Torino' Hospital, Torino,
Italy
(Filippini) Clinical Statistics, Department of Surgical Sciences,
University of Torino, Corso Bramante 88, Turin, Italy
(Piccioni) General and Specialistic Surgical Department, Anesthesia and
Intensive Care Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
(Pedoto) Clinical Attending Department of Anesthesia and CCM, Memorial
Sloan Kettering Cancer Center, NY, United States
Publisher
SAGE Publications Ltd
Abstract
Background: Several peripheral regional anaesthesia (RA) techniques are
commonly used in thoracic surgery even in the absence of precise
indications regarding their effectiveness on postoperative pain
management. Objective(s): This systematic review and meta-analysis
aims to describe and evaluate the relative effectiveness of different
peripheral regional blocks and systemic analgesia in the context of
video-assisted thoracoscopic surgery (VATS) or thoracotomy.
 Design(s): Systematic review of randomized controlled clinical trials
(RCTs) with meta-analyses. Data sources: We searched PubMed and Embase for
all RCTs comparing the 24 hour morphine equivalents (MMEs) consumption
following peripheral regional blocks and systemic analgesia (SA).
Eligibility criteria: We selected only RCTs including adult participants
undergoing thoracic surgery, including esophagectomy and reporting on
postoperative pain outcomes including 24 hour MMEs consumption.
 Result(s): Among the 28 randomized studies including adult
participants undergoing thoracic surgery and reporting on 24 hour opioid
consumption, 11 reporting a comparison of individual blocks with systemic
analgesia were meta-analyzed. RA was effective for almost all peripheral
blocks. Regarding intercostal block, its antalgic effect was not well
evaluated SMD -1.57 (CI -3.88, 0.73). RA in VATS was more effective in
reducing MMEs than thoracotomy SMD -1.10 (CI -1.78, -0.41).
 Conclusion(s): RA is a useful choice in thoracic surgery. However, it
is still not possible to determine the most appropriate block in the
individual surgical settings to be performed due to RCTs
paucity. Copyright © Fondazione IRCCS Istituto Nazionale dei
Tumori 2022.

<59>
Accession Number
2021652407
Title
The efficacy and safety of direct oral anticoagulants versus vitamin K
antagonists in patients with left-sided bioprosthetic heart valves and
atrial fibrillation: a systematic review and meta-analysis.
Source
European Journal of Clinical Pharmacology. (no pagination), 2023. Date of
Publication: 2023.
Author
Li D.; Chang P.; Zhang H.; Bai F.; Wu Q.
Institution
(Li, Chang, Zhang, Bai, Wu) Department of Cardiovascular Medicine, Second
Hospital of Lanzhou University, Lanzhou, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The efficacy and safety of direct oral anticoagulants (DOACs)
versus vitamin K antagonists (VKAs) for the treatment of patients with
left-sided bioprosthetic heart valves (BHV) and atrial fibrillation (AF)
remain controversial. This study aims to perform a meta-analysis to
evaluate the efficacy and safety of DOACs versus VKAs in this region.
 Method(s): We retrieved all relevant randomized controlled studies
and observational cohort studies, which critically assessed the efficacy
and safety of DOACs versus VKAs among patients with left-sided BHV and AF
in databases of PubMed, Cochrane, ISI Web of Sciences, and Embase. The
efficacy outcomes of this meta-analysis were stroke events and all-cause
death when the safety outcomes included major and any bleeding.
 Result(s): The analysis integrated 13 studies while enrolling 27,793
patients with AF and left-sided BHV. DOACs reduced the rate of stroke by
33% compared with VKAs (risk ratio [RR] 0.67; 95% CI 0.50-0.91), with no
increased incidence of all-cause death (RR 0.96; 95% CI 0.82-1.12). For
safety outcomes, major bleeding was reduced by 28% using DOACs rather than
VKAs (RR 0.72; 95% CI 0.52-0.99), while there was no difference in the
events of any bleeding (RR 0.84; 95% CI 0.68-1.03). In addition, in
patients younger than 75 years old, the stroke rate was reduced by 45% in
the population using DOACs (RR 0.55; 95% CI 0.37-0.84).
 Conclusion(s): Our meta-analysis demonstrated that in patients with
AF and BHV, compared with VKAs, using DOACs was associated with reduced
stroke and major bleeding events without an increase of all-cause
mortality and any bleeding. In the population younger than 75 years old,
DOAC might be more effective in preventing cardiogenic
stroke. Copyright © 2023, The Author(s), under exclusive licence
to Springer-Verlag GmbH Germany, part of Springer Nature.

<60>
Accession Number
2021632876
Title
Comparison of the LigaSureTM bipolar vessel sealer to monopolar
electrocoagulation for thoracoscopic lobectomy and lymphadenectomy: a
prospective randomized controlled trial.
Source
Surgical Endoscopy. (no pagination), 2023. Date of Publication: 2023.
Author
Gabryel P.; Kasprzyk M.; Roszak M.; Campisi A.; Smolinski S.; Zielinski
P.; Piwkowski C.
Institution
(Gabryel, Kasprzyk, Smolinski, Zielinski, Piwkowski) Department of
Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego
62 Street, Poznan 60-569, Poland
(Roszak) Department of Computer Science and Statistics, Poznan University
of Medical Sciences, Poznan, Poland
(Campisi) Department of Thoracic Surgery, University and Hospital
Trust-Ospedale Borgo Trento, Verona, Italy
Publisher
Springer
Abstract
Background: High-energy devices allow better vessel sealing compared with
monopolar electrocautery and could improve the outcomes of surgical
operations. The objective of the study was to compare tissue dissection by
the LigaSureTM device with that by monopolar electrocoagulation for
thoracoscopic lobectomy and lymphadenectomy. Method(s): This
pragmatic, parallel group, prospective randomized controlled trial was
funded by the Medtronic External Research Program (ISR-2016-10,756) and
registered at www.clinicaltrials.gov (NCT03125798). The study included
patients aged 18 years or older, who had undergone thoracoscopic lobectomy
with lymphadenectomy at the Department of Thoracic Surgery of Poznan
University of Medical Sciences between May 3, 2018, and November 4, 2021.
Using simple randomization, the patients were assigned to undergo tissue
dissection with either the LigaSure device (study group) or monopolar
electrocautery (control group). Participants and care givers, except
operating surgeons, were blinded to group assignment. The primary outcome
was postoperative chest drainage volume. Secondary outcomes were change of
the esophageal temperature during subcarinal lymphadenectomy and
C-reactive protein level 72 h after surgery. Result(s): Study
outcomes were analyzed in 107 patients in each group. We found no
differences between the study and control groups in terms of chest
drainage volume (550 vs. 600 mL, respectively; p = 0.315), changes in
esophageal temperature (- 0.1 degreeC vs. - 0.1 degreeC, respectively; p =
0.784), and C-reactive protein levels (72.8 vs. 70.8 mg/L, respectively; p
= 0.503). The mean numbers of lymph nodes removed were 12.9 (SD: 3.1; 95%
CI, 12.4 to 13.5) in the study group and 11.6 (SD: 3.2; 95% CI, 11.0 to
12.2) in the control group (p < 0.001). Conclusion(s): The use of the
LigaSure device did not allow to decrease the chest drainage volume, local
thermal spread, and systemic inflammatory response. The number of lymph
nodes removed was higher in patients operated with the LigaSure device,
which indicated better quality of lymphadenectomy. Copyright ©
2023, The Author(s).

<61>
Accession Number
640339078
Title
Low dose dopamine and new onset atrial fibrillation after coronary artery
bypass surgery.
Source
Journal of Arrhythmia. Conference: 15th Asia Pacific Heart Rhythm Society
Scientific Session, APHRS 2022. Singapore Singapore. 39(Supplement 1) (pp
196-197), 2023. Date of Publication: January 2023.
Author
Ferly A.; Geffanie A.
Institution
(Ferly, Geffanie) National Cardiovascular Center Harapan Kita, Jakarta,
Indonesia
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To determine whether the administration of low dose dopamine
is related to the incidence of new onset atrial fibrillation in patients
who had undergone coronary artery bypass surgery procedures.
 Material(s) and Method(s): A systematic review were conducted in the
following database: PubMed, Embase and Google Scholar. The following
keywords and its variations were used: New Onset Atrial Fibrillation, Low
Dose Dopamine, Post-Coronary Artery Bypass Surgery. From the initial
keywords search, seven literatures were identified. Further reading of the
literature revealed that two literatures discusses about the topic and
critical appraisal using CEBM critical appraisal tool were done.
Appraisals were done by two distinct appraisers. Result(s): Two
retrospective cohort studies were included in this paper. The first
article was a retrospective cohort study involving 1731 patients
administered renal dose dopamine. This study found that administration of
renal dose dopamine may increase the risk of the appearance of paroxysmal
AF by 74%. The second article showed that dopamine administration does not
influence the incidence of paroxysmal atrial fibrillation. The benefit of
the dopamine administration was also controversial: in the first study, no
hemodynamic benefits were seen in the patients whereas in the second
study, there is a significant hemodynamic benefits of dopamine
administration. Critical appraisal analysis showed that the first study
has higher VIA score compared to the second. Conclusion(s): Low dose
dopamine administration may lead to increased risk of the paroxysmal
atrial fibrillation appearance.

<62>
Accession Number
640339011
Title
The use of hatch score for the prediction of post operative atrial
fibrillation (poaf) after coronary artery bypass graft: a meta-analysis.
Source
European Heart Journal. Conference: European Society of Cardiology Asia
with APSC and AFC Congress 2022. Singapore Singapore. 44(Supplement 1) (pp
22), 2023. Date of Publication: February 2023.
Author
Ramos O.S.
Institution
(Ramos) Asian Hospital And Medical Center, Cardiology, Muntinlupa,
Philippines
Publisher
Oxford University Press
Abstract
Background and Aims: Atrial fibrillation (AF) is the most common sustained
cardiac arrhythmia in post-cardiac surgery. It is associated with
substantial morbidity and mortality, thus portending a significant burden
to patients and the health economy. A HATCH score is a handy tool in
predicting new onset atrial fibrillation which consists of (Hypertension
<1 point>, Age >75 years old <1 point>, transient ischemic attack or
stroke <2 points>, chronic obstructive pulmonary disease [COPD] <1 point>,
and heart failure <2 points>. In this study, the authors aimed to
determine the role of HATCH score in predicting the occurrence of
post-operative atrial fibrillation (PoAF) who had undergone coronary
artery bypass graft surgery. Method(s): We conducted a systematic
review and meta-analysis of three studies. The study included patients
undergoing cardiac surgery and using HATCH score as a predicting tool for
post-operative atrial fibrillation. Result(s): A total of 3 trials
eligible for inclusion in our systematic review, giving a total of 908
participants. All three trials used the HATCH score to predict PoAF. The
study was done retrospectively. The pooled RR's showed an important risk
for PoAF in patients with a HATCH score of 2 or more, indicating an
approximately 2-fold greater risk (RR: 2.86 [95% CI 2.27-3.59], p =
0.00001. Conclusion(s): This study investigated the development of
PoAF with reference to the HATCH score. The study demonstrated a
correlation of having a high HATCH score and PoAF who had undergone
coronary artery bypass surgery.

<63>
Accession Number
640338715
Title
Effects of epicardial adipose tissue volume and thickness assessed by
computed tomography and echocardiography on cardiovascular and
cerebrovascular outcomes: a systematic review and meta-analysis.
Source
European Heart Journal. Conference: European Society of Cardiology Asia
with APSC and AFC Congress 2022. Singapore Singapore. 44(Supplement 1) (pp
10), 2023. Date of Publication: February 2023.
Author
Chong B.; Jayabaskaran J.; Ruban J.; Goh R.; Chin Y.H.; Kong G.; Ng C.H.;
Foo R.; Chai P.; Kong W.; Poh K.K.; Chan M.Y.; Mehta A.; Dimitriadis G.K.;
Chew N.W.S.
Institution
(Chong, Jayabaskaran, Ruban, Goh, Chin, Kong, Ng, Foo, Chai, Kong, Poh,
Chan, Mehta, Dimitriadis, Chew) 1National University of Singapore,
Singapore, Singapore; National University Heart Centre, Department of
Cardiology, Singapore, Singapore; VCU Health Pauley Heart Center, Division
of Cardiology, Richmond, United States of America; King's College Hospital
NHS Foundation Trust, Department of Endocrinology, London, United Kingdom
of Great Britain & Northern Ireland
Publisher
Oxford University Press
Abstract
Background: Epicardial adipose tissue (EAT) has garnered attention as a
potential imaging biomarker for the risk stratification of cardiovascular
diseases (CVD). However, the prognostic utility of EAT due to inter-ethnic
differences and imaging modality (computed tomography (CT) or
transthoracic echocardiography (TTE)) remains undetermined.
 Purpose(s): To evaluate the effect of EAT volume and thickness on
cardiovascular and cerebrovascular outcomes. We also aim to compare the
prognostic utility between CT volumetric and TTE thickness quantification;
and provide consolidated data on the heterogeneity in EAT measurements
across different ethnic groups. Method(s): Medline and Embase
databases were searched from inception till 16 May 2022 for studies that
measured EAT volume or thickness of adult patients at baseline and
reported follow-up data on outcomes of interest. Outcomes included MACE,
all-cause mortality, cardiac death, myocardial infarction (MI), coronary
revascularisation, atrial fibrillation (AF), and stroke. Statistical
analyses were conducted on Review Manager 5.4.1 to obtain unadjusted and
adjusted hazard ratios (HR) and odds ratios (OR) with the results
presented on forest plots. Result(s): Twenty-nine studies comprising
19709 patients were included in our analysis. Increased EAT thickness and
volume were associated with higher risks of MACE (adjusted HR [aHR] 1.46,
95%CI 1.25-1.71, p<0.001), cardiac death (OR 2.53, 95%CI 1.17-5.44,
p=0.020), MI (OR 2.63, 95%CI 1.39-4.96, p=0.003), coronary
revascularisation (OR 2.99, 95%CI 1.64-5.44, p<0.001), AF (aOR 4.04, 95%CI
3.06-5.32, p<0.001), and stroke (HR 1.02, 95%CI 1.01-1.03, p<0.001).
CT-volumetric quantification of EAT conferred a larger MACE risk (aHR
1.79, 95%CI 1.47-2.17, p<0.001) compared to TTE thickness quantification
(aHR 1.20, 95%CI 1.09-1.32, p<0.001). Studies originating from North
America (HR 1.91, 95%CI 1.26-2.89, p=0.002) and Asia (HR 1.60, 95%CI
1.09-2.36, p=0.020) demonstrated a significantly higher risk of MACE with
increased EAT thickness and volume. However, this significance was not
seen in European studies (HR 1.48, 95%CI 0.99- 2.20, p=0.060). Subgroup
differences were also noted across the studies' countries of origin when
analysing the association of EAT and MI (p=0.020). European studies
reported a higher magnitude of MI risk associated with higher EAT
thickness and volume (OR 5.28, 95%CI 2.34- 11.95, p<0.001) as compared to
Asian studies (OR 1.75, 95%CI 1.05- 2.92, p=0.030). No differences were
noted across other outcomes in the subgroup comparisons by geographical
region and between CT and TTE quantification of EAT. Conclusion(s):
The utility of EAT as an imaging biomarker for predicting and
prognosticating CVD is promising. Future efforts to harmonise the EAT
parameter thresholds, based on the type of imaging modality and the target
population's ethnic characteristics, will be the next important step
before including EAT in CVD prediction models.

<64>
Accession Number
640338644
Title
THE USE OF IMMUNOMODULATORS, BIOLOGIC THERAPIES AND SMALL MOLECULES IN
PATIENTS WITH INFLAMMATORY BOWEL DISEASE AND SOLID ORGAN TRANSPLANTS.
Source
Inflammatory Bowel Diseases. Conference: 2023 Crohn's and Colitis
Congress. Denver, CO United States. 29(Supplement 1) (pp S3), 2023. Date
of Publication: February 2023.
Author
Ghusn W.; Francis F.; Farraye F.; Hashash J.G.
Publisher
Oxford University Press
Abstract
INTRODUCTION: Over the past 20 years, the number of solid organ
transplants (SOT) for a variety of indications has been on the rise.
Consequently, more patients with inflammatory bowel diseases (IBD) are
also receiving SOT. Although SOT related immunosuppression may at times
control IBD related inflammation, many patients still require additional
immunosuppressive medications for control of their IBD. With the growing
therapeutic armamentarium for IBD, physicians are in search for guidance
on the safety of using additional immunosuppressive medications in
patients who are already receiving transplant related immunosuppressive
medications. METHOD(S): We performed a review of published literature
that addressed the use of immunomodulators, biologic agents, and small
molecules in patients with IBD who also had a SOT. We searched PubMed,
Scopus, MEDLINE, and Google Scholar databases for studies published on the
topic in English between January 1st, 1910, and August 1st, 2022. We have
included data from systematic reviews, meta-analyses, case reports and
case series to assess the safety, effectiveness, and side effects of
immunomodulators, biologic therapies and small molecules in patients with
liver, renal and/or heart transplantations. RESULT(S): We identified
25 publications on liver transplants, 6 on renal transplants, and 1 on
heart transplants in patients with IBD. Among liver transplant patients,
the most common immunosuppressive medications used were tacrolimus,
mycophenolate mofetil, cyclosporine and steroids. In patients with IBD,
anti-TNF agents (infliximab and adalimumab) were used in SOT with no major
adverse safety concerns. The most common adverse events included
infections (Clostridioides difficile and CMV) and malignancies (colon
cancer). As for anti-integrin agents (vedolizumab and natalizumab) and
ustekinumab, their efficacy and safety were mainly reported in patients
with liver transplant on tacrolimus with no major adverse events reported.
For patients with renal transplant, the main immunosuppression used were
cyclosporine and tacrolimus. The combination of these immunosuppressive
drugs with either anti-TNF therapy or ustekinumab had a good safety
profile with rare malignancy occurrence. In one case report with heart
transplant in a patient with IBD and on tacrolimus, no complications were
reported. CONCLUSION(S): SOT has become the mainstay for treating
several common diseases. As such, gastroenterologists will care for more
patients with IBD who have had a SOT. From this extensive review, the use
of anti-TNF, anti-integrin agents and ustekinumab seem to be safe in
patients with SOT, regardless of their transplant related
immunosuppression which is usually comprised of tacrolimus, cyclosporine,
and prednisone. More studies are needed in patients with renal and heart
transplant and in patients treated with small molecules for their IBD.

<65>
Accession Number
640338600
Title
Antithrombotic monotherapy for stable coronary artery disease and atrial
fibrillation patients with and without prior coronary artery
revascularization: Insights from the AFIRE trial.
Source
European Heart Journal. Conference: European Society of Cardiology Asia
with APSC and AFC Congress 2022. Singapore Singapore. 44(Supplement 1) (pp
62-63), 2023. Date of Publication: February 2023.
Author
Noda T.; Nochioka K.; Kaikita K.; Akao M.; Ako J.; Matoba T.; Nakamura M.;
Miyauchi K.; Hagiwara N.; Kimura K.; Hirayama A.; Matsui K.; Ogawa H.;
Yasuda S.
Institution
(Noda, Nochioka, Kaikita, Akao, Ako, Matoba, Nakamura, Miyauchi, Hagiwara,
Kimura, Hirayama, Matsui, Ogawa, Yasuda) 1Tohoku University Graduate
School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan;
University of Miyazaki, Faculty of Medicine, Division of Cardiovascular
Medicine and Nephrology, Department of Internal Medi, Miyazaki, Japan;
National Hospital Organization Kyoto Medical Center, Department of
Cardiology, Kyoto, Japan; Kitasato University School of Medicine,
Department of Cardiovascular Medicine, Sagamihara, Japan; Kyushu
University Faculty of Medical Sciences, Department of Cardiovascular
Medicine, Fukuoka, Japan; Toho University Ohashi Medical Center, Division
of Cardiovascular Medicine, Tokyo, Japan; Juntendo Tokyo Koto Geriatric
Medical Center, Department of Cardiovascular Medicine, Tokyo, Japan; Tokyo
Women's Medical University, Department of Cardiology, Tokyo, Japan;
Yokohama City University Medical Center, Cardiovascular Center, Yokohama,
Japan; Osaka Police Hospital, Department of Cardiology, Osaka, Japan;
Kumamoto University, Department of General Medicine and Primary Care,
Kumamoto, Japan; Kumamoto University, Kumamoto, Japan
Publisher
Oxford University Press
Abstract
Background: The AFIRE (Atrial Fibrillation and Ischemic Events With
Rivaroxaban in Patients With Stable Coronary Artery Disease) trial
demonstrated that rivaroxaban monotherapy was noninferior to combination
therapy with rivaroxaban plus a single antiplatelet therapy regarding
efficacy and superior for safety endpoints in patients with atrial
fibrillation and stable coronary artery disease including patients not
requiring revascularization [prior percutaneous coronary intervention
(PCI) or bypass grafting (CABG)]. Purpose(s): The aim of this
post-hoc subgroup analysis was to investigate the efficacy and safety of
rivaroxaban monotherapy compared to combination therapy in patients with
and without prior revascularization. Method(s): Among 2,215 patients
included in the modified intention-to-treat analysis in the AFIRE trial,
1445 patients (65.2%) had undergone previous PCI alone, and 252 (11.4%)
had undergone previous CABG. The remaining 518 patients (23.4%) was
categorized as a group without prior revascularization and then compared
with a group with prior revascularization (PCI or CABG). The primary
efficacy end point was a composite of stroke, systemic embolism,
myocardial infarction, unstable angina requiring revascularization, or
death from any cause. The primary safety end point was major bleeding,
according to the criteria of the International Society on Thrombosis and
Hemostasis. Result(s): In 1697 patients with prior revascularization,
efficacy and safety endpoints of rivaroxaban monotherapy were superior to
combination therapy (efficacy: HR 0.62, 95%CI 0.45-0.85, p=0.003; safety:
HR 0.62, 95% CI 0.39-0.98, p=0.040), whereas there were no significant
differences in efficacy and safety endpoints among 518 patients without
prior revascularization (efficacy: HR 1.19, 95%CI 0.67-2.11, p=0.553;
safety: HR 0.47, 95%CI 0.18-1.26, p=0.125). There was a borderline
interaction of efficacy endpoint (P for interaction=0.055) by randomized
treatment assignment (Figure 1 and Figure 2). Compared with combination
therapy, the safety benefit of rivaroxaban monotherapy on any bleeding was
significant in patients without prior revascularization (HR 0.59, 95%CI
0.38-0.93, p=0.022). Conclusion(s): In patients with prior PCI or
CABG, rivaroxaban monotherapy resulted in more favorable safety and
efficacy outcomes than combination therapy. There was a borderline
interaction for primary efficacy outcome between prior revascularization
and anti-thrombotic therapy.

<66>
Accession Number
640340267
Title
Using computed tomogram atrial myocardial thickness maps in high-power
short-duration radiofrequency pulmonary vein isolation.
Source
Journal of Arrhythmia. Conference: 15th Asia Pacific Heart Rhythm Society
Scientific Session, APHRS 2022. Singapore Singapore. 39(Supplement 1) (pp
28-31), 2023. Date of Publication: January 2023.
Author
Hwang T.; Kwon O.S.; Yang S.-Y.; Kim D.; Yu H.T.; Kim T.-H.; Uhm J.-S.;
Joung B.; Lee M.-H.; Pak H.-N.
Institution
(Hwang, Kwon, Yang, Kim, Yu, Kim, Uhm, Joung, Lee, Pak) Yonsei University
Health System, Seoul, South Korea
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Catheter ablation is the most effective rhythm control
strategy for patients with atrial fibrillation (AF), but continuous
long-term recurrence is common after the procedure. Pulmonary vein (PV)
isolation (PVI) is the cornerstone of AF catheter ablation (AFCA), and PV
reconnection is one of the most common mechanisms of AF recurrence after
the procedure. PVI durability could be affected by various factors such as
the type of catheter, energy source, radiofrequency (RF) power, duration
of energy delivery, contact force, and the stability of catheter or
objective physical parameters including ablation index or lesion index. In
addition, patient-specific atrial wall thickness (WT) may be a factor that
must be considered for appropriate transmural lesion generation. The
consideration of atrial WT is important in terms of evaluating the safety
as well as efficacy and durability of PVI. The risk of procedure-related
complications, including hemopericardium, increases in elderly ladies and
patients with malnutrition with relatively thinner PV antrums than healthy
young males. Recently, higher-power short-duration (HPSD) RF-PVI has been
widely used, and plenty of studies evaluating its efficacy and safety
comparative are emerging. Therefore, we explored the efficacy and safety
of PV antral WT-guided HPSD RF-PVI by titrating the duration of 60 W
energy delivery to each point. Based on our previous studies and
experience, 15 seconds of 60 W HPSD using FlexAbility was considered the
control treatment. We compared the control treatment with the WT-guided
ablation, which reduces RF delivery time in the thin LAWT areas, in this
prospective single-center randomized clinical trial. We measured and
utilized LAWT using automated customized software (AMBER, LaonMed, Korea)
in real-time during AFCA procedures. Method(s): Study population and
randomization The study protocol adhered to the Declaration of Helsinki
and was approved by the institutional review board of Yonsei University.
Written informed consent was obtained from all participants before the
study began (ClinicalTrials.gov; NCT03912324). The study cohort initially
included 200 patients with PAF (70.0% males, 59.6 +/- 11.8-years-of-age)
who underwent AFCA for symptomatic and drug-refractory non-valvular AF.
The exclusion criteria were as follows: (1) persistent or permanent AF,
(2) AF with severe cardiac malformation or structural heart disease, (3)
severe renal impairment or CT imaging difficulty using contrast media, (4)
a history of AF ablation or cardiac surgery, and (5) valvular AF (mitral
stenosis >grade 2, mechanical valve, and mitral valvuloplasty). Before all
ablation procedures, we defined the anatomy of the LAs and PVs using
three-dimensional (3D) computed tomography (CT) scans (64-channel, light
speed volume CT, Philips, Brilliance 63, Amsterdam, Netherlands). All
patients discontinued all anti-arrhythmic drugs (AADs) for at least five
half-lives, and amiodarone was stopped more than 1 month before the
procedure. This study was performed under a prospective single-center
randomized clinical study protocol. We conducted randomization using
computer-generated random permutation sequences to avoid any potential
bias. The patients were blinded to the initial allocation, and the rhythm
outcomes were determined by the research coordinators based on Holter and
electrocardiogram (ECG) monitoring. Except for three patients whose
follow-up duration was less than 3 months, of the 197 enrolled patients,
104 and 93 were assigned to the WT-guided PVI (WT group) and conventional
PVI (Control group) groups, respectively (Figure 1). Preparing left atrial
wall thickness maps using CT We used the previously developed automated
customized software (AMBER, LaonMed, Korea) to measure myocardial
thickness from cardiac CT images. This software has been validated with
3D-printed LA phantom models, over 120 AF patients, and through 12 other
previously published studies. The day before the procedure, experienced
investigators measured a 3D LAWT map from CT images of the patient
acquired before the ablation procedure and then delivered it to the
clinical procedure team (taking approximately 20 min per patient). As a
summary of AMBER software, obtaining myocardial wall thickness consists of
three steps. First, we divided the boundaries of the myocardium with
thresholds of cardiac tissues obtained from CT histograms and guidelines
drawn by investigators. Next, we extracted the myocardial wall based on
the morphological and intersection operations. In the third stage, we
calculated the WT of the streamlines connecting the endo-and epicardium by
applying Laplace's equation and Euler's method. This approach is reported
as a robust method for WT measurement because it considers both endo-and
epicardial surfaces despite the complex morphology of the atria.
Electrophysiological mapping and AF catheter ablation Intracardiac
electrograms were recorded using the Prucka CardioLabTM Electrophysiology
system (General Electric Medical Systems, Inc., Milwaukee, WI, USA). After
the transseptal puncture, multi-view pulmonary venograms were obtained.
Details of the AFCA technique and strategy have been reported in our
previous studies. Systemic anticoagulation was performed using intravenous
heparin to maintain an activated clotting time of 350-400 seconds during
the procedure. The esophageal temperature was monitored in all patients,
and the luminal esophageal cut-off temperature was 38.4C for AFCA. The
AFCA was performed using a 3D electro-anatomical mapping system (NavX; St.
Jude Medical, USA.) merged with 3D spiral CT. In the WT group, we merged
the spatiotemporal information of each electrogram with a previously
analyzed LAWT map (merging time, 15 min). In both groups, we used a
FlexAbility catheter (St. Jude Medical, Inc., Minnetonka, MN) without
contact force monitoring. In the Control group, we delivered 60 W (for a
target temperature of 45degreeC) to the anterior part of the LA and a
constant 50 W RF to the posterior part of the LA for 15 seconds. However,
in the WT group, we used the same catheter but delivered RF for 15 s at
each point with LAWT>2.1 mm, 13 s at points with LAWT around 1.4-2.1 mm,
and 11 s at areas with LAWT <1.4 mm. Cavotricuspid isthmus ablation and
SVC-RA isolation were carried out in the majority of patients in both
groups. Ablation endpoint and repeat ablation After the completion of the
protocol-based ablation, we conducted an isoproterenol provocation test to
induce extra-PV triggers in both groups. We observed extra-PV foci within
10 min after cardioversion with an isoproterenol infusion (5-10 mug/min
depending on the s-blocker use with a target sinus heart rate of 120 bpm).
After careful mapping, any extra-PV triggers were ablated as much as
possible. Post-ablation management and follow-up We tried to discharge all
patients without AADs except for those who had recurrent extra-PV triggers
after the AFCA procedure, symptomatic frequent atrial premature beats,
non-sustained atrial tachycardia (AT), or early AF recurrence on telemetry
during the admission period. Patients visited the outpatient clinic
regularly at 1, 3, 6, and 12 months postoperatively and then every 6
months thereafter or whenever symptoms occurred after the AFCA. All
patients underwent ECGs during every visit and 24-h Holter recordings at 3
and 6 months postoperatively and then every 6 months thereafter according
to the 2012 HRS/EHRA/ECAS Expert Consensus Statement guidelines. Holter
monitoring or event monitor recordings were obtained when the patients
reported symptoms of palpitations suggestive of an arrhythmia recurrence.
Holter analysis and adjudication were performed by an individual blinded
to the study group assignments. AF recurrence was defined as any episode
of AF or AT lasting at least 30 seconds. Any ECG documentation of AF
recurrence within a 3-month blanking period was diagnosed as early
recurrence, while any AF recurrence that took place more than 3 months
after the procedure was diagnosed as a clinical recurrence. The primary
study endpoint was freedom from documented episodes of AF or AT lasting
longer than 30 seconds and occurring after a 3-month blanking period
following a single ablation procedure. The secondary endpoints were the
peri-procedural complication rate and the response to AADs or the
electrical cardioversion rates after post-procedural recurrences.

<67>
Accession Number
640339891
Title
Safety and efficacy of cerebral embolic protection devices in
transcatheter aortic valve implantation: a meta-analysis.
Source
European Heart Journal. Conference: European Society of Cardiology Asia
with APSC and AFC Congress 2022. Singapore Singapore. 44(Supplement 1) (pp
120), 2023. Date of Publication: February 2023.
Author
Tan N.; Gao F.; Mohammed R.A.; Lim S.T.; Abdul Aziz Z.; Govindasamy S.;
Chao V.T.T.; Ewe S.H.; Ho K.W.; Yap J.
Institution
(Tan, Gao, Mohammed, Lim, Abdul Aziz, Govindasamy, Chao, Ewe, Ho, Yap)
1National Heart Centre Singapore, Department of Cardiology, Singapore,
Singapore; National Heart Centre Singapore, Department of Cardiothoracic
Surgery, Singapore, Singapore
Publisher
Oxford University Press
Abstract
Background: Stroke during Transcatheter Aortic Valve implantation (TAVI)
is not an uncommon complication with potential devastating consequences.
With the extension of TAVI to the low-risk patient, stroke prevention
takes on increasing importance. The use of cerebral embolic protection
device (EPD) reveals conflicting data. This meta-analysis aims to evaluate
the clinical efficacy and safety of EPDs. Method(s): A comprehensive
literature search for all studies tillMay 2022 reporting clinical safety
and efficacy outcomes of the only EPD approved for use by the Food and
Drug Administration (FDA) was performed. Study outcomes were divided based
on time period - overall (up to 30 days and inhospital) and short (<=7
days). Primary outcome was stroke - major and minor. Secondary outcomes
included transient ischaemic attack (TIA), mortality, acute kidney injury
(AKI), major vascular and bleeding complications. Result(s): A total
of 12 studies involving 288531 patients were analysed, which included 3
randomised controlled trials (RCTs), 7 propensitymatched and 2 cohort
studies. Regarding overall outcomes, significant differences were noted
for mortality (OR 0.59 [0.42-0.84], p=0.0036) and major stroke (OR 0.40
[0.18-0.91], p=0.028) (Fig 1). No significant differences were noted for
all stroke (p=0.058), minor stroke (p=0.32), TIA (p=0.49), AKI (p=0.17),
major vascular complications (p=0.40) and major bleeding complications
(p=0.11). There was significant heterogeneity across the studies for
mortality (p=0.032) and all stroke (p=0.009). In the subgroup analysis of
studies reporting <=7 days outcomes (n=5), EPDs showed significantly lower
rates of all stroke (0.33 [95% CI 0.19-0.56], p=<0.0001), major stroke
(0.19 [0.08-0.48], p=0.0004) and major bleeding complications (OR 0.29
[0.10-0.79], p=0.016), but no significant differences for mortality
(p=0.67) and minor stroke (p=0.070). There was no significant
heterogeneity across the studies (all p>0.05) Conclusion(s): In this
meta-analysis including non-randomised studies, the use of EPDs was
associated with lower mortality and major stroke rates, although
significant heterogeneity was noted for the studies reporting mortality.
Further ongoing larger scale RCTs will further clarify these results.

<68>
Accession Number
640339856
Title
Comparison of transcatheter, minimally invasive and conventional surgical
aortic valve replacement: a systematic review and network meta-analysis.
Source
European Heart Journal. Conference: European Society of Cardiology Asia
with APSC and AFC Congress 2022. Singapore Singapore. 44(Supplement 1) (pp
118-119), 2023. Date of Publication: February 2023.
Author
Fong K.; Yap J.J.L.; Chan Y.H.; Ewe S.H.; Chao V.T.T.; Rizwan M.;
Govindasamy S.P.; Aziz Z.A.; Tan V.H.; Ho K.W.
Institution
(Fong, Yap, Chan, Ewe, Chao, Rizwan, Govindasamy, Aziz, Tan, Ho) 1National
University of Singapore, Yong Loo Lin School of Medicine, Singapore,
Singapore; National Heart Centre Singapore, Singapore, Singapore; National
University of Singapore, Biostatistics Unit, Singapore, Singapore; Changi
General Hospital, Singapore, Singapore
Publisher
Oxford University Press
Abstract
Background/Introduction: The landscape of aortic valve replacement (AVR)
has evolved dramatically over the years, but long-term outcomes have yet
to be comprehensively explored. Purpose(s): To compare long-term
mortality among three AVR techniques: transcatheter (TAVI), minimally
invasive (MIAVR), and conventional surgical AVR (CAVR). Method(s): An
electronic literature search was performed for randomized controlled
trials (RCTs) comparing TAVI to CAVR, and RCTs or propensity score-matched
(PSM) studies comparing MIAVR to CAVR or MIAVR to TAVI. Individual patient
data for all-cause mortality was derived from graphical reconstruction of
digitized Kaplan-Meier curves. Pairwise comparisons followed by network
meta-analysis were conducted. Sensitivity analyses were performed in the
TAVI arm for high risk and low/intermediate risk as well as transfemoral
(TF-TAVI) patients. Result(s): A total of 27 studies involving 16,554
patients were included. In the pairwise comparison of TAVI versus CAVR,
TAVI showed superior mortality to CAVR until 39.5 months, beyond which
there was no significant difference in longer term mortality. When
restricted to TF-TAVI versus CAVR, consistent mortality benefit favoring
TAVI was seen (shared-frailty hazard ratio [HR]=1.17, 95%CI=1.03-1.33,
p=0.016). In the network meta-analysis involving majority PSM data, MIAVR
was associated with significantly lower mortality than TAVI (HR=0.69,
95%CI=0.59-0.82) and CAVR (HR=0.68, 95%CI=0.58-0.80); this significant
association was not seen when compared to TF-TAVI patients.
 Conclusion(s): An initial short-medium term mortality benefit for
TAVI over CAVR was noted but this benefit was attenuated over the longer
term. In the subset of TF-TAVI patients, this long-term mortality benefit
persisted, suggesting that non-TF techniques are associated with higher
mortality. Amongst majority PSM data, MIAVR showed improved mortality
compared to TAVI and CAVR but this was not seen in the TF-TAVI subset.
This suggests that MIAVR may have a role in treating patients who are
ineligible for TF-TAVI in experienced centers, and future RCTs are needed
to conclusively validate this.

<69>
Accession Number
640340376
Title
Conduction system pacing after TAVR: A systematic review and
meta-analysis.
Source
Journal of Arrhythmia. Conference: 15th Asia Pacific Heart Rhythm Society
Scientific Session, APHRS 2022. Singapore Singapore. 39(Supplement 1) (pp
246-247), 2023. Date of Publication: January 2023.
Author
Cheng S.; Liu X.; Deng Y.; Cai M.; Huang H.; Yu Y.; Hua W.
Institution
(Cheng, Liu, Deng, Cai, Huang, Yu, Hua) Fuwai Hospital, Chinese Academy of
Medical Sciences, Peking Union Medical College, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Roughly 15% of patients require permanent pacemaker
implantation within 30 days following transcatheter aortic valve
replacement (TAVR) due to complete heart block1. And His-Purkinje
conduction system pacing (CSP) including his-bundle pacing (HBP) and left
bundle branch pacing (LBBB) could establish normal myocardial activation.
However, the feasibility of CSP in patients requiring pacemaker
implantation after TAVR remains unclear. The aim of this study is to
evaluate the feasibility of CSP in patients requiring pacemaker
implantation after TAVR. Material(s) and Method(s): We searched the
MEDLINE, Embase, Web of Science, and ClinicalTrials until March 5, 2022.
The primary endpoint was the success rate of CSP. We used the fixed model
to investigate the success rate in HBP and LBBP, respectively. And we
reported the success rate of CSP using random-effect model. All statistics
were performed using R 4.1.2. Result(s): We included six studies with
a total number of 162 patients. Among these, two studies included both HBP
and LBBP after TAVR. Success rates ranged from 50% to 81% in HBP and 80%
to 95% in LBBP. For patients requiring pacemaker implantation after TAVR,
HBP was successful in 65% of patients (95% CI 54%-75%), while LBBP was
successful in 92% of patients (95% CI 83%-95%). Overall, CSP could be
achieved in 80% of patients (95% CI 65%-89%). Conclusion(s): Our
study demonstrated that CSP, especially LBBP was feasible in patients
requiring pacemaker after TAVR. And LBBP had a higher success rate than
HBP. (Table Presented).

<70>
Accession Number
640339713
Title
Lusutrombopag for the treatment of thrombocytopenia in Chinese patients
with chronic liver disease undergoing elective invasive procedures: A
randomized, multicenter, doubleblind phase 3 study.
Source
Liver Cancer. Conference: 12th Asia-Pacific Primary Liver Cancer Expert
Meeting, APPLE 2022. Shanghai China. 11(Supplement 1) (pp 30-31), 2022.
Date of Publication: 2022.
Author
Ding Z.
Institution
(Ding) Zhongshan Hospital, Fudan University, Shanghai, China
Publisher
S. Karger AG
Abstract
Aims: Lusutrombopag has been approved for treating thrombocytopenia
associated with chronic liver disease (CLD) in patients who are scheduled
to undergo invasive procedures in U.S., Europe, and Japan. We aimed to
evaluate the efficacy and safety of lusutrombopag in Chinese patients with
CLD-associated thrombocytopenia undergoing elective invasive procedures.
 Method(s): This multicenter, randomized, double-blind,
placebo-controlled phase 3 trial (CTR20192384) was conducted in 9 centers
in China. Patients over 18 who had severe thrombocytopenia (platelet [PLT]
counts <50x109/L) associated with CLD, and were scheduled to undergo
invasive procedures (excluding thoracotomy, laparotomy, open-heart
surgery, craniotomy, organ or partial organ resection) were enrolled.
Eligible patients were 2:1 randomly assigned to receive once-daily oral 3
mg of lusutrombopag or placebo from day 1 to day 7. The scheduled invasive
procedures were performed between day 9 and day 15. Preoperative platelet
transfusion was allowed in patients with the PLT <50x109/L. The primary
endpoint was the proportion of responders (defined as the patients with
PLT >=50x109/L and with an increase of PLT >=20x109/L from baseline with
no rescue therapy for bleeding) on day 8. The key secondary endpoint was
the proportion of patients with PLT >=50x109/L on or after day 8 and
within 2 days (the alternative criterion that does not require platelet
transfusion) prior to the invasive procedure. Adverse events (AEs) were
also recorded. Result(s): From July 2020 to June 2021, 66 patients
were enrolled. Lusutrombopag had potent effect of platelet elevation and
was well tolerated. All of the AEs were mild or moderate in severity. Only
one patient in the lusutrombopag group reported thrombosis-related AEs
(brachiocephalic vein thrombosis), which was mild and determined not
related to the treatment. Three bleeding events in three patients occurred
in the lusutrombopag group, and four bleeding events in three patients
reported in the placebo group (6.8% vs. 13.6%). Conclusion(s):
Lusutrombopag was effective in increasing PLT and avoiding preoperative
platelet transfusion in Chinese patients with CLD-associated
thrombocytopenia scheduled to undergo invasive procedures, with comparable
safety profiles to placebo.

<71>
Accession Number
2022804253
Title
Characteristics of Clinical Trial Sites for Novel Transcatheter Mitral and
Tricuspid Valvular Therapies.
Source
JAMA Cardiology. 8(2) (pp 120-128), 2023. Date of Publication: 08 Feb
2023.
Author
Nathan A.S.; Reddy K.P.; Yang L.; Eberly L.A.; Dayoub E.J.; Khatana
S.A.M.; Julien H.M.; Desai N.D.; Szeto W.Y.; Herrmann H.C.; Kobayashi
T.J.; Fiorilli P.; Batchelor W.B.; Mehran R.; Alkhouli M.A.; Giri J.;
Groeneveld P.W.; Fanaroff A.C.
Institution
(Nathan, Eberly, Dayoub, Khatana, Julien, Herrmann, Kobayashi, Fiorilli,
Giri, Fanaroff) Division of Cardiology, Hospital of the University of
Pennsylvania, Philadelphia, United States
(Nathan, Reddy, Yang, Eberly, Dayoub, Khatana, Julien, Desai, Kobayashi,
Giri, Groeneveld, Fanaroff) Penn Cardiovascular Outcomes, Quality, and
Evaluative Research Center, University of Pennsylvania, Philadelphia,
United States
(Nathan, Yang, Eberly, Dayoub, Khatana, Julien, Desai, Kobayashi, Giri,
Groeneveld, Fanaroff) Leonard Davis Institute of Health Economics,
University of Pennsylvania, Philadelphia, United States
(Nathan, Khatana, Julien, Kobayashi, Fiorilli, Giri, Groeneveld) Corporal
Michael J. Crescenz Va Medical Center, Philadelphia, PA, United States
(Desai, Szeto) Division of Cardiac Surgery, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, United States
(Batchelor) Inova Heart and Vascular Institute, Fairfax, VA, United States
(Mehran) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Alkhouli) Mayo Clinic, Rochester, MN, United States
(Groeneveld) Division of General Internal Medicine, Perelman School of
Medicine, University of Pennsylvania, Philadelphia, United States
Publisher
American Medical Association
Abstract
Importance: Racial and ethnic minority and socioeconomically disadvantaged
patients have been underrepresented in randomized clinical trials. Efforts
have focused on enhancing inclusion of minority groups at sites
participating at clinical trials; however, there may be differences in the
patient populations of the sites that participate in clinical trials.
 Objective(s): To identify any differences in the racial, ethnic, and
socioeconomic composition of patient populations among candidate sites in
the US that did vs did not participate in trials for novel transcatheter
therapies. Design, Setting, and Participant(s): This cross-sectional
analysis used Medicare Provider Claims from 2019 for patients admitted to
hospitals in the US. All clinical trials for transcatheter mitral and
tricuspid valve therapies and the hospitals participating in each of the
trials were identified using ClinicalTrials.gov. Hospitals with active
cardiac surgical programs that did not participate in the trials were also
identified. Data analysis was performed between July 2021 and July 2022.
Exposures: Multivariable linear regression models were used to identify
differences in racial, ethnic, and socioeconomic characteristics among
patients undergoing cardiac surgery or transcatheter aortic valve
replacement at trial vs nontrial hospitals. Main Outcome and Measures: The
main outcome of the study was participation in a clinical trial for novel
transcatheter mitral or tricuspid valve therapies. Result(s): A total
of 1050 hospitals with cardiac surgery programs were identified, of which
121 (11.5%) participated in trials for transcatheter mitral or tricuspid
therapies. Patients treated in trial hospitals had a higher median zip
code-based household income (difference of $5261; 95% CI, $2986-$7537), a
lower Distressed Communities Index score (difference of 5.37; 95% CI,
2.59-8.15), and no significant difference in the proportion of patients
dual eligible for Medicaid (difference of 0.86; 95% CI, -2.38 to 0.66).
After adjusting for each of the socioeconomic indicators separately, there
was less than 1% difference in the proportion of Black and Hispanic
patients cared for at hospitals participating vs not participating in
clinical trials. Conclusions and Relevance: In this cohort study
among candidate hospitals for clinical trials for transcatheter mitral or
tricuspid valve therapies, trial hospitals took care of a more
socioeconomically advantaged population than nontrial hospitals, with a
similar proportion of Black and Hispanic patients. These data suggest that
site selection efforts may improve enrollment of socioeconomically
disadvantaged patients but may not improve the enrollment of Black and
Hispanic patients.. Copyright © 2022 American Medical
Association. All rights reserved.

<72>
Accession Number
2022678435
Title
Cardiac Surgery Training in Brazil - What Are We Discussing in Our
Journal?.
Source
Brazilian Journal of Cardiovascular Surgery. 38(1) (pp 157-161), 2023.
Date of Publication: 2023.
Author
da Silveira Maia A.
Institution
(da Silveira Maia) Department of Cardiovascular Surgery, Instituto Dante
Pazzanese de Cardiologia (IDPC), Sao Paulo, Sao Paulo, Brazil
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Cardiovascular surgery has undergone numerous changes over
the last decades. Transcatheter technologies, endovascular procedures,
hybrids, and minimally invasive surgery have undoubtedly advanced as a
therapy for patients. Thus, the discussion about the training of residents
in the face of new technologies in the specialty is in check. In this
article, it is proposed a review to discuss the challenges in this
scenario as well as the current training in cardiovascular surgery in
Brazil. Method(s): A comprehensive review was performed in the
Brazilian Journal of Cardiovascular Surgery. All editions from 1986 to
2022 were included. The research was carried out using the search engine
on the journal's website (https://www.bjcvs.org) and an individual
analysis of the titles and abstracts of each article published.
 Result(s): All the studies are summarized in the appropriate table
with a discussion along this review. Conclusion(s): Most articles
that discuss training in cardiovascular surgery in the national context
are editorials and expert points of view with no observational studies
evaluating the residency programs. Keywords: Cardiovascular Surgery.
Internship and Residency. Mentoring. Minimally Invasive Surgical
Procedures. Patients. Research. Review. Copyright © 2023,
Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

<73>
Accession Number
2022804255
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: 08 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, GA, United States
(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, New York, 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, United States
(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
American Medical Association
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.
 Objective(s): To evaluate the 5-year incidence, clinical outcomes,
and predictors of hemodynamic SVD in patients undergoing self-expanding
TAVI or surgery. 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.
 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. 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.
 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. 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. Copyright © 2022
American Medical Association. All rights reserved.

<74>
Accession Number
2022678445
Title
Biocompatibility of the Oxygenator on Pulsatile Flow by Electron
Microscope.
Source
Brazilian Journal of Cardiovascular Surgery. 38(1) (pp 62-70), 2023. Date
of Publication: 2023.
Author
Ulus A.T.; Guray T.; Urpermez E.; Ozyalcin S.; Taner A.; Haberal E.;
Kocakulak M.
Institution
(Ulus, Ozyalcin) Cardiovascular Surgery Clinic, Turkiye Yuksek Ihtisas
Research and Training Hospital, Ankara, Turkey
(Ulus) Cardiovascular Surgery Department, Hacettepe University, Ankara,
Turkey
(Guray, Urpermez, Haberal) Biomedical Engineering Department, Baskent
University, Ankara, Turkey
(Taner) Department of Cardiology, Aksaray Hospital, Aksaray, Turkey
(Kocakulak) Biomedical Engineering Department, Izmir Democracy University,
Karabaglar, Izmir, Turkey
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Extracorporeal perfusion flow type requires further
investigation. The aim of this study is to compare the effects of
pulsatile and nonpulsatile flow on oxygenator fibers that were analyzed by
scanning electron microscope (SEM) and to extensively study patients'
coagulation profiles, inflammatory markers, and functional blood tests.
 Method(s): Twelve patients who had open heart surgery were randomly
divided into two groups; the nonpulsatile flow (group NP, six patients)
and pulsatile flow (group P, six patients) groups. Both superficial view
and axial sections of the oxygenator fiber samples were examined under SEM
to compare the thickness of absorbed blood proteins and amount of blood
cells on the surface of oxygenators. Platelet count, coagulation profile,
and inflammatory predictors were also studied from the blood samples.
 Result(s): Fibrinogen levels after cardiopulmonary bypass were
significantly lower in group NP (group P, 2.57+/-2.78 g/L; group NP;
2.39+/-0.70 g/L, P=0.03). Inflammatory biomarkers such as C-reactive
protein, interleukin (IL)-6, IL-12, apelin, S100beta, and tumor necrosis
factor alpha were comparable in both groups. Axial sections of the
oxygenator fiber samples had a mean thickness of 45.2 microm and 46.5
microm in groups P and NP, respectively, and this difference is
statistically significant (P=0.006). Superficial view of the fiber samples
showed obviously lower platelet, leukocyte, and erythrocyte levels in
group P. Conclusion(s): Our study demonstrated that both cellular
elements and protein adsorption on oxygenator fibers are lower in the
group P than in the group NP. Pulsatile perfusion has better
biocompatibility on extracorporeal circulation when analyzed by SEM
technique. Copyright © 2023, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<75>
Accession Number
2022678443
Title
The Effect of Female Sex on Short-Term Outcomes of Patients Undergoing
Off-Pump Versus On-Pump Coronary Artery Bypass Grafting.
Source
Brazilian Journal of Cardiovascular Surgery. 38(1) (pp 110-123), 2023.
Date of Publication: 2023.
Author
Fan J.; Luo S.-L.; Pan Y.-C.; Wu T.-Y.; Chen Y.; Li W.-J.
Institution
(Fan, Luo, Pan, Wu, Chen, Li) Department of Cardiology, Guangzhou First
People's Hospital, School of Medicine, South China University of
Technology, Guangzhou, China
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: According to the American Heart Association guideline for
coronary artery bypass grafting (CABG), female patients undergoing on-pump
CABG (ONCAB) are at higher risk of short-term adverse outcomes than male
patients. However, whether off-pump CABG (OPCAB) can improve the
short-term outcome of female patients compared to ONCAB remains unclear.
 Method(s): We conducted a meta-analysis to study the effect of the
female sex on short-term outcomes of OPCAB vs. ONCAB. A total of 31,115
patients were enrolled in 12 studies, including 20,245 females who
underwent ONCAB and 10,910 females who underwent OPCAB. Result(s):
The in-hospital mortality in female patients who underwent OPCAB was
significantly lower than in those in the ONCAB group with (2.7% vs. 3.4%;
odds ratio [OR] 0.76; 95% confidence interval [CI] 0.65-0.89) and without
(OR 0.68; 95% CI 0.52-0.89) adjustment for cardiovascular risk factor. The
incidence of postoperative stroke in female patients who underwent OPCAB
was lower than in those in the ONCAB group (1.2% vs. 2.1%; OR 0.59; 95% CI
0.48-0.73) before cardiovascular risk factor adjustment but was not
significant (OR 0.87; 95% CI 0,66-1.16) after adjustment. There was no
significant difference in the incidence of postoperative myocardial
infarction between women who underwent OPCAB and those in the ONCAB group
(1.3% vs. 2.3%; OR 0.88; 95% CI 0.54-1.43). Conclusion(s): In
contrast to the American Heart Association CABG guideline, female patients
who had OPCAB don't have unfavorable outcomes compared with the ONCAB
group. Copyright © 2023, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<76>
Accession Number
2022819151
Title
Surgical valvotomy versus balloon dilatation for children with severe
aortic valve stenosis: a systematic review.
Source
Future Cardiology. 18(11) (pp 901-913), 2022. Date of Publication: 2022.
Author
Elhedai H.; Mohamed S.S.S.; Idriss H.; Bhattacharya P.; Mohamedahmed
A.Y.Y.
Institution
(Elhedai) Department of Cardiology, Birmingham Women's & Children's Nhs
Foundation Trust, Birmingham, United Kingdom
(Mohamed) Anaesthesia & Intensive Care Department, Sudan Medical
Specialization Board, Khartoum, Sudan
(Idriss) Department of Paediatrics, Homerton University Hospitals Nhs
Trust, London, United Kingdom
(Bhattacharya, Mohamedahmed) Department of General Surgery, Sandwell &
West Birmingham Hospitals Nhs Trust, Birmingham, United Kingdom
Publisher
Newlands Press Ltd
Abstract
Aim: To evaluate outcomes of interventions for severe aortic valve
stenosis (AS), whether it is done by surgical aortic valvotomy (SAV) or
balloon aortic dilatation (BAD). Result(s): Eleven studies with total
number of 1733 patients; 743 patients had SAV, while 990 patients received
BAD. There was no significant difference in early mortality (odds ratio
[OR]: 0.96, p = 0.86), late mortality (OR: 1.28, p = 0.25), total
mortality (OR: 1.10, p = 0.56), and freedom from aortic valve replacement
(OR: 1.00, p = 1.00). Reduction of aortic systolic gradient was
significantly higher in the SAV group (OR: 2.24, p = 0.00001), and
postprocedural AR rate was lower in SAV group (OR: 0.21, p = 0.00001).
 Conclusion(s): SAV is associated with better reduction of aortic
systolic gradient and lesser post procedural AR which reduce when compared
with BAD. Copyright © 2022 Future Medicine Ltd.

<77>
[Use Link to view the full text]
Accession Number
2022810945
Title
Family nursing with the assistance of network improves clinical outcome
and life quality in patients underwent coronary artery bypass grafting: A
consolidated standards of reporting trials-compliant randomized controlled
trial.
Source
Medicine (United States). 99(50) (pp E23488), 2020. Date of Publication:
11 Dec 2020.
Author
Jin L.; Pan R.; Huang L.; Zhang H.; Jiang M.; Zhao H.
Institution
(Jin, Pan, Huang, Zhang, Jiang, Zhao) Department of Cardiac Surgery, The
First Hospital of Jilin University, Changchun, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Family nursing with the assistance of network (FNAN) improves
nurses' practice and provides family/community-oriented nursing care. This
study aimed to explore the effects of FNAN on the clinical outcome and
life quality of coronary atherosclerotic heart disease (CHD) patients
underwent coronary artery bypass grafting (CABG). Trial Design: This study
is a randomized, placebo-controlled and double-blind trial.
 Method(s): One-hundred and twelve patients underwent CABG were
randomly divided into control group (CG, routine family nursing care) and
experimental group (EG, FNAN) and the allocation ratio was 1: 1. The
situation of anxiety and depression were analyzed using the Hamilton
Anxiety Scale (HAMA) scale and Hamilton Depression Scale (HAMD). Sleep
quality was measured by using Pittsburgh Sleep Quality Index (PSQI). Lung
function parameters were measured, including minute ventilation (MVV),
partial pressure of oxygen (PaO2), partial pressure of arterial carbon
dioxide (PaCO2), oxygen saturation measurement by pulse oximetry (SpO2),
forced expiratory volume in 1 second (FEV1) and forced vital capacity
(FVC). Life quality was measured by using Chronic Obstructive Pulmonary
Disease Assessment Test (CAT). Result(s): After a 3-month
intervention, 10 and 6 patients were lost in the CG and EG groups,
respectively. The scores of HAMA, HAMD, PSQI and CAT were reduced in the
EG group when compared with the CG group (P<.05). The values of MVV, PaO2,
SpO2, FEV1 and FVC in the EG group was higher than those in the CG group
whereas the levels of PaCO2 in the EG group was lower than those in the CG
group (P<.05). PSQI score had a strong relationship with the values of
MVV, PaO2, PaCO2, SpO2, FEV1, and FVC. Conclusion(s): FNAN improves
the clinical outcome and life quality in the patients underwent CABG.
 Copyright © 2020 the Author(s).

<78>
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Accession Number
2022810887
Title
Comparison of different transcatheter interventions for treatment of
mitral regurgitation: A protocol for a network meta-analysis.
Source
Medicine (United States). 99(50) (pp E23623), 2020. Date of Publication:
11 Dec 2020.
Author
Zhang B.; Li M.; Kang Y.; Xing L.; Zhang Y.
Institution
(Zhang) Department of Cardiothoracic Surgery, Wuwei People's Hospital,
Gansu, China
(Li) The Second Clinical Medical College, Lanzhou University, Lanzhou,
China
(Kang, Xing) School of Basic Medical Sciences, Lanzhou University, China
(Zhang) Department of Thoracic Surgery, First Hospital of Lanzhou
University, Lanzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The arrival of transcatheter mitral valve therapies has
provided feasible and safe alternatives to medical and surgical treatments
for mitral regurgitation. The aim of this study is to estimate the
relative efficacy and safety of different transcatheter mitral valve
therapies for mitral regurgitation patients through network meta-analysis.
 Method(s): A systematic search will be performed using PubMed,
EMBASE, the Cochrane Library, Web of Science, Chinese Biomedical
Literature Database, and China National Knowledge Infrastructure to
include random controlled trials and nonrandom controlled trials comparing
the efficacy and safety of different transcatheter mitral valve
techniques. The risk of bias for the included nonrandom controlled studies
will be evaluated according to Risk of Bias in Non-randomized Studies - of
Interventions. For random controlled trials, we will use Cochrane Handbook
version 5.1.0 as the risk of bias tool. A Bayesian network meta-analysis
will be conducted using R-4.0.3 software. Grading of recommendations
assessment, development, and evaluation will be used to assess the quality
of evidence. Result(s): The results of this network meta-analysis
will be submitted to a peer-reviewed journal for publication.
 Conclusion(s): This study will provide broad evidence of efficacy and
safety of different transcatheter mitral valve therapies for treatment of
mitral regurgitation and provide suggestions for clinical practice and
future research. Copyright © 2020 the Author(s).

<79>
[Use Link to view the full text]
Accession Number
2022810831
Title
Anaesthesia and ICU sedation with sevoflurane do not reduce myocardial
injury in patients undergoing cardiac surgery: A randomized prospective
study.
Source
Medicine (United States). 99(50) (pp E23253), 2020. Date of Publication:
11 Dec 2020.
Author
Guinot P.-G.; Ellouze O.; Grosjean S.; Berthoud V.; Constandache T.;
Radhouani M.; Anciaux J.-B.; Aho-Glele S.; Morgant M.-C.; Girard C.;
Nguyen M.; Bouhemad B.
Institution
(Guinot, Ellouze, Grosjean, Berthoud, Constandache, Radhouani, Anciaux,
Girard, Nguyen, Bouhemad) Department of Anesthesiology and Critical Care
Medicine, Dijon University Medical Center, Dijon, France
(Guinot) Universite Bourgogne Franche-Comte, LNC UMR866, Dijon, France
(Aho-Glele) Departement of Epidemiology, Dijon University Medical Center,
Dijon, France
(Morgant) Department of Cardiac Surgery, Dijon University Medical Center,
Dijon, France
Publisher
Lippincott Williams and Wilkins
Abstract
Background: To evaluate the effect of anaesthesia and ICU sedation with
sevoflurane to protect the myocardium against ischemia-reperfusion injury
associated to cardiac surgery assessed by troponin release.
 Method(s): We performed a prospective, open-label, randomized study
in cardiac surgery with cardiopulmonary bypass. Patients were randomized
to an algorithm-based intervention group and a control group. The main
outcome was the perioperative kinetic of cardiac troponin I (cTnI). The
secondary outcomes included composite endpoint, GDF-15 (macrophage
inhibitory cytokine-1) value, arterial lactate levels, and the length of
stay (LOS) in the ICU. Result(s): Of 82 included patients, 81 were
analyzed on an intention-to-treat basis (intervention group: n = 42;
control group: n = 39). On inclusion, the intervention and control groups
did not differ significantly in terms of demographic and surgical data.
The postoperative kinetics of cTnI did not differ significantly between
groups: the mean difference was 0.44 +/- 1.09 mug/ml, P = .69. Incidence
of composite endpoint and GDF-15 values were higher in the sevoflurane
group than in propofol group. The intervention and control groups did not
differ significantly in terms of ICU stay and hospital stay.
 Conclusion(s): The use of an anaesthesia and ICU sedation with
sevoflurane was not associated with a lower incidence of myocardial injury
assessed by cTnI. Sevoflurane administration was associated with higher
prevalence of acute renal failure and higher GDF-15 values. Copyright
© 2020 the Author(s).

<80>
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Accession Number
2022810819
Title
Efficacy and safety of corticosteroids prophylaxis in cardiac surgery: A
protocol for systematic review and meta-analysis.
Source
Medicine (United States). 99(50) (pp E23240), 2020. Date of Publication:
11 Dec 2020.
Author
He J.; Zhang Y.; Qiu Z.; Chai T.; Fang G.; Hu Y.; Xu F.; Huang Q.; Zheng
H.; Zhou H.; Tian M.; Chen L.W.
Institution
(He, Zhang, Qiu, Chai, Fang, Hu, Xu, Huang, Zheng, Zhou, Chen) Department
of Cardiac Surgery, Fujian Medical University Union Hospital, Fuzhou,
China
(Tian) School of Nursing, Xuzhou Medical University, Xuzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Although corticosteroid prophylaxis in adult cardiac surgery
has been studied extensively for 40 years, its role remains controversial,
and the optimal dose remains uncertain. The objective of this
meta-analysis was to estimate the clinical benefits and risks of
corticosteroid use in cardiopulmonary bypass. Method(s): We will
search Pubmed, Web of Science, Embase, Clinical Trials, and Cochrane
Central Register of Controlled Trials for relevant clinical trials
published in any language before August 1, 2020. Randomized controlled
trials (RCTs) of interest which meet inclusion criteria published or
unpublished will be included. We will divide the included studies into
child and adult groups for analysis. If sufficient data are available, the
included trials will be divided into 4 subgroups: <=20 mg/kg (low dose),
20-40 mg/kg (slightly high dose), 40-100 mg/kg (high dose), and >100 mg/kg
(ultra high dose) based on the equivalent hydrocortisone dose. INPLASY
registration number: INPLASY2020100044. Result(s): The results of
this study will be published in a peer-reviewed journal.
 Conclusion(s): This study will compare the efficacy of tprophylactic
corticosteroids for adults and children undergoing cardiac surgery with
CPB. Due to the nature of the disease and intervention methods, randomized
controlled trials may be inadequate, and we will carefully consider
inclusion in high-quality, non-randomized controlled trials, but this may
result in high heterogeneity and affect the reliability of the results.
 Copyright © 2020 the Author(s).

<81>
Accession Number
640341896
Title
Efficacy of propofol-supplemented cardioplegia on biomarkers of organ
injury in patients having cardiac surgery using cardiopulmonary bypass: A
protocol for a randomised controlled study (ProMPT2).
Source
Perfusion. (pp 2676591231157269), 2023. Date of Publication: 16 Feb 2023.
Author
Heys R.; Angelini G.D.; Joyce K.; Smartt H.; Culliford L.; Maishman R.; de
Jesus S.E.; Emanueli C.; Suleiman M.-S.; Punjabi P.; Rogers C.A.; Gibbison
B.
Institution
(Heys, Joyce, Smartt, Culliford, Maishman, de Jesus, Rogers) Bristol
Trials Centre, Bristol Medical School, 1980University of Bristol, Bristol,
United Kingdom
(Angelini, Suleiman) Bristol Heart Institute, 1980University of Bristol,
Bristol, United Kingdom
(Emanueli, Punjabi) National Heart and Lung Institute, 156647Hammersmith
Hospital, London, United Kingdom
(Gibbison) Department of Anaesthesia, 1984University Hospitals Bristol and
Weston NHS Foundation Trust, Bristol, United Kingdom
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Cardiac surgery with cardiopulmonary bypass and cardioplegic
arrest is known to be responsible for ischaemia and reperfusion organ
injury. In a previous study, ProMPT, in patients undergoing coronary
artery bypass or aortic valve surgery we demonstrated improved cardiac
protection when supplementing the cardioplegia solution with propofol (6
mcg/ml). The aim of the ProMPT2 study is to determine whether higher
levels of propofol added to the cardioplegia could result in increased
cardiac protection. METHODS AND ANALYSIS: The ProMPT2 study is a
multi-centre, parallel, three-group, randomised controlled trial in adults
undergoing non-emergency isolated coronary artery bypass graft surgery
with cardiopulmonary bypass. A total of 240 patients will be randomised in
a 1:1:1 ratio to receive either cardioplegia supplementation with high
dose of propofol (12 mcg/ml), low dose of propofol (6 mcg/ml) or placebo
(saline). The primary outcome is myocardial injury, assessed by serial
measurements of myocardial troponin T up to 48 hours after surgery.
Secondary outcomes include biomarkers of renal function (creatinine) and
metabolism (lactate). ETHICS AND DISSEMINATION: The trial received
research ethics approval from South Central - Berkshire B Research Ethics
Committee and Medicines and Healthcare products Regulatory Agency in
September 2018. Any findings will be shared though peer-reviewed
publications and presented at international and national meetings.
Participants will be informed of results through patient organisations and
newsletters. TRIAL REGISTRATION: ISRCTN15255199. Registered in March 2019.

<82>
Accession Number
640341690
Title
Ultrafiltration in cardiac surgery: Results of a systematic review and
meta-analysis.
Source
Perfusion. (pp 2676591231157970), 2023. Date of Publication: 16 Feb 2023.
Author
Hensley N.B.; Colao J.A.; Zorrilla-Vaca A.; Nanavati J.; Lawton J.S.;
Raphael J.; Mazzeffi M.A.; Wierschke C.; Kostibas M.P.; Cho B.C.; Frank
S.M.; Grant M.C.
Institution
(Hensley, Colao, Kostibas, Cho, Frank, Grant) Department of Anesthesiology
and Critical Care Medicine, 1501Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Zorrilla-Vaca) Department of Anesthesiology, Perioperative and Pain
Medicine, 1861Brigham and Women's Hospital, Boston, MA, United States
(Nanavati) Welch Medical Library, 1501Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Lawton) Department of Surgery, Division of Cardiac Surgery, 1501Johns
Hopkins University School of Medicine, Baltimore, MD, United States
(Raphael) Sidney Kimmel Medical College, Department of Anesthesiology,
12313Thomas Jefferson University Hospitals, Philadelphia, PA, United
States
(Mazzeffi) Department of Anesthesiology, George Washington University
Hospital, WA, United States
(Wierschke) Department of Surgery, Johns Hopkins Hospital, Baltimore, MD,
United States
Publisher
NLM (Medline)
Abstract
Background: Ultrafiltration is used with cardiopulmonary bypass to reduce
the effects of hemodilution and restore electrolyte balance. We performed
a systematic review and meta-analysis to analyze the effect of
conventional and modified ultrafiltration on intraoperative blood
transfusion. Method(s): Utilizing the Preferred Reporting Items for
Systematic Reviews and Meta-Analysis (PRISMA) statement, we systematically
searched MEDLINE, EMBASE, Web of Science, and Cochrane Library to perform
a meta-analysis of studies of randomized controlled trials (RCTs) and
observational studies evaluating conventional ultrafiltration (CUF) and
modified ultrafiltration (MUF) on the primary outcome of intraoperative
red cell transfusions. Result(s): A total of 7 RCTs (n = 928) were
included, comparing modified ultrafiltration (n = 473 patients) to
controls (n = 455 patients) and 2 observational studies (n = 47,007),
comparing conventional ultrafiltration (n = 21,748) to controls (n =
25,427). Overall, MUF was associated with transfusion of fewer
intraoperative red cell units per patient (n = 7); MD -0.73 units; 95% CI
-1.12 to -0.35 p = 0.04; p for heterogeneity = 0.0001, I2 = 55%) compared
to controls. CUF was no difference in intraoperative red cell transfusions
compared to controls (n = 2); OR 3.09; 95% CI 0.26-36.59; p = 0.37; p for
heterogeneity = 0.94, I2 = 0%. Review of the included observational
studies revealed an association between larger volumes (>2.2 L in a 70 kg
patient) of CUF and risk of acute kidney injury (AKI). Conclusion(s):
The results of this systematic review and meta-analysis suggest that MUF
is associated with fewer intraoperative red cell transfusions. Based on
limited studies, CUF does not appear to be associated with a difference in
intraoperative red cell transfusion.

<83>
Accession Number
640338127
Title
Health Inequities in Coronary Artery Bypass Grafting Literature: A Scoping
Review.
Source
Current problems in cardiology. (pp 101640), 2023. Date of Publication:
13 Feb 2023.
Author
Fisher Z.; Hughes G.; Staggs J.; Moore T.; Kinder N.; Vassar M.
Institution
(Fisher, Hughes, Moore, Vassar) Office of Medical Student Research,
Oklahoma State University Center for Health Sciences, Tulsa, OK, United
States
(Staggs) Office of Medical Student Research, Oklahoma State University
Center for Health Sciences, Tulsa, OK, United States
(Kinder) Cape Fear Valley Medical Center, Fayetteville, NC, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Although life saving, health inequities exist regarding access
and patient outcomes in Coronary artery bypass grafting (CABG), especially
among marginalized groups. This scoping review's goal is to outline
existing literature and highlight gaps for future research.
 METHOD(S): Researchers followed guidance from the Joanna Briggs
Institute and PRISMA extension for scoping reviews. We conducted a search
to identify articles published between 2016-2022 regarding CABG and
inequity groups, defined by the National Institutes of Health.
 RESULT(S): 57 articles were included in our final sample.
Race/Ethnicity was examined in 39 incidences, Sex or Gender 29 times,
Income 17 instances, Geography 10 instances, and Education Level 3
instances. Occupation Status 2 instances, and LGBTQ+ 0 times.
 CONCLUSION(S): Important disparities exist regarding CABG access and
outcomes, especially involving members of the LGBTQ+, Native American, and
Black communities. Further research is needed to address health
disparities and their root causes for focused action and improved health
of minoritized groups. Copyright © 2023 Elsevier Ltd. All rights
reserved.

<84>
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. Design(s): A randomized, controlled,
double-blinded, superiority study. Setting(s): University hospital.
 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. 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. 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. 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. Copyright © 2022 Elsevier Inc.

<85>
[Use Link to view the full text]
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. Copyright © 2022
Wolters Kluwer Health, Inc. All rights reserved.

<86>
[Use Link to view the full text]
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. Copyright © 2022 Wolters
Kluwer Health, Inc. All rights reserved.

<87>
Accession Number
2022465560
Title
Factors affecting extubating time of postoperative patients who underwent
congenital cardiac surgery: a randomized prospective study.
Source
European Review for Medical and Pharmacological Sciences. 27(2) (pp
763-772), 2023. Date of Publication: 2023.
Author
Onur T.; Karaca U.; Onur A.; Engin M.; Demirel A.; Sayan H.E.; Ozgunay
S.E.; Kilicarslan N.; Secici S.; Yirtimci S.
Institution
(Onur, Karaca, Onur, Demirel, Sayan, Ozgunay, Kilicarslan, Yirtimci)
Department of Anesthesiology and Reanimation, University of Health
Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa,
Turkey
(Engin) Department of Cardiovascular Surgery, University of Health
Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa,
Turkey
(Secici) Pediatric Cardiac Surgery, Medicana Hospital, Bursa, Turkey
Publisher
Verduci Editore s.r.l
Abstract
OBJECTIVE: Anesthesia management in pediatric cardiac surgery using health
resources sparingly focuses on reducing morbidity and mortality and
increasing patients' quality of life. The duration of postoperative
mechanical ventilation (MV) heavily influences pediatric cardiac surgery
recovery. Thus, in this study we aimed to determine factors influencing
extubation times after pediatric cardiac surgery. PATIENTS AND
METHODS: A total of 72 pediatric patients with an ASA score of III or
above undergoing cardiac surgery were included in the study. As a result
of their extubation time, the patients were divided into three groups as
follows: those who were extubated immediately after surgery or in the
operating room (OR) were recorded as Immediate Extubators (IE); those who
were extubated within 6 to 48 hours of entering the intensive care unit
were recorded as Early Extubators (EE), and those who were extubated after
48 hours or not extubated were recorded as Delayed Extubators (DE).
 RESULT(S): A logistic regression analysis showed that anomalies and
need of MV before surgery, airway difficulty, and prolonged cross-clamp
(CC) time were observed as factors affecting DE. The risk of DE was
significantly correlated with the presence of abnormality [Odds ratio
(OR): 20.3, 95% Confident interval (CI): 2.8-142.7], with the need of MV
before surgery (OR: 1,844, 95% CI: 1.8-1,790,461.9), and with the presence
of airway difficulty (OR: 44.7, 95% CI: 4.4-445.0). In addition, it was
determined that CC time increased the probability of DE 1.038 times per
minute (95% CI: 1.004-1.072). CONCLUSION(S): Early and immediate
extubation in children who underwent congenital heart surgery was
successfully performed in our clinic. Early and immediate extubation in
pediatric cardiac surgery can be completed safely and successfully when
suitable conditions are provided. Copyright © 2023 Verduci
Editore s.r.l. All rights reserved.

<88>
Accession Number
2019659546
Title
Octreotide for Acquired Chylothorax in Pediatric Patients
Post-Cardiothoracic Surgery for Congenital Heart Disease: A Systematic
Review.
Source
Pediatric Cardiology. 44(2) (pp 297-305), 2023. Date of Publication:
February 2023.
Author
Jenkinson A.C.; McGuinness J.; Prendiville T.
Institution
(Jenkinson, Prendiville) Department of Cardiology, Children's Heart
Centre, Children's Health Ireland at Crumlin, Dublin, Ireland
(McGuinness) Department of Cardiothoracic Surgery, Children's Heart
Centre, Children's Health Ireland at Crumlin, Dublin, Ireland
(Prendiville) Department of Pediatric Cardiology, Children's Heart Centre,
Children's Health Ireland at Crumlin Hospital, Dublin, Ireland
Publisher
Springer
Abstract
Chylothorax is a life-threatening complication post-corrective congenital
heart surgery. Octreotide is used for treatment of refractory
chylothoraces, with no standardized treatment protocol and a paucity of
literature describing its efficacy. Our aim was to provide an update on
the safety and efficacy of octreotide for the treatment of refractory
chylothoraces in neonatal and pediatric patients' post-corrective
congenital heart surgery. We performed a systematic review of PubMed,
Medline, CINAHL, and Cochrane Library databases. Only intravenous
octreotide treatment was included. A total of 621 patients across 27
studies were included. Studies included were 11 case series, 5 case
studies, and 11 retrospective cohort studies. Variation in treatment
regimens were reported. Treatment efficacy was reported in 95% (23/27) of
studies. Definitions of treatment efficacy were reported in 33% (9/27) of
studies. No prospective or randomized control trials were available for
inclusion. Octreotide efficacy is widely reported despite a lack of
standardization on criteria for treatment initiation or what defines an
appropriate response to therapy.Please check and confirm whether the edit
made to the article title is in order.Yes. Copyright © 2022, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<89>
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. 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. 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.
 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. Copyright © 2023 by
Author/s and Licensed by Modestum. All rights reserved.

<90>
[Use Link to view the full text]
Accession Number
2022653576
Title
Dual Pathway Inhibition with Rivaroxaban and Aspirin Reduces Inflammatory
Biomarkers in Atherosclerosis.
Source
Journal of Cardiovascular Pharmacology. 81(2) (pp 129-133), 2023. Date of
Publication: 26 Feb 2023.
Author
Russo V.; Fabiani D.; Leonardi S.; Attena E.; D'Alterio G.; Cotticelli C.;
Rago A.; Sarpa S.; Maione B.; D'Onofrio A.; Golino P.; Nigro G.
Institution
(Russo, Fabiani, Cotticelli, Golino, Nigro) Department of Medical
Translational Sciences, University of Campania, Luigi Vanvitelli, Naples,
Italy
(Leonardi, Sarpa, Maione) Clinical Biochemistry Unit, Monaldi Hospital,
Naples, Italy
(Attena, D'Alterio, Rago, D'Onofrio) Department of Cardiology, Monaldi
Hospital, Naples, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Dual pathway inhibition (DPI) with low-dose rivaroxaban and aspirin in
patients with coronary artery disease (CAD) and/or peripheral artery
disease (PAD) reduces the occurrence of cardiovascular (CV) events;
however, the underlying mechanisms explaining these latter CV benefits are
not clearly understood. Our explorative observational study aimed to
evaluate the effect of dual pathway inhibition on plasma inflammation and
coagulation markers among real-world patients with CAD and/or PAD. We
prospectively included all consecutive patients with an established
diagnosis of CAD and/or PAD treated with aspirin 100 mg once daily (OD)
and rivaroxaban 2.5 mg twice daily (TD). Clinical evaluation and
laboratory analyses, including hemoglobin, renal function (creatinine,
urea, and cystatin-C), coagulation markers (INR and aPTT), inflammation
markers (IL-6, CRP, lipoprotein-associated phospholipase A2, and
copeptin), and growth differentiation factor-15 (GDF-15), were conducted
at baseline, before starting treatment, and at 4 and 24 weeks after study
drug administration. Fifty-four consecutive patients (mean age 66 +/- 7
years; male 83%) who completed the 6-month follow-up were included. At
24-week follow-up, a statistically significant reduction in IL-6 serum
levels [4.6 (3.5-6.5) vs. 3.4 (2.4-4.3) pg/mL; P = 0.0001] and fibrinogen
[336 (290-390) vs. 310 (275-364) mg/dL; P = 0.04] was shown; moreover, a
significant increase in GDF-15 serum level [1309 (974-1961) vs. 1538
(1286-2913) pg/mL; P = 0.002] was observed. Hemoglobin, renal function,
and cardiovascular homeostasis biomarkers remain stable over the time. The
anti-Xa activity at both [0.005 (0-0.02) vs. 0.2 (0.1-0.34); P < 0.0001)
significantly increased. The dual pathway inhibitions with low-dose
rivaroxaban and aspirin in patients with CAD and/or PAD were associated
with the reduction of inflammation biomarkers. Copyright ©
Lippincott Williams & Wilkins.

<91>
Accession Number
2021027313
Title
Regression-based estimation of heterogeneous treatment effects when
extending inferences from a randomized trial to a target population.
Source
European Journal of Epidemiology. 38(2) (pp 123-133), 2023. Date of
Publication: February 2023.
Author
Robertson S.E.; Steingrimsson J.A.; Dahabreh I.J.
Institution
(Robertson, Dahabreh) CAUSALab, Harvard T.H. Chan School of Public Health,
Boston, MA, United States
(Robertson, Dahabreh) Department of Epidemiology, Harvard T.H. Chan School
of Public Health, Boston, MA 02115, United States
(Steingrimsson) Department of Biostatistics, Brown University School of
Public Health, Providence, RI, United States
(Dahabreh) Department of Biostatistics, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
Publisher
Springer Science and Business Media B.V.
Abstract
Most work on extending (generalizing or transporting) inferences from a
randomized trial to a target population has focused on estimating average
treatment effects (i.e., averaged over the target population's covariate
distribution). Yet, in the presence of strong effect modification by
baseline covariates, the average treatment effect in the target population
may be less relevant for guiding treatment decisions. Instead, the
conditional average treatment effect (CATE) as a function of key effect
modifiers may be a more useful estimand. Recent work on estimating target
population CATEs using baseline covariate, treatment, and outcome data
from the trial and covariate data from the target population only allows
for the examination of heterogeneity over distinct subgroups. We describe
flexible pseudo-outcome regression modeling methods for estimating target
population CATEs conditional on discrete or continuous baseline covariates
when the trial is embedded in a sample from the target population (i.e.,
in nested trial designs). We construct pointwise confidence intervals for
the CATE at a specific value of the effect modifiers and uniform
confidence bands for the CATE function. Last, we illustrate the methods
using data from the Coronary Artery Surgery Study (CASS) to estimate CATEs
given history of myocardial infarction and baseline ejection fraction
value in the target population of all trial-eligible patients with stable
ischemic heart disease. Copyright © 2023, Springer Nature B.V.

<92>
Accession Number
2021351790
Title
Association of renin-angiotensin system inhibitors use with short- and
long-term mortality in patients with aortic stenosis: A systematic review
and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 917064. Date of Publication: 23 Jan 2023.
Author
Guan Y.; Kong X.; Zhu H.; Li H.; Zhao L.; Guo F.; Lv Q.
Institution
(Guan, Zhu, Li, Guo, Lv) Department of Cardiology, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
(Kong, Zhao) Department of General Medicine, Beijing Luhe Hospital,
Capital Medical University, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Purpose: The present study aimed to investigate the association of
renin-angiotensin system inhibitors (RASi) with short- and long-term
mortality in patients with aortic stenosis (AS). Method(s): A
systematic search was performed in PubMed, Embase, and Cochrane library
databases for relevant studies published before March 2022. Studies
meeting the inclusion criteria were included to assess the effect of RASi
on short-term (<=30 days) and long-term (>=1 year) mortality in patients
with AS. Result(s): A total of 11 studies were included in the
meta-analysis. Our results demonstrated that RASi reduced short-term
mortality (OR = 0.76, 95% CI 0.63-0.93, p = 0.008) after aortic valve
replacement (AVR). Subgroup analysis revealed that RASi was still
associated with lower short-term mortality after transcatheter aortic
valve replacement (TAVR); however, the association was relatively weak in
patients who underwent surgical aortic valve replacement (SAVR). For
long-term mortality, the pooled OR was 1.04 (95% CI 0.88-1.24, p = 0.63)
after sensitivity analysis in patients who did not undergo AVR. In
addition, our study confirmed that RASi significantly reduced long-term
mortality (OR = 0.57, 95% CI 0.44-0.74, p < 0.0001) in patients who
underwent AVR. Subgroup analysis showed that both TAVR and SAVR groups
treated with RASi had lower long-term mortality. Conclusion(s):
Renin-angiotensin system inhibitors did not change long-term mortality in
AS patients who did not undergo AVR. However, RASi reduced short- and
long-term mortality in patients who underwent AVR. Copyright ©
2023 Guan, Kong, Zhu, Li, Zhao, Guo and Lv.

<93>
Accession Number
2022503193
Title
Durable polymer versus biodegradable polymer drug-eluting stents in
patients with acute coronary syndrome undergoing complex percutaneous
coronary intervention: a post hoc analysis of the HOST-REDUCE-POLYTECH-ACS
trial.
Source
EuroIntervention. 18(11) (pp E910-E919), 2022. Date of Publication:
December 2022.
Author
Hwang D.; Lim H.-S.; Park K.W.; Shin W.-Y.; Kang J.; Han J.-K.; Yang
H.-M.; Kang H.-J.; Koo B.-K.; Cho Y.-K.; Hong S.J.; Kim S.; Jo S.-H.; Kim
Y.H.; Kim W.; Lee S.Y.; Oh S.K.; Kim D.-B.; Kim H.-S.
Institution
(Hwang, Park, Kang, Han, Yang, Kang, Koo, Kim) Department of Internal
Medicine, Cardiovascular Center, Seoul National University Hospital,
Seoul, South Korea
(Lim) Department of Cardiology, Ajou University, School of Medicine,
Suwon, South Korea
(Shin) Division of Cardiology, Department of Internal Medicine,
Soonchunhyang University Cheonan Hospital, Cheonan, South Korea
(Cho) Division of Cardiology, Department of Internal Medicine, Keimyung
University Dongsan Hospital, Keimyung University, School of Medicine,
Daegu, South Korea
(Hong) Division of Cardiology, Cardiovascular Center, Korea University
Anam Hospital, Seoul, South Korea
(Kim) Division of Cardiology, Department of Internal Medicine, SMG-SNU
Boramae Medical Center, Seoul, South Korea
(Jo) Division of Cardiology, Department of Internal Medicine, Hallym
University Sacred Heart Hospital, Anyang, South Korea
(Kim) Division of Cardiology, Department of Internal Medicine, Kangwon
National University, School of Medicine, Chuncheon, South Korea
(Kim) Department of Internal Medicine, Kyung Hee University Medical
Center, Kyung Hee University, Seoul, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Inje
University Ilsan Paik Hospital, Goyang, South Korea
(Oh) Department of Cardiology, Wonkwang University, School of Medicine,
Iksan, South Korea
(Kim) Division of Cardiology, Department of Internal Medicine, Bucheon St.
Mary's Hospital, College of Medicine, Bucheon, South Korea
Publisher
Europa Group
Abstract
Background: Comparative data of durable polymer (DP) versus biodegradable
polymer (BP) drug-eluting stents (DES) are limited in patients presenting
with acute coronary syndrome (ACS) undergoing complex percutaneous
coronary intervention (PCI). Aim(s): We sought to evaluate the
efficacy and safety of DP-DES and BP-DES in ACS patients receiving complex
PCI. Method(s): This study was a post hoc analysis of the
HOST-REDUCE-POLYTECH-ACS trial. ACS patients were randomly assigned 1:1 to
DP-DES or BP-DES in the HOST-REDUCE-POLYTECH-ACS trial. Complex PCI was
defined as having at least 1 of the following features: >=3 stents
implanted, >=3 lesions treated, total stent length >=60 mm, bifurcation
PCI with 2 stents, left main PCI, or heavy calcification. Patient-oriented
(POCO, a composite of all-cause death, non-fatal myocardial infarction,
and any repeat revascularisation) and device-oriented composite outcomes
(DOCO, a composite of cardiac death, target vessel myocardial infarction,
or target lesion revascularisation) were evaluated at 12 months.
 Result(s): Among 3,301 patients for whom full procedural data were
available, 1,140 patients received complex PCI. Complex PCI was associated
with higher risks of POCO and DOCO. The risks of POCO were comparable
between DP-DES and BP-DES in both the complex (HR 0.87, 95% confidence
interval [CI]: 0.57-1.33; p=0.522) and non-complex (HR 0.83, 95% CI:
0.56-1.24; p=0.368; p for interaction=0.884) PCI groups. DOCO was also not
significantly different between DP-DES and BP-DES in both the complex (HR
0.74, 95% CI: 0.43-1.27; p=0.278) and non-complex (HR 0.67, 95% CI:
0.38-1.19; p=0.175; p for interaction=0.814) PCI groups.
 Conclusion(s): In ACS patients, DP-DES and BP-DES showed similar
clinical outcomes irrespective of PCI complexity. The registration
information for the HOST-REDUCE-POLYTECH-ACS trial is available at
ClinicalTrials.gov: NCT02193971. Copyright © Europa Digital &
Publishing 2022. All rights reserved.

<94>
Accession Number
2020895286
Title
Mitral regurgitation management: A systematic review of clinical practice
guidelines and recommendations.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 8(5) (pp
481-495), 2022. Date of Publication: 01 Sep 2022.
Author
Galusko V.; Sekar B.; Ricci F.; Wong K.; Bhattacharyya S.; Mullen M.;
Gallina S.; Ionescu A.; Khanji M.Y.
Institution
(Galusko) Department of Cardiology, King's College Hospital, London SE5
9RS, United Kingdom
(Sekar) Department of Cardiology, Gloucestershire Hospitals NHS Foundation
Trust, Gloucester GL1 3NN, United Kingdom
(Ricci, Gallina) Department of Neuroscience, Imaging and Clinical
Sciences, Institute of Advanced Biomedical Technologies, G.d'Annunzio
University, Chieti 66100, Italy
(Ricci) Department of Clinical Sciences, Lund University, Jan Waldenstroms
gata 35-205, Malmo 22100, Sweden
(Ricci) Department of Cardiology, Casa di Cura Villa Serena, Citta
sant'Angelo, Pescara 65013, Italy
(Wong, Bhattacharyya, Mullen, Khanji) Department of Cardiology, Barts
Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE,
United Kingdom
(Bhattacharyya, Khanji) NIHR Barts Biomedical Research Centre, William
Harvey Research Institute, Queen Mary University of London, London EC1A
7BE, United Kingdom
(Ionescu) Department of Cardiology, Morriston Cardiac Regional Centre,
Swansea Bay Health Board, Swansea SA6 6NL, United Kingdom
(Khanji) Department of Cardiology, Newham University Hospital, Barts
Health NHS Trust, Glen Road, London E13 8SL, United Kingdom
Publisher
Oxford University Press
Abstract
Multiple guidelines exist for the diagnosis and management of mitral
regurgitation (MR), the second most common valvular heart disease in
high-income countries, with recommendations that do not always match. We
systematically reviewed guidelines on diagnosis and management of MR,
highlighting similarities and differences to guide clinical
decision-making. We searched national and international guidelines in
MEDLINE and EMBASE (1 June 2010 to 1 September 2021), the Guidelines
International Network, National Guideline Clearinghouse, National Library
for Health Guidelines Finder, Canadian Medical Association Clinical
Practice Guidelines Infobase, and websites of relevant organizations. Two
reviewers independently screened the abstracts and identified articles of
interest. Guidelines that were rigorously developed (as assessed with the
Appraisal of Guidelines for Research and Evaluation II instrument) were
retained for analysis. Five guidelines were retained. There was consensus
on a multidisciplinary approach from the heart team and for the definition
and grading of severe primary MR. There was general agreement on the
thresholds for intervention in symptomatic and asymptomatic primary MR;
however, discrepancies were present. There was agreement on optimization
of medical therapy in severe secondary MR and intervention in patients
symptomatic despite optimal medical therapy, but no consensus on the
choice of intervention (surgical repair/replacement vs.Transcatheter
approach). Cut-offs for high-risk intervention in MR, risk stratification
of progressive MR, and guidance on mixed valvular disease were
sparse. Copyright © 2021 The Author(s). Published by Oxford
University Press on behalf of the European Society of Cardiology.

<95>
Accession Number
2020895277
Title
Randomized comparison of the clinical Outcome of single versus Multiple
Arterial grafts: Quality of Life (ROMA:QOL)-Rationale and Study Protocol.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 8(5) (pp
510-517), 2022. Date of Publication: 01 Sep 2022.
Author
Masterson Creber R.; Safford M.; Ballman K.; Myers A.; Fremes S.; Gaudino
M.
Institution
(Masterson Creber, Ballman, Myers) Division of Health Informatics,
Department of Population Health Sciences, Weill Cornell Medicine, 425 East
61st Street, Suite 301, New York, NY 10065, United States
(Safford) Division of General Internal Medicine, Department of Medicine,
Weill Cornell Medicine, 1300 York Ave F-2007, New York, NY 10065, United
States
(Fremes) Department of Surgery (Cardiac), Schulich Heart Centre,
Sunnybrook Health Science, University of Toronto, 2075 Bayview Avenue,
H-Wing Room H410, Toronto, ON M4N 3M5, Canada
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
525 E 68th St M-404, New York, NY 10065, United States
Publisher
Oxford University Press
Abstract
Aims: The objective of the Randomized comparison of the Outcome of single
vs. Multiple Arterial grafts: Quality of Life (ROMA:QOL) trial is to
evaluate the impact of coronary artery bypass graft surgery (CABG) on
quality of life (QOL). The primary hypothesis of ROMA:QOL is that
participants in the multiple arterial graft (MAG) will report time-varying
changes in QOL that will be lower in the post-operative recovery period
and higher after 12 months compared to patients in the single arterial
graft (SAG). The secondary hypotheses are that both groups will have
improvements in symptoms at 12 months, and that compared to the SAG group,
participants in the MAG group will experience better physical functioning
and physical and mental health symptoms. Methods and Results: An
estimated 2111 participants will be enrolled from the parent ROMA trial
from 13 countries. Outcome assessments include the Seattle Angina
Questionnaire (SAQ) (primary outcome), Short Form-12v2, EuroQol-5D
(EQ-5D)-5L, PROMIS-29, and PROMIS Neuropathic Pain measured at baseline,
first post-operative visit, 6, 12, 24, 36, 48, and 60 months. The analysis
for the primary outcome, the change in the SAQ from baseline to 12 months,
will be compared across all time-points between the two treatment arms.
 Conclusion(s): The ROMA:QOL trial will answer whether there are
differences in QOL, physical and mental health symptoms overall for CABG,
by MAG and SAG intervention arms, by sex, and between patients with and
without diabetes. Copyright © 2021 Published on behalf of the
European Society of Cardiology. All rights reserved.

<96>
Accession Number
2020010524
Title
Coronary artery bypass surgery for acute coronary syndrome: A network
meta-analysis of on-pump cardioplegic arrest, off-pump, and on-pump
beating heart strategies.
Source
Journal of Cardiac Surgery. 37(12) (pp 5290-5299), 2022. Date of
Publication: December 2022.
Author
Hwang B.; Williams M.L.; Tian D.H.; Yan T.D.; Misfeld M.
Institution
(Hwang) School of Medicine, University of New South Wales, Sydney,
Australia
(Hwang, Williams, Tian, Yan) The Collaborative Research (CORE) Group,
Macquarie University, Sydney, Australia
(Williams) Department of Cardiothoracic Surgery, Dunedin Hospital,
Dunedin, New Zealand
(Yan, Misfeld) Department of Cardiothoracic Surgery, Royal Prince Alfred
Hospital, Sydney, Australia
Publisher
John Wiley and Sons Inc
Abstract
Background: Coronary artery bypass grafting (CABG) in the setting of an
acute coronary syndrome is a high-risk procedure, and the best strategy
for myocardial revascularisation remains debated. This study compares the
30-day mortality benefit of on-pump CABG (ONCAB), off-pump CABG (OPCAB),
and on-pump beating heart CABG (OnBHCAB) strategies. Method(s): A
systematic search of three electronic databases was conducted for studies
comparing ONCAB with OPCAB or OnBHCAB in patients with acute coronary
syndrome (ACS). The primary outcome, 30-day mortality, was compared using
a Bayesian hierarchical network meta-analysis (NMA). A random effects
consistency model was applied, and direct and indirect comparisons were
made to determine the relative effectiveness of each strategy on
postoperative outcomes. Result(s): One randomised controlled trial
and eighteen observational studies fulfilling the inclusion criteria were
identified. A total of 4320, 5559, and 1962 patients underwent ONCAB,
OPCAB, and OnBHCAB respectively. NMA showed that OPCAB had the highest
probability of ranking as the most effective treatment in terms of 30-day
mortality (odds ratio [OR], 0.50; 95% credible interval [CrI], 0.23-1.00),
followed by OnBHCAB (OR, 0.62; 95% CrI, 0.20-1.57), however the 95% CrI
crossed or included unity. A subgroup NMA of nine studies assessing only
acute myocardial infarction (AMI) patients demonstrated a 72% reduction in
likelihood of 30-day mortality after OPCAB (CrI, 0.07-0.83). No
significant increase in rate of stroke, renal dysfunction or length of
intensive care unit stay was found for either strategy.
 Conclusion(s): Although no single best surgical revascularisation
approach in ACS patients was identified, the significant mortality benefit
with OPCAB seen with AMI suggests high acuity patients may benefit most
from avoiding further myocardial injury associated with cardiopulmonary
bypass and cardioplegic arrest. Copyright © 2022 The Authors.
Journal of Cardiac Surgery published by Wiley Periodicals LLC.

<97>
Accession Number
2019217596
Title
Surgical Resection of a Recurrent Hepatocellular Carcinoma with Portal
Vein Thrombosis: Is It a Good Treatment Option? A Case Report and
Systematic Review of the Literature.
Source
Journal of Clinical Medicine. 11(18) (no pagination), 2022. Article
Number: 5287. Date of Publication: September 2022.
Author
Sena G.; Paglione D.; Gallo G.; Goglia M.; Osso M.; Nardo B.
Institution
(Sena) Department of Vascular Surgery, Pugliese-Ciaccio Hospital,
Catanzaro 88100, Italy
(Paglione, Osso, Nardo) Department of Pharmacy, Health and Nutritional
Sciences, University of Calabria, Rende 87036, Italy
(Gallo) Department of Surgical Sciences, Sapienza University of Rome, Rome
00161, Italy
(Goglia) Department of General Surgery, Sant'Andrea University Hospital,
Sapienza University of Rome, Rome 00189, Italy
Publisher
MDPI
Abstract
Background: Hepatocellular carcinoma (HCC) is the sixth most frequent
diagnosed tumor worldwide and the third leading cause of cancer related
death. According to the EASL Guidelines, HCC with portal vein tumor
thrombosis (PVTT) is classified as an advanced stage (BCLC stage C) and
the only curative option is represented by systemic therapy. Therefore,
treatment of HCC patients with PVTT remains controversial and debated. In
this paper, we describe the case of a 66-year-old man with a recurrent HCC
with PVTT who underwent surgical resection. A systematic review of the
literature, comparing surgical resection with other choices of treatment
in HCC patients with PVTT, is reported. Method(s): A systematic
review of the literature regarding all prospective and retrospective
studies comparing the survival outcomes of HCC patients with PVTT treated
with surgical resections (SRs) or other non-surgical treatments (n-SRs)
has been conducted. Case presentation: A 66-year-old Caucasian man with a
history of Hepatitis C Virus (HCV) related liver cirrhosis and previous
hepatocellular carcinoma of the VI segment treated with percutaneous
ethanol infusion (PEI) seven years before presented to our clinics. A new
nodular hypoechoic lesion in the VI hepatic segment was demonstrated on
follow-up ultrasound examination. A hepatospecific magnetic resonance
imaging (MRI) scan confirmed also the presence of a 18 x 13 mm nodular
lesion in the V hepatic segment with satellite micronodules associated
with V-VIII sectoral portal branch thrombosis. The case was then discussed
at the multidisciplinary team meeting, and it was decided to perform a
right hepatectomy. The postoperative course was regular and uneventful,
and the discharge occurred seven days after the surgery. At eight-month
follow-up, there was no clinical nor radiological evidence of neoplastic
recurrence, with well-preserved liver function (Child-Pugh A5).
 Result(s): Nine studies were included in the review. Median Overall
Survaival (OS) ranged from 8.2 to 30 months for SRs patients and from 7 to
13.3 for n-SRs patients. In SR patients, one-year survival ranged from
22.7% to 100%, two-year survival from 9.8% to 100%, and three-year
survival from 0% to 71%. In n-SRs patients, one-year survival ranged from
11.8% to 77.6%, two-year survival from 0% to 47.8%, and three-year
survival from 0% to 20.9%. Conclusion(s): The present systematic
literature review and the case presented demonstrated the efficacy of
surgery as a first-line treatment in well-selected HCC patients with PVTT
limited or more distal to the right and left portal branches. However,
further studies, particularly randomized trials, need to be conducted in
future to better define the surgical indications. Copyright ©
2022 by the authors.

<98>
Accession Number
2019217560
Title
The Analgesic Efficacy of the Single Erector Spinae Plane Block with
Intercostal Nerve Block Is Not Inferior to That of the Thoracic
Paravertebral Block with Intercostal Nerve Block in Video-Assisted
Thoracic Surgery.
Source
Journal of Clinical Medicine. 11(18) (no pagination), 2022. Article
Number: 5452. Date of Publication: September 2022.
Author
Kim S.; Song S.W.; Do H.; Hong J.; Byun C.S.; Park J.-H.
Institution
(Kim, Song, Do, Hong, Park) Department of Anesthesiology and Pain
Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, South
Korea
(Byun) Department of Thoracic and Cardiovascular Surgery, Wonju College of
Medicine, Yonsei University, Wonju 26426, South Korea
Publisher
MDPI
Abstract
This monocentric, single-blinded, randomized controlled noninferiority
trial investigated the analgesic efficacy of erector spinae plane block
(ESPB) combined with intercostal nerve block (ICNB) compared to that of
thoracic paravertebral block (PVB) with ICNB in 52 patients undergoing
video-assisted thoracic surgery (VATS). The endpoints included the
difference in visual analog scale (VAS) scores for pain (0-10, where 10 =
worst imaginable pain) in the postanesthetic care unit (PACU) and 24 and
48 h postoperatively between the ESPB and PVB groups. The secondary
endpoints included patient satisfaction (1-5, where 5 = extremely
satisfied) and total analgesic requirement in morphine milligram
equivalents (MME). Median VAS scores were not significantly different
between the groups (PACU: 2.0 (1.8, 5.3) vs. 2.0 (2.0, 4.0), p = 0.970; 24
h: 2.0 (0.8, 3.0) vs. 2.0 (1.0, 3.5), p = 0.993; 48 h: 1.0 (0.0, 3.5) vs.
1.0 (0.0, 5.0), p = 0.985). The upper limit of the 95% CI for the
differences (PACU: 1.428, 24 h: 1.052, 48 h: 1.176) was within the
predefined noninferiority margin of 2. Total doses of rescue analgesics
(110.24 +/- 103.64 vs. 118.40 +/- 93.52 MME, p = 0.767) and satisfaction
scores (3.5 (3.0, 4.0) vs. 4.0 (3.0, 5.0), p = 0.227) were similar. Thus,
the ESPB combined with ICNB may be an efficacious option after
VATS. Copyright © 2022 by the authors.

<99>
Accession Number
2018424050
Title
Antiplatelets Versus Anticoagulation in Cervical Artery Dissection: A
Systematic Review and Meta-analysis of 2064 Patients.
Source
Drugs in R and D. 22(3) (pp 187-203), 2022. Date of Publication: September
2022.
Author
Hagrass A.I.; Almaghary B.K.; Mostafa M.A.; Elfil M.; Elsayed S.M.; Aboali
A.A.; Hamdallah A.; Hasan M.T.; Al-kafarna M.; Ragab K.M.; Doheim M.F.
Institution
(Hagrass, Hasan) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Almaghary, Al-kafarna) Faculty of Pharmacy, Al-Azhar University-Gaza,
Gaza Strip, Palestine
(Mostafa) Paradise Neurology and Rehabilitation Clinics, Alexandria, Egypt
(Elfil) Department of Neurological Sciences, University of Nebraska
Medical Center, Omaha, NE, United States
(Elsayed) Faculty of Medicine, October 6 University, Giza, Egypt
(Aboali, Doheim) Faculty of Medicine, Alexandria University, El-Shatby, 22
El-Guish Road, Alexandria 21526, Egypt
(Hamdallah) Faculty of Medicine, Al-Azhar University, Damietta, Egypt
(Ragab) Faculty of Medicine, Minia University, Minia, Egypt
Publisher
Adis
Abstract
Background and Objectives: In young people aged < 50 years, cervical
artery dissection (CeAD) is among the most common causes of stroke.
Currently, there is no consensus regarding the safest and most effective
antithrombotic treatment for CeAD. We aimed to synthesize concrete
evidence from studies that compared the efficacy and safety of
antiplatelet (AP) versus anticoagulant (AC) therapies for CeAD.
 Method(s): We searched major electronic databases/search engines from
inception till September 2021. Cohort studies and randomized controlled
trials (RCTs) comparing anticoagulants with antiplatelets for CeAD were
included. A meta-analysis was conducted using articles that were obtained
and found to be relevant. Mean difference (MD) with 95% confidence
interval (CI) was used for continuous data and odds ratio (OR) with 95% CI
for dichotomous data. Result(s): Our analysis included 15 studies
involving 2064 patients, 909 (44%) of whom received antiplatelets and 1155
(56%) received anticoagulants. Our analysis showed a non-significant
difference in terms of the 3-month mortality (OR 0.47, 95% CI 0.03-7.58),
> 3-month mortality (OR 1.63, 95% CI 0.40-6.56), recurrent stroke (OR
0.97, 95% CI 0.46-2.02), recurrent transient ischaemic attack (TIA) (OR
0.93, 95% CI 0.44-1.98), symptomatic intracranial haemorrhage (sICH) (OR
0.38, 95% CI 0.12-1.19), and complete recanalization (OR 0.70, 95% CI
0.46-1.06). Regarding primary ischaemic stroke, the results favoured AC
over AP among RCTs (OR 6.97, 95% CI 1.25-38.83). Conclusion(s): Our
study did not show a considerable difference between the two groups, as
all outcomes showed non-significant differences between them, except for
primary ischaemic stroke (RCTs) and complete recanalization (observational
studies), which showed a significant favour of AC over AP. Even though
primary ischaemic stroke is an important outcome, several crucial points
that could affect these results should be paid attention to. These include
the incomplete adjustment for the confounding effect of AP-AC doses,
frequencies, administration compliance, and others. We recommend more
well-designed studies to assess if unnecessary anticoagulation can be
avoided in CeAD. Copyright © 2022, The Author(s).

<100>
Accession Number
2020969939
Title
Interleukin 4/13 signaling in cardiac regeneration and repair.
Source
American Journal of Physiology - Heart and Circulatory Physiology. 323(5)
(pp H833-H844), 2022. Date of Publication: November 2022.
Author
Nik A.B.; Alvarez-Argote S.; O'Meara C.C.
Institution
(Nik, Alvarez-Argote, O'Meara) Department of Physiology, Cardiovascular
Center, Medical College of Wisconsin, Milwaukee, WI, United States
Publisher
American Physiological Society
Abstract
Interleukin 4 (IL4) and interleukin 13 (IL13) are closely related
cytokines that have been classically attributed to type II immunity,
namely, differentiation of T-helper 2 (T<inf>H</inf>2) cells and
alternative activation of macrophages. Although the role of IL4/13 has
been well described in various contexts such as defense against helminth
parasites, pathogenesis of allergic disease, and several models of wound
healing, relatively little is known about the role of IL4/13 in the heart
following injury. Emerging literature has identified various roles for
IL4/13 in animal models of cardiac regeneration as well as in the adult
mammalian heart following myocardial injury. Notably, although IL4 and
IL13 signal to hematopoietic cell types following myocardial infarction
(MI) to promote wound healing phenotypes, there is substantial evidence
that these cytokines can signal directly to non-hematopoietic cell types
in the heart during development, homeostasis, and following injury.
Comprehensive understanding of the molecular and cellular actions of
IL4/13 in the heart is still lacking, but overall evidence to date
suggests that activation of these cytokines results in beneficial outcomes
with respect to cardiac repair. Here, we aim to comprehensively review the
role of IL4 and IL13 and their prospective mechanisms in cardiac
regeneration and repair. Copyright © 2022 the American
Physiological Society.

<101>
Accession Number
640324779
Title
Clinical Outcomes by Consolidation of Bone Marrow Stem Cell Therapy and
Coronary Artery Bypass Graft in Patients With Heart Failure With Reduced
Ejection Fraction: A Meta-analysis.
Source
Cell transplantation. 32 (pp 9636897231152381), 2023. Date of Publication:
01 Jan 2023.
Author
Jiang Y.; Yang Z.; Shao L.; Shen H.; Teng X.; Chen Y.; Ding Y.; Fan J.; Yu
Y.; Shen Z.
Institution
(Jiang, Yang, Shao, Shen, Teng, Chen, Ding, Fan, Yu, Shen) Department of
Cardiovascular Surgery of the First Affiliated Hospital & Institute for
Cardiovascular Science, Soochow University, Suzhou, China
Publisher
NLM (Medline)
Abstract
Bone marrow stem cell (BMSC) transplantation during coronary artery bypass
graft (CABG) is an innovative treatment for ischemic heart disease (IHD).
We conduct a meta-analysis to examine whether patients with IHD presenting
heart failure with reduced ejection fraction (HFrEF) can be beneficent
from CABG with additional BMSC transplantation. Electronic searches were
performed on PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov from
their inception to July 2021. The efficacy was based on left ventricular
ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD),
left ventricular end-diastolic volume (LVEDV), left ventricular
end-diastolic volume index (LVEDVi), left ventricular end-systolic volume
index (LVESVi), and 6-min walk test (6MWT) change after treatment. Eight
randomized-controlled trials (RCTs) were included in this meta-analysis,
with a total of 350 patients. Results showed BMSC transplantation
significantly improved the LVEF [mean difference (MD) = 6.23%, 95%
confidence interval (CI): 3.22%-9.24%, P < 0.0001], LVEDVi (MD = -20.15
ml/m2, 95% CI: -30.49 to -9.82 ml/m2, P < 0.00001), and LVESVi (MD =
-17.69 ml/m2, 95% CI: -25.24 to -10.14 ml/m2, P < 0.00001). There was no
statistically significant difference in the improvement of LVEDD, LVEDV,
and 6MWT between the cell transplantation group and control groups.
Subgroup analysis revealed that the intervention for control group could
affect the efficacy of BMSC transplantation. Sensitivity analysis found
the conclusion of LVEDD, LVEDV, and 6MWT changes was not stable.
Therefore, among patients with IHD presenting HFrEF, BMSC transplantation
during CABG is promising to be beneficial for postoperative left
ventricular (LV) function improvement. However, according to the unstable
results of the sensitivity analysis, it cannot be concluded whether the
extra step has a positive effect on left ventricular remodeling and
exercise capacity. RCTs with larger cohorts and more strict protocols are
needed to validate these conclusions.

<102>
Accession Number
635350189
Title
A randomized trial comparing left distal radial versus femoral approach
for coronary artery bypass graft angiography: a pilot study.
Source
Minerva cardiology and angiology. 71(1) (pp 27-34), 2023. Date of
Publication: 01 Feb 2023.
Author
Aksoy M.N.; Sahinkus S.; Agac M.T.; Tatli E.
Institution
(Aksoy) Department of Cardiology, Faculty of Medicine, Sakarya University,
Sakarya, Turkey
(Sahinkus, Agac, Tatli) Department of Cardiology, Faculty of Medicine,
Sakarya University, Sakarya, Turkey
Publisher
NLM (Medline)
Abstract
BACKGROUND: Left distal transradial angiography (ldTRA) is a new technique
for radial coronary angiography and may be an alternative to conventional
transfemoral angiography (TFA) in patients who had previously undergone
coronary artery bypass graft (CABG) surgery. In this study we compared
ldTRA with TFA in patients who had undergone CABG surgery in terms of
procedural details. METHOD(S): Fifty-seven consecutive patients with
history of previous CABG among 459 patients who were admitted to coronary
angiography unit (elective and acute coronary syndromes) in our center
between October 2019 and February 2020 were included in the study.
Consecutive patients were randomized to ldTRA (34 patients) and TFA (23
patients) group. The difference in total procedure times was defined as
primary endpoint. The difference in sheat times, fluoroscopy times,
contrast volume used and radiation exposure were designated as secondary
endpoints. Post angiographic complications were compared between two
groups. RESULT(S): Out of 34 patients, successful distal radial
access was obtained in 25 patients (74%). Baseline demographics, contrast
use and radiation exposure were similar between groups. Sheath times in
ldTRA was significantly longer (P<0.001), but total procedure times were
not different (18.4+/-7.8 vs. 14.6+/-6.1, P=0.07). Non-standard
angiographic equipment usage was significantly higher in ldTRA procedures
(80% vs. 13%, P<0.001). There was no major bleeding in neither of groups,
and three minor bleedings in FA group (0% vs.13%, P=0.10).
 CONCLUSION(S): ldTRA in patients with a palpable pulse and successful
access might be used successfully for angiography in patient with previous
CABG even early in an operator's experience.

<103>
Accession Number
2020127676
Title
Revisiting prediction of collapse in hip osteonecrosis with artificial
intelligence and machine learning: a new approach for quantifying and
ranking the contribution and association of factors for collapse.
Source
International Orthopaedics. 47(3) (pp 677-689), 2023. Date of Publication:
March 2023.
Author
Hernigou P.
Institution
(Hernigou) University Paris East, Creteil, France
Publisher
Institute for Ionics
Abstract
Purpose: This study proposes machine learning to analyze the risk factors
of the collapse in patients with non-traumatic hip osteonecrosis of the
femoral head. Method(s): We collected data of 900 consecutive
patients (634 males) with bilateral (428) or unilateral non-traumatic
osteonecrosis diagnosed before collapse (at stage I or stage II). The
follow-up was average five years (3 to 8 years). A total of 50 variables
related to the osteonecrosis were included in the study. The osteonecroses
were randomly divided into a training set (80%) and a validation set (20%)
with a similar percentage of hips with collapse in the two groups. Machine
learning (ML) algorithms were trained with the selected variables.
Performance was evaluated and the different factors (variables) for
collapse were ranked with Shapley values. The primary outcome was
prediction of occurrence of collapse from automated inventory systems.
 Result(s): In this series of patients, the accuracy with machine
learning for predicting collapse within three years follow-up was 81.2%.
Accuracies for predicting collapse within six to 12-24 months were 54.2%,
67.3%, and 71.2%, respectively, demonstrating that the accuracy is lower
for a prevision in the short term than for the mid-term. Despite none of
the risk-factors alone achieving statistical significance for prediction,
the system allowed ranking the different variables for risk of collapse.
The highest risk factors for collapse were sickle cell disease, liver, and
cardiac transplantation treated with corticosteroids, osteonecrosis volume
> 50% of the femoral head. Cancer (such as leukemia), alcohol abuse, lupus
erythematosus, Crohn's disease, pemphigus vulgaris treated with
corticosteroids, and osteonecrosis volume between 40 and 50% were medium
risk factors for collapse. Familial cluster of collapse, HIV infection,
chronic renal failure, nephrotic syndrome, and renal transplantation, when
treated with corticosteroids, stage II, osteonecrosis volume between 30
and 40%, chemotherapy, hip pain with VAS > 6, and collapse progression on
the contralateral side, were also significant but lowest risk factors. A
heat map is proposed to illustrate the ranking of the combinations of the
different variables. The highest risk of collapse is obtained with
association of various risks factors. Conclusion(s): This study, for
the first time, demonstrated prediction of collapse and ranking of factors
for collapse with a machine learning system. This study also shows that
collapse is due to a multifactorial risk factors. Copyright ©
2022, The Author(s) under exclusive licence to SICOT aisbl.

<104>
Accession Number
2021622191
Title
Pharmacological prevention of postoperative delirium in patients
undergoing cardiac surgery: a bayesian network meta-analysis.
Source
Journal of Anesthesia. (no pagination), 2023. Date of Publication: 2023.
Author
Meco M.; Giustiniano E.; Cecconi M.; Albano G.
Institution
(Meco) Department of Anesthesia and Intensive Care, San Carlo Clinic, Via
Dell'Ospedale, 2, Paderno Dugnano, Milan 20030, Italy
(Giustiniano, Cecconi) Department of Anesthesia and Intensive Care,
IRCCS-Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan 20089,
Italy
(Albano) Department of Anesthesia and Intensive Care, Humanitas Gavazzeni
Hospital, Via Gavazzeni, 27, Bergamo 24125, Italy
Publisher
Springer
Abstract
The incidence of postoperative delirium in patients undergoing cardiac
surgery is very high and increases morbidity and mortality. The
possibility of pharmacological means to reduce its incidence is very
attractive. At present, there is still no clear demonstration that any
drug can prevent postoperative delirium in these patients. The aim of this
Bayesian network meta-analysis (NMA) was to evaluate whether there is
evidence that a drug is effective in reducing the incidence of POD in
cardiac surgical patients. Our NMA showed that preoperative ketamine at
subanesthetic doses can significantly reduce the incidence of POD.
Risperidone also decreases the incidence of POD, but not
significantly. Copyright © 2023, The Author(s) under exclusive
licence to Japanese Society of Anesthesiologists.

<105>
Accession Number
2022689144
Title
Type D Personality as a Risk Factor for Adverse Outcome in Patients With
Cardiovascular Disease: An Individual Patient-Data Meta-analysis.
Source
Psychosomatic Medicine. 85(2) (pp 188-202), 2023. Date of Publication: 01
Feb 2023.
Author
Lodder P.; Wicherts J.M.; Antens M.; Albus C.; Bessonov I.S.; Conden E.;
Dulfer K.; Gostoli S.; Grande G.; Hedberg P.; Herrmann-Lingen C.; Jaarsma
T.; Koo M.; Lin P.; Lin T.-K.; Meyer T.; Pushkarev G.; Rafanelli C.; Raykh
O.I.; Schaan De Quadros A.; Schmidt M.; Sumin A.N.; Utens E.M.W.J.; Van
Veldhuisen D.J.; Wang Y.; Kupper N.
Institution
(Lodder, Wicherts) Department of Methodology and Statistics, Tilburg
University, Tilburg, Netherlands
(Lodder, Antens, Kupper) Center of Research on Psychology in Somatic
Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg
University, Tilburg, Netherlands
(Albus) Department of Psychosomatics and Psychotherapy, University of
Cologne, Medical Faculty and University Hospital, Cologne, Germany
(Bessonov, Pushkarev) Tyumen Cardiology Research Center, Tomsk National
Research Medical Center, Russian Academy of Science, Tyumen, Russian
Federation
(Conden) Uppsala University, Centre for Clinical Research, Hospital of
Vastmanland, Vastmanland, Sweden
(Dulfer) Intensive Care Unit, Department of Pediatrics and Pediatric
Surgery, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam,
Netherlands
(Gostoli, Rafanelli) Department of Psychology, University of Bologna,
Bologna, Italy
(Grande) Brandenburgische Technische Universitat Cottbus-Senftenberg,
Cottbus, Germany
(Hedberg) Department of Clinical Physiology and Centre for Clinical
Research, Uppsala University, Vastmanland County Hospital, Vasteras,
Sweden
(Herrmann-Lingen, Meyer) Department of Psychosomatic Medicine and
Psychotherapy, University of Gottingen Medical Center, German Center for
Cardiovascular Research (DZHK), Gottingen, Germany
(Jaarsma) Department of Health, Medicine and Caring Sciences, Linkoping
University, Linkoping, Sweden
(Koo) Graduate Institute of Long-term Care, Tzu Chi University of Science
and Technology, Hualien, Hualien City, Taiwan (Republic of China)
(Koo) Dalla Lana School of Public Health, University of Toronto, Toronto,
ON, Canada
(Lin) College of Nursing of Harbin Medical University, The Second
Affiliated Hospital of Harbin Medical University, Harbin, China
(Lin) Division of Cardiology, Department of Internal Medicine, Dalin Tzu
Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
(Republic of China)
(Lin) School of Medicine, Tzu Chi University, Hualien, Hualien City,
Taiwan (Republic of China)
(Raykh, Sumin) Laboratory of Comorbidity in Cardiovascular Diseases, Fed.
State Budgetary Sci. Inst. research Institute for Complex Issues of
Cardiovascular Diseases, Moscow, Russian Federation
(Schaan De Quadros, Schmidt) Institute of Cardiology, University
Foundation of Cardiology, Rio Grande do Sul, Porto Alegre, Brazil
(Utens) Research Institute of Child Development and Education, Amsterdam
UMC/ Level, Amsterdam, Netherlands
(Van Veldhuisen) Department of Cardiology, University of Groningen,
University Medical Center Groningen, Groningen, Netherlands
(Wang) Department of Cardiology, The Second Affiliated Hospital of Harbin
Medical University, Harbin, China
Publisher
Lippincott Williams and Wilkins
Abstract
Objective Type D personality, a joint tendency toward negative affectivity
and social inhibition, has been linked to adverse events in patients with
heart disease, although with inconsistent findings. Here, we apply an
individual patient-data meta-analysis to data from 19 prospective cohort
studies (N = 11,151) to investigate the prediction of adverse outcomes by
type D personality in patients with acquired cardiovascular disease.
Method For each outcome (all-cause mortality, cardiac mortality,
myocardial infarction, coronary artery bypass grafting, percutaneous
coronary intervention, major adverse cardiac event, any adverse event), we
estimated type D's prognostic influence and the moderation by age, sex,
and disease type. Results In patients with cardiovascular disease,
evidence for a type D effect in terms of the Bayes factor (BF) was strong
for major adverse cardiac event (BF = 42.5; odds ratio [OR] = 1.14) and
any adverse event (BF = 129.4; OR = 1.15). Evidence for the null
hypothesis was found for all-cause mortality (BF = 45.9; OR = 1.03),
cardiac mortality (BF = 23.7; OR = 0.99), and myocardial infarction (BF =
16.9; OR = 1.12), suggesting that type D had no effect on these outcomes.
This evidence was similar in the subset of patients with coronary artery
disease (CAD), but inconclusive for patients with heart failure (HF).
Positive effects were found for negative affectivity on cardiac and
all-cause mortality, with the latter being more pronounced in male than
female patients. Conclusion Across 19 prospective cohort studies, type D
predicts adverse events in patients with CAD, whereas evidence in patients
with HF was inconclusive. In both patients with CAD and HF, we found
evidence for a null effect of type D on cardiac and all-cause mortality.
 Copyright © Lippincott Williams & Wilkins.

<106>
Accession Number
2021595413
Title
The impact of postoperative cognitive training on health-related quality
of life and cognitive failures in daily living after heart valve surgery:
A randomized clinical trial.
Source
Brain and Behavior. (no pagination), 2023. Date of Publication: 2023.
Author
Butz M.; Gerriets T.; Sammer G.; El-Shazly J.; Tschernatsch M.; Schramm
P.; Doeppner T.R.; Braun T.; Boening A.; Mengden T.; Choi Y.-H.;
Schoenburg M.; Juenemann M.
Institution
(Butz, Gerriets, Sammer, Tschernatsch, Schramm, Braun, Schoenburg,
Juenemann) Heart and Brain Research Group, Kerckhoff Heart and Thorax
Center, Bad Nauheim, Germany
(Butz, Gerriets, Tschernatsch, Schramm, Doeppner, Braun, Schoenburg,
Juenemann) Department of Neurology, University Hospital Giessen and
Marburg, Giessen, Germany
(Sammer) Cognitive Neuroscience at the Centre of Psychiatry, University
Giessen, Giessen, Germany
(Sammer) Department of Psychology, Justus-Liebig University, Giessen,
Germany
(El-Shazly) Department of Psychocardiology, Kerckhoff Heart and Thorax
Center, Bad Nauheim, Germany
(Boening) Department of Cardiovascular Surgery, University Hospital
Giessen and Marburg, Giessen, Germany
(Mengden) Department of Rehabilitation, Kerckhoff Heart and Thorax Center,
Bad Nauheim, Germany
(Choi, Schoenburg) Department of Cardiac Surgery, Kerckhoff Heart and
Thorax Center, Bad Nauheim, Germany
Publisher
John Wiley and Sons Ltd
Abstract
Background: Heart surgery is a risk factor for objectively and
subjectively assessable postoperative cognitive decline (POCD), which is
relevant for everyday life. The aim of this study was to investigate
whether early postoperative cognitive training has an impact on
health-related quality of life and cognitive failures in daily living
after cardiac surgery. Method(s): The study was a two-arm,
randomized, controlled, outcome-blinded trial involving older patients
undergoing elective heart valve surgery with extracorporeal circulation
(ECC). Recruitment took place at the Departments of Cardiac Surgery of the
Kerckhoff Clinic in Bad Nauheim (Germany) and the University Hospital in
Giessen (Germany). The patients were randomized (1:1 ratio) to either a
paper-and-pencil-based cognitive training group or a control group. We
applied the Short Form Health Survey (SF-36) and the Cognitive Failures
Questionnaire (CFQ) prior to surgery and 3 months after the cognitive
training. Data were analyzed in a per-protocol fashion. Result(s):
Three months after discharge from rehabilitation, the training group (n =
31) showed improvement in health-related quality of life compared to the
control group (n = 29), especially in role limitations due to emotional
problems (U = -2.649, p =.008, eta2 = 0.121), energy and
fatigue (F[2.55] = 5.72, p =.020, eta2 = 0.062), social
functioning (U = -2.137, p =.033, eta2 = 0.076), the average of
all SF-36 factors (U = -2.374, p =.018, eta2 = 0.094), health
change from the past year to the present time (U = -2.378, p =.017,
eta2 = 0.094), and the mental component summary (U = -2.470, p
=.013, eta2 = 0.102). Conclusion(s): As our cognitive
training has shown beneficial effects, this intervention could be a
promising method to enhance health-related quality of life after cardiac
surgery. Copyright © 2023 The Authors. Brain and Behavior
published by Wiley Periodicals LLC.

<107>
Accession Number
2021659887
Title
Rationale and design of the TUXEDO-2 India study: Ultra-Thin strUt
Supraflex Cruz versus XiencE in a Diabetic pOpulation with multi-vessel
disease-2.
Source
American Heart Journal. 256 (pp 128-138), 2023. Date of Publication:
February 2023.
Author
Kaul U.; Arambam P.; Sinha S.K.; Abhaichand R.; Parida A.K.; Banker D.;
Mody R.; Khan A.; Sharma R.; Moorthy N.; Chandra S.; Koduganti S.C.; Garg
R.; Sarma P.R.; Agrawal D.K.; Reddy K.M.K.; Bangalore S.
Institution
(Kaul, Arambam) Batra Hospital & Medical Research Centre, New Delhi,
Delhi, India
(Sinha) LPS Institute of cardiology and Cardiac surgery, Uttar Pradesh,
Kanpur, India
(Abhaichand) G.Kuppuswamy Naidu Memorial Hospital, Tamil Nadu, Coimbatore,
India
(Parida) Health World Hospitals, West Bengal, Durgapur, India
(Banker) Bankers Heart Institute, Gujarat, Vadodara, India
(Mody) Max Super Specialty Hospital, Punjab, Bhatinda, India
(Khan) Crescent Hospital and Heart Centre, Maharashtra, Nagpur, India
(Sharma) Indira Gandhi Medical College & Hospital, Himachal Pradesh,
Shimla, India
(Moorthy) Sri Jayadeva Institute of Cardiovascular Sciences and Research,
Karnataka, Bengaluru, India
(Chandra) King George's Medical University, Uttar Pradesh, Lucknow, India
(Koduganti) Virinchi Hospitals, Telangana, Hyderabad, India
(Garg) Aware Gleneagles Global Hospital, Telangana, Hyderabad, India
(Sarma) Lalitha Super Speciality Hospitals, Andhra Pradesh, Guntur, India
(Agrawal) Mahatma Gandhi University of Medical Sciences & Technology,
Rajasthan, Jaipur, India
(Reddy) Osmania General Hospital, Telangana, Hyderabad, India
(Bangalore) NYU School of Medicine, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The role of percutaneous coronary interventions (PCI) in
patients with diabetes mellitus and multi-vessel disease has been
questioned by the results of the FREEDOM trial, which showed superiority
of coronary artery bypass graft(CABG) over first generation drug-eluting
stents (DES) including a reduction in mortality. In the light of safer and
more efficacious stents and significantly better medical management, those
results that date back to 2012 need to be revisited. TUXEDO-2 is a study
designed to compare two contemporary stents in Indian diabetic patients
with multi-vessel disease. Aim(s): The primary objective of the
TUXEDO-2 study is to compare the clinical outcomes of PCI with ultra-thin
Supraflex Cruz vs Xience when combined with contemporary optimal medical
therapy (OMT) in diabetic patients with multi-vessel disease. The
secondary objective is to compare clinical outcomes between a pooled
cohort from both arms of the study (Supraflex Cruz + Xience; PCI arm) vs
CABG based on a performance goal derived from the CABG arm of the FREEDOM
trial (historical cohort). The tertiary objective is a randomized
comparison of ticagrelor vs prasugrel in addition to aspirin for the
composite of ischemic and bleeding events. Method(s): In this
prospective, open-label, multi-centre, 2 x 2 factorial, randomized,
controlled study, 1,800 patients with diabetes mellitus and multi-vessel
disease (inclusion criteria similar to FREEDOM trial) with indication for
coronary revascularization will be randomly assigned to Supraflex Cruz or
Xience stents and also to ticagrelor- or prasugrel- based antiplatelet
strategies. All patients will receive guideline directed OMT and optimal
PCI including image- and physiology-guided complete revascularization
where feasible. The patients will be followed through five years to assess
their clinical status and major clinical events. The primary endpoint is a
non-inferiority comparison of target lesion failure at one-year for
Supraflex Cruz vs Xience (primary objective) with an expected event rate
of 11% and a non-inferiority margin of 4.5%. For PCI vs CABG (secondary
objective), the primary endpoint is major adverse cardiac events (MACE),
defined as a composite of all cause death, nonfatal myocardial infarction,
or stroke at one-year and yearly up to five years, with a performance goal
of 21.6%. For ticagrelor vs prasugrel (tertiary objective), the primary
endpoint is composite of death, myocardial infarction, stroke, and major
bleeding as per the Bleeding Academic Research Consortium (BARC) at
one-year with expected event rate of 15% and a non-inferiority margin of
5%. Conclusion(s): The TUXEDO-2 study is a contemporary study
involving state-of-the-art PCI combined with guideline directed OMT in a
complex subset of patients with diabetes mellitus and multi-vessel
disease. The trial will answer the question as to whether a biodegradable
polymer coated ultra-thin Supraflex Cruz stent is an attractive option for
PCI in diabetic patients with multi-vessel disease. It will also help
address the question whether the results of FREEDOM trial would have been
different in the current era of safer and more efficacious stents and
modern medical therapy. In addition, the comparative efficacy and safety
of ticagrelor vs prasugrel in addition to aspirin will be evaluated.
(CTRI/2019/11/022088) Copyright © 2022

<108>
Accession Number
631561764
Title
Tricuspid valve intervention at the time of mitral valve surgery: A
meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 29(2) (pp 193-200), 2019.
Date of Publication: 01 Aug 2019.
Author
Tam D.Y.; Tran A.; Mazine A.; Tang G.H.L.; Gaudino M.F.L.; Calafiore A.M.;
Friedrich J.O.; Fremes S.E.
Institution
(Tam, Tran, Mazine, Fremes) Division of Cardiac Surgery, Department of
Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Tam) Dalla Lana School of Public Health, Institute of Health Policy,
Management and Evaluation, University of Toronto, Toronto, ON, Canada
(Tang) Department of Cardiovascular Surgery, Mount Sinai Medical Center,
New York, NY, United States
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Calafiore) Department of Cardiovascular Disease, John Paul II Foundation,
Campobasso, Italy
(Friedrich) Department of Critical Care and Medicine, St. Michael's
Hospital, University of Toronto, Toronto, ON, Canada
Publisher
Oxford University Press
Abstract
OBJECTIVES: The surgical management of tricuspid regurgitation (TR) at the
time of mitral valve surgery remains controversial. Our objectives were to
determine the safety and efficacy of tricuspid valve (TV) repair during
mitral valve surgery in a meta-analysis. METHOD(S): MEDLINE and
EMBASE were searched from 1946 to 2017 for all studies comparing TV repair
to no intervention at the time of mitral valve surgery on early and late
mortality and late TR. A random-effects meta-analysis of all outcomes was
performed. RESULT(S): One thousand four hundred and seventeen studies
were retrieved and a total of 17 studies [2 randomized clinical trial (n =
211), 11 adjusted observational studies (n = 3848) and 4 unadjusted
observational studies (n = 67 010)] that compared TV repair (n = 11 787)
to no intervention (n = 56 027) at a mean follow-up of 6.0 +/- 0.64 years
were included. There was no difference in 30-day/in-hospital mortality
between repair and no repair [risk ratio (RR) 1.19, 95% confidence
interval (95% CI) 0.70-2.02; P = 0.52]. The incidence of new permanent
pacemaker implantation was higher in the TV repair group (RR 2.73, 95% CI
2.57-2.89; P < 0.01). TV repair was protective against late moderate or
greater TR [incident rate ratio (IRR) 0.28, 95% CI 0.17-0.47; P < 0.01]
and severe TR (IRR 0.38, 95% CI 0.17-0.84). There was a numerically lower
rate of late TV reoperation (IRR 0.39, 95% CI 0.12-1.25; P = 0.11) that
did not reach statistical significance. Overall, there was no difference
in late mortality between the 2 treatments (IRR 0.87, 95% CI 0.63-1.24; P
= 0.43). CONCLUSION(S): TV repair appears safe in the perioperative
period and may reduce future recurrent TR without any survival
benefit. Copyright © 2019 The Author(s) 2019. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<109>
Accession Number
631561280
Title
Bilateral internal thoracic artery versus single internal thoracic artery:
A meta-analysis of propensity score-matched observational studies.
Source
Interactive Cardiovascular and Thoracic Surgery. 29(2) (pp 163-172), 2019.
Date of Publication: 01 Aug 2019.
Author
Urso S.; Nogales E.; Gonzalez J.M.; Sadaba R.; Tena M.A.; Bellot R.; Rios
L.; Portela F.
Institution
(Urso, Tena, Bellot, Rios, Portela) Cardiac Surgery Department, Hospital
Universitario Dr. Negrin, Barranco de la Ballena, s/n, Las Palmas de Gran
Canaria 35010, Spain
(Nogales) Cardiology Department, Hospital Universitario Insular, Las
Palmas de Gran Canaria, Spain
(Gonzalez) Research Unit, Hospital Universitario Dr. Negrin, Las Palmas de
Gran Canaria, Spain
(Sadaba) Cardiac Surgery Department, Complejo Hospitalario de Navarra,
Pamplona, Spain
Publisher
Oxford University Press
Abstract
The lack of benefit in terms of mid-term survival and the increase in the
risk of sternal wound complications published in a recent randomized
controlled trial have raised concerns about the use of bilateral internal
thoracic artery (BITA) in myocardial revascularization surgery. For this
reason, we decided to explore the current evidence available on the
subject by carrying out a meta-analysis of propensity score-matched
studies comparing BITA versus single internal thoracic artery (SITA).
PubMed, EMBASE and Google Scholar were searched for propensity
score-matched studies comparing BITA versus SITA. The generic inverse
variance method was used to compute the combined hazard ratio (HR) of
long-term mortality. The DerSimonian and Laird method was used to compute
the combined risk ratio of 30-day mortality, deep sternal wound infection
and reoperation for bleeding. Forty-five BITA versus SITA matched
populations were included. Meta-analysis showed a significant benefit in
terms of long-term survival in favour of the BITA group [HR 0.78; 95%
confidence interval (CI) 0.71-0.86]. These results were consistent with
those obtained by a pooled analysis of the matched populations comprising
patients with diabetes (HR 0.65; 95% CI 0.43-0.99). When compared with the
use of SITA plus radial artery, BITA did not show any significant benefit
in terms of long-term survival (HR 0.86; 95% CI 0.69-1.07). No differences
between BITA and SITA groups were detected in terms of 30-day mortality or
in terms of reoperation for bleeding. Compared with the SITA group,
patients in the BITA group had a significantly higher risk of deep sternal
wound infection (risk ratio 1.66; 95% CI 1.41-1.95) even when the pooled
analysis was limited to matched populations in which BITA was harvested
according to the skeletonization technique (risk ratio 1.37; 95% CI
1.04-1.79). The use of BITA provided a long-term survival benefit compared
with the use of SITA at the expense of a higher risk of sternal deep wound
infection. The long-term survival advantage of BITA is undetectable when
compared with SITA plus radial artery. Copyright © 2019 The
Author(s) 2019. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<110>
Accession Number
2021362208
Title
Effect of remote ischaemic conditioning on left ventricular function in
ST-segment elevation myocardial infarction patients: The CONDI-2
echocardiographic sub-study.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1054142. Date of Publication: 25 Jan 2023.
Author
Wood G.; Johnsen P.H.; Pedersen A.L.D.; Frederiksen C.A.; Poulsen S.H.;
Botker H.E.; Kim W.Y.
Institution
(Wood, Johnsen, Pedersen, Frederiksen, Poulsen, Botker, Kim) Department of
Cardiology, Aarhus University Hospital, Aarhus, Denmark
(Wood, Johnsen, Pedersen, Frederiksen, Poulsen, Botker, Kim) Department of
Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
Publisher
Frontiers Media S.A.
Abstract
Background: Remote ischaemic conditioning (RIC) applied to the arm by
inflation and deflation of a pneumatic cuff has been shown to reduce
myocardial infarct size in patients with ST-elevation myocardial
infarction undergoing primary percutaneous coronary intervention (PPCI).
However, the effect of RIC on left ventricular ejection fraction (LVEF)
following infarct healing remains unknown. Objective(s): To
investigate whether RIC applied in the ambulance before PPCI can improve
left ventricular (LV) function in STEMI patients 3 months following
infarction. Method(s): Echocardiography was performed in a total of
694 patients from the CONDI-2 study a median of 112 days (IQR 63) after
the initial admission. LVEF and LV end-diastolic and end-systolic volumes
were calculated using the modified Simpsons biplane method of disks. LV
global longitudinal strain (GLS) was estimated using 2-dimensional
cine-loops with a frame rate > 55 frames/second, measured in the three
standard apical views. Result(s): There was no difference in the
measured echocardiographic parameters in the RIC group as compared to the
control group, including LV EF, LV GLS, tricuspid annular plane systolic
excursion or left ventricular volumes. In the control group, 32% had an
ejection fraction < 50% compared to 37% in the RIC group (p = 0.129).
 Conclusion(s): In this largest to date randomized imaging study of
RIC, RIC as an adjunct to PPCI was not associated with a change in
echocardiographic measures of cardiac function compared to standard PPCI
alone. Copyright © 2023 Wood, Johnsen, Pedersen, Frederiksen,
Poulsen, Botker and Kim.

<111>
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).
 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. 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. 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. 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. Copyright © 2023 Felbel, Paukovitsch,
Forg, Stephan, Mayer, Kesler, Tadic, Dahme, Rottbauer, Markovic and
Schneider.

<112>
Accession Number
2021279375
Title
Neurodevelopmental and functional outcome in hypoplastic left heart
syndrome after Hybrid procedure as stage I.
Source
Frontiers in Pediatrics. 10 (no pagination), 2023. Article Number:
1099283. Date of Publication: 16 Jan 2023.
Author
Knirsch W.; De Silvestro A.; von Rhein M.
Institution
(Knirsch, De Silvestro) Pediatric Cardiology, Pediatric Heart Center,
Department of Surgery, University Children's Hospital Zurich, Switzerland
(Knirsch, De Silvestro, von Rhein) Children's Research Center, University
Children's Hospital Zurich, Switzerland
(Knirsch, De Silvestro, von Rhein) University of Zurich (UZH), Switzerland
(von Rhein) Child Development Center, University Children's Hospital
Zurich, Switzerland
Publisher
Frontiers Media S.A.
Abstract
Background: Patients with hypoplastic left heart syndrome (HLHS)
undergoing staged palliation until Fontan procedure are at risk for
impaired neurodevelopmental (ND) outcome. The Hybrid procedure with
bilateral pulmonary artery banding, ductal stenting, and balloon
atrioseptostomy may offer a less invasive stage I procedure compared to
the Norwood stage I procedure avoiding early neonatal cardiopulmonary
bypass (CPB) surgery. Despite altered fetal cerebral hemodynamics, the
type of stage I procedure may be a covariate influencing ND outcome and
functional outcome may also be altered due to postponing neonatal CPB
surgery. Within this review, we analyzed ND outcome as well as functional
outcome after Hybrid procedure as stage I procedure. Method(s): The
review analyzed original publications (OPs) published before March 15,
2022, identified by Cochrane, EMBASE, OVID, Scopus, and Web of science. An
OP was included if short-to-long-term neurodevelopment outcome, brain
development, somatic, and cardiac outcome in patients for HLHS and
variants treated by Hybrid procedure were analyzed. In addition to
database searches, we reviewed all references of the analyzed OP to obtain
a comprehensive list of available studies. The author, year of
publication, demographic characteristics of study population, study design
(prospective or retrospective), study assessment, and main findings were
summarized. Result(s): Twenty-one OPs were included with data of
patients with ND outcome and functional cardiac outcome. Overall, there is
an impaired mid-term ND outcome in patients with Hybrid procedure as stage
I for HLHS. Only slight differences between stage I procedures (Hybrid vs.
Norwood) in two comparing studies have been determined affecting right
ventricular remodeling, short- and mid-term ND outcome, reduced brain
growth until two years of age, sufficient quality of life, and altered
hemodynamics influencing brain volumes and cerebral perfusion pattern.
 Conclusion(s): Despite some minor differences regarding the mid-term
follow-up in patients with HLHS comparing Hybrid vs. Norwood procedure,
its impact on ND outcome seems rather low. This may be explained by the
large number of covariates as well as the small study populations and the
different selection criteria for patients undergoing Hybrid or Norwood
procedure as stage I. Copyright 2023 Knirsch, De Silvestro and von
Rhein.

<113>
Accession Number
2022388428
Title
Low-Density Lipoprotein Cholesterol Levels on Statins and Cardiovascular
Event Risk in Stable Coronary Artery Disease - An Observation From the
REAL-CAD Study -.
Source
Circulation Journal. 87(2) (pp 360-367), 2023. Date of Publication: 2023.
Author
Toyota T.; Morimoto T.; Iimuro S.; Fujita R.; Iwata H.; Miyauchi K.; Inoue
T.; Nakagawa Y.; Nishihata Y.; Daida H.; Ozaki Y.; Suwa S.; Sakuma I.;
Furukawa Y.; Shiomi H.; Watanabe H.; Yamaji K.; Saito N.; Natsuaki M.;
Ohashi Y.; Matsuzaki M.; Nagai R.; Kimura T.
Institution
(Toyota, Furukawa) Department of Cardiovascular Medicine, Kobe City
Medical Center General Hospital, Kobe, Japan
(Morimoto) Department of Clinical Epidemiology, Hyogo College of Medicine,
Nishinomiya, Japan
(Iimuro, Fujita) Innovation and Research Support Center, International
University of Health and Welfare, Tokyo, Japan
(Iwata, Miyauchi, Daida) Department of Cardiovascular Medicine, Juntendo
University Graduate School of Medicine, Tokyo, Japan
(Inoue) Department of Cardiovascular Medicine, Dokkyo Medical University,
Mibu, Japan
(Nakagawa) Department of Cardiovascular Medicine, Shiga University of
Medical Science, Otsu, Japan
(Nishihata) Department of Cardiovascular Medicine, St. Luke's
International Hospital, Tokyo, Japan
(Ozaki) Department of Cardiology, Fujita Health University School of
Medicine, Toyoake, Japan
(Suwa) Department of Cardiovascular Medicine, Juntendo University Shizuoka
Hospital, Shizuoka, Japan
(Sakuma) Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
(Shiomi, Watanabe, Yamaji, Saito, Kimura) Department of Cardiovascular
Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
(Natsuaki) Department of Cardiovascular Medicine, Saga University
Hospital, Saga, Japan
(Ohashi) Department of Integrated Science and Technology for Sustainable
Society, Chuo University, Tokyo, Japan
(Matsuzaki) St. Hill Hospital, Ube, Japan
(Nagai) Jichi Medical University, Shimotsuke, Japan
Publisher
Japanese Circulation Society
Abstract
Background: The relationship between very low on-treatment low-density
lipoprotein cholesterol (LDL-C) level and cardiovascular event risk is
still unclear in patients receiving the same doses of statins.
 Methods and Results: From the REAL-CAD study comparing high-dose (4
mg/day) with low-dose (1 mg/day) pitavastatin therapy in patients with
stable coronary artery disease, 11,105 patients with acceptable statin
adherence were divided into 3 groups according to the on-treatment LDL-C
level at 6 months (<70 mg/dL, 70-100 mg/dL, and >=100 mg/dL). The primary
outcome measure was a composite of cardiovascular death, non-fatal
myocardial infarction, non-fatal ischemic stroke, or unstable angina
requiring emergent admission. The adjusted risks of the LDL-C <70 mg/dL
group relative to the LDL-C 70-100 mg/dL group (reference) was not
significantly different for the primary outcome measure in both 1 mg/day
and 4 mg/day strata (HR 0.84, 95% CI 0.58-1.18, P=0.32, and HR 1.25, 95%
CI 0.88-1.79, P=0.22). The adjusted risk of the LDL-C >=100 mg/dL group
relative to the reference group was not significant for the primary
outcome measure in the 1 mg/day stratum (HR 0.82, 95% CI 0.60-1.11,
P=0.21), whereas it was highly significant in the 4 mg/day stratum (HR
3.32, 95% CI 2.08-5.17, P<0.001). Conclusion(s): A very low
on-treatment LDL-C level (<70 mg/dL) was not associated with lower
cardiovascular event risk compared with moderately low on-treatment LDL-C
level (70-100 mg/dL) in patients receiving the same doses of
statins. Copyright © 2023 Japanese Circulation Society. All
rights reserved.

<114>
Accession Number
2022483570
Title
Accuracy of stroke volume variation and pulse pressure variation in
predicting fluid responsiveness undergoing one-lung ventilation during
thoracic surgery: a systematic review and meta-analysis.
Source
Annals of Translational Medicine. 11(1) (no pagination), 2023. Article
Number: 19. Date of Publication: January 2023.
Author
Wang C.; Feng Z.; Cai J.; Duan M.; Li H.; Dai Z.; Lv H.; Xu Z.; Wang H.;
Chen Y.
Institution
(Wang, Feng, Cai, Lv, Wang, Chen) Department of Anesthesiology, Sixth
Medical Center, PLA General Hospital, Beijing, China
(Duan) Department of Anesthesiology, Hainan Branch of the General Hospital
of People's Liberation Army, Sanya, China
(Li) Department of Gastroenterology, Sixth Medical Center, PLA General
Hospital, Beijing, China
(Dai) Department of Medical Records, Sixth Medical Center, PLA General
Hospital, Beijing, China
(Xu) Department of Anesthesiology, First Medical Center, PLA General
Hospital, Beijing, China
Publisher
AME Publishing Company
Abstract
Background: Stroke volume variation (SVV) and pulse pressure variation
(PPV) are based on the interaction between the heart and lungs during
mechanical ventilation. However, debate continues as to whether SVV and
PPV can accurately predict fluid responsiveness during the one-lung
ventilation (OLV). We therefore undertook a systematic review and
meta-analysis of clinical trials that investigated the diagnostic value of
SVV and PPV in predicting fluid responsiveness undergoing OLV during
thoracic surgery. Method(s): The MEDLINE, EMBASE, WANFANG, and
CENTRAL databases were systematically searched for studies on the use of
SVV and/or PPV in patients undergoing OLV from 2010 to 2021. Heterogeneity
was assessed using I2 statistics. The funnel diagram analysis
was used to test publication bias. A fixed-effects model was used to
calculate the pooled values of sensitivity, specificity, the diagnostic
odds ratio (DOR), and the relevant 95% confidence intervals (95% CIs). The
summary receiver operating characteristic (SROC) curves were estimated,
and the areas under the SROC curve were calculated. Result(s): In
total nine studies, comprising 452 patients were ultimately included in
this meta-analysis, including 217 (48%) responders and 235 (52%)
nonresponders. After combining the correlation coefficients, a slight
heterogeneity was found between SVV and PPV in these selected studies
(I2 <inf>SVV</inf> =19.7%, I2 <inf>PPV</inf>
=15.3%), and the funnel diagram also showed that the P values of SVV and
PPV were 0.33 and 0.26. After the pooled analysis, the respective
sensitivity of SVV and PPV in predicting fluid responsiveness was 0.66 and
0.61, the specificity was 0.62 and 0.53, the positive likelihood ratios
were 1.7 and 1.3, the negative likelihood ratios were 0.55 and 0.74, and
the DORs were 3 and 2. The areas under the SROC curve of SVV and PPV were
0.68 and 0.60, respectively, according to STATA SE16 software, and the
combined areas under the receiver operating characteristic (ROC) curve of
SVV and PPV were 0.681 and 0.604, respectively, according to MedCalc19.0.4
software. Conclusion(s): Current evidence suggests that SVV and PPV
are not suitable for guiding intraoperative fluid therapy due to their
poor ability to predict fluid responsiveness in patients undergoing OLV,
and we need a better indicator instead. Copyright © Annals of
Translational Medicine. All rights reserved.

<115>
Accession Number
2017868182
Title
PCSK9 inhibitors safely and effectively lower LDL after heart
transplantation: a systematic review and meta-analysis.
Source
Heart Failure Reviews. 28(1) (pp 149-156), 2023. Date of Publication:
January 2023.
Author
Jennings D.L.; Sultan L.; Mingov J.; Choe J.; Latif F.; Restaino S.;
Clerkin K.; Habal M.V.; Colombo P.C.; Yuzefpulskaya M.; Sayer G.; Uriel
N.; Baker W.L.
Institution
(Jennings, Sultan, Mingov) Department of Pharmacy Practice, Long Island
University College of Pharmacy, New York, NY, United States
(Jennings, Choe) Department of Pharmacy, New York-Presbyterian Hospital,
Columbia University Medical Center, 622 W. 168th Street, New York, NY,
United States
(Latif, Restaino, Clerkin, Habal, Colombo, Yuzefpulskaya, Sayer, Uriel)
Division of Cardiology, Department of Medicine, New York-Presbyterian
Hospital, Columbia University, New York, NY, United States
(Baker) Department of Pharmacy Practice, University of Connecticut School
of Pharmacy, Storrs, CT, United States
Publisher
Springer
Abstract
Coronary allograft vasculopathy (CAV) continues to afflict a high number
of heart transplant (HT) recipients, and elevated LDL is a key risk
factor. Many patients cannot tolerate statin medications after HT;
however, data for alternative agents remains scarce. To address this key
evidence gap, we evaluated the safety and efficacy of the PCSK9i after HT
through systematic review and meta-analysis. We searched Medline, Cochrane
Central, and Scopus from the earliest date through July 15th, 2021.
Citations were included if they were a report of PCSK9i use in adults
after HT and reported an outcome of interest. Outcomes included change in
LDL cholesterol from baseline, incidence of adverse events, and evidence
of CAV. Changes from baseline and outcome incidences were pooled using
contemporary random-effects model methodologies. A total of six studies
including 97 patients were included. Over a mean follow-up of 13 months
(range 3-21), PCSK9i use lowered LDL by 82.61 mg/dL (95% CI - 119.15 to -
46.07; I2 = 82%) from baseline. Serious adverse drug reactions
were rarely reported, and none was attributable to the PCSK9i therapy.
Four studies reported stable calcineurin inhibitor levels during PCSK9i
initiation. One study reported outcomes in 33 patients with serial
coronary angiography and intravascular ultrasound, and PCSK9i were
associated with stable coronary plaque thickness and lumen area. One study
reported on immunologic safety, showing no DSA development within 1 month
of therapy. Preliminary data suggest that long-term PCSK9i therapy is
safe, significantly lowers LDL, and may attenuate CAV after HT. Additional
study on larger cohorts is warranted to confirm these
findings. Copyright © 2022, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<116>
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. Copyright © 2022 The Authors. The Kaohsiung Journal
of Medical Sciences published by John Wiley & Sons Australia, Ltd on
behalf of Kaohsiung Medical University.

<117>
Accession Number
2018480294
Title
Late Infective Endocarditis After Transcatheter Mitral Valve
Reconstruction (MitraClip) :A Case Report and a Review of the Literature.
Source
Angiology. 74(3) (pp 205-215), 2023. Date of Publication: March 2023.
Author
Chourdakis E.; Koniari I.; Osman N.; Kounis N.; Hahalis G.; Werner N.
Institution
(Chourdakis, Osman, Werner) Krankenhaus der Barmherzigen Bruder, Trier,
Germany
(Koniari) University Hospital of South Manchester, Manchester, United
Kingdom
(Kounis, Hahalis) Patras University Hospital, Patras, Greece
Publisher
SAGE Publications Inc.
Abstract
Percutaneous transcatheter mitral valve reconstruction in edge to edge
fashion is a well-established option in inoperable or high peri-operative
risk patients with severe, symptomatic mitral valve regurgitation.
MitraClip in combination with medical treatment improves survival and
reduces hospitalization rates compared with optimal medical therapy alone
in well selected patients. Clip-associated endocarditis is a rare
complication with only few reported cases in the literature. We present a
case of late infective endocarditis post Mitral Clip implantation and also
review the literature regarding this new rare condition. Copyright
© The Author(s) 2022.

<118>
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. Copyright © 2023 The Authors

<119>
Accession Number
2013992742
Title
Transition to heart transplantation in post-myocardial infarction
ventricular septal rupture: a systematic review.
Source
Heart Failure Reviews. 28(1) (pp 217-227), 2023. Date of Publication:
January 2023.
Author
Perez-Villa B.; Cubeddu R.J.; Brozzi N.; Sleiman J.R.; Navia J.;
Hernandez-Montfort J.
Institution
(Perez-Villa, Brozzi, Sleiman, Navia, Hernandez-Montfort) Heart, Vascular
and Thoracic Institute, Cleveland Clinic Florida, Weston, FL, United
States
(Cubeddu) Naples Heart Institute, NCH Healthcare System, Naples, FL,
United States
Publisher
Springer
Abstract
Post-myocardial infarction ventricular septal rupture (MI-VSR) remains a
dreadful complication with dismal prognosis. Surgical repair is the
primary treatment strategy, whereas the role of heart transplantation (HT)
as a primary option in MI-VSR is limited to case reports (CRs). We
performed a systematic review of CRs to describe in-hospital mortality,
and survival at 6 and 12 months in adult patients with MI-VSR treated with
HT as a primary or bailout strategy. We performed a comprehensive search
of Web of Science, PubMed, and Ovid Medline. The last search was completed
on March 10, 2020. An aggregated score based on the CARE case report
guideline was used to assess the quality of the CRs. We included CRs that
described adult patients with MI-VSR treated with HT as a primary or
bailout strategy. A total of 14 CRs between 1994 and 2015 were included,
retrieving and analyzing the characteristics of 17 patients. A total of 12
patients underwent HT, with HT being the primary strategy in 8 patients
and a bailout strategy for 4 patients following initial surgical repair,
while 5 patients died awaiting HT under mechanical circulatory support
(MCS), accounting for the total in-hospital mortality of this series
(29%). Regarding long-term outcomes, 6 patients were reported to be alive
at 6 months and 1 year after HT, while information was missing in the
remaining 6 patients. In conclusion, HT supported by the use of temporary
and durable MCS as a bridge to HT could be a feasible primary or bailout
strategy to reduce the high in-hospital mortality of patients with
MI-VSR. Copyright © 2021, The Author(s), under exclusive licence
to Springer Science+Business Media, LLC, part of Springer Nature.

<120>
Accession Number
2020392268
Title
Association of Metabolic Syndrome with Adverse Outcomes in Patients with
Stable Coronary Artery Disease: A Meta-Analysis.
Source
Hormone and Metabolic Research. 55(2) (pp 96-102), 2023. Date of
Publication: February 2023.
Author
Su Y.; Zhang X.
Institution
(Su, Zhang) Department of Cardiology, The First People's Hospital of
Zhaoqing City, Zhaoqing, China
Publisher
Georg Thieme Verlag
Abstract
A consensus has not been reached on the association of metabolic syndrome
(MetS) with adverse outcomes in patients with stable coronary artery
disease (CAD). The purpose of this systematic review and meta-analysis was
to summarize the prognostic implication of MetS in patients with stable
CAD. We comprehensively searched articles indexing in PubMed and Embase
databases until August 14, 2022. Original studies investigating the
association of MetS with adverse outcomes in patients with stable CAD were
included. Seven studies including 32 736 patients with stable CAD were
identified. Depending on the definition of MetS, the reported prevalence
of MetS ranged from 23.4% to 63%. Meta-analysis showed that patients with
MetS conferred an increased risk of all-cause mortality [risk ratio (RR)
1.22; 95% confidence intervals (CI) 1.15-1.19], cardiovascular mortality
(RR 1.49; 95% CI 1.16-1.92), and MACEs defined by death, myocardial
infarction, revascularization, cardiac arrest, or angina admission (RR
1.47; 95% CI 1.20-1.79), respectively. Leave-one-out sensitivity analysis
indicated the robustness of the value of MetS in prediction of all-cause
mortality. MetS may be an independently predictor of adverse outcomes in
patients with stable CAD. However, future studies are required to
consolidate the current evidence due to the small number of studies
included. Copyright © 2022. Thieme. All rights reserved.

<121>
Accession Number
2015643766
Title
Donor substance abuse and heart transplantation outcomes.
Source
Heart Failure Reviews. 28(1) (pp 207-215), 2023. Date of Publication:
January 2023.
Author
Sabra M.; Ilonze O.; Rao R.A.; Saleem K.; Guglin M.E.
Institution
(Ilonze, Rao, Saleem, Guglin) Indiana University School of Medicine,
Krannert Institute of Cardiology, Indianapolis, IN, United States
(Sabra) Department of Internal Medicine, Indiana University School of
Medicine, Indinapolis, IN, United States
Publisher
Springer
Abstract
Heart failure continues to account for millions of cases and deaths
worldwide. Heart transplant is the gold standard for treatment of advanced
heart failure. Unfortunately, the supply of donor hearts continues to be
limited with the increase in demand for heart transplantation. In this
review, we aim to explore the safety and efficacy of using hearts from
donors with history of substance use. Despite the theoretical effect of
cocaine and alcohol on the cardiovascular system, several studies
demonstrate no difference in outcomes (overall survival, graft rejection,
graft vasculopathy) when using hearts from patients with history of
cocaine and alcohol use. The opioid epidemic has expanded the potential
donor pool where the current studies have not shown any adverse outcomes
when considering donors with history of opioid use. The currently
available evidence would support the use of donor hearts from patients
with history of alcohol, cocaine, opioids, and marijuana use. Further
studies are needed to evaluate the safety of using donor hearts from
patients with history of nicotine use. Copyright © 2022, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<122>
Accession Number
2022503192
Title
Ticagrelor with and without aspirin in patients with a prior coronary
artery bypass graft undergoing percutaneous coronary intervention: the
TWILIGHT-CABG study.
Source
EuroIntervention. 18(11) (pp E897-E909), 2022. Date of Publication:
December 2022.
Author
Sardella G.; Beerkens F.J.; Dangas G.; Cao D.; Baber U.; Sartori S.; Cohen
D.J.; Briguori C.; Gil R.; Nicolas J.; Zhang Z.; Dudek D.; Kunadian V.;
Kornowski R.; Weisz G.; Claessen B.; Marx S.O.; Escaned J.; Huber K.;
Collier T.; Moliterno D.J.; Magnus Ohman E.; Krucoff M.W.; Kastrati A.;
Steg P.G.; Angiolillo D.J.; Mehta S.R.; Shlofmitz R.; Sharma S.; Pocock
S.; Gibson C.M.; Mehran R.
Institution
(Sardella) Department of Cardiology, Policlinico Umberto I University,
Rome, Italy
(Beerkens, Dangas, Cao, Sartori, Nicolas, Zhang, Sharma, Mehran) The Zena
and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine
at Mount Sinai, New York, NY, United States
(Cao) Cardio Center, Humanitas Research Hospital IRCCS, Milan, Italy
(Baber) Cardiovascular Disease Section, Department of Medicine, University
of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
(Cohen, Shlofmitz) Department of Cardiology, St. Francis Hospital & Heart
Center, Roslyn, NY, United States
(Cohen) Cardiovascular Research Foundation, New York, NY, United States
(Briguori) Mediterranea Cardiocentro, Naples, Italy
(Gil, Dudek) Center of Postgraduate Medical Education, Central Clinical
Hospital, The Ministry of Interior and Administration, Warsaw, Poland
(Kunadian) Translational and Clinical Research Institute, Faculty of
Medical Sciences, Newcastle University, Freeman Hospital, Newcastle upon
Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
(Kornowski) Cardiology Department, Rabin Medical Center, Petah Tikva,
Israel
(Weisz, Marx) Division of Cardiology, Department of Medicine, Columbia
University Medical Center, Vagelos College of Physicians and Surgeons, New
York, NY, United States
(Claessen) Department of Cardiology, Amsterdam University Medical Center,
Amsterdam, Netherlands
(Escaned) Hospital Clinico San Carlos IdISCC, Complutense University of
Madrid, Madrid, Spain
(Huber) 3rd Department of Medicine, Cardiology and Intensive Care
Medicine, Wilhelminen Hospital, Vienna, Austria
(Huber) Sigmund Freud University, Medical Faculty, Vienna, Austria
(Collier, Pocock) Department of Medical Statistics, London School of
Hygiene and Tropical Medicine, London, United Kingdom
(Moliterno) University of Kentucky, Lexington, KY, United States
(Magnus Ohman, Krucoff) Duke University Medical Center, Duke Clinical
Research Institute, Durham, NC, United States
(Kastrati) Department of Cardiology, Deutsches Herzzentrum Munchen,
Munich, Germany
(Kastrati) German Center for Cardiovascular Research (DZHK), Partner Site
Munich Heart Alliance, Munich, Germany
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Mehta) Department of Cardiology, Hamilton Health Sciences, Hamilton, ON,
Canada
(Gibson) Department of Cardiology, Beth Israel Deaconess Medical Center,
Boston, MA, United States
Publisher
Europa Group
Abstract
Background: Prior coronary artery bypass graft surgery (CABG) patients
undergoing percutaneous coronary intervention (PCI) are often older and
present with multiple comorbidities. Ticagrelor monotherapy after a short
course of dual antiplatelet therapy (DAPT) has emerged as an effective
bleeding-avoidance strategy among high-risk patients. Aim(s): We
aimed to examine the effects of ticagrelor with or without aspirin in
prior CABG patients undergoing PCI within the TWILIGHT trial.
 Method(s): After 3 months of ticagrelor plus aspirin, patients were
randomised to either aspirin or placebo, in addition to ticagrelor, for 12
months and compared by prior CABG status. The primary endpoint was
Bleeding Academic Research Consortium (BARC) type 2, 3 or 5 bleeding. The
key secondary endpoint was all-cause death, myocardial infarction (MI), or
stroke. Result(s): Out of 7,119 patients, a total of 703 (10.8%)
patients had prior CABG within the randomised cohort. Prior CABG patients
had more comorbidities and a higher incidence of BARC type 2, 3, or 5
bleeding and death, MI or stroke at 1 year after randomisation, compared
with patients without prior CABG. Ticagrelor monotherapy was associated
with significantly less BARC 2, 3, or 5 bleeding among prior CABG patients
compared with DAPT (4.9% vs 9.6%, hazard ratio [HR] 0.50, 95% confidence
interval [CI]: 0.28 to 0.90; p<inf>interaction</inf>=0.676) and similar
rates of death, MI or stroke (10.0% vs 8.7%, HR 1.14, 95% CI: 0.70 to
1.87; p<inf>interaction</inf>=0.484). When comparing target vessel type,
treatment effects were consistent among graft- and native-vessel
interventions. Conclusion(s): In high-risk patients with prior CABG,
ticagrelor monotherapy reduced bleeding without compromising ischaemic
outcomes compared with ticagrelor plus aspirin. Copyright ©
Europa Digital & Publishing 2022. All rights reserved.

<123>
Accession Number
2020155027
Title
Acquired atrioesophageal fistula: Need it be lethal? Sizing up the
problem, diagnostic modalities, and best management.
Source
Journal of Cardiac Surgery. 37(12) (pp 5362-5370), 2022. Date of
Publication: December 2022.
Author
Povey H.G.; Page A.; Large S.
Institution
(Povey, Page, Large) Department of Cardio-Thoracic Surgery, Royal Papworth
Hospital NHS Foundation Trust, Cambridge, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim of the Study: An atrioesophageal fistula is a
devastating complication of ablation for atrial fibrillation. For the
surgeon facing this dreaded complication, it may be a 'once in a lifetime'
case. This review aims to describe the clinical problem and evaluate the
outcome of different surgical techniques to start guiding cardiothoracic
surgeons toward those which offer the best chance of survival.
 Method(s): An electronic search retrieved 125 articles containing 195
cases of atrioesophageal fistula secondary to atrial fibrillation
ablation. Reports of pericardio-esophageal or mediastino-esophageal
fistula were excluded. Result(s): The median age was 61 and 143 (73%)
cases occurred in males. Fever (n = 147; 75%) and neurological dysfunction
(n = 151; 77%) were the most common symptoms. The median time from
ablation to symptom onset was 21 days (interquartile range: 12-28). The
most sensitive thoracic imaging modality was computed tomography (n =
135/153; 90%). Immediate deterioration occurred during 11/58 (19%)
oesophago-gastro-duodenoscopies. Mortality was lower in patients who had
surgery (39%) compared with endoscopic intervention (94%) or conservative
management (97%). Patients who had atrial repair combined with esophageal
repair or oesophagectomy were more likely to survive than those who had
atrial repair alone (OR 6.97; p <.001). Isolation of the esophageal aspect
of the fistula conferred an additional survival benefit (OR 5.85; p =.02).
 Conclusion(s): Fever, neurological symptoms, and chest pain in the
context of recent ablation should prompt immediate evaluation. Urgent CT
thorax should be arranged and repeated if initially unremarkable.
Esophageal instrumentation should be avoided due to the risk of
catastrophic air embolism or massive hemorrhage. The best way forward is
emergency surgical repair; the combination which offers the best survival
benefit is atrial repair combined with esophageal surgery and isolation of
the esophageal aspect of the fistula. Copyright © 2022 Wiley
Periodicals LLC.

<124>
[Use Link to view the full text]
Accession Number
2020828786
Title
Routine Functional Testing or Standard Care in High-Risk Patients after
PCI.
Source
New England Journal of Medicine. 387(10) (pp 905-915), 2022. Date of
Publication: 08 Sep 2022.
Author
Park D.-W.; Kang D.-Y.; Ahn J.-M.; Yun S.-C.; Yoon Y.-H.; Hur S.-H.; Lee
C.H.; Kim W.-J.; Kang S.H.; Park C.S.; Lee B.-K.; Suh J.-W.; Yoon J.H.;
Choi J.W.; Kim K.-S.; Choi S.W.; Lee S.N.; Park S.-J.
Institution
(Park, Kang, Ahn, Park) Divisions of Cardiology, Asan Medical Center,
University of Ulsan, College of Medicine, South Korea
(Yun) Biostatistics, Asan Medical Center, University of Ulsan College of
Medicine, South Korea
(Park) Cardiovascular Center and Cardiology Division, Yeouido St. Mary's
Hospital, South Korea
(Choi) Division of Cardiology, Eulji General Hospital, Seoul, South Korea
(Yoon) Division of Cardiology, Chungnam National University Sejong
Hospital, Sejong, South Korea
(Hur, Lee) Division of Cardiology, Keimyung University Dongsan Hospital,
South Korea
(Kim) Division of Cardiology, Daegu Catholic University Medical Center,
Daegu, South Korea
(Kim, Kang) Division of Cardiology, CHA Bundang Medical Center, Seongnam,
South Korea
(Suh) Cardiovascular Center, Seoul National University Bundang Hospital,
Seongnam, South Korea
(Lee) Division of Cardiology, Kangwon National University Hospital,
Chuncheon, South Korea
(Yoon) Division of Cardiology, Wonju Severance Christian Hospital, Wonju,
South Korea
(Choi) Division of Cardiology, Chungnam National University Hospital,
Daejeon, South Korea
(Lee) Division of Cardiology, St. Vincent's Hospital, Suwon, South Korea
Publisher
Massachussetts Medical Society
Abstract
Background: There are limited data from randomized trials to guide a
specific follow-up surveillance approach after myocardial
revascularization. Whether a follow-up strategy that includes routine
functional testing improves clinical outcomes among highrisk patients who
have undergone percutaneous coronary intervention (PCI) is uncertain.
 Method(s): We randomly assigned 1706 patients with high-risk
anatomical or clinical characteristics who had undergone PCI to a
follow-up strategy of routine functional testing (nuclear stress testing,
exercise electrocardiography, or stress echocardiography) at 1 year after
PCI or to standard care alone. The primary outcome was a composite of
death from any cause, myocardial infarction, or hospitalization for
unstable angina at 2 years. Key secondary outcomes included invasive
coronary angiography and repeat revascularization. Result(s): The
mean age of the patients was 64.7 years, 21.0% had left main disease,
43.5% had bifurcation disease, 69.8% had multivessel disease, 70.1% had
diffuse long lesions, 38.7% had diabetes, and 96.4% had been treated with
drug-eluting stents. At 2 years, a primary-outcome event had occurred in
46 of 849 patients (Kaplan-Meier estimate, 5.5%) in the functional-testing
group and in 51 of 857 (Kaplan-Meier estimate, 6.0%) in the standard-care
group (hazard ratio, 0.90; 95% confidence interval [CI], 0.61 to 1.35; P =
0.62). There were no betweengroup differences with respect to the
components of the primary outcome. At 2 years, 12.3% of the patients in
the functional-testing group and 9.3% in the standard-care group had
undergone invasive coronary angiography (difference, 2.99 percentage
points; 95% CI, -0.01 to 5.99), and 8.1% and 5.8% of patients,
respectively, had undergone repeat revascularization (difference, 2.23
percentage points; 95% CI, -0.22 to 4.68). Conclusion(s): Among
high-risk patients who had undergone PCI, a follow-up strategy of routine
functional testing, as compared with standard care alone, did not improve
clinical outcomes at 2 years. Copyright © 2022 Massachusetts
Medical Society.

<125>
Accession Number
2019075225
Title
Feasibility and oncological outcomes of video-assisted thoracic surgery
versus thoracotomy for pathologic N2 disease in non-small cell lung
cancer: A comprehensive systematic review and meta-analysis.
Source
Thoracic Cancer. 13(21) (pp 2917-2928), 2022. Date of Publication:
November 2022.
Author
Li X.; Huang K.; Deng H.; Zheng Q.; Xiao T.; Yu J.; Zhou Q.
Institution
(Li, Huang, Deng, Zheng, Xiao, Yu, Zhou) Lung Cancer Center, West China
Hospital of Sichuan University, Chengdu, China
(Yu) Department of Radiation Oncology and Shandong Provincial Key
Laboratory of Radiation Oncology, Shandong First Medical University and
Shandong Academy of Medical Sciences, Jinan, China
(Yu) Research Unit of Radiation Oncology, Chinese Academy of Medical
Sciences, Jinan, China
Publisher
John Wiley and Sons Inc
Abstract
This meta-analysis aimed to evaluate the feasibility and oncological
outcomes between video-assisted thoracic surgery (VATS) and thoracotomy
for non-small cell lung cancer (NSCLC) patients with pathologic N2 (pN2)
disease. Data for analysis included short-term outcomes and long-term
outcomes. We calculated the weighted mean differences (WMDs) for
continuous data and the results of overall survival (OS) and disease free
survival (DFS) were pooled using the hazard ratios (HRs) with 95%
confidence intervals (CIs). Heterogeneity was assessed using the Q-test
and I2-test. Sensitivity analysis was performed to further
examine the stability of pooled HRs and WMDs. In the pooled analyses of 10
eligible studies, results showed that VATS for NSCLC patients with pN2
disease yielded significantly less blood loss (WMD = -61.43; 95%
confidence intervals [CI], [-87.69, -35.18]; p < 0.001), less
post-operation hospital stay (WMD, -1.62; 95% CI, [-2.96, -0.28]; p =
0.02), and comparable operation time (WMD, -8.32; 95% CI, [-23.88, 7.23];
p = 0.29), post-operation complication rate (risk ratio [RR], 0.95; 95%
CI, [0.78, 1.15]; p = 0.59), chest tube duration to thoracotomy (WMD,
-0.64; 95% CI, [-1.45, 0.17]; p = 0.12), extent of lymph node dissection
(WMD, -1.46; 95% CI, [-3.87, 0.95]; p = 0.23) and 1-year OS (HR, 1.30; 95%
CI, [0.96, 1.76]; p = 0.09) than thoracotomy. However, VATS may improve
3-year OS (HR, 1.26; 95% CI, [1.12, 1.42]; p = 0.0002) and yield
comparable 1-year DFS (HR, 1.14; 95% CI, [0.89, 1.46]; p = 0.32) and
3-year DFS (HR, 1.03; 95% CI, [0.88, 1.22]; p = 0.70) for NSCLC patients
with pN2 disease than thoracotomy. VATS could yield less surgical trauma
and improve post-operative recovery than thoracotomy. Moreover, VATS may
improve the oncological outcomes of those patients. Copyright ©
2022 The Authors. Thoracic Cancer published by China Lung Oncology Group
and John Wiley & Sons Australia, Ltd.

<126>
Accession Number
2020934570
Title
The Value of Cardiopulmonary Exercise Testing as a Predictor of Mortality
in Heart Failure.
Source
Chest. 162(5) (pp 957-958), 2022. Date of Publication: November 2022.
Author
Casaburi R.
Institution
(Casaburi) Lundquist Institute for Biomedical Innovation at Harbor-UCLA
Medical Center, Torrance, CA, United States
Publisher
Elsevier Inc.

<127>
Accession Number
2019861932
Title
The short-term efficacy of high flow nasal oxygen therapy on
cardiovascular surgical patients: a randomized crossover trial.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 331. Date
of Publication: December 2022.
Author
Shiho D.; Kusaka Y.; Nakano S.; Umegaki O.
Institution
(Shiho, Kusaka, Nakano, Umegaki) Department of Anesthesiology, Osaka
Medical and Pharmaceutical University, Daigaku-machi 2-7, Takatsuki, Osaka
569-8686, Japan
Publisher
BioMed Central Ltd
Abstract
Background: Oxygen therapy after extubation in the intensive care unit
(ICU) is essential in order to maintain adequate oxygenation, especially
in patients who have undertaken cardiovascular surgery. A Venturi mask
(VM) has been routinely used as an oxygen therapy in the ICU. Recently,
however, the high flow nasal cannula (HFNC) has become available, and this
device can deliver up to 60 L/min of humidified oxygen. The aim of this
study is to evaluate the short-term efficacy between HFNC and VM in
cardiovascular surgical patients. Method(s): Forty patients who
underwent cardiovascular surgery were randomized to either protocol A
(HFNC followed by VM) or protocol B (VM followed by HFNC). After
60-minutes of use with either device, arterial blood gas analysis was
performed, and the PaO<inf>2</inf>/FiO<inf>2</inf> ratio (PFR) was
calculated. Simultaneously, physiological data (respiratory rate, heart
rate, mean arterial pressure, continuous cardiac index, and mixed venous
oxygen saturation) were recorded. During this procedure, FiO<inf>2</inf>
and gas flow were maintained at a fixed rate. These variables were
compared by using the paired t-test, and a p value < 0.05 was considered
significant. All data were expressed as mean (standard deviation).
 Result(s): Thirty-five patients (17 from protocol A and 18 from
protocol B) were enrolled, and 5 patients were excluded from analysis in
accordance with the exit criteria. PaO<inf>2</inf> was significantly
higher in the HFNC group than in the VM group [101.7 (25.9) vs. 91.8
(23.0), mean difference 9.87 (18.5), 95% confidence interval 3.5 to 16.2,
p = 0.003]. Moreover, PFR was significantly higher in the HFNC group than
in the VM group [265.9 (81.4) vs. 238.7 (68.5), p = 0.002]. Moreover,
PaCO<inf>2</inf> was significantly lower in the HFNC group than in the VM
group [33.8 (3.5) vs. 34.7 (2.9), p = 0.033]. The respiratory rate was
significantly lower in the HFNC group than in the VM group [18 (4) vs. 21
(4), p = 0.006], and no significant differences were seen in any of the
other parameters. Conclusion(s): Compared to VM, HFNC ameliorated
oxygenation function and decreased patients' effort in breathing. The
hemodynamic state did not differ between HFNC and VM. Therefore, HFNC can
be used safely in cardiovascular surgical patients. Trial registration:
This trial was registered with the UMIN Clinical Trials Registry (ID
UMIN000016572). Copyright © 2022, The Author(s).

<128>
Accession Number
2017578605
Title
Socioeconomic inequity in incidence, outcomes and care for acute coronary
syndrome: A systematic review.
Source
International Journal of Cardiology. 356 (pp 19-29), 2022. Date of
Publication: 01 Jun 2022.
Author
Simoni A.H.; Frydenlund J.; Kragholm K.H.; Boggild H.; Jensen S.E.;
Johnsen S.P.
Institution
(Simoni, Frydenlund, Johnsen) Danish Center for Clinical Health Services
Research (DACS), Department of Clinical Medicine, Aalborg University,
Denmark
(Kragholm, Boggild) Unit of Clinical Biostatistics, Aalborg University
Hospital, Denmark
(Kragholm) Department of Cardiology North Denmark Regional and Aalborg
University Hospital, Denmark
(Boggild) Public Health and Epidemiology Group, Department of Health
Science and Technology, Aalborg University, Denmark
(Jensen) Department of Cardiology, Aalborg University Hospital, Denmark
(Jensen) Department of Clinical Medicine, Aalborg University, Denmark
Publisher
Elsevier Ireland Ltd
Abstract
Background: Socioeconomic inequities in acute coronary syndrome (ACS)
epidemiology and care have been reported for at least 30-40 years.
However, an up-to-date overview of evidence reflecting current clinical
practice is not available. This systematic review aimed to summarize
literature published in the last decade, regarding the association between
socioeconomic position (SEP), incidence and prevalence of ACS, post-ACS
medical care, and mortality. Method(s): The systematic search was
performed in PubMed and Embase restricted to publication year (2009-2021),
according to predefined methods (PROSPERO: CRD42020197654). Results were
classified according to outcomes and socioeconomic exposures, and the risk
of bias was evaluated. Result(s): In total, 181 studies were
included, mainly from high-income countries (81%). The majority showed an
association between lower SEP (i.e. education, income, occupation,
insurance, or composite SEP) and increased ACS incidence (89%)(incidence
rate ratios: 1.1-4.7), increased ACS prevalence (88%)(odds ratios (ORs):
1.8-3.9), receiving suboptimal ACS-related medical care (46%)(ORs:
1.1-10.0), or increased post-ACS mortality (71%)(hazard rate ratios:
1.1-4.13). Studies with a lower risk of bias appeared more likely to
describe inequity in favor of higher SEP than studies with a higher risk
of bias. Conclusion(s): Across studies from the last decade, lower
SEP is associated with higher risks of ACS, subsequent suboptimal medical
care, and mortality among the ACS patients, in particular in studies with
a lower risk of bias. This indicates considerable socioeconomic inequity
among ACS patients internationally, despite low- and middle-low-income
countries being inadequately represented. Thus, efforts are warranted to
continuously monitor ACS-related socioeconomic inequity. Copyright
© 2022

<129>
Accession Number
2022370034
Title
Antineutrophil Cytoplasm Antibody-Associated Vasculitides Valvular
Impairment: Multicenter Retrospective Study and Systematic Review of the
Literature.
Source
Journal of Rheumatology. 49(12) (pp 1349-1355), 2022. Date of Publication:
01 Dec 2022.
Author
Jeantin L.; Lenfant T.; Bataille P.; de Boysson H.; Cathebras P.; Agard
C.; Faguer S.; Poindron V.; Ruivard M.; Silva N.M.; Monge M.; Guillevin
L.; Puechal X.; Terrier B.; Dechartres A.; Charles P.
Institution
(Jeantin, Lenfant, Charles) Department of Internal Medicine, Institut
Mutualiste Montsouris, Paris, France
(Bataille) Department of Nephrology, CH Boulogne-sur-Mer,
Boulogne-sur-Mer, France
(de Boysson, Silva) Department of Internal Medicine, CHU Caen, Caen,
France
(Cathebras) Department of Internal medicine, Hopital Nord, CHU St Etienne,
St Etienne, France
(Agard) Nantes Universite, CHU Nantes, Department of Internal Medicine,
Nantes, France
(Faguer) Department of Nephrology and Organ Transplantation, Rangueuil
Hospital, Toulouse, France
(Poindron) Referral Center for Autoimmune and Rare Systemic Diseases,
Strasbourg University Hospital, Strasbourg, France
(Ruivard) Department of Internal Medicine, CHU Estaing, CHU
Clermont-Ferrand, Clermont-Ferrand, France
(Monge) Hemodialysis Department, Institut Mutualiste Montsouris, Paris,
France
(Guillevin, Puechal, Terrier) National Referral Centre for Rare Systemic
Autoimmune Diseases, Department of Internal Medicine, CHU Cochin, Paris,
France
(Dechartres) Sorbonne Universite, INSERM, Institut Pierre Louis
d'Epidemiologie et de Sante Publique, AP-HP, Hopital Pitie Salpetriere,
Departement de Sante Publique, Paris, France
Publisher
Journal of Rheumatology
Abstract
Objective. While myocardial impairment is a predictor of poor prognosis in
antineutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV),
little is known about valvular involvement. This study aims at describing
the clinical presentation, management, and outcome of endocarditis
associated with AAV. Methods. We conducted a multicenter retrospective
study in centers affiliated with the French Vasculitis Study Group. We
included patients with granulomatosis with polyangiitis (GPA), microscopic
polyangiitis (MPA), or eosinophilic GPA with endocardial impairment. A
systematic review was then performed through PubMed, Embase, and Cochrane
Library from inception up to September 2020. Results. The retrospective
cohort included 9 patients (82%) with GPA, 1 (9%) with MPA, and 1 (9%)
with unclassified AAV. Clinical presentation included acute valvular
insufficiency (n = 7, 64%), cardiac failure (n = 3, 27%), dyspnea (n = 3,
27%), and no symptoms (n = 2, 18%). The aortic valve was the most
frequently affected (n = 8/10, 80%), and vegetations were noted in 4 of 10
patients (40%). Six patients (55%) underwent surgical valvular
replacement. No death from endocarditis was reported. The systematic
review retrieved 42 patients from 40 references: 30 (71%) had GPA, 21
(50%) presented with vegetations, the aortic valve (n = 26, 62%) was the
most frequently involved. Valvular replacement was required in 20 cases
(48%) and 5 patients (13%) died from the endocarditic impairment.
Conclusion. Endocarditis is a rare and potentially life-threatening
manifestation of AAV. Acute valvular insufficiency may lead to urgent
surgery. Implementing transthoracic echocardiography in standard
assessment at baseline and follow-up of AAV might reduce the delay to
diagnosis and allow earlier immunosuppressive treatment before surgery is
needed. Copyright © 2022 Journal of Rheumatology. All rights
reserved.

<130>
[Use Link to view the full text]
Accession Number
2022653673
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, Jiangsu, Suzhou 215006, China
(Long, Shan, Ji, Peng) Institute of Anesthesiology, Soochow University,
Jiangsu, Suzhou 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
Lippincott Williams and Wilkins
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. 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. 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.
 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. Copyright © 2022
Lippincott Williams and Wilkins. All rights reserved.

<131>
[Use Link to view the full text]
Accession Number
2022653672
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, Tian, Li, Liu, Chen, Jiang, Chen, Xue) Department of Anesthesiology,
Beijing Friendship Hospital, Capital Medical University, Beijing 100050,
China
Publisher
Lippincott Williams and Wilkins
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. 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). 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.
 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. Copyright © 2022 Lippincott Williams
and Wilkins. All rights reserved.

<132>
Accession Number
640315252
Title
Alcohol Septal Ablation Versus Surgical Septal Myectomy of Obstructive
Hypertrophic Cardiomyopathy: Systematic Review and Meta-Analysis.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2023.
Date of Publication: 14 Feb 2023.
Author
Yokoyama Y.; Shimoda T.; Shimada Y.J.; Shimamura J.; Akita K.; Yasuda R.;
Takayama H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
PA, United States
(Shimoda) School of Medicine, University of Tsukuba, Ibaraki, Japan
(Shimada, Akita, Yasuda) Division of Cardiology, Department of Medicine,
Columbia University Irving Medical Center, NY, United States
(Shimamura) Department of Surgery, Division of Cardiothoracic Surgery,
Emory University, GA, United States
(Takayama) Department of Surgery, Columbia University Irving Medical
Center, NY, United States
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, NY, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To elucidate the optimal septal reduction therapy for
obstructive hypertrophic cardiomyopathy, we conducted a meta-analysis
comparing alcohol septal ablation and septal myectomy. METHOD(S):
MEDLINE, EMBASE, and Cochrane CENTRAL were searched to identify studies
investigating the outcomes of alcohol septal ablation and septal myectomy
in patients with obstructive hypertrophic cardiomyopathy in January 2023.
The primary outcome of interest was all-cause mortality in studies with >=
1year of follow-up. The secondary outcomes of interest comprised left
ventricular outflow tract pressure gradient reduction and reoperations of
left ventricular outflow tract. A subgroup analysis of all-cause mortality
including studies with follow-up >= 5years was performed. RESULT(S):
27 observational studies were included (15,968 patients). Analysis
demonstrated similar all-cause mortality (hazard ratio [HR] [95%
confidence interval (CI)] = 1.24 [0.88-1.76]; P=0.21; I2 =56%). In
contrast, alcohol septal ablation was associated with less reduction of
left ventricular outflow tract pressure gradient and a reoperation rate
(weighted mean difference [95% CI] = 11.04mmHg [5.60-16.48]; P<0.01; I2
=64%, HR [95% CI] = 9.14 [6.55-12.75]; P<0.001; I2 =0%, respectively). The
subgroup analysis with follow-up >= 5years revealed higher long-term
mortality with alcohol septal ablation (HR [95% CI] = 1.50 [1.04-2.15];
P=0.03; I2 =52%). CONCLUSION(S): Although both septal reduction
therapies were associated with similar all-cause mortality, alcohol septal
ablation was associated with a higher rate of reoperation and less
reduction of left ventricular outflow tract pressure gradient.
Furthermore, all-cause mortality with follow-up >= 5years showed favorable
outcomes with septal myectomy, although the result is only
hypothesis-generating given a subgroup analysis. Copyright © The
Author(s) 2023. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<133>
Accession Number
640314744
Title
Pectus Excavatum in Cardiac Surgery Patients.
Source
The Annals of thoracic surgery. (no pagination), 2023. Date of
Publication: 11 Feb 2023.
Author
Stephens E.H.; Dearani J.A.; Jaroszewski D.E.
Institution
(Stephens, Dearani) Pediatric and Congenital Cardiac Surgery, Department
of Cardiovascular Surgery, Mayo Clinic Rochester
(Jaroszewski) Thoracic Surgery, Department of Cadiovascular and Thoracic
Surgery, Mayo Clinic Arizona.
Publisher
NLM (Medline)
Abstract
BACKGROUND: Pectus excavatum frequently accompanies congenital heart
disease and connective tissue diseases requiring cardiac surgery.
Sometimes the indication is cardiac repair with the pectus being
incidentally noticed, and other times the pectus subsequently develops or
becomes more significant after cardiac surgery. This review arms cardiac
and congenital surgeons with background regarding the physiological impact
of pectus, indications for repair and repair strategies, and outcomes for
cardiac surgery patients requiring pectus repair. METHOD(S): A
comprehensive literature review was performed using keywords related to
pectus excavatum, pectus repair and cardiac/congenital heart surgery
within the PubMed database. RESULT(S): The risks of complications
related to pectus repair, including in the setting of cardiac surgery or
after cardiac surgery, are low in experienced hands and patients
demonstrate cardiopulmonary benefits and symptom relief. Concomitant
pectus and cardiac surgery should be considered if performed in
conjunction with those experienced in pectus repair, particularly given
the increased cardiopulmonary impact of pectus after bypass. In the
setting of potential bleeding and/or hemodynamic instability, delayed
sternal closure is recommended. For those with anticipated pectus repair
after cardiac surgery, the pericardium should be reconstructed for cardiac
protection. For those undergoing pectus repair after cardiac surgery
without a membrane placed, a "hybrid" approach is safe and effective.
 CONCLUSION(S): Patients undergoing cardiac surgery noted to have
pectus should be considered for possible concomitant or staged pectus
repair. For those who will undergo a staged procedure, a barrier membrane
should be placed before chest closure. Copyright © 2023.
Published by Elsevier Inc.

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