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<1>
Accession Number
2022040704
Title
Microvascular resistance reserve in the presence of functionally
significant epicardial stenosis and changes after revascularization.
Source
Physiological Reports. 11(5) (no pagination), 2023. Article Number:
e15627. Date of Publication: March 2023.
Author
Hanyu Y.; Hoshino M.; Usui E.; Sugiyama T.; Kanaji Y.; Hada M.; Nagamine
T.; Nogami K.; Ueno H.; Sayama K.; Matsuda K.; Sakamoto T.; Yonetsu T.;
Sasano T.; Kakuta T.
Institution
(Hanyu, Hoshino, Usui, Kanaji, Hada, Nagamine, Nogami, Ueno, Sayama,
Matsuda, Sakamoto, Kakuta) Division of Cardiovascular Medicine, Tsuchiura
Kyodo General Hospital, Ibaraki, Japan
(Sugiyama, Yonetsu) Department of Interventional Cardiology, Tokyo Medical
and Dental University, Tokyo, Japan
(Sasano) Department of Cardiovascular Medicine, Tokyo Medical and Dental
University, Tokyo, Japan
Publisher
American Physiological Society
Abstract
In the presence of functionally significant epicardial lesions,
microvascular resistance reserve (MRR) calculation needs incorporation of
collateral flow. Coronary fractional flow reserve (FFR<inf>cor</inf>)
requiring coronary wedge pressure (P<inf>w</inf>), which is an essential
part of the true MRR calculation, is reportedly estimated by myocardial
FFR (FFR<inf>myo</inf>) not requiring P<inf>w</inf> measurement. We sought
to find an equation to calculate MRR without the need for P<inf>w</inf>.
Furthermore, we assessed changes in MRR after percutaneous coronary
intervention (PCI). An equation to estimate FFR<inf>cor</inf> was
developed from a cohort of 230 patients who underwent physiological
measurements and PCI. Corrected MRR was calculated using this equation and
compared with true MRR in 115 patients of the different set of the
validation cohort. True MRR was calculated using FFR<inf>cor</inf>.
FFR<inf>cor</inf> and FFR<inf>myo</inf> showed a strong linear
relationship (r2 = 0.86) and an equation was FFR<inf>cor</inf>
= 1.36 x FFR<inf>myo</inf> - 0.34. This equation provided no significant
difference between corrected MRR and true MRR in the validation cohort.
Pre-PCI lower coronary flow reserve and higher index of microcirculatory
resistance were independent predictors of pre-PCI decreased true MRR. True
MRR significantly decreased after PCI. In conclusion, MRR can be
accurately corrected using an equation for FFR<inf>cor</inf> estimation
without P<inf>w</inf>. Copyright © 2023 The Authors.
Physiological Reports published by Wiley Periodicals LLC on behalf of The
Physiological Society and the American Physiological Society.

<2>
Accession Number
2021679362
Title
The impact of chronic total occlusions in patients undergoing
transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 101(4) (pp 806-812),
2023. Date of Publication: 01 Mar 2023.
Author
Will M.; Schwarz K.; Weiss T.; Leibundgut G.; Lamm G.; Vock P.;
Mascherbauer J.; Kwok C.S.
Institution
(Will, Schwarz, Lamm, Vock, Mascherbauer) Department of Internal Medicine
3, University Hospital St. Polten, Karl Landsteiner University of Health
Sciences, Krems, Austria
(Will, Weiss) Karl Landsteiner Institute for Cardiometabolics, Karl
Landsteiner Society, St Poelten, Austria
(Weiss) Medical School, Sigmund-Freud University, Vienna, Austria
(Leibundgut) Klinik fur Kardiologie, Universitatsspital Basel, Basel,
Switzerland
(Kwok) Department of Post-Qualifying Healthcare Practice, School of
Nursing and Midwifery, Birmingham City University, Birmingham, United
Kingdom
(Kwok) Department of Cardiology, University Hospitals of North Midlands
NHS Trust, Stoke-on-Trent, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Coronary artery disease (CAD) is frequently encountered in patients
evaluated for transcatheter aortic valve replacement (TAVR) due to severe
aortic stenosis. The prognostic relevance of chronic total occlusions
(CTOs) in this setting is poorly understood. We conducted a search of
MEDLINE and EMBASE to identify studies evaluating patients who underwent
TAVR and evaluated outcomes depending on the presence of coronary CTOs.
Pooled analysis was performed to estimate the rate and risk ratio for
mortality. Four studies involving 25,432 patients fulfilled the inclusion
criteria. The follow up ranged from in-hospital outcomes to 8-years
follow-up. Coronary artery disease was present in 67.8% to 75.5% of
patients in 3 studies which reported this variable. The prevalence of CTOs
varied between 2% and 12.6% in this cohort. The presence of CTOs was
associated with increase in length of stay (8.1 +/- 8.2 vs. 5.9 +/- 6.5, p
< 0.01), cardiogenic shock (5.1% vs. 1.7%, p < 0.01), acute myocardial
infarction (5.8% vs. 2.8%, p = 0.02) and acute kidney injury (18.6% vs.
13.9%, p = 0.048). The pooled 1-year death rate revealed 41 deaths in 165
patients in the CTO group and 396 deaths in 1663 patients with no CTO
((24.8%) vs. (23.8%)). The meta-analysis of death with CTO versus no CTO
showed a nonsignificant trend toward increased mortality with CTOs (risk
ratio 1.11 95% CI 0.90-1.40, I2 = 0%). Our analysis suggests
that concomitant CTO lesions in patients undergoing TAVR are common, and
its presence was associated with increased in-hospital complications.
However, CTO presence by itself was not associated with increased
long-term mortality, only a nonsignificant trend toward an increased risk
of death in patients with CTO was found. Further studies are warranted to
assess the prognostic relevance of CTO lesion in TAVR
patients. Copyright © 2023 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<3>
Accession Number
2011934093
Title
Atrial fibrillation after cardiac surgery: A systematic review and
meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(1) (pp 94-103.e24),
2023. Date of Publication: January 2023.
Author
Caldonazo T.; Kirov H.; Rahouma M.; Robinson N.B.; Demetres M.; Gaudino
M.; Doenst T.; Dobrev D.; Borger M.A.; Kiehntopf M.; Skoloff K.
Institution
(Caldonazo, Kirov, Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Jena, Germany
(Rahouma, Robinson, Gaudino) Department of Cardiothoracic Surgery at New
York Presbyterian, Weill Cornell Medical Center, New York, NY, United
States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medical Center, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Objective: New-onset postoperative atrial fibrillation (POAF) after
cardiac surgery is common, with rates up to 60%. POAF has been associated
with early and late stroke, but its association with other cardiovascular
outcomes is less known. The objective was to perform a meta-analysis of
the studies reporting the association of POAF with perioperative and
long-term outcomes in patients with cardiac surgery. Method(s): We
performed a systematic review and a meta-analysis of studies that
presented outcomes for cardiac surgery on the basis of the presence or
absence of POAF. MEDLINE, EMBASE, and the Cochrane Library were assessed;
57 studies (246,340 patients) were selected. Perioperative mortality was
the primary outcome. Inverse variance method and random model were
performed. Leave-one-out analysis, subgroup analyses, and metaregression
were conducted. Result(s): POAF was associated with perioperative
mortality (odds ratio [OR], 1.92; 95% confidence interval [CI],
1.58-2.33), perioperative stroke (OR, 2.17; 95% CI, 1.90-2.49),
perioperative myocardial infarction (OR, 1.28; 95% CI, 1.06-1.54),
perioperative acute renal failure (OR, 2.74; 95% CI, 2.42-3.11), hospital
(standardized mean difference, 0.80; 95% CI, 0.53-1.07) and intensive care
unit stay (standardized mean difference, 0.55; 95% CI, 0.24-0.86),
long-term mortality (incidence rate ratio [IRR], 1.54; 95% CI, 1.40-1.69),
long-term stroke (IRR, 1.33; 95% CI, 1.21-1.46), and longstanding
persistent atrial fibrillation (IRR, 4.73; 95% CI, 3.36-6.66).
 Conclusion(s): The results suggest that POAF after cardiac surgery is
associated with an increased occurrence of most short- and long-term
cardiovascular adverse events. However, the causality of this association
remains to be established. Copyright © 2021 The American
Association for Thoracic Surgery

<4>
Accession Number
2021360321
Title
Utilization of TandemHeart in cardiogenic shock: Insights from the THEME
registry.
Source
Catheterization and Cardiovascular Interventions. 101(4) (pp 756-763),
2023. Date of Publication: 01 Mar 2023.
Author
Megaly M.; Gandolfo C.; Zakhour S.; Jiang M.; Burgess K.; Chetcuti S.;
Ragosta M.; Adler E.; Coletti A.; O'Neill B.; Alaswad K.; Basir M.B.
Institution
(Megaly, Gandolfo, Zakhour, O'Neill, Alaswad, Basir) Division of
Cardiology, Henry Ford Health System, Detroit, MI, United States
(Jiang, Burgess) LivaNova, PLC, London, United Kingdom
(Chetcuti) Division of Cardiology, University of Michigan, Ann Arbor, MI,
United States
(Ragosta) Division of Cardiology, University of Virginia Health System,
Charlottesville, VA, United States
(Adler) Division of Cardiology, University of California San Diego Medical
Center, La Jolla, CA, United States
(Coletti) Division of Cardiology, Providence Sacred Heart Medical Center,
Spokane, WA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: TandemHeart has been demonstrated to improve hemodynamic and
metabolic complications in cardiogenic shock (CS). Contemporary outcomes
have not been reported. Objective(s): To evaluate the outcomes of the
TandemHeart (LivaNova) in contemporary real-world use. Method(s): We
analyzed baseline characteristics, hemodynamic changes, and outcomes of
all patients treated with TandemHeart who were enrolled in the THEME
registry, a multicenter, prospective, observational study. Result(s):
Between May 2015 and June 2019, 50 patients underwent implantation of the
TandemHeart device. 22% of patients had TandemHeart implanted within 12 h,
32% within 24 h, and 52% within 48 h of CS diagnosis. Cardiac index (CI)
was significantly improved 24 h after implantation (median change 1.0,
interquartile range (IQR) (0.5-1.4 L/min/m2). In survivors,
there was a significant improvement in CI (1.0, IQR (0.5-2.25
L/min/m2) and lactate clearance -2.3 (-5.0 to -0.7 mmol/L). The
30-day and 180-day survival were 74% (95% confidence interval: 60%-85%)
and 66% (95% confidence interval: 51%-79%), respectively. Survival was
similarly high in those in whom TandemHeart has been used as a bridge to
surgery (85% 180-day survival). Conclusion(s): In a contemporary
cohort of patients presenting in CS, the use of TandemHeart is associated
with a 74% 30-day survival and a 66% 180-day survival. Copyright
© 2023 Wiley Periodicals LLC.

<5>
Accession Number
2021025924
Title
Excess Reintervention With Mitroflow Prosthesis for Aortic Valve
Replacement: Ten-Year Outcomes of a Randomized Trial.
Source
Annals of Thoracic Surgery. 115(4) (pp 949-956), 2023. Date of
Publication: April 2023.
Author
Cangut B.; Schaff H.V.; Suri R.M.; Greason K.L.; Stulak J.M.; Lahr B.D.;
Michelena H.I.; Daly R.C.; Dearani J.A.; Crestanello J.A.
Institution
(Cangut, Schaff, Greason, Stulak, Daly, Dearani, Crestanello) Department
of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, United
States
(Suri) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(Lahr) Division of Biomedical Statistics and Informatics, Mayo Clinic
College of Medicine and Science, Rochester, Minnesota, United States
(Michelena) Department of Cardiovascular Diseases, Mayo Clinic, Rochester,
Minnesota, United States
Publisher
Elsevier Inc.
Abstract
Background: Current bioprostheses are considered to have improved
durability and better hemodynamic performance compared with previous
designs, but there are limited comparative data on late outcomes.
 Method(s): From 2009 through 2011, 300 adults with severe aortic
valve stenosis undergoing aortic valve replacement (AVR) were randomly
assigned to receive Edwards Magna, St Jude Epic, or Sorin Mitroflow
bioprostheses (n = 100, n = 101, n = 99, respectively). Overall survival
was analyzed using Kaplan-Meier and Cox proportional hazards methods,
whereas competing risk analysis was used for all time-to-event outcomes.
Serial echocardiographic data were fitted with longitudinal models
stratified by implant valve size. Result(s): During median follow-up
of 9.8 years (interquartile range, 8.7-10.2), 10-year survival was 50% for
the Magna group, 42% for the Epic group, and 41% for the Mitroflow group
(P = .415). Cumulative risk of stroke was 9% at 10 years, and rates were
comparable for the three groups. Indexed aortic valve area and mean
gradients were similar among the three groups receiving 19 mm and 21 mm
valves, but in larger (23 mm or more) prostheses, gradients were lower (P
< .001) and indexed aortic valve areas were higher in the Magna group (P <
.001). The 10-year risk of endocarditis differed by group (P = .033), with
higher incidence in the Mitroflow vs the Magna group (7% vs 0%, P = .019).
Late risk of reinterventions in the Mitroflow group was 22%, compared with
0% in the Magna group (P < .001) and 5% in the Epic group (P = .008).
 Conclusion(s): The Magna valve had the lowest gradients and largest
indexed aortic valve area with larger implant sizes. The Mitroflow
bioprosthesis is associated with an increased rate of reintervention and
possible increased risk of infection compared with Magna and Epic
valves. Copyright © 2023 The Society of Thoracic Surgeons

<6>
Accession Number
2020820981
Title
Dexmedetomidine Increases MMP-12 and MBP Concentrations after Coronary
Artery Bypass Graft Surgery with Extracorporeal Circulation Anaesthesia
without Impacting Cognitive Function: A Randomised Control Trial.
Source
International Journal of Environmental Research and Public Health. 19(24)
(no pagination), 2022. Article Number: 16512. Date of Publication:
December 2022.
Author
Kowalczyk M.; Panasiuk-Kowalczyk A.; Stadnik A.; Guz M.; Cybulski M.;
Jeleniewicz W.; Stepulak A.; Kwiatosz-Muc M.
Institution
(Kowalczyk, Panasiuk-Kowalczyk, Kwiatosz-Muc) 1st Department of
Anaesthesiology and Intensive Care, Medical University of Lublin, ul.
Jaczewskiego 8, Lublin 20-954, Poland
(Stadnik) Department of Cardiac Surgery, Medical University of Lublin, ul.
Jaczewskiego 8, Lublin 20-954, Poland
(Guz, Cybulski, Jeleniewicz, Stepulak) Department of Biochemistry and
Molecular Biology, Medical University of Lublin, ul. Chodzki 1, Lublin
20-093, Poland
Publisher
MDPI
Abstract
Postoperative neurological deficits remain a concern for patients
undergoing cardiac surgeries. Even minor injuries can lead to
neurocognitive decline (i.e., postoperative cognitive dysfunction).
Dexmedetomidine may be beneficial given its reported neuroprotective
effect. We aimed to investigate the effects of dexmedetomidine on brain
injury during cardiac surgery anaesthesia. This prospective observational
study analysed data for 46 patients who underwent coronary artery bypass
graft surgery with extracorporeal circulation between August 2018 and
March 2019. The patients were divided into two groups: control (CON) with
typical anaesthesia and dexmedetomidine (DEX) with dexmedetomidine
infusion. Concentrations of the biomarkers matrix metalloproteinase-12
(MMP-12) and myelin basic protein (MBP) were measured preoperatively and
at 24 and 72 h postoperatively. Cognitive evaluations were performed
preoperatively, at discharge, and 3 months after discharge using
Addenbrooke's Cognitive Examination version III (ACE-III). The primary
endpoint was the ACE-III score at discharge. Increased MMP-12 and MBP
concentrations were observed in the DEX group 24 and 72 h postoperatively.
No significant differences in ACE-III scores were observed between the
groups at discharge; however, the values were increased when compared with
initial values after 3 months (p = 0.000). The current results indicate
that the administration of dexmedetomidine as an adjuvant to anaesthesia
can increase MMP-12 and MBP levels without effects on neurocognitive
outcomes at discharge and 3 months postoperatively. Copyright ©
2022 by the authors.

<7>
Accession Number
2019158270
Title
A comprehensive review of Strongyloides stercoralis infection after solid
organ and hematopoietic stem cell transplantation.
Source
Clinical Transplantation. 36(11) (no pagination), 2022. Article Number:
e14795. Date of Publication: November 2022.
Author
Abad C.L.R.; Bhaimia E.; Schuetz A.N.; Razonable R.R.
Institution
(Abad) Department of Medicine, Division of Infectious Diseases, University
of the Philippines-Manila, Philippine General Hospital, Manila,
Philippines
(Bhaimia, Razonable) Department of Medicine, Division of Public Health,
Infectious Diseases and Occupational Medicine, and The William J Von
Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic
College of Medicine and Sciences, Rochester, MN, United States
(Schuetz) Division of Clinical Microbiology, Department of Laboratory
Medicine and Pathology, Mayo Clinic College of Medicine and Sciences,
Rochester, MN, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: We reviewed the scientific literature to gain insight on the
epidemiology and outcome of Strongyloides stercoralis infections after
transplantation. Method(s): CINAHL, PUBMED, and OVID/MEDLINE were
reviewed from inception through March 31, 2022 using key words
Strongyloides and transplantation. Result(s): Our review identified
108 episodes of Strongyloides infection among 91 solid organ transplant
(SOT) and 15 hematopoietic cell transplant (HCT) recipients. Median time
to infection was 10.8 (range,.14-417) and 8.8 (range, 0-208) weeks after
SOT and HCT, respectively. Gastrointestinal symptoms were frequent (86/108
[79.6%]), while skin rash (22/108 [20.3%]) and fever (31/103 [30%]) were
less common. Peripheral eosinophilia was observed in half of patients
(41/77 [53.2%]). Bacteremia (31/59 [52.5%]) was frequently due to
Gram-negative organisms (24/31 [77.4%]). Abnormal chest radiologic
findings were reported in half (56/108 [51.9%]). The majority had
hyperinfection syndrome (97/108 [89.8%]) while disseminated
strongyloidiasis was less common (11/108 [10.2%]). Thirty-two cases were
categorized as donor-derived infection (DDI), with donors (23/24 [95.8%])
who had traveled to or lived in endemic areas. Median time to DDI was 8
weeks (range.5-34.3 weeks) after transplantation. Treatment consisted of
ivermectin (n = 26), a benzimidazole (n = 27), or both drugs (n = 28).
There was high all-cause mortality (48/107, 44.9%) and a high
Strongyloides-attributable mortality (32/49, 65.3%). Conclusion(s):
Strongyloidiasis should be strongly considered among recipients with
epidemiologic risk factors for infection, even in the absence of
eosinophilia or rash. A policy that provides guidance on pro-active
screening is needed, to ensure preventive measures are provided to
recipients at increased risk. Copyright © 2022 The Authors.
Clinical Transplantation published by John Wiley & Sons Ltd.

<8>
Accession Number
2021956084
Title
Concordance between Patient-Reported Health Data and Electronic Health
Data in the ADAPTABLE Trial.
Source
JAMA Cardiology. 7(12) (pp 1235-1243), 2022. Date of Publication: 14 Dec
2022.
Author
O'Brien E.C.; Mulder H.; Jones W.S.; Hammill B.G.; Sharlow A.; Hernandez
A.F.; Curtis L.H.
Institution
(O'Brien, Hammill, Curtis) Department of Population Health Sciences, Duke
University, School of Medicine, Durham, NC, United States
(O'Brien, Mulder, Jones, Hernandez, Curtis) Duke Clinical Research
Institute, Duke University, School of Medicine, Durham, NC, United States
(Jones, Hernandez, Curtis) Department of Medicine, Duke University, School
of Medicine, Durham, NC, United States
(Sharlow) Medidata Solutions, New York, NY, United States
Publisher
American Medical Association
Abstract
Importance: Patient-reported health data can facilitate clinical event
capture in pragmatic clinical trials. However, few data are available on
the fitness for use of patient-reported data in large-scale health
research. Objective(s): To evaluate the concordance of a set of
variables reported by patients and available in the electronic health
record as part of a pragmatic clinical trial. Design, Setting, and
Participant(s): Data from ADAPTABLE (Aspirin Dosing: A Patient-Centric
Trial Assessing Benefits and Long-term Effectiveness), a pragmatic
clinical trial, were used in a concordance substudy of a comparative
effectiveness research trial. The trial randomized 15076 patients with
existing atherosclerotic cardiovascular disease in a 1:1 ratio to low- or
high-dose aspirin from April 2016 through June 30, 2019. Main
Outcomes and Measures: Concordance of data was evaluated from 4 domains
(demographic characteristics, encounters, diagnoses, and procedures)
present in 2 data sources: patient-reported data captured through an
online portal and data from electronic sources (electronic health record
data). Overall agreement, sensitivity, specificity, positive predictive
value, negative predictive value, and kappa statistics with 95% CIs were
calculated using patient report as the criterion standard for demographic
characteristics and the electronic health record as the criterion standard
for clinical outcomes. Result(s): Of 15076 patients with complete
information, the median age was 67.6 years (range, 21-99 years), and 68.7%
were male. With the use of patient-reported data as the criterion
standard, agreement (kappa) was high for Black and White race and
ethnicity but only moderate for current smoking status. Electronic health
record data were highly specific (99.6%) but less sensitive (82.5%) for
Hispanic ethnicity. Compared with electronic health record data, patient
report of clinical end points had low sensitivity for myocardial
infarction (33.0%), stroke (34.2%), and major bleeding (36.6%). Positive
predictive value was similarly low for myocardial infarction (40.7%),
stroke (38.8%), and major bleeding (21.9%). Coronary revascularization was
the most concordant event by data source, with only moderate agreement
(kappa = 0.54) and positive predictive value. Agreement metrics varied by
site for all demographic characteristics and several clinical events.
 Conclusions and Relevance: In a concordance substudy of a large,
pragmatic comparative effectiveness research trial, sensitivity and
chance-corrected agreement of patient-reported data captured through an
online portal for cardiovascular events were low to moderate. Findings
suggest that additional work is needed to optimize integration of
patient-reported health data into pragmatic research studies. Trial
Registration: ClinicalTrials.gov Identifier: NCT02697916. Copyright
© 2022 Authors. All rights reserved.

<9>
Accession Number
2021955819
Title
Dual Antiplatelet Therapy with Ticagrelor and Vein Graft Failure after
Coronary Artery Bypass Graft Surgery - Reply.
Source
JAMA. 328(22) (pp 2273-2274), 2022. Date of Publication: 13 Dec 2022.
Author
Sandner S.; Redfors B.; Gaudino M.
Institution
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
Publisher
American Medical Association

<10>
Accession Number
2021955817
Title
Dual Antiplatelet Therapy with Ticagrelor and Vein Graft Failure after
Coronary Artery Bypass Graft Surgery.
Source
JAMA. 328(22) (pp 2273), 2022. Date of Publication: 13 Dec 2022.
Author
Zeng B.-Y.; Tseng P.-T.; Liang C.-S.
Institution
(Zeng) Department of Internal Medicine, E-DA Dachang Hospital, Kaohsiung,
Taiwan (Republic of China)
(Tseng) College of Medical and Health Science, Asia University, Taichung,
Taiwan (Republic of China)
(Liang) Tri-Service General Hospital Beitou Branch, National Defense
Medical Center, Taipei City, Taiwan (Republic of China)
Publisher
American Medical Association

<11>
Accession Number
2021591676
Title
Outcomes of Cardiac Arrest with Valve Surgery Among Infective Endocarditis
Patients: A United States National Cohort Study.
Source
Cardiovascular Revascularization Medicine. 49 (pp 49-53), 2023. Date of
Publication: April 2023.
Author
Mir T.; Uddin M.M.; Shanah L.; Hussain T.; Parajuli T.; Shafi O.; Ullah
W.; Rab T.; Sheikh M.; Eltahawy E.
Institution
(Mir, Uddin, Shanah, Hussain) Internal Medicine, Wayne State University,
Detroit, MI, United States
(Mir, Parajuli) Internal Medicine, Baptist Health System, Montgomery, AL,
United States
(Hussain) Critical Care Medicine, Summa Health System, Akron, OH, United
States
(Shafi) Clinical Informatics, University of Arkansas for Medical Sciences,
Little Rock, AR, United States
(Ullah) Division of Cardiology, Thomas Jefferson Hospital, PA, United
States
(Rab) Division of Cardiology, Emory University, Atlanta, GA, United States
(Sheikh) Division of Cardiology, Promedica Toledo Hospital, OH, United
States
(Eltahawy) Division of Cardiology, University of Toledo College of
Medicine, and Life Sciences, OH, United States
Publisher
Elsevier Inc.
Abstract
Objective: Cardiac arrest can complicate infective endocarditis (IE) and
is associated with significant in-hospital complications and mortality
rates. We report the characteristics, outcomes, and readmission rates for
IE patients with cardiac arrest in the United States. Method(s): We
surveyed the Nationwide Readmission Database (NRD), a database designed to
support national level readmission analyses, for patients admitted with IE
and who had cardiac arrest during index admission between 2016 and 2019.
Baseline demographics, comorbidities, surgical procedures, and outcomes
were identified using their respective International Classification of
Diseases (ICD) codes. Result(s): There were 663 index admissions
(mean age 55.87 +/- 17.21 years;34.2 % females) for IE with cardiac arrest
in the study period, with an overall mortality rate of 55.3 %. Of these,
270 (40.7 %) had surgical procedures performed during the hospitalization
encounter. In patients who had a surgical procedure, 72 (26.8 %) patients
had in-hospital mortality while 293 (74.9 %) patients without surgical
procedures had in-hospital mortality (p < 0.001). After coarsened matching
for baseline characteristics, surgical valve procedures were less likely
to be associated with mortality (OR = 0.09, 95%CI 0.04-0.24; p < 0.001).
Among the 295 alive discharges associated with cardiac arrest, 76 (38.57
%) were readmitted within 30-days, with a mortality rate of 22 % noted for
readmissions. Conclusion(s): Among IE patients who had cardiac
arrest, surgical procedures subgroup had low mortality despite having
higher complication rates. However, due to chances of bias more randomized
trials are needed evaluate the hypothesis. Copyright © 2022
Elsevier Inc.

<12>
Accession Number
2021159430
Title
Trends in the cost-effectiveness level of percutaneous coronary
intervention: Macro socioeconomic analysis and health technology
assessment.
Source
Journal of Cardiology. 81(4) (pp 356-363), 2023. Date of Publication:
April 2023.
Author
Takura T.; Komuro I.; Ono M.
Institution
(Takura) Department of Healthcare Economics and Health Policy, Graduate
School of Medicine, The University of Tokyo, Tokyo, Japan
(Komuro) Department of Cardiovascular Medicine, Graduate School of
Medicine, The University of Tokyo, Tokyo, Japan
(Ono) Department of Cardiac Surgery, University of Tokyo Hospital, The
University of Tokyo, Tokyo, Japan
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Percutaneous coronary intervention (PCI), one of the most prevalent
techniques of revascularization, is a procedure that remarkably improves
treatment outcomes. However, it consumes large amounts of medical
resources and has resulted in an increased socioeconomic burden due to the
increasing number of target patients. In recent years, there have been
sporadic discussions, both in Japan and other countries, regarding the
optimization of interventions and the perspective of medical economics.
Based on this, previous studies on PCI-related cost-effectiveness were
reviewed in order to consider the current level of medical economics
regarding PCI. Using the databases MEDLINE and EMBASE, a survey involving
data from original articles and systematic reviews was conducted from
January 2010 to August 2022. Conditions were not imposed on the evidence
level due to the paucity of studies, although field studies were
prioritized over simulation studies. The macro medical economics of acute
myocardial infarction treatment, which is the primary target of PCI, were
generally at an average level when compared to those in other countries;
however, there is room for further improvement in Japan's performance.
Revascularization in a population with multivessel coronary artery disease
showed that coronary artery bypass graft surgery tended to be more
cost-effective than PCI in the long-term setting. However, it was
suggested that PCI may be more cost-effective in patients with SYNTAX
Score <=22 or left main artery disease. A cost-effectiveness report for
stable angina patients was not in favor of PCI over medical therapy.
Moreover, there were some reports showing the medical economic superiority
of early myocardial ischemia evaluation, and it was foreseen that active
selection of patients will contribute to the improvement of the overall
cost-effectiveness of PCI. In order to further improve the socioeconomic
significance of PCI in the future, it is necessary to aim for harmony
between clinical practice and health economics. Copyright © 2022
The Authors

<13>
Accession Number
2020265852
Title
Use of Indocyanine Green Fluorescence Imaging in Thoracic and Esophageal
Surgery.
Source
Annals of Thoracic Surgery. 115(4) (pp 1068-1076), 2023. Date of
Publication: April 2023.
Author
Ng C.S.-H.; Ong B.-H.; Chao Y.K.; Wright G.M.; Sekine Y.; Wong I.; Hao Z.;
Zhang G.; Chaturvedi H.; Thammineedi S.R.; Law S.; Kim H.K.
Institution
(Ng) Department of Surgery, The Chinese University of Hong Kong, Hong
Kong, Hong Kong
(Ong) Department of Cardiothoracic Surgery, National Heart Centre
Singapore, Singapore
(Chao) Division of Thoracic Surgery, Chang Gung Memorial Hospital-Linko,
Chang Gung University, Taoyuan, Taiwan (Republic of China)
(Wright) Department of Surgery, St. Vincent's Hospital, University of
Melbourne, Melbourne, VIC, Australia
(Sekine) Department of Thoracic Surgery, Yachiyo Medical Center, Tokyo
Women's Medical University, Yachiyo, Japan
(Wong, Law) Department of Surgery, School of Clinical Medicine, The
University of Hong Kong, Hong Kong, Hong Kong
(Hao) Department of Thoracic Surgery, The First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, China
(Zhang) Department of Thoracic Surgery, The First Affiliated Hospital of
Xi'an Jiaotong University, Xi'an, China
(Chaturvedi) Department of Surgical Oncology, Max Hospital, New Delhi,
India
(Thammineedi) Department of Surgical Oncology, Basavatarakam Indo American
Cancer Hospital and Research Institute, Hyderabad, India
(Kim) Department of Thoracic and Cardiovascular Surgery, College of
Medicine, Korea University Guro Hospital, Seoul, South Korea
Publisher
Elsevier Inc.
Abstract
Background: Fluorescence imaging using indocyanine green in thoracic and
esophageal surgery is gaining popularity because of the potential to
facilitate surgical planning, to stage disease, and to reduce
postoperative complications. To optimize use of fluorescence imaging in
thoracic and esophageal surgery, an expert panel sought to establish a set
of recommendations at a consensus meeting. Method(s): The panel
included 12 experts in thoracic and upper gastrointestinal surgery from
Asia-Pacific countries. Before meeting, 7 focus areas were defined:
intersegmental plane identification for sublobar resections; pulmonary
nodule localization; lung tumor detection; bullous lesion detection;
lymphatic mapping of lung tumors; evaluation of gastric conduit perfusion;
and lymphatic mapping in esophageal surgical procedures. A literature
search of the PubMed database was conducted using keywords indocyanine
green, fluorescence, thoracic, surgery, and esophagectomy. At the meeting,
panelists addressed each focus area by discussing the most relevant
evidence and their clinical experiences. Consensus statements were derived
from the proceedings, followed by further discussions, revisions,
finalization, and unanimous agreement. Each statement was assigned a level
of evidence and a grade of recommendation. Result(s): A total of 9
consensus recommendations were established. Identification of the
intersegmental plane for sublobar resections, localization of pulmonary
nodules, lymphatic mapping in lung tumors, and assessment of gastric
conduit perfusion were applications of fluorescence imaging that have the
most robust current evidence. Conclusion(s): Based on best available
evidence and expert opinions, these consensus recommendations may
facilitate thoracic and esophageal surgery using fluorescence
imaging. Copyright © 2023 The Society of Thoracic Surgeons

<14>
Accession Number
639092291
Title
Efficacy of Prehabilitation Before Cardiac Surgery: A Systematic Review
and Meta-analysis.
Source
American journal of physical medicine & rehabilitation. 102(4) (pp
323-330), 2023. Date of Publication: 01 Apr 2023.
Author
Steinmetz C.; Bjarnason-Wehrens B.; Walther T.; Schaffland T.F.; Walther
C.
Institution
(Steinmetz) From the Department of Geriatrics, University Medical Center
Gottingen, Georg August University, Gottingen, Germany (CS); Institute of
Cardiology and Sports Medicine, Department Preventive and Rehabilitative
Sport and Exercise Medicine, German Sport University, Cologne, Germany
(BBW); Department of Cardiothoracic Surgery, University of Frankfurt,
Frankfurt am Main, Germany (TW); Methods Center Tubingen, University of
Tubingen, Tubingen, Germany (TFS); and Cardiovascular Centrum Bethanien,
Department of Cardiology, Frankfurt am Main, Germany (CW)
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Patients awaiting cardiac surgery seem to benefit from
exercise-based prehabilitation, but the impact on different perioperative
outcomes compared with standard care is still unclear. DESIGN: Eligible
nonrandomized/randomized controlled studies investigating the impact of
exercise-based prehabilitation in adults scheduled for elective cardiac
surgery were searched on December 16, 2020, from electronic databases,
including MEDLINE, CENTRAL, and CINAHL. The data were pooled and a
meta-analysis was conducted. RESULT(S): Of 1490 abstracts, six
studies ( n = 665) were included into the review and meta-analysis. At
postintervention interval and at postsurgery interval, 6-min-walking
distance improved significantly in exercise-based prehabilitation group
compared with controls (mean difference, 75.4 m; 95% confidence interval,
13.7 to 137.1 m, P = 0.02, and 30.5 m, 95% confidence interval, 8.5 to
52.6 m, P = 0.007, respectively). Length of hospital stay was
significantly shorter in exercise-based prehabilitation group (mean
difference, -1.00 day; 95% confidence interval, -1.78 to -0.23 day, P =
0.01). Participation in exercise-based prehabilitation revealed a
significant decrease in the risk of postoperative atrial fibrillation in
patients 65 yrs or younger (risk ratio, 0.34; 95% confidence interval,
0.14 to 0.83, P = 0.02). CONCLUSION(S): The participation in
exercise-based prehabilitation significantly improves postintervention and
postsurgery 6-min walking distance, length of hospital stay, and decreases
the risk of postoperative atrial fibrillation in patients 65 yrs or
younger compared with controls. Copyright © 2022 The Author(s).
Published by Wolters Kluwer Health, Inc.

<15>
Accession Number
2023395110
Title
Diuretic treatment before and after transcatheter aortic valve
implantation: A Danish nationwide study.
Source
PLoS ONE. 18(3 March) (no pagination), 2023. Article Number: e0282636.
Date of Publication: March 2023.
Author
Begun X.; Butt J.H.; Lund Kristensen S.; Weeke P.E.; De Backer O.; Schou
M.; Kober L.; Fosbol E.L.
Institution
(Begun, Butt, Lund Kristensen, Weeke, De Backer, Kober, Fosbol) Department
of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen,
Denmark
(Schou) Department of Cardiology, Herlev-Gentofte University Hospital,
Hellerup, Denmark
Publisher
Public Library of Science
Abstract
Objectives We examined loop diuretic treatment before and 1-year after
transcatheter aortic valve implantation (TAVI), as a proxy for changes in
symptom severity and secondly assessed how changes in loop diuretics
related to mortality risk. Background Randomized clinical trials suggest
that approximately one third of patients undergoing TAVI do not achieve
symptom relief, but "all-comer"data are lacking. Methods Using Danish
nationwide registries, we identified all citizens, who underwent TAVI from
2008 to 2019 and were alive at 1-year post-discharge. Loop diuretic
treatment pre-TAVI and at 1-year post-TAVI were assessed and grouped as
receiving 1) no-loop diuretics; 2) low: 1-40 mg of furosemide (or
equivalent bumetanide) daily; 3) intermediate: 41-120 mg of furosemide
daily; or 4) high: >120 mg furosemide daily. Results Among the 4431
patients undergoing TAVI, 2173 (49%) patients were not treated with loop
diuretics at the time of TAVI, 918 (21%) had low-loop diuretics, 881 (20%)
had intermediateloop diuretics, and 459 (10%) had high-loop diuretics. At
1-year post-TAVI, 893 (20%) patients had increased, 1010 (23%) had
reduced, and 2528 (57%) had unchanged loop diuretic treatment. The
cumulative 5-year risk of death in patients surviving one year, was 61%
(95% CI: 56.4% to 65.3%) in patients with increased and 47% (95% CI: 44.9%
to 49.9%) in patients with reduced/unchanged loop diuretic treatment,
respectively. In multivariable Cox proportional hazard analysis, increased
loop diuretic treatment was associated with a higher risk of death
compared with reduced/unchanged loop diuretic treatment (Hazard ratio:
1.4; 95% CI: 1.22 to 1.52). Conclusions Among patients undergoing TAVI,
surviving one year, one fifth of patients had increased loop diuretic
treatment, and a little over one fifth had reduced loop diuretic treatment
1-year post-procedure. In patients with increased diuretic treatment, the
risk of death was higher compared to those with reduced/unchanged loop
diuretic treatment. Copyright © 2023 Begun et al.

<16>
Accession Number
640264641
Title
Direct oral anticoagulants in patients with a left-sided bioprosthetic
heart valve: a systematic review and meta-analysis.
Source
Internal and emergency medicine. 18(2) (pp 535-547), 2023. Date of
Publication: 01 Mar 2023.
Author
Silvia G.; Valentina P.; Leonardo C.; Daniela P.; Alessandro S.
Institution
(Silvia) Internal Medicine, Ospedale San Valentino-AULSS 2 Marca
Trevigiana, Via Palmiro Togliatti, 1, 31044, Montebelluna, Treviso, Italy
(Valentina) Internal Medicine Residency Program, School of Medicine,
University of Insubria, Italy
(Leonardo) Department of Medicine and Surgery, University of Insubria,
Varese, Italy
(Daniela) Thrombosis Center, Azienda Ospedaliero-Universitaria Careggi,
Florence, Italy
(Alessandro) Research Center On Thromboembolic Disorders and
Antithrombotic Therapies, ASST Lariana, University of Insubria, Como,
Italy
Publisher
NLM (Medline)
Abstract
To compare the efficacy/effectiveness and safety of DOACs versus VKAs in
patients with a previously and newly surgically implanted BHV with or
without AF. A systematic search on MEDLINE and EMBASE was performed till
November 2022. Treatment effects were estimated with relative risk (RR)
and 95% confidence intervals (CIs). Statistical heterogeneity was assessed
with the I2 statistic. Four randomized controlled trials (RCTs), 2
subgroup analysis from ARISTOTLE and ENGAGE-AF-TIMI 48 and 4 observational
studies were included for a total of 5808 patients, 1893 on DOACs and 3915
on VKAs. AF prevalence was 98.28%. In the overall analysis, DOACs vs VKAs
were associated with a RR for stroke/transient ischemic attack
(TIA)/systemic embolism (SE) of 0.63 (95% CI 0.51-0.79; I2=0%) and a RR of
major bleeding of 0.50 (95% CI 0.39-0.63; I2=0%) in a median follow-up of
19 months (IQR 4.5-33.4). In the 3 RCTs (DAWA, RIVER, ENAVLE), DOACs vs
VKAs were associated with a RR of stroke/TIA/SE and major bleeding of 0.38
(95% CI 0.13-1.58, I2=0%) and of 0.68 (95% CI 0.32-1.44; I2=5%)
respectively. In patients randomized during the first three months from
valve surgery, DOACs vs VKAs were associated with a RR of stroke/TIA/SE
and major bleeding of 0.54 (95% CI 0.14-2.08; I2=0%) and of 0.76 (95% CI
0.05-10.72; I2=66%). In previously implanted BHV patients with AF, DOACs
showed a risk-benefit profile at least comparable to VKAs. DOACs showed a
similar, even if underpowered, risk-benefit profile during the first three
months after BHV implantation prevalently in patients with
AF. Copyright © 2023. The Author(s), under exclusive licence to
Societa Italiana di Medicina Interna (SIMI).

<17>
Accession Number
640666159
Title
Post Extubation Dysphagia: Development and Implementation of an
Evidence-Based Screening Algorithm.
Source
Dysphagia. Conference: 10th European Society for Swallowing Disorders
Annual Congress, ESSD 2020. Virtual. 38(Supplement 1) (pp S53), 2023. Date
of Publication: March 2023.
Author
Williams T.; Barker J.; Hellen S.; Fielding C.; Davidson M.; Martino R.
Institution
(Williams, Barker, Hellen, Fielding, Davidson, Martino) University Health
Network, Canada
Publisher
Springer Science and Business Media B.V.
Abstract
Introduction: Dysphagia is common after prolonged endotracheal intubation.
A prevalence of 67.5% in patients intubated for greater than 48 h
post-cardiovascular surgery has been reported, with patients twice as
likely to develop dysphagia for every additional 12 h period of
intubation. Best practice guidelines for screening and referral to
speech-language pathology (SLP) for post-extubation dysphagia (PED)
assessment do not exist. The purpose of this review was to develop and
implement an evidence-based screening algorithm for PED to guide
appropriate referrals for assessment. Method(s): A Medline database
literature review was conducted on April 17, 2017 (all published articles
before April 2017). Search terms included: airway extubation, extubation,
deglutition disorders, and dysphagia. Articles were limited to English
language, humans and adults. Further articles were sourced through manual
searching of relevant journals and bibliographies and consultation with
colleagues. Twenty-seven articles were reviewed by an interdisciplinary
working group from four intensive care units. Based on group consensus,
risk factors from 20 of these articles were included in the Swallowing
Algorithm Post-Extubation (SAPE). Result(s): SAPE was developed and
implemented across four critical care units. Surveys of critical care
nursing staff revealed that post- SAPE implementation, 74% identified
prolonged intubation as a risk factor for PED, 64% were confident knowing
when to start PO intake and 84% consulted SLP post-extubation. Referrals
to SLP increased by 40%. Conclusion(s): SAPE was developed based on
best evidence to identify patients at risk of dysphagia and implemented
across four critical care units, resulting in an increased number of
referrals to SLP and earlier access to swallow rehabilitation. Research is
required to evaluate sensitivity and specificity and to determine efficacy
with respect to referring appropriate patients for assessment.

<18>
Accession Number
640666105
Title
Transesophageal Echocardiography-Dysphagia Risk in Acute Stroke (Tedras):
A Prospective, Blind, Randomized, and Controlled Clinical Trial.
Source
Dysphagia. Conference: 11th European Society for Swallowing Disorders
Annual Congress, ESSD 2021. Online. 38(Supplement 1) (pp S74), 2023. Date
of Publication: March 2023.
Author
Hamzic S.; Braun T.; Butz M.; Khilan H.; Weber S.; Yeniguen M.; Gerriets
T.; Schramm P.; Juenemann M.
Institution
(Hamzic, Braun, Butz, Khilan, Yeniguen, Gerriets, Schramm, Juenemann)
Justus Liebig University, University Hospital Giessen and Marburg, Campus
Giessen, Germany
(Weber) Gesundheitszentrum Wetterau, Germany
Publisher
Springer Science and Business Media B.V.
Abstract
Background and purpose: Dysphagia is common in acute stroke and leads to
worse overall outcome. Transesophageal echocardiography (TEE) is used in
the diagnostic evaluation of stroke with regard to its etiology and is a
known cause of postoperative dysphagia in cardiac surgery. The prevalence
of dysphagia in acute stroke patients undergoing TEE remains unknown. The
aim of the Transesophageal Echocardiography-Dysphagia Risk in Acute Stroke
(TEDRAS) study was to assess the influence of TEE on swallowing among
patients who have experienced acute stroke. Method(s): The TEDRAS
study was a prospective, blind, randomized, controlled trial that included
two groups of patients with acute stroke. Simple unrestricted
randomization was performed, and examiners were blinded to each other's
results. Swallowing was tested using flexible endoscopic evaluation of
swallowing (FEES) at three different time points in the intervention group
(24 h before, immediately after and 24 h after TEE) and in the control
group (FEES on three consecutive days and TEE earliest after the third
FEES). Validated scales were used to assess dysphagia severity for all
time points as primary outcome measures. Result(s): A total of 34
patients were randomized: 19 to the intervention group and 15 to the
control group. The key findings of the repeated-measures between-group
comparisons were significant increases in the intervention group for the
following dysphagia measures: (1) secretion severity score (immediately
after TEE: P<0.001; 24 h after TEE: P<0.001) and (2)
Penetration-Aspiration Scale score for saliva (immediately after TEE:
P<0.001; 24 h after TEE: P = 0.007), for small (immediately after TEE: P =
0.009) and large liquid boli (immediately after TEE: P = 0.009; 24 h after
TEE: P = 0.025). Conclusion(s): The results indicate a negative
influence of TEE on swallowing in acute stroke patients for at least 24 h.

<19>
Accession Number
640681742
Title
Individualized flow-controlled versus conventional pressure-controlled
ventilation in on-pump heart surgery (FLOWVENTIN HEARTSURG): study
protocol for a randomized controlled trial.
Source
Trials. 24(1) (pp 195), 2023. Date of Publication: 16 Mar 2023.
Author
Becker S.; Schnitzler R.; Rembecki M.; Geppert J.; Kurz C.T.; Wichelhaus
L.-M.; Timmesfeld N.; Zahn P.K.
Institution
(Becker, Schnitzler, Rembecki, Geppert, Kurz, Wichelhaus, Zahn) Department
of Anesthesiology, Intensive Care and Pain Medicine, BG University
Hospital Bergmannsheil, Ruhr-University Bochum, Buerkle de La Camp-Platz
1, Bochum 44789, Germany
(Timmesfeld) Department of Medical Informatics, Biometry & Epidemiology,
Ruhr-University Bochum, Bochum 44780, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: In on-pump cardiac surgery, lungs are at high risk of
periprocedural organ impairment because of atelectasis formation,
ventilator-induced lung injury, and hyperinflammation due to the
cardiopulmonary bypass which results in postoperative pulmonary
complications in half of this patient population. The new ventilation mode
flow-controlled ventilation (FCV) uniquely allows full control of ins- and
expiratory airway flows. This approach reduces the mechanical power of
invasive ventilation as a possible cause of ventilator-induced lung
injury. The scope of FLOWVENTIN HEARTSURG is to compare perioperative
individualized FCV with best clinical practice pressure-controlled
ventilation (PVC) modes in patients with elective on-pump cardiac surgery
procedures. We hypothesize that the postoperative inflammatory response
can be reduced by the perioperative application of FCV compared to PCV.
 METHOD(S): FLOWVENTIN HEARTSURG is a single-center, randomized,
parallel-group trial with two intervention arms: perioperative PCV modes
(n=70, PCV group) with an individualized positive end-expiratory pressure
(PEEP) and a tidal volume of 6-8 ml/kg predicted bodyweight compared to
perioperative FCV (n=70, FCV group) with an individualized PEEP and
driving pressure, resulting in a liberal tidal volume. As the primary
study endpoint interleukin 8 plasma level is assessed 6 h after
cardiopulmonary bypass as a surrogate biomarker of systemic and pulmonary
inflammation. As secondary aims clinically relevant patient outcomes are
analyzed, e.g., perioperative lung function regarding oxygenation indices,
postoperative pulmonary and extra-pulmonary complications, SIRS-free days
as well as ICU and total inpatient stays. As additional sub-studies with
an exploratory approach perioperative right ventricular function
parameters are assessed by echocardiography and perioperative lung
aeration by electrical impedance tomography. DISCUSSION: Current paradigms
regarding protective low tidal volume ventilation are consciously left in
the FCV intervention group in order to reduce mechanical power as a
determinant of ventilator-induced lung injury in this high-risk patient
population and procedures. This approach will be compared in a randomized
controlled trial with current best clinical practice PCV in FLOWVENTIN
HEARTSURG. TRIAL REGISTRATION: German Clinical Trials Register
DRKS00018956 . Registered on 12 June 2020 (Version 1), last update on 22
August 2022 (Version 4). Copyright © 2023. The Author(s).

<20>
Accession Number
640681637
Title
The protocol for the prehabilitation for thoracic surgery study: a
randomized pragmatic trial comparing a short home-based multimodal program
to aerobic training in patients undergoing video-assisted thoracoscopic
surgery lobectomy.
Source
Trials. 24(1) (pp 194), 2023. Date of Publication: 15 Mar 2023.
Author
Liu Y.; Liu Z.; Zhang Y.; Cui Y.; Pei L.; Huang Y.
Institution
(Liu, Liu, Pei, Huang) Department of Anesthesiology, Chinese Academy of
Medical Sciences & Peking Union Medical College Hospital, Beijing 100730,
China
(Zhang) Department of Medical Research Center, Chinese Academy of Medical
Sciences & Peking Union Medical College Hospital, Beijing 100730, China
(Cui) Department of Thoracic Surgery, Chinese Academy of Medical Sciences
& Peking Union Medical College Hospital, Beijing 100730, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Prehabilitation has been shown to have a positive effect on
the postoperative recovery of functional capacity in patients undergoing
video-assisted thoracoscopic surgery (VATS) lobectomy. The optimal way to
implement prehabilitation programs, such as the optimal forms of
prehabilitation, duration, intensity, and methods to improve compliance,
remained to be studied. This Prehabilitation for Thoracic Surgery Study
will compare the effectiveness of multimodal and aerobic training-only
programs in patients undergoing thoracoscopic lobectomy. METHOD(S):
This randomized pragmatic trial will be conducted in Peking Union Medical
College Hospital (PUMCH) and include 100 patients who are eligible to
undergo VATS lobectomy. Patients will be randomized to a multimodal or
aerobic training group. Prehabilitation training guidance will be provided
by a multidisciplinary care team. The patients in the multimodal group
will perform aerobic exercises, resistance exercises, breathing exercises,
psychological improvement strategies, and nutritional supplementation.
Meanwhile, the patients in the aerobic group will conduct only aerobic
exercises. The interventions will be home-based and supervised by medical
providers. The patients will be followed up until 30 days after surgery to
investigate whether the multimodal prehabilitation program differs from
the aerobic training program in terms of the magnitude of improvement in
functional capability pre- to postoperatively. The primary outcome will be
the perioperative 6-min walk distance (6MWD). The secondary outcomes will
include the postoperative pulmonary functional recovery status,
health-related quality of life score, incidence of postoperative
complications, and clinical outcomes. DISCUSSION: Prehabilitation remains
a relatively new approach that is not widely performed by thoracic surgery
patients. The existing studies mainly focus on unimodal interventions.
While multimodal prehabilitation strategies have been shown to be
preferable to unimodal strategies in a few studies, the evidence remains
scarce for thoracic surgery patients. The results of this study will
contribute to the understanding of methods for thoracoscopic lobectomy
patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT04049942 . Registered
on August 8, 2019. Copyright © 2023. The Author(s).

<21>
Accession Number
640678551
Title
Methods for assessing guideline adherence for invasive procedures in the
care of chronic coronary artery disease: a scoping review.
Source
BMJ open. 13(3) (pp e069832), 2023. Date of Publication: 15 Mar 2023.
Author
Kentenich H.; Muller D.; Wein B.; Stock S.; Seleznova Y.
Institution
(Kentenich, Muller, Stock, Seleznova) Institute for Health Economics and
Clinical Epidemiology, Faculty of Medicine and University Hospital
Cologne, University of Cologne, Cologne, Germany
(Wein) Department of Cardiology and Angiology, Contilia Heart and Vascular
Center, Elisabeth-Hospital Essen, Essen, Germany
(Wein) Department of Cardiology, Faculty of Medicine, University of
Augsburg, Augsburg, Germany
Publisher
NLM (Medline)
Abstract
OBJECTIVES: In the care of coronary artery disease (CAD), evidence
questions the adequate application of guidelines for cardiovascular
procedures, particularly coronary angiographies (CA) and myocardial
revascularisation. This review aims to examine how care providers'
guideline adherence for CA and myocardial revascularisation in the care of
chronic CAD was assessed in the literature. DESIGN: Scoping review. DATA
SOURCES: PubMed and EMBASE were searched through in June 2021 (rerun in
September 2022). ELIGIBILITY CRITERIA: We included studies assessing care
providers' adherence to evidence-based guidelines for CA or myocardial
revascularisation in the care of chronic CAD. Studies had to list the
evaluation of guideline adherence as study objective, describe the
evaluation methods used and report the underlying guidelines and
recommendations. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers
used standardised forms to extract study characteristics, methodological
aspects such as data sources and variables, definitions of guideline
adherence and quantification methods and the extent of guideline
adherence. To elucidate the measurement of guideline adherence, the main
steps were described. RESULT(S): Twelve studies (311869 participants)
were included, which evaluated guideline adherence by (1) defining
guideline adherence, (2) specifying the study population, (3) assigning
(classes of) recommendations and (4) quantifying adherence. Thereby,
primarily secondary data were used. Studies differed in their definitions
of guideline adherence, where six studies each considered only
recommendation class I/grade A/strong recommendations as adherent or
additionally recommendation classes IIa/IIb. Furthermore, some of the
studies reported a priori definitions and allocation rules for the
assignment of recommendation classes. Guideline adherence results ranged
from 10% for percutaneous coronary intervention with prior heart team
discussion to 98% for coronary artery bypass grafting. CONCLUSION(S):
Due to remarkable inconsistencies in the assessment, a cautious
interpretation of the guideline adherence results is required. Future
efforts should endeavour to establish a consistent understanding of the
concept of guideline adherence. 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.

<22>
Accession Number
2023085542
Title
Comparison of Ventral Midline and Right Flank Approaches of
Ovariohysterectomy in Bitches.
Source
Journal of Veterinary Clinics. 40(1) (pp 25-30), 2023. Date of
Publication: February 2023.
Author
Dhakal I.; Regmi B.; Thakur B.; Tiwari I.; Tiwari S.; Oh Y.; Shah M.K.
Institution
(Dhakal, Regmi, Thakur, Tiwari, Shah) Department of Surgery and
Pharmacology, FAVF, Agriculture and Forestry University, Chitwan 44200,
Nepal
(Dhakal) Military Canine Breeding Center, Bhaktapur 44600, Nepal
(Regmi) Veterinary Hospital and Expert Center, Pokhara 33700, Nepal
(Thakur) Veterinary Hospital and Expert Center, Nuwakot 44900, Nepal
(Tiwari, Oh) College of Veterinary Medicine and Institute of Veterinary
Science, Kangwon National University, Chuncheon 24341, South Korea
Publisher
Korean Society of Veterinary Clinics
Abstract
The ventral midline approach (VMA) and right flank approach (RFA) are
common procedures for the sterilization of bitches. This study compared
the different parameters viz. total duration of surgery, recovery time,
and length of the incision as well as body temperature, heart rate,
respiration rate, and SpO2 in each approach. Twenty (20) bitches were
divided randomly for the RFA and VMA. Meloxicam (0.2 mg/kg) was
administered subcuta-neously half an hour before the induction to provide
preemptive analgesia. Diazepam and ketamine were administered
intravenously at dose rates of 0.25 mg/kg and 2.5 mg/kg, and 0.17 mg/kg
and 3.33 mg/kg, respectively to produce and maintain anesthesia. Each
parameter was recorded at the pre-operative, operative and post-operative
times. The average duration of surgery and length of incision of RFA (16.1
+/- 5.13 min and 2.44 +/- 0.83 cm) were significantly lower (p < 0.05)
than the VMA (21.3 +/- 5.48 min and 3.53 +/- 0.7 cm). The operated bitches
showed hypothermia (p < 0.05) at 1 hour compared to baseline and 24 hours
of surgery. Heart and respiration rates increased significantly (p < 0.05)
during traction and severing of ovarian ligaments in bitches within the
RFA group, but there was no significant difference within VMA approaches.
The sedation score was significantly higher (p < 0.05) at 1 hour after
surgery in both approaches. Based on the duration of surgery and length of
incision RFA approach was quick and minimal skin wound. Further studies on
bitches considering molecular investigations of surgical stress are
imperative. Copyright © The Korean Society of Veterinary Clinics.

<23>
Accession Number
2022110521
Title
Preoperative optimization of cardiac valve patients' expectations: Study
protocol of the randomized controlled ValvEx-trial.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1105507. Date of Publication: 2023.
Author
Horn N.; Gartner L.; Rastan A.J.; Andrasi T.B.; Lenz J.; Boning A.;
Salzmann-Djufri M.; Puvogel U.; Genovese M.; Kus S.; Rief W.; Salzmann S.
Institution
(Horn, Gartner, Genovese, Kus, Rief, Salzmann) Division of Clinical
Psychology and Psychotherapy, Philipps University of Marburg, Marburg,
Germany
(Rastan, Andrasi, Lenz) Department of Cardiovascular Surgery, Heart
Center, Philipps University of Marburg, Marburg, Germany
(Boning, Salzmann-Djufri, Puvogel) Department of Cardiovascular Surgery,
Justus Liebig University, Giessen, Germany
Publisher
Frontiers Media S.A.
Abstract
Introduction: Complete recovery after surgery depends on psychological
factors such as preoperative information, expectations, and
surgery-associated anxiety. Prior studies have shown that even a short
preoperative psychological intervention aiming at optimized expectations
(EXPECT) can improve postoperative outcomes in coronary artery bypass
patients. However, this intervention may benefit only a small subgroup of
heart surgery patients since implementing preoperative psychological
interventions into the daily clinical routine is difficult due to the
additional time and appointments. It is unclear whether the EXPECT
intervention can be shortened and whether heart valve patients would also
benefit from interventions that optimize patients' expectations. The
multicenter ValvEx trial aims (i) to adapt an effective preoperative
psychological intervention (EXPECT) to make it brief enough to be easily
integrated into the preoperative routine of heart valve patients and (ii)
to examine if the adapted preoperative psychological intervention improves
the subjectively perceived illness-related disability (PDI) up to 3 months
after surgery. Materials and analysis: In two German university hospitals,
N = 88 heart valve patients who undergo heart surgery are randomized into
two groups [standard of care (SOC) vs. standard of care plus
interventional expectation manipulation (SOC and EXPECT)] after baseline
assessment. Patients in the EXPECT group additionally to standard of care
participate in the preoperative psychological intervention (30-40 min),
focusing on optimizing expectations and have two booster-telephone calls
(4 and 8 weeks after the surgery, approx. 15 min). Both groups have
assessments again on the evening before the surgery, 4 to 6 days, and 3
months after the surgery. Discussion(s): The trial demonstrates
excellent feasibility in the clinical routine and a high interest by the
patients. Ethics and dissemination: The Ethics Committees of the
Department of Medicine of the Philipps University of Marburg and the
Department of Medicine of the University of Giessen approved the study
protocol. Study results will be published in peer-reviewed journals and
presented at congresses. Clinical trial registration: ClinicalTrials.gov,
identifier NCT04502121. Copyright © 2023 Horn, Gartner, Rastan,
Andrasi, Lenz, Boning, Salzmann-Djufri, Puvogel, Genovese, Kus, Rief and
Salzmann.

<24>
Accession Number
2023400145
Title
Topical and Intravenous Tranexamic Acid in Acyanotic Children Undergoing
Congenital Heart Surgery: A Randomized Clinical Trial.
Source
Journal of Surgical Research. 288 (pp 64-70), 2023. Date of Publication:
August 2023.
Author
Bigdelian H.; Montazeri M.; Sedighi M.; Mansouri M.; Amanollahi A.
Institution
(Bigdelian, Montazeri) Department of Cardiovascular Surgery, School of
Medicine, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
(Sedighi) Trauma and Injury Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Mansouri) Cardiovascular Anesthesia Research Center, Cardiovascular
Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Amanollahi) Department of Epidemiology, School of Public Health and
Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
Publisher
Academic Press Inc.
Abstract
Introduction: Postoperative bleeding is a common complication in
congenital heart surgery. We aimed to evaluate effects of topical and
intravenous tranexamic acid (TXA) administration on postoperative
hemoglobin and bleeding in children with acyanotic congenital heart
disease (CHD). Method(s): In this randomized clinical trial, 50
acyanotic CHD children were allocated into two groups of topical (n = 25)
and infusion (n = 25). Children in the infusion group were given
intravenous TXA 50 mg/kg-1 after sternotomy. Children in
topical group were given 50 mg/kg-1 TXA added to 20 mL of
saline intrapericardially before sternal closure. Primary endpoint of
study was comparison of postoperative hemoglobin and bleeding between
topical and infusion groups. A linear mixed model (LMM) was used to
estimate longitudinal changes in postoperative endpoints. Result(s):
We did not observe significant differences in children's characteristics
between two groups. Also, intraoperative and postoperative outcomes did
not differ between two groups but children with intravenous TXA
experienced significantly longer intubation time than topical children (P
= 0.047). LMM analysis revealed that postoperative bleeding in topical
group was lower compared to infusion group (P = 0.036). Also, age of
children had a significant effect on mean changes of hemoglobin during
postoperative care (beta = -0.27, P = 0.030). No children died and none
had serious postoperative complications such as seizures and reoperation.
 Conclusion(s): We found that topical TXA is not superior to
intravenous administration in management of blood loss. Also, no
additional effect was found about topical TXA in further reducing
transfusion rates and postoperative complications in acyanotic CHD
children undergoing cardiac surgery. Copyright © 2023 Elsevier
Inc.

<25>
Accession Number
2023334704
Title
Multivariable prediction models for atrial fibrillation after cardiac
surgery: A systematic review protocol.
Source
BMJ Open. 13(3) (no pagination), 2023. Article Number: e067260. Date of
Publication: 13 Mar 2023.
Author
Fields K.G.; Ma J.; Petrinic T.; Alhassan H.; Eze A.; Reddy A.; Hedayat
M.; Providencia R.; Lip G.Y.H.; Bedford J.P.; Clifton D.A.; Redfern O.C.;
O'Brien B.; Watkinson P.J.; Collins G.S.; Muehlschlegel J.D.
Institution
(Fields, Hedayat, Muehlschlegel) Department of Anesthesiology,
Perioperative and Pain Medicine, Harvard Medical School, Boston, MA,
United States
(Ma, Collins) Centre for Statistics in Medicine, Nuffield Department of
Orthopedics, Rheumatology and Musculoskeletal Sciences, University of
Oxford, Oxford, United Kingdom
(Petrinic) Bodleian Health Care Libraries, University of Oxford, Oxford,
United Kingdom
(Alhassan) Department of Medicine, University of Pittsburgh Medical
Center, Pittsburgh, PA, United States
(Eze) Department of Surgery, Duke University Medical Center, Durham, NC,
United States
(Reddy) University of Texas Medical Branch, School of Medicine, Galveston,
TX, United States
(Providencia) Institute of Health Informatics Research, University College
London, London, United Kingdom
(Providencia) Department of Cardiac Electrophysiology, Barts Heart Centre,
St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
(Lip) Liverpool Centre for Cardiovascular Science, University of
Liverpool, Liverpool John Moores University, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Lip) Department of Clinical Medicine, Aalborg University, Aalborg,
Denmark
(Bedford, Redfern, Watkinson) Kadoorie Centre for Critical Care Research
and Education, Nuffield Department of Clinical Neurosciences, University
of Oxford, Oxford, United Kingdom
(Clifton) Department of Engineering Science, University of Oxford, Oxford,
United Kingdom
(O'Brien) Department of Cardiac Anesthesiology and Intensive Care
Medicine, Deutsches Herzzentrum Berlin, Charite Universitatsmedizin
Berlin, Berlin, Germany
(O'Brien) Department of Perioperative Medicine, St. Bartholomew's Hospital
and Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom
(O'Brien) Outcomes Research Consortium, Cleveland, OH, United States
(Watkinson) Oxford University Hospitals NHS Trust, Oxford, United Kingdom
(Watkinson) NIHR Biomedical Research Centre, Oxford University Hospitals
NHS Foundation Trust, Oxford, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Dozens of multivariable prediction models for atrial
fibrillation after cardiac surgery (AFACS) have been published, but none
have been incorporated into regular clinical practice. One of the reasons
for this lack of adoption is poor model performance due to methodological
weaknesses in model development. In addition, there has been little
external validation of these existing models to evaluate their
reproducibility and transportability. The aim of this systematic review is
to critically appraise the methodology and risk of bias of papers
presenting the development and/or validation of models for AFACS. Methods
We will identify studies that present the development and/or validation of
a multivariable prediction model for AFACS through searches of PubMed,
Embase and Web of Science from inception to 31 December 2021. Pairs of
reviewers will independently extract model performance measures, assess
methodological quality and assess risk of bias of included studies using
extraction forms adapted from a combination of the Critical Appraisal and
Data Extraction for Systematic Reviews of Prediction Modelling Studies
checklist and the Prediction Model Risk of Bias Assessment Tool. Extracted
information will be reported by narrative synthesis and descriptive
statistics. Ethics and dissemination This systemic review will only
include published aggregate data, so no protected health information will
be used. Study findings will be disseminated through peer-reviewed
publications and scientific conference presentations. Further, this review
will identify weaknesses in past AFACS prediction model development and
validation methodology so that subsequent studies can improve upon prior
practices and produce a clinically useful risk estimation tool. PROSPERO
registration number CRD42019127329. 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.

<26>
Accession Number
2023250950
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. 260 (pp 1-8), 2023. Date of Publication: June
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, Spitzer, Daemen) Department of Cardiology, Thoraxcenter, Erasmus
University Medical Center, Rotterdam, Netherlands
(Byrne) Dept. of Cardiology and Cardiovascular Research Institute (CVRI)
Dublin, Mater Private Network, Dublin, Ireland
(Byrne) School of Pharmacy and Biomolecular Sciences, RCSI University of
Medicine and Health Sciences, Dublin, Ireland
(Banning) Department of Cardiology, John Radcliffe Hospital Oxford,
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, Institut Coeur Poumon, CHU Lille,
Lille, France
(Van Belle) Department of Interventional Cardiology for Coronary Valves
and Structural Heart Diseases, Inserm, U1011, Institut Pasteur de Lille,
EGID, Universite de Lille, Lille, 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) European Cardiovascular Research Institute, Rotterdam,
Netherlands
Publisher
Elsevier Inc.
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. Study design and objectives: 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 end point is a composite of all-cause death, any
myocardial infarction, or any revascularization at 1-year
post-randomization. Secondary end points include the individual components
of the primary end point and cost-effectiveness will be investigated.
 Conclusion(s): 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. Copyright ©
2023 The Author(s)

<27>
Accession Number
640691008
Title
Prehabilitation before elective coronary artery bypass grafting surgery: a
scoping review.
Source
JBI evidence synthesis. (no pagination), 2023. Date of Publication: 20
Mar 2023.
Author
Olsen D.B.; Pedersen P.U.; Noergaard M.W.
Institution
(Olsen) Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen
University Hospital, Copenhagen, Denmark
(Pedersen, Noergaard) Danish Centre of Systematic Reviews: A JBI Centre of
Exellence, Centre of Clinical Guidelines - Danish National Clearinghouse,
Faculty of Medicine, Aalborg University, Denmark
(Noergaard) Department of Cardiology, Rigshospitalet, Copenhagen
University Hospital, Copenhagen, Denmark
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The objective of this scoping review was to identify and map
existing preoperative interventions, referred to as prehabilitation, in
adult patients at home awaiting elective coronary artery bypass grafting
surgery. This review also sought to report feasibility and patient
experiences to shape clinical practice and underpin a future systematic
review. INTRODUCTION: As patients age, comorbidities become more common.
Strategies to improve postoperative outcomes and to accelerate recovery
are required in patients undergoing coronary artery bypass grafting.
Prehabilitation refers to a proactive process of increasing functional
capacity before surgery to improve the patient's ability to withstand
upcoming physiologic stress and, thus, avoid postoperative complications.
INCLUSION CRITERIA: Studies that included adult patients awaiting coronary
artery bypass grafting surgery at home and that described interventions
optimizing preoperative physical and psychological health in any setting
were included. METHOD(S): The JBI methodology for conducting scoping
reviews was used to identify relevant studies in MEDLINE, CINAHL, Cochrane
Library, Embase, Scopus, SweMed+, PsycINFO, and PEDro. Gray literature was
identified searching Google Scholar, ProQuest Dissertations and Theses,
MedNar, OpenGrey, NICE Evidence search, and SIGN. Studies in Danish,
English, German, Norwegian, and Swedish were considered for inclusion,
with no geographical or cultural limitations, or date restrictions. Two
independent reviewers screened titles and abstracts, and studies meeting
the inclusion criteria were imported into Covidence. Sixty-seven studies
from November 1987 to September 2022 were included. The data extraction
tool used for the included papers was developed in accordance with the
review questions and tested for adequacy and comprehensiveness with the
first 5 studies by the same 2 independent reviewers. The tool was then
edited to best reflect the review questions. Extracted findings are
described and supported by figures and tables. RESULT(S): Sixty-seven
studies were eligible for inclusion, representing 28,553 participants.
Analyses of extracted data identified various preoperative interventions
for optimizing postoperative and psychological outcomes for adult patients
awaiting elective coronary artery bypass grafting surgery. Based on
similarities, interventions were grouped into 5 categories. Eighteen
studies reported on multimodal interventions, 17 reported on psychological
interventions, 14 on physical training interventions, 13 on education
interventions, and 5 on oral health interventions. CONCLUSION(S):
This scoping review provides a comprehensive summary of strategies that
can be applied when developing a prehabilitation program for patients
awaiting elective coronary artery bypass surgery. Although prehabilitation
has been tested extensively and appears to be feasible, available evidence
is mostly based on small studies. For patients undergoing elective
coronary artery bypass grafting to derive benefit from prehabilitation,
methodologically robust clinical trials and knowledge synthesis are
required to identify optimal strategies for patient selection,
intervention design, adherence, and intervention duration. Future research
should also consider the cost-effectiveness of prehabilitation
interventions before surgery. Finally, there is a need for more
qualitative studies examining whether individual interventions are
meaningful and appropriate to patients, which is an important factor if
interventions are to be effective. Copyright © 2023 JBI.

<28>
Accession Number
2021964765
Title
Effect of transverse thoracic muscle plane block on postoperative
cognitive dysfunction after open cardiac surgery: A randomized clinical
trial.
Source
Journal of Cellular and Molecular Medicine. (no pagination), 2023. Date
of Publication: 2023.
Author
Chen S.; Zhang H.; Zhang Y.
Institution
(Chen, Zhang) Department of Anesthesiology, First Affiliated Hospital of
Nanchang University, Nanchang, China
(Zhang) Department of Anesthesiology, Nanchang Hongdu Hospital of TCM,
Nanchang, China
Publisher
John Wiley and Sons Inc
Abstract
The transversus thoracis muscle plane (TTMP) block provides effective
analgesia in cardiac surgery patients. The aim of this study was to assess
whether bilateral TTMP blocks can reduce the incidence of postoperative
cognitive dysfunction (POCD) in patients undergoing cardiac valve
replacement. A group of 103 patients were randomly divided into the TTM
group (n = 52) and the PLA (placebo) group (n = 51). The primary endpoint
was the incidence of POCD at 1 week after surgery. Secondary outcome
measures included a reduction of intraoperative mean arterial pressure
(MAP) >20% from baseline, intraoperative and postoperative sufentanil
consumption, length of stay in the ICU, incidence of postoperative nausea
and vomiting (PONV), time to first faeces, postoperative pain at 24 h
after surgery, time to extubation and the length of hospital stay.
Interleukin (IL)-6, TNF-alpha, S-100beta, insulin, glucose and insulin
resistance were measured at before induction of anaesthesia, 1, 3and 7
days after surgery. The MoCA scores were significantly lower and the
incidence of POCD decreased significantly in TTM group compared with PLA
group at 7 days after surgery. Perioperative sufentanil consumption, the
incidence of PONV and intraoperative MAP reduction >20% from baseline,
length of stay in the ICU, postoperative pain at 24 h after surgery, time
to extubation and the length of hospital stay were significantly decreased
in the TTM group. Postoperatively, IL-6, TNF-alpha, S-100beta, HOMA-IR,
insulin, glucose levels increased and the TTM group had a lower degree
than the PLA group at 1, 3 and 7 days after surgery. In summary, bilateral
TTMP blocks could improve postoperative cognitive function in patients
undergoing cardiac valve replacement. Copyright © 2023 The
Authors. Journal of Cellular and Molecular Medicine published by
Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.

<29>
Accession Number
640694639
Title
Posterior pericardiotomy for the prevention of atrial fibrillation after
cardiac surgery: a systematic review and meta-analysis of 25 randomised
controlled trials.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2023. Date of Publication: 16 Mar 2023.
Author
abdelAziz A.; Hafez A.H.; Elaraby A.; Roshdy M.R.; Abdelaziz M.; Eltobgy
M.A.; Elsayed H.; El-Samahy M.; Elbehbeh N.A.; Philip K.G.; Abdelaty A.M.;
Rizk M.A.; Al-Tawil M.; AboElfarh H.E.; Ramadan A.; Ghaith H.S.; Wahsh
E.A.; Abdelazeem B.; Fayed B.
Institution
(abdelAziz, Hafez, Elaraby, Roshdy, Abdelaziz, Eltobgy, Elsayed,
El-Samahy, Elbehbeh, Philip, Abdelaty, Rizk, Al-Tawil, AboElfarh, Ramadan,
Ghaith, Wahsh, Abdelazeem) Medical Research Group of Egypt (MRGE), Cairo,
Egypt
(abdelAziz, Hafez, Elaraby, Abdelaziz, Ghaith) Faculty of Medicine,
Al-Azhar University, Cairo, Egypt
(Roshdy, Philip) Faculty of Medicine, Sohag University, Sohag, Egypt
(Eltobgy) Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
(Elsayed, El-Samahy, Elbehbeh, Abdelaty, Rizk) Faculty of Medicine,
Zagazig University, Zagazig, Egypt
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(AboElfarh) Mansoura Manchester Programme for Medical Education, Faculty
of Medicine, Mansoura University, Mansoura, Egypt
(Ramadan) Faculty of Medicine, South Valley University, Egypt
(Wahsh) Department of Clinical Pharmacy, Faculty of Pharmacy, October 6
University, Giza, Egypt
(Abdelazeem) McLaren Flint Hospital, Flint, MI, United States
(Abdelazeem) Michigan State University, East Lansing, MI, United States
(Fayed) Cardiothoracic Surgery Department, Faculty of Medicine, Port Said
University, Port Said, Egypt
Publisher
NLM (Medline)
Abstract
BACKGROUND: Atrial fibrillation (AF) associated with postoperative
pericardial effusion is the most commonly reported adverse event after
cardiac surgery. AIMS: We aimed to determine the role of posterior
pericardiotomy in preventing postoperative AF (POAF). METHOD(S): We
searched PubMed, Scopus, Web of Science, Ovid, and EBSCO from inception
until 30 June 2022. We included randomised clinical trials (RCTs) that
compared posterior pericardiotomy (PP) versus control (no PP) in patients
undergoing cardiac surgery. The primary endpoint was the incidence of POAF
after cardiac surgery. The secondary endpoints were supraventricular
arrhythmias, early/late pericardial effusion, pericardial tamponade,
pleural effusion, length of hospital/intensive care unit stay,
intra-aortic balloon pump use, revision surgery for bleeding, and
mortality. RESULT(S): Twenty-five RCTs comprising 4,467 patients were
included in this systematic review and meta-analysis. The overall
incidence rate of POAF was 11.7% in the PP group compared with 23.67% in
the no PP or control group, with a significant decrease in the risk of
POAF following PP (odds ratio [OR] 0.49, 95% confidence interval [CI]:
0.38-0.61). Compared with the control group, the risk of supraventricular
tachycardia (OR 0.66, 95% CI: 0.43-0.89), early pericardial effusion (OR
0.32, 95% CI: 0.22-0.46), late pericardial effusion (OR 0.15, 95% CI:
0.09-0.25), and pericardiac tamponade (OR 0.18, 95% CI: 0.10-0.33) were
lower in the PP group. CONCLUSION(S): PP is an effective intervention
for reducing the risk of POAF after cardiac surgery. Also, PP is
economically efficient in terms of decreasing the length of hospital stay.

<30>
Accession Number
640683098
Title
Novel Measures of Arterial Hemodynamics and Wave Reflections Associated
With Clinical Outcomes in Patients With Heart Failure.
Source
Journal of the American Heart Association. (pp e027666), 2023. Date of
Publication: 16 Mar 2023.
Author
Steinberg R.S.; Udeshi E.; Dickert N.; Quyyumi A.; Chirinos J.A.; Morris
A.A.
Institution
(Steinberg, Udeshi, Dickert, Quyyumi, Morris) Division of Cardiology Emory
University Atlanta GA
(Chirinos) Division of Cardiology University of Pennsylvania Philadelphia
PA
Publisher
NLM (Medline)
Abstract
Background Arterial stiffness and earlier wave reflections can increase
afterload and impair cardiovascular function. Most prior studies have been
performed in patients with preserved left ventricular function. We
describe novel measures of pulsatile arterial hemodynamics and their
association with clinical outcomes in patients with heart failure with
reduced ejection fraction. Methods and Results Participants with heart
failure with reduced ejection fraction (n=137, median age 56years, 49%
women, 58% Black) and age-matched healthy controls (n=124) underwent
measurements of large artery stiffness and pulsatile arterial
hemodynamics. Carotid-femoral pulse wave velocity and augmentation index
were assessed using radial applanation tonometry. Pressure-flow analyses
derived reflected wave transit time, the systolic pressure-time integral
imposed by proximal aortic characteristic impedance, and the pressure-time
integral from wave reflection (wasted pressure effort). Cox proportional
hazards models defined associations between hemodynamic measures and (1)
all-cause death and (2) a combined end point of left ventricular assist
device implant, heart transplant, and death, at 2years adjusted for race,
BNP (B-type natriuretic peptide), and the Meta-Analysis Global Group in
Chronic Heart Failure Risk Score. Compared with controls, participants
with heart failure with reduced ejection fraction exhibited similar
carotid-femoral pulse wave velocity (6.8+/-1.6 versus 7.0+/-1.6m/s,
P=0.40) but higher augmentation index normalized to a heart rate of 75 bpm
(13+/-2% versus 22+/-2%, P<0.001). Shorter reflected wave transit time
(ie, earlier wave reflection arrival to the proximal aorta) was associated
with an increased risk of death (adjusted hazard ratio [aHR] 1.67 [95% CI
1.03-1.63]) and the combined end point of death/left ventricular assist
device/heart transplant (aHR, 1.61 [95% CI, 1.06-2.44]) at 2years. Wasted
pressure effort/proximal aortic characteristic impedance, representing the
proportion of systolic load from wave reflection versus aortic root
characteristic impedance, was univariately associated with death (hazard
ratio (HR), 1.44 [95% CI, 1.05-1.97]) and with death/left ventricular
assist device/heart transplant on univariate (HR, 1.42 [95% CI,
1.07-1.88]) and multivariable (aHR, 1.40 [95% CI, 1.02-1.93]) analysis.
Conclusions Increased left ventricular systolic load from premature wave
reflections is associated with adverse clinical outcomes in patients with
heart failure with reduced ejection fraction.

<31>
Accession Number
640678240
Title
Long-term outcomes comparison between surgical and percutaneous coronary
revascularization in patients with multivessel coronary disease or left
main disease. A systematic review and study level meta-analysis of
randomized trials.
Source
Current problems in cardiology. (pp 101699), 2023. Date of Publication:
13 Mar 2023.
Author
Formica F.; Gallingani A.; Tuttolomondo D.; Hernandez-Vaquero D.; Singh
G.; Pattuzzi C.; Maestri F.; Niccoli G.; Ceccato E.; Lorusso R.; Nicolini
F.
Institution
(Formica) University of Parma, Department of Medicine and Surgery, Parma,
Italy
(Gallingani, Maestri) Cardiac Surgery Unit, University Hospital of Parma,
Parma, Italy
(Tuttolomondo) Cardiology Unit, University Hospital of Parma, Parma, Italy
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, Canada
(Pattuzzi, Nicolini) University of Parma, Department of Medicine and
Surgery, Parma, Italy; Cardiac Surgery Unit, University Hospital of Parma,
Parma, Italy
(Niccoli) University of Parma, Department of Medicine and Surgery, Parma,
Italy; Cardiology Unit, University Hospital of Parma, Parma, Italy
(Ceccato) Medical Library, University of Parma, Parma, Italy
(Lorusso) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht, Netherlands
Publisher
NLM (Medline)
Abstract
Recent randomized trials comparing coronary artery bypass graft (CABG)
with percutaneous coronary intervention (PCI) utilizing drug-eluting
stents in patients with left main (LMD) disease and/or multivessel disease
(MVD), reported conflicting results. We performed a study level
meta-analysis comparing the two interventions for the treatment of LMD or
MVD. Using electronic databases, we retrieved 6 trials, between January,
2010 and December, 2022. Five-years Kaplan-Meier curves of endpoints where
reconstructed. Comparisons were made by Cox-linear regression frailty
model and by landmark analysis. A random-effect method was applied. 8269
patients were included and randomly assigned to CABG (n=4135) or PCI
(n=4134). During 5-years follow-up, PCI showed a higher incidence of
all-cause mortality [hazard ratio (HR) 1.28; 95% confidence interval (CI),
1.11-1.47; p<0.0001)], spontaneous myocardial infarction (MI) (HR 1.84;
95% CI, 1.54-2.19; p<0.0001) and repeat coronary revascularization (HR
1.96; 95% CI, 1.72-2.24; p<0.0001). There was no long-term difference
between the two interventions for cardiovascular death (p=0.14) and stroke
(p=0.20), although the incidence of stroke was higher with CABG within
30-days from intervention (p<0.0001). PCI was associated with an increased
risk for composite endpoints (p<0.0001) and major cerebral and
cardiovascular events. (p<0.0001). In conclusion, at 5-year follow-up, in
patients with LMD and/or MVD there was a significant higher incidence of
all-cause mortality, spontaneous MI and repeat revascularization with PCI
compared to CABG. The incidence of stroke was higher with CABG during the
post-procedural period, but no difference was found during 5-years
follow-up. Longer follow-up is mandatory to better define outcome
difference between the two interventions. Copyright © 2023.
Published by Elsevier Inc.

<32>
Accession Number
637563420
Title
Cost-effectiveness analysis of a resource-intensive approach versus
minimally invasive strategy for high-risk transcatheter aortic valve
replacement patients.
Source
Journal of Comparative Effectiveness Research. 11(4) (pp 217-227), 2022.
Date of Publication: March 2022.
Author
Mayhew C.R.; Gallagher A.; Bensimhon A.; Dauerman H.L.; Tsai M.H.; Martin
J.A.
Institution
(Mayhew, Gallagher, Bensimhon, Tsai, Martin) Department of Anesthesiology
and Pain Medicine, University of Vermont Larner College of Medicine,
Burlington, VT 05401, United States
(Dauerman) Division of Cardiovascular Medicine, University of Vermont
Larner College of Medicine, Burlington, VT 05401, United States
(Tsai) Department of Orthopaedics and Rehabilitation, University of
Vermont Larner College of Medicine, Burlington, VT 05401, United States
Publisher
Newlands Press Ltd
Abstract
Aortic stenosis has a high mortality rate in patients who do not receive
aortic valve replacement. Previously, transcatheter aortic valve
replacement (TAVR) was an intervention reserved for individuals deemed
high-risk for surgery. Since that time, TAVR has increasingly been offered
to lower risk patients, yet it is unclear whether TAVR will meet an
acceptable cost-effectiveness threshold in this group. In this
cost-effectiveness study, we employed a decision tree model with Monte
Carlo probability sensitivity analysis to determine the incremental cost
(in US$) per quality-Adjusted life year (QALY) and life year (LY) of
performing the TAVR procedure using the resource-intensive approach versus
the minimally invasive strategy in high-risk surgical
patients. Copyright © 2022 Future Medicine Ltd.

<33>
Accession Number
626728419
Title
Use of echocardiograms in the Medicare population: A diagnostic tool in
the fight against severe aortic stenosis.
Source
Journal of Comparative Effectiveness Research. 8(4) (pp 265-275), 2019.
Date of Publication: March 2019.
Author
Grossi E.A.; Moore K.A.; Gunnarsson C.
Institution
(Grossi) Department of Cardiothoracic Surgery, NYU-Langone Medical Center,
New York, NY 10016, United States
(Moore) Edwards Lifesciences, Irvine, CA 92614, United States
(Gunnarsson) Gunnarsson Consulting, Jupiter, FL 33477, United States
Publisher
Newlands Press Ltd
Abstract
Aim: To estimate undiagnosed aortic stenosis (AS) in the Medicare
population. Method(s): Patients enrolled (2011-2014) were eligible.
After criteria were applied, time zero was the first record of an
echocardiogram (ECHO) for the ECHO-AS cohort and randomly assigned for the
no-ECHO cohort. The ECHO-AS cohort was propensity matched to patients in
the no-ECHO cohort, and survival analysis was performed. Result(s):
Of the 854,493 (25%) patients who received an ECHO, 1 in 4 were diagnosed
with AS. After propensity matching, the no-ECHO cohort who died, almost
half (49%) had a record of a cardiovascular event prior to their death.
The no-ECHO cohort had statistically significant (p = 0.003) higher risk
of death than their ECHO-AS counterparts. Conclusion(s): In the
Medicare population, patients aged 65 years or older, with increased risk
factors for and symptoms common in AS patients, should be considered for
diagnostic ECHOs. Copyright © 2019 EA Grossi, KA Moore & C
Gunnarsson.

<34>
Accession Number
625574201
Title
Comparing the conventional 15 cm and the C-length approaches for central
venous catheter placement.
Source
Journal of Cardiovascular and Thoracic Research. 10(4) (pp 221-226), 2018.
Date of Publication: 2018.
Author
Jarineshin H.; Sharifi M.; Kashani S.
Institution
(Jarineshin, Sharifi, Kashani) Anesthesiology, Critical Care and Pain
Management Research Center, Hormozgan University of Medical Sciences,
Bandar Abbas, Iran, Islamic Republic of
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: The present guidelines recommend placing the catheter tip in
the superior vena cava (SVC) above the pericardial cephalic reflection.
The aim of this study was to compare the accuracy of two different
approaches in locating the tip of the Central venous catheter (CVC) at the
suggested vascular zone. Method(s): This was an interventional study
on two hundred patients undergoing Coronary artery bypass surgery (CABG)
operation who required a central venous cannulation. They were randomly
assigned into two groups. in the first group catheter placement was
applied through using the conventional 15 cm method. in the second group a
C-length method was applied for measuring the depth of catheter tip
placement from the preoperative chest radiographs. For statistical
analysis Chi-square test and T-test were used. Result(s): in the
first group (15 cm) 100% of the patients had their catheters placed below
the C-line (Carina line) and the average distance between the catheter tip
and the C-line was +4.22+/-2.10 cm. in the second (C-Length) group 52% of
the catheters were below C-line with an average distance of +0.77+/-0.5
cm. There was a meaningful difference between the two groups in respect to
the catheter location depth and zone of placement (P<0.001).
 Conclusion(s): The C-Length approach in comparison to the
conventional 15 cm approach resulted in a considerable higher number of
catheters above the recommended C-line, thus it can provide a more
reliable and safe mode for CVC placement in the SVC. Copyright ©
2018 The Author (s).

<35>
Accession Number
625573701
Title
Influence of arm position during infraclavicular subclavian vein
catheterization in coronary artery bypass graft surgery.
Source
Journal of Cardiovascular and Thoracic Research. 10(4) (pp 192-196), 2018.
Date of Publication: 2018.
Author
Tarbiat M.; Davoudi M.; Salimbahrami S.A.
Institution
(Tarbiat, Davoudi, Salimbahrami) Clinical Research Development Unit of
Farshchian Heart Center, Department of Anesthesiology, School of Medicine,
Hamadan University of Medical Sciences, Hamadan, Iran, Islamic Republic of
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: Percutaneous subclavian vein catheterization via
infraclavicular approach is one of the most widely used cannulation
techniques for inserting catheters into a central vein. The aim of this
study was to evaluate influence of arm position during infraclavicular
subclavian vein catheterization with landmark-based technique in coronary
artery bypass graft (CABG) surgery. Method(s): Between September 2017
and June 2018, this prospective randomized clinical trial was performed in
320 patients. The patients were randomly assigned to the Neutral group
(the arms kept by the side) or Abduction group (the arm was abducted to
90degree). The success and complication rates were compared in the two
groups. The data were analyzed using SPSS software. Result(s): in the
first attempt of subclavian vein cannulation, the success rate had no
significant difference between the two groups (P= 0.185). in the second
attempt of catheterization, the success rate in Abduction group (40.5%)
was lower than Neutral group (81.2%). The overall success rate in two
attempts were (84.4%) in the Abduction group and (96.2%) in the Neutral
group. There was a significant difference between two groups in the second
and overall success rates (P= 0.0001). In 34 (10.6%) patients, subclavian
artery puncture occurred, 30 (18.8%) in the Abduction group and 4 (2.5%)
in the Neutral group. There was a significant difference between two
groups (P= 0.0001). Pneumothorax was occurred in 15 (9.4%) in the
Abduction group and 3 (1.9%) in the Neutral group. There was also a
significant difference between two groups (P= 0.004). The differences in
other complications on two groups were statistically insignificant.
 Conclusion(s): Compared with Abduction group, the Neutral group
resulted in higher success rate and fewer subclavian artery puncture and
pneumothorax. The incidences of other complications were similar on both
groups. Copyright © 2018 The Author (s).

<36>
Accession Number
625573250
Title
Outcomes following transcatheter transseptal versus transapical mitral
valve-in-valve and valve-in-ring procedures.
Source
Journal of Cardiovascular and Thoracic Research. 10(4) (pp 182-186), 2018.
Date of Publication: 2018.
Author
Nazir S.; Lohani S.; Tachamo N.; Khan M.S.; Timilsina B.; Luni F.K.;
Donato A.
Institution
(Nazir, Lohani, Tachamo, Khan, Timilsina) Department of Medicine, Reading
Hospital-Tower Health System, West Reading, PA, United States
(Luni) Division of Cardiology, Mercy Saint Vincent Medical Center, Toledo,
OH, United States
(Donato) Sidney Kimmel Medical College at Thomas Jefferson University,
Philadelphia, PA, United States
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: Transcatheter mitral valve-in-valve (ViV) & valve-in-ring
(ViR) are relatively novel therapeutic alternatives for patients with
degenerated bioprostheses or failed annuloplasty rings whose reoperative
risk is too high. The predominant procedural access for both procedures is
transapical or transseptal. However, whether there are differences in
outcomes of this procedure using transseptal versus transapical access has
not yet been defined. Method(s): We conducted a systematic review of
all published articles from MEDLINE and EMBASE to explore the outcomes of
these two procedural approaches. Result(s): A total of 55 studies
including 183 patients (154 ViV and 29 ViR) were included. Patients that
underwent ViV (101 transapical and 53 transseptal) using the transseptal
approach required more iatrogenic atrial septal defect (ASD) closure (19%
versus 0.0 %; P< 0.001) and hence had a lower device success rate (68%
versus 89%; P= 0.001). However, there was no significant difference
between the two groups in procedural success and all-cause mortality at 30
days. Overall severe bleeding complications (major or life threatening)
were not different the two groups (3.7% versus 7.9%; P= 0.321). in the ViR
group (19 transapical and 10 transseptal), no difference in procedural
success, device success or 30-day outcomes were identified between
transseptal and transapical groups, although sample size was small.
 Conclusion(s): In conclusion, mitral ViV and ViR using the two
different procedural approaches appear to confer equal and reasonable
30-day outcomes. Copyright © 2018 The Author (s).

<37>
Accession Number
2021679335
Title
Complex primary percutaneous coronary intervention with ultrathin-strut
biodegradable versus thin-strut durable polymer drug-eluting stents in
patients with ST-segment elevation myocardial infarction: A subgroup
analysis from the BIOSTEMI randomized trial.
Source
Catheterization and Cardiovascular Interventions. 101(4) (pp 687-700),
2023. Date of Publication: 01 Mar 2023.
Author
Iglesias J.F.; Muller O.; Losdat S.; Roffi M.; Kurz D.J.; Weilenmann D.;
Kaiser C.; Heg D.; Windecker S.; Pilgrim T.
Institution
(Iglesias, Roffi) Department of Cardiology, Geneva University Hospitals,
Geneva, Switzerland
(Muller) Department of Cardiology, Lausanne University Hospital, Lausanne,
Switzerland
(Losdat, Heg) CTU Bern, University of Bern, Bern, Switzerland
(Kurz) Department of Cardiology, Triemlispital, Zurich, Switzerland
(Weilenmann) Department of Cardiology, Kantonsspital, St. Gallen,
Switzerland
(Kaiser) Department of Cardiology, Basel University Hospital, Basel,
Switzerland
(Windecker, Pilgrim) Department of Cardiology, Bern University Hospital,
Bern, Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Background: Ultrathin-strut biodegradable polymer sirolimus-eluting stents
(BP-SES) are superior to thin-strut durable polymer everolimus-eluting
stents (DP-EES) with respect to target lesion failure (TLF) at 2 years
among patients with ST-segment elevation myocardial infarction (STEMI). We
sought to determine the impact of primary percutaneous coronary
intervention (pPCI) complexity on long-term clinical outcomes with BP-SES
versus DP-EES in STEMI patients. Method(s): We performed a post hoc
subgroup analysis from the BIOSTEMI (NCT02579031) randomized trial, which
included individual data from 407 STEMI patients enrolled in the
BIOSCIENCE trial (NCT01443104). STEMI patients were randomly assigned to
treatment with ultrathin-strut BP-SES or thin-strut DP-EES, and further
categorized into those undergoing complex versus noncomplex pPCI. Complex
pPCI was defined by the presence of >=1 of the following criteria: 3
vessel treatment, >=3 stents implanted, >=3 lesions treated, bifurcation
lesion with >=2 stents implanted, total stent length >=60 mm, and/or
chronic total occlusion treatment. The primary endpoint was TLF, a
composite of cardiac death, target-vessel myocardial reinfarction, or
clinically indicated target lesion revascularization, within 2 years.
 Result(s): Among a total of 1707 STEMI patients, 421 (24.7%)
underwent complex pPCI. Baseline characteristics were similar between
groups. At 2 years, TLF occurred in 14 patients (7.1%) treated with BP-SES
and 25 patients (11.6%) treated with DP-EES (hazard ratio [HR]: 0.62; 95%
confidence interval [CI]: 0.32-1.19; p = 0.15) in the complex pPCI group,
and in 28 patients (4.4%) treated with BP-SES and 49 patients (8.2%)
treated with DP-EES (HR: 0.54; 95% CI: 0.34-0.86; p = 0.008; p for
interaction = 0.74) in the noncomplex pPCI group. Individual TLF
components and stent thrombosis rates did not significantly differ between
groups. Conclusion(s): In a post hoc subgroup analysis from the
BIOSTEMI randomized trial, ultrathin-strut BP-SES were superior to
thin-strut DP-EES with respect to TLF at 2 years among STEMI patients
undergoing both complex and noncomplex pPCI. Copyright © 2023 The
Authors. Catheterization and Cardiovascular Interventions published by
Wiley Periodicals LLC.

<38>
Accession Number
2023094933
Title
Quality of life, patient satisfaction, and cardiovascular outcomes of the
randomised 2 x 3 factorial Copenhagen insulin and Metformin therapy (CIMT)
trial - A detailed statistical analysis plan.
Source
Contemporary Clinical Trials Communications. 33 (no pagination), 2023.
Article Number: 101095. Date of Publication: June 2023.
Author
Olsen M.H.; Almdal T.P.; Madsbad S.; Ovesen C.; Gluud C.; Sneppen S.B.;
Breum L.; Hedetoft C.; Krarup T.; Lundby-Christensen L.; Mathiesen E.R.;
Roder M.E.; Vestergaard H.; Wiinberg N.; Jakobsen J.C.
Institution
(Olsen, Ovesen, Gluud, Jakobsen) Copenhagen Trial Unit, Centre for
Clinical Intervention Research, Copenhagen University Hospital -
Rigshospitalet, The Capital Region, Copenhagen, Denmark
(Olsen) Department of Neuroanaesthesiology, The Neuroscience Centre,
Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
(Almdal, Mathiesen) Department of Endocrinology, Centre for Cancer and
Organ Diseases, Copenhagen University Hospital - Rigshospitalet,
Copenhagen, Denmark
(Madsbad) Department of Endocrinology, Copenhagen University Hospital -
Amager and Hvidovre, Copenhagen, Denmark
(Ovesen) Department of Neurology, Copenhagen University Hospital -
Bispebjerg and Frederiksberg, Copenhagen, Denmark
(Gluud, Jakobsen) Department of Regional Health Research, The Faculty of
Health Sciences, University of Southern Denmark, Odense, Denmark
(Sneppen) Section of Endocrinology, Department of Internal Medicine,
Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
(Breum, Hedetoft) Department of Medicine and Endocrinology, Zealand
University Hospital, Koge, Denmark
(Krarup, Lundby-Christensen) Steno Diabetes Centre Zealand, Holbaek,
Denmark
(Mathiesen) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
(Roder) Steno Diabetes Center Odense, Odense University Hospital, Odense,
Denmark
(Vestergaard) Department of Medicine, Bornholms Hospital, Ronne, Denmark
(Vestergaard) Novo Nordisk Foundation Center for Basic Metabolic Research,
University of Copenhagen, Copenhagen, Denmark
(Wiinberg) Department of Clinical Physiology and Nuclear Medicine,
Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen,
Denmark
Publisher
Elsevier Inc.
Abstract
Background: The evidence on the effects of metformin and insulin in type 2
diabetes patients on quality of life, patient satisfaction, and
cardiovascular outcomes is unclear. Method(s): The Copenhagen Insulin
and Metformin Therapy (CIMT) trial is an investigator-initiated
multicentre, randomised, placebo-controlled trial with a 2 x 3 factorial
design conducted at eight hospitals in Denmark. Participants with type 2
diabetes were randomised to metformin (n = 206) versus placebo (n = 206);
in combination with open-label biphasic insulin aspart one to three times
daily (n = 137) versus insulin aspart three times daily in combination
with insulin detemir once daily (n = 138) versus insulin detemir once
daily (n = 137). We present a detailed description of the methodology and
statistical analysis of the clinical CIMT outcomes including a detailed
description of tests of the assumptions behind the statistical analyses.
The outcomes are quality of life (Short Form Health Survey (SF-36)),
Diabetes Medication Satisfaction Questionnaire, and Insulin Treatment
Satisfaction Questionnaire (assessed at entry and 18 months after
randomisation) and cardiovascular outcomes including time to a composite
of either myocardial infarction, stroke, peripheral amputation, coronary
revascularisation, peripheral revascularisation, or death.
 Discussion(s): This statistical analysis plan ensure the highest
possible quality of the subsequent post-hoc analyses. Trial registration:
The protocol was approved by the Regional Committee on Biomedical Research
Ethics (H-D-2007-112), the Danish Medicines Agency (EudraCT:
2007-006665-33 CIMT), and registered within ClinicalTrials.gov
(NCT00657943, 8th of April 2008). Copyright © 2023 The
Authors

<39>
Accession Number
2023006850
Title
Comparison of Combined Aerobic-Resistance and Aerobic Training on Heart
Systolic Function in Heart Failure Patients after Coronary Artery Bypass
Graft Surgery (CABG).
Source
Journal of Kermanshah University of Medical Sciences. 27(1) (no
pagination), 2023. Article Number: e128953. Date of Publication: Mar 2023.
Author
Amiripour M.S.; Amiripour A.; Nasiri S.; Omidi S.; Raisi F.
Institution
(Amiripour) Student Researchs Center, Medical Sciences University,
Kermanshah, Iran, Islamic Republic of
(Amiripour, Nasiri, Omidi, Raisi) Imam Ali Cardiovascular Research Center,
Medical Science University, Kermanshah, Iran, Islamic Republic of
Publisher
Kermanshah University of Medical Sciences
Abstract
Background: Heart disease is the most common cause of mortality worldwide,
and heart surgery frequently occurs. The results are strongly dependent on
lifestyle modification and especially sports exercises. Objective(s):
In this study, aimed to compare the effect of eight weeks of aerobic and
combined training on systolic cardiac function in heart failure patients
after coronary artery bypass surgery. Method(s): In this randomized
clinical trial, 30 cardiac patients under CABG surgery at Kermanshah Heart
Center were randomly divided into three groups, control, combined, and
aerobic training. The protocols of the combined group included two
movements of the upper limbs (pectoralis major and deltoid muscles) and
two movements of the lower limbs (quadriceps and hamstring muscles) by
three sets/10Rep and aerobic group with 60-85-minute exercises at 70-85%
peak HR in three sessions per week for eight weeks. The collected data
were analyzed using the SPSS software version 22, One-way ANOVA, and Tukey
tests; P < 0.05 was considered significant. Result(s): After eight
weeks, Systolic heart function wasn't increased in the control group (P >
0.05) but was raised in the aerobic and combined training groups (P =
0.0001). There was no significant difference between in two intervention
groups (P > 0.05). Conclusion(s): Aerobic and combined exercises
positively affect systolic cardiac function after coronary artery bypass
surgery. Therefore, doing both exercises in these patients is
recommended. Copyright © 2023, Journal of Kermanshah University
of Medical Sciences.

<40>
Accession Number
2022998977
Title
Acupuncture for the prevention of postoperative delirium: A systematic
review and meta-analysis.
Source
European Journal of Integrative Medicine. 59 (no pagination), 2023.
Article Number: 102235. Date of Publication: April 2023.
Author
Liang S.; Huang K.-Y.; Xu Y.-Y.; Chen L.; Zhang Y.; Feng X.-X.
Institution
(Liang, Huang, Xu, Chen, Zhang, Feng) Department of Acupuncture, Ningbo
Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang
Chinese Medical University, Ningbo, China
Publisher
Elsevier GmbH
Abstract
Introduction: Postoperative delirium (POD) is a huge burden on the health
of surgical patients and the medical system. Acupuncture has been used to
prevent delirium. This review aimed to evaluate the preventive effect of
acupuncture on POD. Method(s): Four key databases were searched from
inception to July 31, 2022 for randomized controlled trials (RCTs) where
acupuncture was the main intervention for preventing POD. The primary
outcome was the incidence of POD and the secondary outcome was the
duration of POD. Data were synthesized using risk ratio (RR) or mean
difference with 95% confidence interval (CI). Result(s): Eleven
trials with 801 participants were included, which were generally of low
methodological quality. Acupuncture could reduce the incidence of POD
(RR=0.39, 95%CI= 0.30 to 0.51, P<0.00001). Subgroup analyses demonstrated
that the preventive effect of acupuncture on POD was observed in patients
with mean age >= 65 years and mean age < 65 years or patients undergoing
orthopedic surgery, digestive surgery and cardiac surgery; both
electroacupuncture and manual acupuncture were beneficial; and acupuncture
was favored in preventing POD when compared with blank control and sham
control. No significant publication bias was found. Due to the limited
number of trials reporting on the duration of POD, it was not analyzed.
 Conclusion(s): Acupuncture could significantly reduce the incidence
of POD. However, the findings were inconclusive due to weak evidence.
High-quality, large sample and multi-center RCTs are needed to reconfirm
the findings. (PROSPERO ID is CRD42022348136). Copyright © 2023

<41>
Accession Number
639488043
Title
Association of Serial High-Sensitivity Cardiac Troponin T with Subsequent
Cardiovascular Events in Patients Stabilized after Acute Coronary
Syndrome: A Secondary Analysis from IMPROVE-IT.
Source
JAMA Cardiology. 7(12) (pp 1199-1206), 2022. Date of Publication: 14 Dec
2022.
Author
Patel S.M.; Qamar A.; Giugliano R.P.; Jarolim P.; Marston N.A.; Park
J.-G.; Blazing M.A.; Cannon C.P.; Braunwald E.; Morrow D.A.
Institution
(Patel, Giugliano, Marston, Park, Braunwald, Morrow) Thrombolysis in
Myocardial Infarction Clinical Trials (TIMI) Study Group, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Patel, Giugliano, Marston, Cannon, Braunwald, Morrow) Cardiovascular
Division, Department of Medicine, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Qamar) Section of Interventional Cardiology & Vascular Medicine,
NorthShore University Health System, University of Chicago, Pritzker
School of Medicine, Evanston, IL, United States
(Jarolim) Department of Pathology, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Blazing) Duke Clinical Research Institute, Duke University, School of
Medicine, Durham, NC, United States
Publisher
American Medical Association
Abstract
Importance: Studies have demonstrated an association between single
measures of high-sensitivity troponin (hsTn) and future cardiovascular
events in patients with chronic coronary syndromes. However, limited data
exist regarding the association between changes in serial values of hsTn
and subsequent cardiovascular events in this patient population.
 Objective(s): To evaluate the association between changes in
high-sensitivity troponin T (hsTnT) and subsequent cardiovascular events
in patients stabilized after acute coronary syndrome (ACS). Design,
Setting, and Participant(s): This is a secondary analysis from the
Improved Reduction of Outcomes: Vytorin Efficacy International Trial
(IMPROVE-IT), a randomized clinical trial of ezetimibe vs placebo on a
background of simvastatin in 18144 patients hospitalized for an ACS across
1147 sites in 39 countries. The current biomarker substudy includes the
6035 participants consenting to the biomarker substudy with available
hsTnT at months 1 and 4. Data were collected from October 26, 2005,
through July 8, 2010, with the database locked October 21, 2014. Data were
analyzed from February 28, 2021, through August 14, 2022. Main
Outcomes and Measures: The outcomes of interest were cardiovascular death,
myocardial infarction (MI), stroke, or hospitalization for heart failure
(HHF). Associations of absolute and relative changes in hsTnT between
month 1 and month 4 as a function of the starting month 1 hsTnT and the
composite outcome were examined using landmark analyses. Result(s):
Of 6035 patients in this analysis (median [IQR] age, 64 [57-71]), 1486
(24.6%) were female; 361 (6.0%) were Asian; 121 were (2.0%) Black; 252
(4.2%) were Spanish descent; 4959 were (82.2%) White; and 342 (5.7%)
reported another race (consolidated owing to small numbers), declined to
respond, or were not asked to report race owing to regulatory
prohibitions. Most patients (4114 [68.2%]) had stable hsTnT values (change
<3 ng/L), with 1158 (19.2%) and 763 (12.6%) having changes of 3 to less
than 7 ng/L and 7 ng/L or more, respectively. After adjustment for
clinical risk factors and stratification by the starting month 1 hsTnT
level, an absolute increase in hsTnT of 7 ng/L or more was associated with
a more than 3-fold greater risk of the composite outcome (adjusted hazard
ratio [aHR], 3.33; 95% CI, 1.99-5.57; P <.001), whereas decreases of 7
ng/L or more were associated with similar to lower risk (aHR, 0.51; 95%
CI, 0.26-1.03; P =.06) compared with stable values. There was a stepwise
association moving from larger absolute decreases (aHR, 0.51; 95% CI,
0.26-1.03) to larger absolute increases (aHR, 3.33; 95% CI, 1.99-5.57) in
hsTnT with future risk of the composite outcome (P trend <.001). A similar
association was observed when analyzed on the basis of relative percent
and continuous change. Conclusions and Relevance: Among stable
patients post-ACS, changes in hsTnT were associated with a gradient of
risk of subsequent cardiovascular events across the range of starting
hsTnT values. Serial assessment of hsTnT may refine risk stratification
with the potential to guide therapy decisions in this patient population.
Trial Registration: ClinicalTrials.gov Identifier:
NCT00202878. Copyright © 2022 Authors. All rights reserved.

<42>
[Use Link to view the full text]
Accession Number
2021414189
Title
The effect of tranexamic acid on myocardial injury in cardiac surgical
patients: a systematic review and meta-analysis.
Source
Blood Coagulation and Fibrinolysis. 33(8) (pp 429-437), 2022. Date of
Publication: 01 Dec 2022.
Author
Wang X.; Li L.; He L.; Yao Y.
Institution
(Wang, Li) Department of Anesthesiology, Fuwai Yunnan Cardiovascular
Hospital, Yunnan Province, Kunming, China
(He, Yao) Department of Anesthesiology, Fuwai Hospital, National Center
for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy
of Medical Sciences, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Tranexamic acid (TXA) is one of the most commonly used antifibrinolytic
agents for surgical patients. However, the effect of TXA on myocardial
injury remains controversial. We systemically reviewed literature
regarding the effectiveness of TXA on myocardial injury in patients who
have undergone a cardiac surgery. We included all randomized controlled
trials (RCTs) comparing TXA and control (saline) in cardiac surgical
patients. Relevant studies were identified by a comprehensive electronic
literature search from database inception to 15 August 2021. A
standardized data extraction form was used to collect methodological and
outcome variables from each eligible study. We conducted a meta-analysis
to estimate the pooled effect size of TXA administration on myocardial
injury. In total, eight RCTs were identified, with 292 patients in the TXA
group, and 241 patients in saline or control group. The meta-analysis
demonstrated that patients in the TXA group had lower levels of CK-MB and
cTnI within 24 h postoperatively (CK-MB: P = 0.005; cTnI: P = 0.01),
compared with the saline group. No significant difference was found with
respect to AST level (P = 0.71) between TXA and saline groups within 24 h
postoperatively. TXA administration was found to be associated with less
myocardial injury among patients who have undergone cardiac surgery.
High-quality randomized controlled trials are warranted to further examine
the cardioprotective effects of TXA. Copyright © 2022 Wolters
Kluwer Health, Inc. All rights reserved.

<43>
Accession Number
640226359
Title
Corrigendum to: Dual versus single antiplatelet therapy after
transcatheter aortic valve replacement: a systematic review and
meta-analysis.
Source
European heart journal. 44(11) (pp 930), 2023. Date of Publication: 14 Mar
2023.
Author
Anonymous
Publisher
NLM (Medline)

<44>
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. 13(3) (no pagination), 2023. Article Number: e2915.
Date of Publication: March 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.

<45>
Accession Number
635378130
Title
Tranexamic Acid in Neuroanesthesia and Neurocritical Care: Time for Its
Critical Appraisal.
Source
Journal of Neuroanaesthesiology and Critical Care. 6(3) (pp 257-266),
2019. Article Number: JNACC1900159. Date of Publication: 01 Sep 2019.
Author
Hooda B.; Muthuchellappan R.
Institution
(Hooda) Department of Anaesthesiology and Critical Care, Army Hospital
Research and Referral, New Delhi 110010, India
(Muthuchellappan) Department of Neuroanaesthesia and Neurocritical Care,
National Institute of Mental Health and Neurosciences (NIMHANS),
Bengaluru, Karnataka, India
Publisher
Georg Thieme Verlag
Abstract
There is a renewed interest in the use of antifibrinolytics, especially
tranexamic acid (TxA), in varied clinical settings such as trauma,
perioperative bleeding, cardiac surgery, and multilevel spine
instrumentation procedures. Because of its prothrombotic potential, the
use of TxA in neurosurgical disorders has not gained popularity since this
subset of the population is more prone to developing thromboembolic
complications. However, recent studies have shown that TxA reduces blood
loss, reduces the need for allogeneic blood transfusion, and is associated
with minimal side effects. In this narrative review, Google Scholar,
PubMed, and EMBASE databases were searched to identify publications
relevant to the current use of TxA in varied neurosurgical and critical
care settings. These publications were analyzed, and a summary of the
findings and the role of future research on this drug are presented in
this review. Copyright © 2019 Indian Society of
Neuroanaesthesiology and Critical Care.

<46>
Accession Number
2023033204
Title
STROKE AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION: INCIDENCE AND
TEMPORAL TRENDS BETWEEN 2007 AND 2022.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 823), 2023. Date of
Publication: 07 Mar 2023.
Author
Van Nieuwkerk A.; Romaguera R.; Tchetche D.; De Brito F.S.; Barbanti M.;
Kornowski R.; Latib A.; D'Onofrio A.; Ribichini F.; Alfonso F.; Dumonteil
N.; Abizaid A.; sartori S.; D'Errigo P.; Tarantini G.; Orvin K.; Pagnesi
M.; PINAR E.; Dangas G.D.; Mehran R.; Delewi R.
Institution
(Van Nieuwkerk, Romaguera, Tchetche, De Brito, Barbanti, Kornowski, Latib,
D'Onofrio, Ribichini, Alfonso, Dumonteil, Abizaid, sartori, D'Errigo,
Tarantini, Orvin, Pagnesi, PINAR, Dangas, Mehran, Delewi) Department of
Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam
Cardiovascular Sciences, Amsterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background Stroke remains one of the most devastating complications of
transcatheter aortic valve implantation (TAVI). This study aimed to assess
contemporary incidence, outcomes and temporal trends in stroke after
transfemoral TAVI in a real world patient cohort. Methods The
CENTER2-study includes TAVI patients treated between 2007 and 2022. The
patient level database contains pooled data from 10 clinical studies.
Primary outcome was 30-day stroke incidence after TAVI. Secondary outcomes
included one-year stroke rate, predictors for stroke and temporal trends.
Outcomes were defined according to the second Valve Academic Research
Consortium. Results In 24,305 transfemoral TAVI patients, mean age was
81.4+/-6.7 years, 56% was female and median STS-PROM was 4.9% (3.1%-8.4%).
A total of 534 patients (2.2%) experienced stroke in the first 30 days.
Median time to stroke was 1.0 day (IQR 0.0-6.0) and 52% of these
periprocedural strokes happened within 24 hours after TAVI. Stroke rates
did not decrease during the treatment period (2007-2010 2.1%, 2011-2014
2.5%, 2015-2018 2.1%, 2019-2022 2.0%, p for trend 0.28). Thirty-day stroke
incidence was similar across STS-PROM risk categories: low risk 2.1%,
intermediate risk 2.6%, and high risk 2.5% (p=0.21). One-year stroke
occurred in 7.0% of patients of which median time to stroke was 4.0 days
(IQR 1.0-63.8). One-year mortality was 4.5-fold higher in 30-day stroke
patients (44.1% vs 15.0%, OR 4.5, 95%CI 3.6-5.6, p<0.001). Mortality in
stroke patients did not decline over the years (p for trend 0.32).
Independent predictors for 30-day stroke were: age >=85 (OR 1.42, 95%CI
1.12-1.81 p=0.004); previous cerebrovascular events (OR 1.83, 95%CI
1.35-2.49, p<0.001), and New York Heart Association class >=3 (OR 1.28,
95%CI 1.01-1.61, p=0.04). Conclusion In 24,305 transfemoral TAVI patients,
30-day stroke incidence remained stable around 2.2% between 2007 and 2022.
Stroke rates were similar across STS-PROM risk categories. Our results
underscore the importance of periprocedural stroke
prevention. Copyright © 2023 American College of Cardiology
Foundation

<47>
Accession Number
2023032986
Title
UTILIZATION OF HEART-SUPPORTING DEVICES IN CONGENITAL HEART DISEASE
AWAITING HEART TRANSPLANTATION: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 679), 2023. Date of
Publication: 07 Mar 2023.
Author
Mendel B.; Husen T.F.; Adhimulia S.I.; Kohar K.; Prakoso R.; Siagian S.
Institution
(Mendel, Husen, Adhimulia, Kohar, Prakoso, Siagian) National
Cardiovascular Center of Harapan Kita, Jakarta, Indonesia
(Mendel, Husen, Adhimulia, Kohar, Prakoso, Siagian) Sultan Sulaiman
Government Hospital, Jakarta, Indonesia
Publisher
Elsevier Inc.
Abstract
Background The only effective treatment for patients with end-stage
congenital heart disease (CHD) heart failure is cardiac transplantation.
However, longer waiting times lead to a greater reliance on mechanical
circulatory support. Methods This systematic review and meta-analysis were
conducted according to the PRISMA statement. The literature on VAD and
ECMO as the available heart-supporting equipment was searched through four
databases, including Pubmed, Google Scholar, Scopus, and Cochrane. The
main result was overall mortality. Using a random-effects model of
proportional meta-analysis, R software (version 4.1.3) was used to
estimate the total proportion. Results There were a total of 17 trials
included, with 834 and 1004 patients undergoing VAD and ECMO,
respectively, as a stopgap measure before heart transplantation. Compared
to Centrifugal THORATEC VAD and ECMO (56.9% CI: 38.5-75.4% vs. 42.4% CI:
24.3-60.4%), Berlin Heart EXCOR VAD had the lowest mortality rate (30.4%
CI: 22.7-38.1%). Conclusion Berlin Heart EXCOR VAD type is a preferable
option to improve the survival rate of congenital heart disease patients
awaiting heart transplantation. [Formula presented] Copyright ©
2023 American College of Cardiology Foundation

<48>
Accession Number
2023349802
Title
EFFICACY OF INTRAVENOUS ESMOLOL WITH INTRANASAL NITROGLYCERINE SPRAY GIVEN
BEFORE ENDOTRACHEAL EXTUBATION ON THE ATTENUATION OF PRESSOR RESPONSE: A
COMPARATIVE STUDY.
Source
Asian Journal of Pharmaceutical and Clinical Research. 16(3) (pp 62-66),
2023. Date of Publication: March 2023.
Author
Kokate M.V.; Kokate V.R.; Mahure S.M.; Jumade P.P.
Institution
(Kokate, Mahure) Department of Anesthesiology, Dr. Punjabrao Deshmukh
Medical College, Maharashtra, Amravati, India
(Kokate) Department of Medicine, Dr. Punjabrao Deshmukh Medical College,
Maharashtra, Amravati, India
(Jumade) Department of Community Medicine, Karpagam Faculty of Medical
Sciences and Research, Tamil Nadu, Coimbatore, India
Publisher
Innovare Academics Sciences Pvt. Ltd
Abstract
Objectives: The aim of the study was to compare the effects of intravenous
esmolol and intranasal nitroglycerine spray on attenuation of extubation
pressor response in terms of hemodynamic parameters and to compare the
adverse effects, if any, of either drug. Method(s): This was a
randomized comparative study conducted in a tertiary care medical college
in which 64 patients of ASA Grade I with age between 18 and 60 years,
including both males and females undergoing elective non cardiac surgeries
under general anesthesia with orotracheal intubation were included in this
study on the basis of a predefined inclusion and exclusion criteria.
Patients were divided into two groups (Depending on whether they received
Intravenous Esmolol or NTG spray) of 32 patients each. Attenuation of
extubation pressor response in terms of hemodynamic parameters (systolic
blood pressure [SBP], diastolic blood pressure [DBP], mean arterial
pressure [MAP], heart rate, and rate pressure product) were recorded and
compared before induction, during surgery and postoperatively up to 10 min
after surgery. Result(s): The gender distribution was comparable in
both the groups. The mean age of patients in Group A and Group B was found
to be 36.90+/-10.12 and 35.20+/-11.32 years, respectively. The mean age of
both the groups was found to be comparable with no statistically
significant difference. Both the study groups were comparable in base line
parameters with no significant difference seen in mean age, mean heart
rate, mean SBP and DBP, MAP, anesthesia time, and surgery time. Both drugs
controlled the blood pressure changes effectively; however, NTG group had
a better control of systolic as well as DBP. Heart rate was better
controlled in esmolol group. Conclusion(s): Intranasal
nitro-glycerine and intravenous esmolol before tracheal extubation in ASA
Grade I patients are simple, effective, and practical methods of blunting
cardiovascular responses to tracheal extubation. Copyright © 2023
The Authors. Published by Innovare Academic Sciences Pvt Ltd.

<49>
Accession Number
2023400410
Title
Pregnancy-Associated Spontaneous Coronary Artery Dissection in Women: A
Literature Review.
Source
Current Therapeutic Research - Clinical and Experimental. 98 (no
pagination), 2023. Article Number: 100697. Date of Publication: January
2023.
Author
Zeven K.
Institution
(Zeven) Warren Alpert Medical School, Brown University, Providence, Rhode
Island, United States
Publisher
Elsevier Inc.
Abstract
Background: Spontaneous coronary artery dissection (SCAD) primarily
affects women younger than age 50 years, is often misdiagnosed or
undiagnosed, and research on this topic is limited. Objective(s): A
literature review was conducted to identify unique factors that can
facilitate pregnancy-related SCAD (P-SCAD) diagnosis as well as
differentiate it from nonpregnancy-related SCAD (NP-SCAD). Method(s):
A literature search was conducted on PubMed, Medline, Embase, The Cochrane
Database of Systematic Reviews, and Google Scholar databases that focused
on NP-SCAD and P-SCAD cases reported in North America between 2006 and
2021 using the terms spontaneous coronary artery dissection, misdiagnosis,
and women, along with postpartum and pregnancy. The Let Evidence Guide
Every New Decision quality assessment tool was applied to all reviews.
 Result(s): A total of 108 journal articles reporting on individual
cases, case series examining independent SCAD registries, as well as
literature reviews were identified. These included 1547 SCAD cases in
women, 510 of which were identified as P-SCAD. SCAD occurs predominantly
in women, and thus presents a diagnostic challenge because women are not
typically considered at risk for developing cardiovascular diseases and
may present with symptoms that mimic other medical conditions. This issue
is further exacerbated when SCAD develops during pregnancy or the
postpartum period (ie, P-SCAD to differentiate it from SCAD occurring in
other periods of woman's life such as NP-SCAD) because P-SCAD patients
often present with less typical cardiac symptoms yet tend to experience
more severe illness that can jeopardize their health and that of their
baby. P-SCAD was associated with higher ST-segment elevation myocardial
infarction rates, higher troponin levels, and a greater risk of
cardiogenic shock compared with NP-SCAD cohorts. It was also evident that
the failure rates associated with invasive procedures such as percutaneous
coronary intervention and coronary artery bypass graft surgery were higher
in P-SCAD patients, whereas the mortality rates are comparable to NP-SCAD
cohorts if diagnosed and treated appropriately. Conclusion(s):
Because younger women are rarely screened, they are at greater risk from
SCAD, especially if this condition develops during pregnancy or <=30 days
following delivery. It is essential that medical professionals providing
care for pregnant women understand P-SCAD risk factors and provide medical
counseling for pregnant women or those planning a pregnancy to be better
equipped to recognize its more subtle signs and symptoms, thus
facilitating timely specialist referral, diagnosis, and treatment. (Curr
Ther Res Clin Exp. 2023; 84:XXX-XXX) Copyright © 2023 The
Author(s)

<50>
Accession Number
2023399032
Title
The Impact of Statins on Postdischarge Atrial Fibrillation After Cardiac
Surgery: Secondary Analysis from a Randomized Trial.
Source
CJC Open. (no pagination), 2023. Date of Publication: 2023.
Author
Hibino M.; Verma S.; Pandey A.K.; Bisleri G.; Yanagawa B.; Verma R.; Puar
P.; Quan A.; Teoh H.; Yau T.M.; Verma A.; Ha A.C.T.; Mazer C.D.
Institution
(Hibino) Division of Cardiothoracic Surgery, Emory University, School of
Medicine, Atlanta, GA, United States
(Verma, Bisleri, Yanagawa, Puar, Quan, Teoh) Division of Cardiac Surgery,
St. Michael's Hospital of Unity Health Toronto, Toronto, ON, Canada
(Verma, Bisleri, Yanagawa, Yau) Division of Cardiovascular Surgery,
Department of Surgery, University of Toronto, Toronto, ON, Canada
(Verma, Yanagawa) Department of Pharmacology and Toxicology, University of
Toronto, Toronto, ON, Canada
(Pandey) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Verma) School of Medicine, Royal College of Surgeons in Ireland, Dublin,
Ireland
(Teoh) Division of Endocrinology and Metabolism, St. Michael's Hospital of
Unity Health Toronto, Toronto, ON, Canada
(Yau) Division of Cardiovascular Surgery, Toronto General Hospital
Research Institute, Toronto, ON, Canada
(Yau, Ha) Peter Munk Cardiac Centre, Toronto General Hospital, University
Health Network, Toronto, ON, Canada
(Verma) Division of Cardiology, McGill University, Montreal, QC, Canada
(Ha) Department of Medicine, University of Toronto, Toronto, ON, Canada
(Mazer) Department of Anesthesia, St. Michael's Hospital of Unity Health
Toronto, Toronto, ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Mazer) Department of Physiology, University of Toronto, Toronto, ON,
Canada
Publisher
Elsevier Inc.
Abstract
Background: Whether statins reliably reduce the risk of postoperative
atrial fibrillation (POAF) in patients undergoing cardiac surgery remains
controversial. We sought to determine the impact of statin use on
new-onset postdischarge POAF in the Post-Surgical Enhanced Monitoring for
Cardiac Arrhythmias and Atrial Fibrillation (SEARCH-AF) CardioLink-1
randomized controlled trial. Method(s): We randomized 336 patients
with risk factors for stroke (CHA<inf>2</inf>DS<inf>2</inf>-VASc score >=
2) and no history of preoperative atrial fibrillation (AF) to 30-day
continuous cardiac rhythm monitoring after discharge from cardiac surgery
with a wearable, patched-based device or to usual care. The primary
endpoint was the occurrence of cumulative AF and/or atrial flutter lasting
for >= 6 minutes detected by continuous monitoring, or AF and/or atrial
flutter documented by a 12-lead electrocardiogram within 30 days of
randomization. Result(s): The 260 patients (77.4%) discharged on
statins were more likely to be male (P = 0.018) and to have lower
CHA<inf>2</inf>DS<inf>2</inf>-VASc scores (P = 0.011). Patients treated
with statins at discharge had a 2-fold lower rate of POAF than those who
were not treated with statins in the entire cohort (18.4% vs 8.1%,
log-rank P = 0.0076). On multivariable Cox regression including the
CHA<inf>2</inf>DS<inf>2</inf>-VASc score adjustment, statin use was
associated with a lower risk of POAF (hazard ratio 0.43, 95% confidence
interval: 0.25-0.98, P = 0.043). Use of statins at a higher intensity was
associated with lower risk of POAF, suggestive of a dose-response effect
(log-rank P<inf>trend</inf> = 0.0082). Conclusion(s): The use of
statins was associated with a reduction in postdischarge POAF risk among
patients undergoing cardiac surgery. The routine use of high-intensity
statin to prevent subacute POAF after discharge deserves further
study. Copyright © 2022 The Authors

<51>
Accession Number
640589288
Title
Confirmation of Safety of Titanium Wire in Sternotomy Closure, A
Randomized Prospective Study.
Source
The Thoracic and cardiovascular surgeon. (no pagination), 2023. Date of
Publication: 14 Mar 2023.
Author
Eraqi M.; Diab A.H.; Matschke K.; Alexiou K.
Institution
(Eraqi) Klinikum Bayreuth GmbH, Bayreuth, Germany
(Eraqi, Diab, Matschke, Alexiou) Department of Cardiac Surgery, Heart
Center Dresden at the University Hospital Carl Gustav Carus, Dresden,
Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: There are many factors that are known to increase the risk of
sternal wound infection (SWI); some studies have reported that nickel is a
risk factor for SWI. Titanium wires have only been used as an alternative
to steel wires in patients with known allergy to nickel. However, there is
a paucity of literature regarding the safety of using titanium wires
compared to that on the safety of steel wires for sternum closure after
cardiac surgery. Therefore, this study aimed to demonstrate the
noninferiority of titanium wires, even in patients without a known
allergy. METHOD(S): A total of 322 patients who underwent elective
full median sternotomy were randomly assigned to sternal closure either by
titanium wires (n=161) or by stainless steel wires. RESULT(S):
Fourteen patients had sternal instability, six (3.7%) patients in the
titanium group and eight (5%) patients in the stainless steel group
(p=0.585). There was no statistically significant difference between both
groups in terms of postoperative wound infection (p=0.147). Patients in
the titanium group experienced statistically significant lower
postoperative pain than those in the stainless steel group (p=0.024). The
wire type was not an independent risk factor for SI, as shown by
univariate and logistic regression analyses. CONCLUSION(S): Titanium
wires are a good alternative and have been proven to be safe and effective
for sternal closure. The surgeon should be aware of the possibility of
developing an allergic reaction to the wires, especially in patients with
previous multiple allergic histories. Copyright The Author(s). This is
an open access article published by Thieme under the terms of the Creative
Commons Attribution-NonDerivative-NonCommercial License, permitting
copying and reproduction so long as the original work is given appropriate
credit. Contents may not be used for commercial purposes, or adapted,
remixed, transformed or built upon.
(https://creativecommons.org/licenses/by-nc-nd/4.0/

<52>
Accession Number
640588795
Title
Clinical characteristics and outcome of Mycobacterium chimaera infections
after cardiac surgery: systematic review and meta-analysis of 180
heater-cooler unit associated cases.
Source
Clinical microbiology and infection : the official publication of the
European Society of Clinical Microbiology and Infectious Diseases. (no
pagination), 2023. Date of Publication: 12 Mar 2023.
Author
Wetzstein N.; Kohl T.A.; Diricks M.; Mas-Peiro S.; Holubec T.; Kessel J.;
Graf C.; Koch B.; Herrmann E.; Vehreschild M.J.G.T.; Hogardt M.; Niemann
S.; Stephan C.; Wichelhaus T.A.
Institution
(Wetzstein, Kessel, Vehreschild, Stephan) Department of Internal Medicine,
Infectious Diseases, University Hospital Frankfurt, Goethe University,
Frankfurt am Main, Germany
(Kohl, Diricks, Niemann) German Center for Infection Research (DZIF),
partner site Hamburg-Lubeck-Borstel-Riems, Germany; Molecular and
Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
(Mas-Peiro) Department of Internal Medicine, Cardiology, University
Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
(Holubec) Department of Cardiovascular Surgery, University Hospital
Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
(Graf) Department of Internal Medicine, Gastroenterology and Hepatology,
University Hospital Frankfurt, Goethe University, Frankfurt am Main,
Germany
(Koch) Department of Internal Medicine, Nephrology, University Hospital
Frankfurt, Goethe University, Frankfurt am Main, Germany
(Herrmann) Institute of Biostatistics and Mathematical Modeling, Goethe
University, Frankfurt am Main, Germany
(Hogardt, Wichelhaus) Institute of Medical Microbiology and Infection
Control, University Hospital Frankfurt, Goethe University, Frankfurt am
Main, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: Since 2013, heater-cooler unit (HCU) associated M. chimaera
infections linked to a global outbreak have been described. These
infections were characterised by high morbidity and mortality due to
delayed diagnosis, as well as challenges in antimycobacterial and surgical
therapy. OBJECTIVE(S): To investigate the clinical characteristics
and outcome of published cases of HCU-associated M. chimaera infections.
DATA SOURCES: We searched PubMed and the Web of Science until June 15th
2022. STUDY ELIGIBILITY CRITERIA: Case reports, case series, cohort
studies, without language restriction. PARTICIPANTS: Patients with M.
chimaera infection and a prior history of cardiac surgery. ASSESSMENT OF
RISK BIAS: In this systematic review of case reports no risk of bias
assessment could be performed. METHODS OF DATA SYNTHESIS: Clinical,
microbiological, and radiological features were recorded. Logistic
regression and time-to-event analysis were performed to identify potential
factors associated with better survival. RESULT(S): 180 patients from
54 publications were included. Most patients underwent surgical aortic
valve (67.0 %; 118/176 of patients with available data) or combined aortic
valve and root replacement (15.3 %; 27/176). Median period between time
point of surgery and first symptoms was 17 months (IQR 13 to 26 months).
The overall case fatality rate was 45.5 % (80/176) with a median survival
of 24 months after the initiation of antimycobacterial therapy or
diagnosis. A re-operation (including the removal or exchange of foreign
material) was associated with better survival in multivariate logistic
regression (OR 0.32 for lethal events; 95 % CI 0.12-0.79; p=0.015) and in
time-to-event-analysis (p=0.0094). CONCLUSION(S): This systematic
review and meta-analysis confirms the high overall mortality of HCU
associated disseminated M. chimaera infections after cardiac surgery. A
re-operation seems to be associated with better survival. Physicians have
to stay aware of this infection, as patients might still present today due
to the long latency period. Copyright © 2023 European Society of
Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd.
All rights reserved.

<53>
Accession Number
2022304168
Title
Radiation dose to heart and cardiac substructures and risk of coronary
artery disease in early breast cancer patients: A DBCG study based on
modern radiation therapy techniques.
Source
Radiotherapy and Oncology. 180 (no pagination), 2023. Article Number:
109453. Date of Publication: March 2023.
Author
Holm Milo M.L.; Slot Moller D.; Bisballe Nyeng T.; Hoffmann L.; Dahl
Nissen H.; Jensen I.; Laugaard Lorenzen E.; Bech Jellesmark Thorsen L.;
Melgaard Nielsen K.; Paaske Johnsen S.; Brink Valentin J.; Alsner J.; Vrou
Offersen B.
Institution
(Holm Milo, Bech Jellesmark Thorsen, Alsner, Vrou Offersen) Department of
Experimental Clinical Oncology, Aarhus University Hospital, Denmark
(Holm Milo) Department of Oncology, Aalborg University Hospital, Denmark
(Slot Moller, Bisballe Nyeng, Hoffmann) Department of Medical Physics,
Aarhus, Denmark
(Slot Moller, Hoffmann) Department of Clinical Medicine, Faculty of Health
Sciences, Aarhus University, Aarhus, Denmark
(Dahl Nissen) Department of Medical Physics, Vejle Hospital, Denmark
(Jensen) Department of Medical Physics, Aalborg University Hospital,
Denmark
(Laugaard Lorenzen) Laboratory of Radiation Physics, Odense University
Hospital, Denmark
(Bech Jellesmark Thorsen, Vrou Offersen) Department of Oncology, Aarhus
University Hospital, Denmark
(Melgaard Nielsen) Department of Cardiology, Aarhus University Hospital,
Denmark
(Paaske Johnsen, Brink Valentin) Danish Center for Clinical Health
Services Research, Department of Clinical Medicine, Aalborg University
Hospital, Denmark
(Vrou Offersen) Danish Center for Particle Therapy, Aarhus, Denmark
Publisher
Elsevier Ireland Ltd
Abstract
Background: Coronary artery disease (CAD) has been reported as a late
effect following radiation therapy (RT) of early breast cancer (BC). This
study aims to report individual RT doses to the heart and cardiac
substructures in patients treated with CT-based RT and to investigate if a
dose-response relationship between RT dose and CAD exists using modern
radiation therapy techniques. Method(s): Patients registered in the
Danish Breast Cancer Group database from 2005 to 2016 with CT-based RT
were eligible. Among 15,765 patients, the study included 204 with CAD
after irradiation (cases) and 408 matched controls. Individual planning
CTs were retrieved, the heart and cardiac substructures were delineated
and dose-volume parameters were extracted. Result(s): The median
follow-up time was 7.3 years (IQR: 4.6-10.0). Among cases, the median mean
heart dose was 1.6 Gy (IQR 0.2-6.1) and 0.8 Gy (0.1-2.9) for left-sided
and right-sided patients, respectively (p < 0.001). The highest RT doses
were observed in the left ventricle and left anterior descending coronary
artery for left-sided RT and in the right atrium and the right coronary
artery after right-sided RT. The highest left-minus-right dose-difference
was located in the distal part of the left anterior descending coronary
artery where also the highest left-versus-right ratio of events was
observed. However, no significant difference in the distribution of CAD
was observed by laterality. Furthermore, no significant differences in the
dose-volume parameters were observed for cases versus controls.
 Conclusion(s): CAD tended to occur in the part of the heart with the
highest left-minus- right dose difference, however, no significant risk of
CAD was observed at 7 years' median follow-up. Copyright © 2023
Elsevier B.V.

<54>
Accession Number
2021754919
Title
Hepatitis B in Heart Transplant Donors and Recipients: A Systematic Review
and Meta-Analysis.
Source
Journal of Surgical Research. 283 (pp 1078-1090), 2023. Date of
Publication: March 2023.
Author
Yost C.C.; Jimenez D.C.; Weber M.P.; Maynes E.J.; Belden K.A.;
Tchantchaleishvili V.; Massey H.T.; Sass D.A.; Rame J.E.; Zurlo J.J.;
Aburjania N.
Institution
(Yost, Jimenez, Weber, Maynes, Tchantchaleishvili, Massey) Division of
Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
(Belden, Zurlo, Aburjania) Division of Infectious Diseases, Thomas
Jefferson University, Philadelphia, Pennsylvania
(Sass) Division of Gastroenterology and Hepatology, Thomas Jefferson
University, Philadelphia, Pennsylvania
(Rame) Division of Cardiology, Thomas Jefferson University, Philadelphia,
Pennsylvania
Publisher
Academic Press Inc.
Abstract
Introduction: Expanding the heart donor pool to include patients with
hepatitis B virus (HBV) could help ameliorate the organ shortage in heart
transplantation. We performed a systematic review and meta-analysis to
evaluate the management and recipient outcomes of D+/R- and D-/R+ heart
transplants. Method(s): An electronic search was performed to
identify all relevant studies published on heart transplants involving
HBV+ donors and/or HBV+ recipients. A comparison was performed between two
groups where heart transplants were performed a) D+/R- (n = 98) versus b)
D-/R+ (n = 65). Result(s): Overall, 13 studies were selected,
comprising 163 patients. Mean patient age was 55 y (95% CI: 39, 78) and
79% (69, 86) were male. Active post-transplant HBV infection requiring
antiviral treatment occurred in 11% (1, 69) of D+/R- recipients and 33%
(9, 71) of D-/R+ recipients. Post-transplant antiviral therapy was given
to 80% (6, 100) of D+/R- recipients compared to 72% (42, 90) of D-/R+
recipients (P = 0.84). Hepatitis-related mortality was observed in no
D+/R- recipients and 7% (2, 27) of D-/R+ recipients. Survival 1-y
post-transplant was comparable between both groups at 83% (83, 92) and 81%
(61, 92) for D+/R- and D-/R+ transplants, respectively.
 Conclusion(s): Our review found that HBV D+/R- heart transplantation
was associated with fewer active hepatitis infections and lower
hepatitis-related mortality than D-/R+ transplantation, with comparable
survival at 1 y. Additional studies utilizing HBV nucleic acid testing
(NAT) to compare outcomes with HBsAg+ and anti-HBc+ donors are crucial to
reach more definitive conclusions about the risk of donor-derived
infections in this context. Copyright © 2022 Elsevier Inc.

<55>
Accession Number
2020399304
Title
Long-Term Outcomes of Randomized Controlled Trials Comparing Percutaneous
Left Atrial Appendage Closure to Oral Anticoagulation for Nonvalvular
Atrial Fibrillation: A Meta-Analysis.
Source
Structural Heart. 7(1) (no pagination), 2023. Article Number: 100096. Date
of Publication: January 2023.
Author
Madhavan M.V.; Howard J.P.; Brener M.I.; Der Nigoghossian C.; Chen S.;
Makkar R.; Osmancik P.; Reddy V.Y.; Holmes D.R.; Stone G.W.; Leon M.B.;
Ahmad Y.
Institution
(Madhavan, Brener, Der Nigoghossian, Leon) Division of Cardiology,
Department of Medicine, NewYork-Presbyterian Hospital and the Columbia
University Irving Medical Center, New York, NY, United States
(Madhavan, Chen, Leon) Cardiovascular Research Foundation, New York, NY,
United States
(Howard) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Makkar) Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles,
CA, United States
(Osmancik) Cardiocenter, Third Faculty of Medicine, Charles University
Prague and University Hospital Kralovske Vinohrady, Prague, Czechia
(Reddy) The Helmsley Electrophysiology Center, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Reddy, Stone) The Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Holmes) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Ahmad) Yale School of Medicine, Yale University, New Haven, CT, United
States
Publisher
Cardiovascular Research Foundation
Abstract
Background: Oral anticoagulation (OAC) has been considered the standard of
care for stroke prophylaxis for patients with nonvalvular atrial
fibrillation; however, many individuals are unable or unwilling to take
long-term OAC. The safety and efficacy of percutaneous left atrial
appendage closure (LAAC) have been controversial, and new trial data have
recently emerged. We therefore sought to perform an updated meta-analysis
of randomized clinical trials (RCTs) comparing OAC to percutaneous LAAC,
focusing on individual clinical endpoints. Method(s): We performed a
systematic search of the MEDLINE, EMBASE, and Cochrane Central Register of
Controlled Trials from January 2000 through December 2021 for all RCTs
comparing percutaneous LAAC to OAC in patients with nonvalvular atrial
fibrillation. Fixed and random effects meta-analyses of hazard ratios
(HRs) were performed using the longest follow-up duration available by
intention-to-treat. The prespecified primary endpoint was all-cause
mortality. Result(s): Three RCTs enrolling 1516 patients were
identified. The weighted mean follow-up was 54.7 months. LAAC was
associated with a reduced risk of all-cause mortality (HR 0.76; 95%
confidence interval [CI], 0.59-0.96; p = 0.023), hemorrhagic stroke (HR
0.24; 95% CI, 0.09-0.61; p = 0.003), and major nonprocedural bleeding (HR
0.52; 95% CI, 0.37-0.74; p < 0.001). There was no significant difference
between LAAC and OAC for any other endpoints. Conclusion(s): The
available evidence from RCTs suggests LAAC therapy is associated with
reduced long-term risk of death compared with OAC. This may be driven by
reductions in hemorrhagic stroke and major nonprocedural bleeding. There
were no significant differences in the risk of all stroke. Further
large-scale clinical trials are needed to validate these
findings. Copyright © 2022 The Authors

<56>
Accession Number
2022952577
Title
Correlation Between Cardiac Index, Plasma Troponin I, Myocardial
Histopathology, CPB and AoX Duration in Glutamine versus No Glutamine
Administered Patients with Low Ejection Fraction Undergoing Elective
On-Pump CABG Surgery: Secondary Analysis of an RCT.
Source
Vascular Health and Risk Management. 19 (pp 93-101), 2023. Date of
Publication: 2023.
Author
Parmana I.M.A.; Boom C.E.; Rachmadi L.; Hanafy D.A.; Widyastuti Y.;
Mansyur M.; Siswanto B.B.
Institution
(Parmana, Boom) Department of Anesthesiology and Intensive Care, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Rachmadi) Department of Anatomical Pathology, Faculty of Medicine,
Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
(Hanafy) Department of Cardiothoracic and Vascular Surgery, Faculty of
Medicine, Universitas Indonesia/National Cardiovascular Center Harapan
Kita, Jakarta, Indonesia
(Widyastuti) Department of Anesthesiology and Intensive Care, Universitas
Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
(Mansyur) Department of Community Medicine, Faculty of Medicine,
Universitas Indonesia, Jakarta, Indonesia
(Siswanto) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Universitas Indonesia/National Cardiovascular Center Harapan
Kita, Jakarta, Indonesia
Publisher
Dove Medical Press Ltd
Abstract
Purpose: On-pump coronary artery bypass graft (CABG) causes myocardial
ischemia, through the cardiopulmonary bypass (CPB) and aortic
cross-clamping (AoX). Glutamine supplementation protects cardiac cells
during cardiac ischemia. This study analysed the correlation between
cardiac index (CI), plasma troponin I, myocardial histopathology, CPB and
AoX duration in low ejection fraction patients receiving glutamine and no
glutamine undergoing elective on-pump CABG. Material(s) and
Method(s): This was a secondary analysis of a double-blind, randomised
controlled trial of 60 patients, split into control and intervention
(glutamine) groups. Glutamine was administered at a dose of 0.5 g/kg/24
hours. There were 29 patients in each respective groups after a total of
two patients dropped out. Result(s): A negative correlation (p =
0.037) was observed between CPB duration and CI at 6 hours after CPB in
the glutamine group. A positive correlation (p = 0.002) was also observed
between AoX duration and plasma troponin I at 6 hours after CPB in the
control group. However, no correlation was observed between myocardial
histopathology and plasma troponin I level at 5 minutes after CPB.
 Conclusion(s): Significant negative correlation between CPB duration
and CI at 6 hours after CPB in the glutamine group, along with significant
positive correlation between AoX duration and plasma troponin I level at 6
hours after CPB in the control group demonstrated the myocardial
protection qualities of intravenous glutamine administration in patients
with low ejection fraction undergoing elective on-pump CABG
surgeries. Copyright © 2023 Parmana et al.

<57>
Accession Number
2022017839
Title
Artificial intelligence guidance of advanced heart failure therapies: A
systematic scoping review.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1127716. Date of Publication: 2023.
Author
Al-Ani M.A.; Bai C.; Hashky A.; Parker A.M.; Vilaro J.R.; Aranda Jr J.M.;
Shickel B.; Rashidi P.; Bihorac A.; Ahmed M.M.; Mardini M.T.
Institution
(Al-Ani, Parker, Vilaro, Aranda Jr, Ahmed) Division of Cardiovascular
Medicine, University of Florida, Gainesville, FL, United States
(Bai, Mardini) Department of Health Outcomes and Biomedical Informatics,
University of Florida, Gainesville, FL, United States
(Hashky) Department of Computer and Information Science and Engineering,
University of Florida, Gainesville, FL, United States
(Shickel, Bihorac) Department of Medicine, University of Florida,
Gainesville, FL, United States
(Shickel, Rashidi, Bihorac) Intelligent Critical Care Center (IC3),
University of Florida, Gainesville, FL, United States
(Rashidi) Department of Biomedical Engineering, University of Florida,
Gainesville, FL, United States
Publisher
Frontiers Media S.A.
Abstract
Introduction: Artificial intelligence can recognize complex patterns in
large datasets. It is a promising technology to advance heart failure
practice, as many decisions rely on expert opinions in the absence of
high-quality data-driven evidence. Method(s): We searched Embase, Web
of Science, and PubMed databases for articles containing "artificial
intelligence," "machine learning," or "deep learning" and any of the
phrases "heart transplantation," "ventricular assist device," or
"cardiogenic shock" from inception until August 2022. We only included
original research addressing post heart transplantation (HTx) or
mechanical circulatory support (MCS) clinical care. Review and data
extraction were performed in accordance with PRISMA-Scr guidelines.
 Result(s): Of 584 unique publications detected, 31 met the inclusion
criteria. The majority focused on outcome prediction post HTx (n = 13) and
post durable MCS (n = 7), as well as post HTx and MCS management (n = 7, n
= 3, respectively). One study addressed temporary mechanical circulatory
support. Most studies advocated for rapid integration of AI into clinical
practice, acknowledging potential improvements in management guidance and
reliability of outcomes prediction. There was a notable paucity of
external data validation and integration of multiple data modalities.
 Conclusion(s): Our review showed mounting innovation in AI
application in management of MCS and HTx, with the largest evidence
showing improved mortality outcome prediction. Copyright © 2023
Al-Ani, Bai, Hashky, Parker, Vilaro, Aranda, Shickel, Rashidi, Bihorac,
Ahmed and Mardini.

<58>
Accession Number
2021935275
Title
Infective endocarditis: Do we have an effective risk score model? A
systematic review.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1093363. Date of Publication: 2023.
Author
Rizzo V.; Salmasi M.Y.; Sabetai M.; Primus C.; Sandoe J.; Lewis M.;
Woldman S.; Athanasiou T.
Institution
(Rizzo, Sabetai) Cardiothoracic Surgery, St. Thomas Hospital, Guy's and St
Thomas' NHS Foundation Trust, London, United Kingdom
(Salmasi, Athanasiou) Department of Cardiothoracic Surgery, Hammersmith
Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
(Primus, Woldman) Specialised Cardiology, St Bartholomew's Hospital, Barts
Health NHS Trust, London, United Kingdom
(Sandoe) Department of Microbiology, Leeds Teaching Hospitals NHS Trust,
Leeds, United Kingdom
(Lewis) Department of Cardiothoracic Surgery, Royal Sussex County
Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton,
United Kingdom
Publisher
Frontiers Media S.A.
Abstract
Background: Infective endocarditis (IE) is a rare, highly morbid condition
with 17% in-hospital mortality. A total of 25-30% require surgery and
there is ongoing debate with regard to markers predicting patient outcomes
and guiding intervention. This systematic review aims to evaluate all IE
risk scores currently available. Method(s): Standard methodology
(PRISMA guideline) was used. Papers with risk score analysis for IE
patients were included, with attention to studies reporting area under the
receiver-operating characteristic curve (AUC/ROC). Qualitative analysis
was carried out, including assessment of validation processes and
comparison of these results to original derivation cohorts where
available. Risk-of-bias analysis illustrated according to PROBAST
guidelines. Result(s): Of 75 articles initially identified, 32 papers
were analyzed for a total of 20 proposed scores (range 66-13,000
patients), 14 of which were specific for IE. The number of variables per
score ranged from 3 to 14 with only 50% including microbiological
variables and 15% including biomarkers. The following scores had good
performance (AUC > 0.8) in studies proposing the score (often the
derivation cohort); however fared poorly when applied to a new cohort:
PALSUSE, DeFeo, ANCLA, RISK-E, EndoSCORE, MELD-XI, COSTA, and SHARPEN.
DeFeo score demonstrated the largest discrepancy with initial AUC of 0.88,
compared to 0.58 when applied to different cohorts. The inflammatory
response in IE has been well documented and CRP has been found to be an
independent predictor for worse outcomes. There is ongoing investigation
on alternate inflammatory biomarkers which may assist in IE management. Of
the scores identified in this review, only three have included a biomarker
as a predictor. Conclusion(s): Despite the variety of available
scores, their development has been limited by small sample size,
retrospective collection of data and short-term outcomes, with lack of
external validation, limiting their transportability. Future population
studies and large comprehensive registries are required to address this
unmet clinical need. Copyright © 2023 Rizzo, Salmasi, Sabetai,
Primus, Sandoe, Lewis, Woldman and Athanasiou.

<59>
Accession Number
2023287895
Title
Effects of Dexmedetomidine on Brain and Inflammatory Outcomes In Pediatric
Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Hashiya M.; Okubo Y.; Kato T.
Institution
(Hashiya) Department of Anesthesiology, National Center for Child Health
and Development, Tokyo, Japan
(Okubo, Kato) Department of Social Medicine, National Center for Child
Health and Development, Tokyo, Japan
Publisher
W.B. Saunders
Abstract
Objective: Dexmedetomidine use decreases adverse neurocognitive outcomes
in adults undergoing cardiovascular surgery, but its effect has been
unclear in children with congenital heart disease. Method(s): The
authors conducted a systematic review using the PubMed, Embase, and
Cochrane Library databases for randomized controlled trials (RCTs) that
compared intravenous dexmedetomidine with normal saline during pediatric
cardiac surgery under anesthesia. Published randomized controlled trials
that evaluated children aged <18 years who underwent congenital heart
surgery were included. Nonrandomized trials, observational studies, case
series and case reports, editorials, reviews, and conference papers were
excluded. The quality of the included studies was assessed using the
Cochrane revised tool for assessing risk-of-bias in randomized trials.
Meta-analysis was performed to estimate the effects of intravenous
dexmedetomidine on brain markers (neuron-specific enolase [NSE], S-100beta
protein) and inflammatory markers (interleukin-6, tumor necrosis factor
[TNF]-alpha, nuclear factor kappa-B [NF-kappaB]) during and after cardiac
surgery, using random-effect models for standardized mean difference
(SMD). Result(s): Seven RCTs involving 579 children were eligible for
the following meta-analyses. Most children underwent cardiac surgery for
atrial or ventricular septum defects. Pooled analyses (5 treatment groups
in 3 RCTs with 260 children) showed that dexmedetomidine use was
associated with reduced serum levels of NSE (pooled SMD, -0.54; 95% CI,
-0.96 to -0.12) and S-100beta (pooled SMD, -0.85; 95% CI, -1.67 to -0.04)
within 24 hours after the surgery. Also, dexmedetomidine use was
associated with reduced levels of interleukin-6 (pooled SMD, -1.55; 95%
CI, -2.82 to -0.27; 4 treatment groups in 2 RCTs with 190 children). In
contrast, the authors observed similar levels of TNF-alpha (pooled SMD,
-0.07; 95% CI, -0.33 to 0.19; 4 treatment groups in 2 RCTs with 190
children) and NF-kappaB (pooled SMD, -0.27; 95% CI, -0.62 to 0.09; 2
treatment groups in 1 RCT with 90 children) between the dexmedetomidine
and control groups. Conclusion(s): The authors' findings support the
effect of dexmedetomidine on reductions in brain markers among children
who undergo cardiac surgery. Further studies would be needed to elucidate
its clinically meaningful effects using cognitive functions in the long
term, and its effects among children who undergo more complex cardiac
surgeries. Copyright © 2023 Elsevier Inc.

<60>
Accession Number
2022363755
Title
Low-Intensity vs. High-Intensity Antithrombotic Therapy After
Transcatheter Aortic Valve Replacement: Meta-Analysis of Randomized
Controlled Trials.
Source
Structural Heart. 7(2) (no pagination), 2023. Article Number: 100133. Date
of Publication: March 2023.
Author
Chakravarty T.; Leong D.; de la Rosa A.; Bhardwaj N.; Makkar R.R.
Institution
(Chakravarty, Leong, de la Rosa, Bhardwaj, Makkar) Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA, United States
Publisher
Cardiovascular Research Foundation
Abstract
Background: The optimal antithrombotic therapy after transcatheter aortic
valve replacement (TAVR) is controversial. We performed a systematic
review and meta-analysis of randomized controlled trials comparing
high-intensity vs. low-intensity antithrombotic therapy after TAVR in the
absence of an established indication for anticoagulation. Method(s):
The primary efficacy and safety endpoints were a composite of death or
thromboembolic events and Valve Academic Research Consortium 2-defined
significant bleeding, respectively. All analyses were by intention to
treat. Risk ratios (RRs) were calculated using the inverse variance
random-effects model. Result(s): Four studies comprising 3358
patients (mean age 81 years, mean Society of Thoracic Surgery score 3.3%)
were identified. Two studies compared anticoagulation vs. antiplatelet
therapy after TAVR; the other 2 trials compared dual-antiplatelet therapy
vs. mono-antiplatelet therapy after TAVR. The incidence of death or
thromboembolic events (RR 0.66 [95% confidence interval (CI) 0.55-0.80], p
< 0.0001, I2 = 0%), death (RR 0.68 [95% CI 0.51-0.92],
I2 = 11%, p = 0.01), and Valve Academic Research Consortium
2-defined major bleeding (RR 0.69 [95% CI 0.48 - 1.00], p = 0.003,
I2 = 44%) was significantly lower in patients on low-intensity
antithrombotic therapy than in those on high-intensity antithrombotic
therapy. Conclusion(s): In an elderly patient population undergoing
TAVR, routine initiation of a high-intensity antithrombotic therapy in the
absence of a clinical indication for anticoagulation was associated with
increased risk of death or thromboembolic complications, increased risk of
death, and increased risk of significant bleeding. Routine initiation of
an anticoagulation therapy or dual-antiplatelet therapy after TAVR in the
absence of an established indication for anticoagulation may not be
advisable. Copyright © 2022

<61>
Accession Number
2022062308
Title
A sealant with a hemostatic mechanism independent of the blood coagulation
function was effective in both elective and emergency surgery for thoracic
aorta.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2023. Date
of Publication: 2023.
Author
Morita S.; Yaku H.
Institution
(Morita) Department of Cardiovascular Surgery, National Hospital
Organization Kyushu Medical Center, Fukuoka, Fukuoka 810-8563, Japan
(Yaku) Department of Cardiovascular Surgery, Kyoto Prefectural University
of Medicine, Kyoto, Japan
Publisher
Springer
Abstract
Objectives: Matsudaito is a unique surgical sealant with a powerful
hemostatic effect that works independent of a patient's blood coagulation
function. Because of its mechanism, this sealant is expected to be
particularly useful in patients with a poor blood coagulation function,
such as in cases of acute aortic syndrome requiring emergency surgery. We,
therefore, evaluated the hemostatic static effect of the sealant in both
emergency and elective surgery of the thoracic aorta. Method(s): We
used data obtained from post-marketing surveillance of the sealant.
Patients who underwent replacement of the thoracic aorta were enrolled.
The hemostatic effect was evaluated as effective if a further hemostatic
procedure was not performed after applying the sealant. Result(s):
From 46 hospitals in Japan, a total of 542 patients (327 elective and 215
emergency cases) were enrolled. Hospital mortality was 4.0% and 11.6% in
elective and emergency cases, respectively (p < 0.05). Among the 1039
anastomoses (609 elective and 430 emergency cases), effective hemostasis
was confirmed in 436 (71.6%) elective and 259 (60.2%) emergency cases. The
data from the clinical trial of the sealant showed a hemostatic rate of
44.4% in elective control cases without the sealant. Conclusion(s):
Given that the hemostatic rate in emergency surgery with the sealant
seemed to be better than that in elective surgery without the sealant
(determined from the clinical trial), we concluded that the sealant was
effective in both emergency and elective thoracic surgery of the
aorta. Copyright © 2023, The Author(s).

<62>
Accession Number
2021196083
Title
Impact of Paravalvular Leak on Outcomes After Transcatheter Aortic Valve
Implantation: Meta-Analysis of Kaplan-Meier-derived Individual Patient
Data.
Source
Structural Heart. 7(2) (no pagination), 2023. Article Number: 100118. Date
of Publication: March 2023.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Tasoudis P.; Erten O.; Sicouri
S.; Macedo F.Y.; Pasala T.; Kaple R.; Weymann A.; Ruhparwar A.; Clavel
M.-A.; Pibarot P.; Ramlawi B.
Institution
(Sa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau Heart
Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Sa, Tasoudis, Erten, Sicouri, Ramlawi) Department of Cardiothoracic
Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA,
United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Macedo, Pasala, Kaple) Division of Structural Heart Disease, Department
of Medicine, Hackensack University Medical Center, Hackensack, NJ, United
States
(Weymann, Ruhparwar) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University of Duisburg-Essen, Essen, Germany
(Clavel, Pibarot) Quebec Heart & Lung Institute, Universite Laval, Quebec
City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Faculty of Medicine, Universite
Laval, Quebec City, Quebec, Canada
Publisher
Cardiovascular Research Foundation
Abstract
Background: Paravalvular leak (PVL) after transcatheter aortic valve
implantation (TAVI) is frequent and the impact of mild PVL on outcomes
remains uncertain. Our study aimed to evaluate the impact of PVL on TAVI
outcomes. Method(s): To analyze late outcomes of patients after TAVI
according to the presence and severity of PVL, PubMed/MEDLINE, EMBASE and
Google Scholar were searched for studies that reported rates of all-cause
mortality/survival and/or rehospitalization and/or cardiovascular
mortality accompanied by at least one Kaplan-Meier curve for any of these
outcomes. We adopted a 2-stage approach to reconstruct individual patient
data based on the published Kaplan-Meier graphs. Result(s):
Thirty-eight studies with Kaplan-Meier curves met our eligibility criteria
including over 25,000 patients. Patients with any degree of PVL after TAVI
had a significantly higher risk of overall mortality (hazard ratio (HR),
1.52; 95% confidence interval (CI), 1.43-1.61; p < 0.001),
rehospitalization (HR, 1.81; 95% CI, 1.54-2.12; p < 0.001), and
cardiovascular mortality (HR, 1.52; 95% CI, 1.33-1.75; p < 0.001) over
time. These findings remained consistent when we stratified the results
for the methods of assessment of PVL (i.e., echocardiography vs.
angiography) and PVL severity. Both moderate/severe PVL and mild PVL were
associated with increased risk of overall mortality (p < 0.001),
rehospitalization (p < 0.001), and cardiovascular mortality (p < 0.001)
during follow-up. Conclusion(s): Patients with PVL, even if mild,
experience higher risk of all-cause mortality, rehospitalization, and
cardiovascular mortality following TAVI. These findings provide support to
the implementation of procedural strategies to prevent any degree of PVL
at the time of TAVI. Copyright © 2022 The Author(s)

<63>
Accession Number
640548875
Title
The effect of rewarming on hemodynamic parameters and arterial blood gases
of patients after open-heart surgery: A randomized controlled trial.
Source
Journal of vascular nursing : official publication of the Society for
Peripheral Vascular Nursing. 41(1) (pp 29-35), 2023. Date of Publication:
01 Mar 2023.
Author
Haji-Jafari S.; Rezaei M.; Azizi-Fini I.; Tafti S.H.A.; Atoof F.
Institution
(Haji-Jafari, Rezaei) Trauma Nursing Research Center, Kashan University of
Medical Sciences, Iran, Islamic Republic of
(Azizi-Fini) Trauma Nursing Research Center, Kashan University of Medical
Sciences, Iran, Islamic Republic of
(Tafti) Research Center for Advanced Technologies in Cardiovascular
Medicine, Tehran Heart Center, Tehran University of Medical Sciences,
Iran, Islamic Republic of
(Atoof) Faculty of Health, Kashan University of Medical Sciences, Iran,
Islamic Republic of
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Hypothermia after open-heart surgery can have potential side
effects for patients. AIM: This study aimed to examine the effects of
rewarming on patients' hemodynamic and arterial blood gases parameters
after open-heart surgery. METHOD(S): This randomized controlled trial
was performed in 2019 on 80 patients undergoing open-heart surgery at
Tehran Heart Center, Iran. The subjects were consecutively recruited and
randomly assigned to an intervention group (n=40) and a control group
(n=40). After the surgery, the intervention group was warmed with an
electric warming mattress while the control group warmed using a simple
hospital blanket. The hemodynamic parameters of the two groups were
measured 6 times and arterial blood gas was measured 3 times. Data were
analyzed by independent samples t and Chi-squared tests, and repeated
measures analysis. RESULT(S): Before the intervention, the two groups
did not significantly differ in terms of hemodynamic and blood gas
parameters. However, the two groups were significantly different in the
mean heart rate, systolic blood pressure, diastolic blood pressure, mean
arterial blood pressure, temperature, right and left lung drainage in the
first half-hour, and the first to fourth hours after the intervention (p <
0.05). Furthermore, there was a significant difference between the mean
arterial oxygen pressure of the two groups during and after rewarming (P
<0.05). CONCLUSION(S): Rewarming of patients after open-heart surgery
can significantly affect hemodynamic and arterial blood gas parameters.
Therefore, rewarming methods can be used safely to improve the patients'
hemodynamic parameters after open-heart surgery. Copyright ©
2023. Published by Elsevier Inc.

<64>
Accession Number
2023310847
Title
Ultrasound-Guided Rhomboid Block versus Paravertebral Block in
Postoperative Analgesia for Video-Assisted Thoracoscopic Surgery: A
Prospective Randomized Controlled Clinical Trial.
Source
Pain Research and Management. 2023 (no pagination), 2023. Article Number:
3924511. Date of Publication: 2023.
Author
Wang Y.; Gu X.; Huang S.; Shi M.; He X.; Ma Z.
Institution
(Wang, Gu, Ma) Department of Anesthesiology, Nanjing Drum Tower Hospital
Clinical College of Nanjing Medical University, Nanjing, China
(Huang) Nanjing Drum Tower Hospital Clinical College of Nanjing Medical
University, Nanjing, China
(Shi, He) Department of Thoracic Surgery, Nanjing Drum Tower Hospital
Clinical College of Nanjing Medical University, Nanjing, China
Publisher
Hindawi Limited
Abstract
Introduction. The anesthetic efficacy of the ultrasound-guided rhomboid
intercostal block (RIB) in alleviating postoperative pain has been well
concerned. This study aims to compare the effectiveness between
ultrasound-guided RIB and paravertebral block (PVB) in alleviating acute
pain following video-assisted thoracic surgery. Methods. It was a
prospective, randomized, double-blinded clinical trial involving 132
patients with video-assisted thoracic surgery divided into three groups:
the general anesthesia (GA) group, RIB group, and PVB group on T5
vertebra, using 0.4% ropivacaine at 3 mg/kg, registered in the Chinese
Clinical Trial Registry (ChiCTR2100054057, "https://www.chictr.org.cn").
The visual analogue scale (VAS) scores at rest and cough during 48 h
postoperatively and the postoperative consumption of pain rescue were the
primary outcomes, and the QoR15 score 48 h postoperatively, the usage of
opioids during and after operation, and nerve block-related complications
were the secondary outcomes. Demographic characteristics, surgery
characteristics, and primary outcomes between the groups were compared.
Results. A total of 120 eligible patients were recruited, including 40 in
each group. Baseline and surgery characteristics between the groups were
comparable (all p>0.05). The PVB and RIB groups were better than the GA
group in the primary and secondary outcomes (p<0.05). The static VAS
score, QoR15 score, and block-related complications within 48 hours after
surgery were better in the RIB group than in the PVB group (p<0.001).
Conclusion. Both PVB and RIB can provide adequate analgesia and accelerate
the recovery of patients. Compared with PVB, RIB has a better analgesic
effect, especially to avoid paravertebral pain caused by block, and the
operation of RIB is more straightforward and the safety is higher.
 Copyright © 2023 Yan Wang et al.

<65>
Accession Number
640558374
Title
CGA AND RELATED INTERVENTIONS TO IMPROVE OUTCOMES FOR OLDER PATIENTS
UNDERGOING TRANSCATHETER AORTIC VALVE IMPLANTATION.
Source
Age and Ageing. Conference: British Geriatrics Society Autumn Meeting.
Online. 52(Supplement 1) (pp i2-i3), 2023. Date of Publication: January
2023.
Author
Jones R.; Lester E.; Schiff R.
Institution
(Jones, Lester, Schiff) Department of Ageing and Health, Guys and St
Thomas' Nhs Foundation Trust, London SE1 7EH, United Kingdom
Publisher
Oxford University Press
Abstract
Introduction The number of transcatheter aortic valve implantations
(TAVIs) performed in the UK is increasing exponentially, providing a new
treatment avenue for patients with severe symptomatic aortic stenosis
previously deemed too frail for surgical intervention. Frailty is known to
be associated with poor outcomes following TAVI, however little is known
as to whether comprehensive geriatric assessment (CGA), the gold standard
intervention for older adults in a range of clinical settings, can change
outcomes for older adults undergoing this procedure. Methods Databases
EMBASE, MEDLINE, CINAHL and Cochrane CENTRAL, along with the World Health
Organisation clinical trials registry platform and Clinicaltrials.gov
registry were searched for relevant reports between 01/01/1980 -
26/01/2022 using a pre-specified search strategy. Patients had to be 65 or
over and studies had to evaluate single- or multi-domain interventions
that may form part of a CGA. Studies were not limited to those only
looking at patients living with or at risk of frailty. Results No studies
of adequate quality evaluated the effect of CGA on outcomes for older
adults undergoing TAVI. 18 studies evaluating CGA-related interventions
were identified that met eligibility criteria, with the majority
evaluating cardiac rehabilitation (CR) as a post-procedural intervention.
Other interventions evaluated included cognitive behavioural therapy,
alternative exercise-based interventions and post-procedural protocols
that promoted early mobilisation and allied health professional
involvement. A high risk of bias and significant methodological flaws were
found in the included studies. There was little evidence that
post-procedural CR reduces mortality and to support the role of
occupational and physical therapy for improving in-hospital outcomes for
these patients. Conclusion(s) There is no convincing evidence to support
CGA or related single domain interventions to improve outcomes for older
adults undergoing TAVI. Further robust research is required to establish
whether CGA improves outcomes for this group.

<66>
Accession Number
640558312
Title
British Geriatrics Society Abstracts from the Autumn Meeting.
Source
Age and Ageing. Conference: British Geriatrics Society Autumn Meeting.
Online. 52(Supplement 1) (no pagination), 2023. Date of Publication:
January 2023.
Author
Anonymous
Publisher
Oxford University Press
Abstract
The proceedings contain 115 papers. The topics discussed include:
identifying Scotland's care home population living with dementia - is data
linkage useful?; understanding pathways into care homes using data (the
UNPICD study); the oxford cognitive comorbidity and ageing research
database (orchard): description of a large acute care research database;
effect of balance training after hip fracture surgery: a systematic review
of randomized controlled studies; sleep deprivation induces ageing-like
changes in antigravity muscles of young adult male Wistar rats;
feasibility of a pharmacist-led intervention for atrial fibrillation in
long-term care: the PIVOTALL study; co-morbidity, frailty and ejection
fraction in older heart failure inpatients; CGA and related interventions
to improve outcomes for older patients undergoing transcatheter aortic
valve implantation; and development of a competency framework for early
career nurses undertaking post-registration education in care for older
people.

<67>
Accession Number
2022041363
Title
Evidence-based health policy in Germany: lack of communication and
coordination between academia and health authorities?.
Source
Systematic Reviews. 12(1) (no pagination), 2023. Article Number: 36. Date
of Publication: December 2023.
Author
Kugler C.M.; Perleth M.; Mathes T.; Goossen K.; Pieper D.
Institution
(Kugler, Pieper) Faculty of Health Sciences Brandenburg, Brandenburg
Medical School (Theodor Fontane), Institute for Health Services and Health
System Research, Seebad 82/83, Rudersdorf bei Berlin 15562, Germany
(Kugler, Pieper) Center for Health Services Research, Brandenburg Medical
School (Theodor Fontane), Seebad 82/83, Rudersdorf bei Berlin 15562,
Germany
(Perleth) Federal Joint Committee (G-BA), Gutenbergstrase 13, Berlin
10587, Germany
(Mathes) Department of Medical Statistics, University Medical Center
Gottingen, Humboldtallee 32, Gottingen 37073, Germany
(Goossen) Witten/Herdecke University, Institute for Research in Operative
Medicine, Ostmerheimer Strase 200, Haus 38, Koln 51109, Germany
Publisher
BioMed Central Ltd
Abstract
Health-care decision making should consider the best available evidence,
often in the form of systematic reviews (SRs). The number of existing SRs
and their overlap make their identification and use difficult. Decision
makers often rely on de novo SRs instead of using existing SRs. We
describe two cases of duplicate reviews (minimum volume threshold of total
knee arthroplasties and lung cancer screening) and one case of duplicate
primary data analysis (transcatheter aortic valve implantation). All cases
have in common that unintended duplication of research occurred between
health authorities and academia, demonstrating a lack of communication and
coordination between them. It is important to note that academia and
health authorities have different incentives. Academics are often measured
by the number of peer-reviewed publications and grants awarded. In
contrast, health authorities must comply with laws and are commissioned to
deliver a specific report within a defined period of time. Most
replication is currently unintended. A solution may be the collaboration
of stakeholders commonly referred to as integrated knowledge translation
(IKT). The IKT approach means that research is conducted in collaboration
with the end users of the research. It requires active collaborations
between researchers and decision-makers or knowledge users (clinicians,
managers, policy makers) throughout the research process. Wherever
cooperation is possible in spite of requirements for independence or
confidentiality, legal regulations should facilitate and support
collaborative approaches between academia and health
authorities. Copyright © 2023, The Author(s).

<68>
Accession Number
2022041099
Title
Safety and efficacy of direct oral anticoagulants in bioprosthetic valves:
A systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1099591. Date of Publication: 2023.
Author
Bakr L.; Elsayed A.; Saleh O.; Abdalraouf M.; Ng G.A.; Ibrahim M.
Institution
(Bakr) The Royal College of Surgeons of England, London, United Kingdom
(Elsayed) Liverpool University Hospitals NHS Foundation Trust, Liverpool,
United Kingdom
(Elsayed) NHS, Health Education England - North West (HEENW), Manchester,
United Kingdom
(Saleh) Suez Canal University Hospital, Ismailia, Egypt
(Abdalraouf) Sheikh Zayed Specialized Hospital, Giza, Egypt
(Ng, Ibrahim) Glenfield Hospital, University Hospitals of Leicester NHS
Trust (UHL), Leicester, United Kingdom
(Ng) Department of Cardiovascular Sciences, University of Leicester,
National Institute for Health Research Leicester Biomedical Research
Center, Leicester, United Kingdom
(Ibrahim) Department of Cardiology, Ain Shams University, Cairo, Egypt
Publisher
Frontiers Media S.A.
Abstract
Background: Direct oral anticoagulants are efficient alternatives to
vitamin K antagonists. There is little evidence regarding their use in
patients who underwent bioprosthetic valve replacement whether surgically
or through a transcatheter approach and have another indication of
anticoagulation. Trials have compared different members of the DOACs
family to VKAs and showed that they were at least non-inferior to VKAs
with regard to safety and efficacy. However, this is still controversial.
Our meta-analysis aims at providing a clearer view of their future use in
this subgroup of patients. Method(s): PubMed and Cochrane were
searched for randomised clinical trials and observational studies.
Bleeding, stroke, and all-cause mortality were the outcomes of interest.
 Result(s): Ten papers with a total of 4,088 patients were included.
Our meta-analysis revealed no significant differences between the
incidence of bleeding between DOACs and warfarin (16% vs. 17%, OR = 0.94,
95% CI [0.56-1.57], p = 0.81, I2 = 81%). No statistical
difference was found in stroke between both groups (2.5% vs. 3.3%, OR =
0.75, 95% CI [0.41-1.38], p = 0.36, I2 = 35%). All-cause
mortality was not statistically significant between both groups (9.2% vs.
13.7%, OR = 0.85, 95% CI [0.68-1.07], p = 0.16, I2 = 56%).
Interestingly, subgroup analysis of randomised controlled trials and
prospective studies favoured DOACs with lower risks of both bleeding and
stroke. Conclusion(s): Direct oral anticoagulants appear to be at
least as safe and effective as VKAs in patients with bioprosthetic valves
and another indication of anticoagulation. There could be potential
benefit from the use of DOACs; however, further evidence is required.
Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021222146,
identifier CRD42021222146. Copyright © 2023 Bakr, Elsayed, Saleh,
Abdalraouf, Ng and Ibrahim.

<69>
Accession Number
2022031163
Title
Perioperative lidocaine and dexmedetomidine intravenous infusion reduce
the serum levels of NETs and biomarkers of tumor metastasis in lung cancer
patients: A prospective, single-center, double-blinded, randomized
clinical trial.
Source
Frontiers in Oncology. 13 (no pagination), 2023. Article Number: 1101449.
Date of Publication: 2023.
Author
Ren B.; Cheng M.; Liu C.; Zheng H.; Zhang J.; Chen W.; Song J.; Zhuang J.;
Liu T.; Wang R.; Wang Z.
Institution
(Ren, Liu, Zheng, Zhang, Chen, Song, Liu, Wang, Wang) Department of
Anesthesiology, The Affiliated Hospital of Xuzhou Medical University,
Xuzhou, China
(Ren, Liu, Zheng, Zhang, Chen, Song, Liu, Wang, Wang) Jiangsu Province Key
Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
(Cheng) Department of Anesthesiology, Xinhua Hospital Affiliated to
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Zhuang) Department of Anesthesiology, The First People's Hospital of
Changde City, Changde, China
Publisher
Frontiers Media S.A.
Abstract
Background: Neutrophil extracellular traps (NETs) can enhance the
metastasis of non-small cell lung cancer (NSCLC). As biomarkers of tumor
metastasis, metalloproteinases (MMPs) and vascular endothelial growth
factor (VEGF) together with NETs are essential to
endothelial-to-mesenchymal transition (EMT). We hypothesized that
intravenous infusion of lidocaine and dexmedetomidine could reduce the
production of NETs and biomarkers of tumor metastasis after video-assisted
thoracic surgery (VATS) in NSCLC patients. Method(s): The trial
included 132 NSCLC patients undergoing VATS. The patients were equally
randomized to a placebo group (Group C), a lidocaine group (Group L,
intravenous lidocaine 8 mg/kg/h for 15 minutes before anesthesia, 2
mg/kg/h during surgery, and 1 mg/kg/h until 24 hours after surgery), a
dexmedetomidine group (Group D, intravenous dexmedetomidine 2 mug/kg/h for
15 minutes before anesthesia, 0.5 mug/kg/h during surgery, and 0.25
mug/kg/h until 24 hours after surgery), and a dexmedetomidine plus
lidocaine group (Group LD, combination use of lidocaine and
dexmedetomidine). The primary outcome was the production of
myeloperoxidase (MPO) and citrullinated histone-3 (H3Cit), biomarkers of
NETs, on postoperative day (POD) 1. MMP-3, MMP-9, and VEGF-alpha, as
biomarkers of tumor metastasis, were also evaluated on POD 1.
 Result(s): The baseline patient characteristics and perioperative
data did not differ between the study groups. MPO was significantly
decreased in Groups L, D, and LD (-197.08 +/- 34.01, -137.37 +/- 32.41,
and -189.45 +/- 33.73 U/ml, P<0.001, respectively) compared with Group C
(-106.51 +/- 25.44 U/ml). H3Cit was also lessened in Groups L, D, and LD
(-49.51 +/- 9.11, -34.80 +/- 10.37, and -51.82 +/- 8.98 ng/ml, P<0.001,
respectively) compared with Group C (-24.73 +/- 7.65 ng/ml). Lidocaine and
dexmedetomidine also reduced MMP-3 (-69.08 +/- 13.22, -52.84 +/- 13.78,
-85.34 +/- 12.59 vs. -40.55 +/- 10.71 ng/ml in Group L, D, LD vs. Group C,
P<0.001, respectively), MMP-9 (-8.46 +/- 1.68, -6.07 +/- 1.82, -9.67 +/-
1.43 vs. -4.28 +/- 1.29 ng/ml in Group L, D, LD vs. Group C, P<0.001,
respectively), and VEGF-alpha (-95.55 +/- 22.53, -71.65 +/- 18.77, -104.89
+/- 15.49 vs. -51.73 +/- 16.27 pg/ml in Group L, D, LD vs. Group C,
P<0.001, respectively) on POD 1. Conclusion(s): In NSCLC patients,
continuous perioperative intravenous infusion of lidocaine and
dexmedetomidine significantly reduced the production of NETs and tumor
metastasis biomarkers on POD 1. Meanwhile, it also decreased inflammation,
protected cellular immune function, reduced pain and opioid consumption,
and improved the quality of postoperative recovery. Clinical trial
registration: chictr.org.cn, identifier: 187049. Copyright © 2023
Ren, Cheng, Liu, Zheng, Zhang, Chen, Song, Zhuang, Liu, Wang and Wang.

<70>
Accession Number
2021719360
Title
Comparing Vitamin K Antagonists and Direct Oral Anticoagulants in Patients
With Atrial Fibrillation Undergoing Transcatheter Aortic Valve
Replacement: A Meta-Analysis.
Source
Clinical and Applied Thrombosis/Hemostasis. 29 (no pagination), 2023. Date
of Publication: January-December 2023.
Author
Lee W.-C.; Shih J.-Y.; Fang H.-Y.; Wu P.-J.; Fang C.-Y.; Chen H.-C.; Fang
Y.-N.; Chang W.-T.; Chen M.-C.
Institution
(Lee, Chang) Institute of Clinical Medicine, College of Medicine, National
Cheng Kung University, Tainan, Taiwan (Republic of China)
(Lee, Shih, Chang) Division of Cardiology, Department of Internal
Medicine, Chi Mei Medical Center, Tainan, Taiwan (Republic of China)
(Lee) School of Medicine, College of Medicine, National Sun Yat-sen
University, Tainan, Taiwan (Republic of China)
(Fang, Wu, Fang, Chen, Fang, Chen) Division of Cardiology, Department of
Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung
University College of Medicine, Kaohsiung, Taiwan (Republic of China)
Publisher
SAGE Publications Inc.
Abstract
Aortic stenosis (AS) is the most prevalent valvular disease in the elderly
population and the prevalence of atrial fibrillation (AF) increases in the
elderly population. Transcatheter aortic valve replacement (TAVR) becomes
an important treatment for patients with AS at high surgical risk. This
metanalysis aimed to compare the efficacy and safety of vitamin K
antagonists (VKAs) and direct oral anticoagulants (DOACs) in patients with
AF undergoing TAVR. We searched the different databases for articles
published before January 31, 2022. In total, 7 studies including 25,255
patients were analyzed. Data on demographics, comorbidities, CHA2DS2-VASc
score, Society of Thoracic Surgeons (STS) score, and incidences of
all-cause mortality, major bleeding, intracranial hemorrhage (ICH),
stroke, and thromboembolic events were obtained and analyzed. The VKA
group had a lower CHA2DS2-VASc score (3.2 +/- 1.2 vs 3.3 +/- 1.2; P <.001)
and a higher STS score (6.6 +/- 3.2 vs 6.1 +/- 2.9; P <.001) than the DOAC
group. The risks of all-cause mortality (odds ratio [OR]: 0.88; 95%
confidence interval [CI], 0.67-1.16), ischemic stroke (OR: 1.06; 95% CI,
0.90-1.24), and thromboembolism (OR: 1.24; 95% CI, 0.63-2.47) in the DOAC
group were comparable to the VKA group. The risks of major bleeding (OR:
0.77; 95% CI, 0.71-0.84) and ICH (OR: 0.62; 95% CI, 0.42-0.90) were lower
in the DOAC group compared to the VKA group. DOACs were associated with
lower risks of major bleeding and ICH, and comparable risks of all-cause
mortality, ischemic stroke, and thromboembolism in patients with AF
undergoing TAVR compared to VKAs. Copyright © The Author(s) 2023.

<71>
Accession Number
640577255
Title
A commentary on 'A comparison of regional anesthesia techniques in
patients undergoing video-assisted thoracic surgery: A network
meta-analysis'.
Source
International journal of surgery (London, England). (no pagination),
2023. Date of Publication: 14 Mar 2023.
Author
Zhao Y.; Cheng C.; Jiao X.; Guo L.
Institution
(Zhao, Guo) Department of Anesthesiology
(Cheng, Jiao) Intensive Care Unit, Shanxi Province Cancer Hospital, Shanxi
Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical
Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Shanxi
Province, Taiyuan, China
Publisher
NLM (Medline)

<72>
Accession Number
640576371
Title
The Thresholds of Caprini Score Associated With Increased Risk of Venous
Thromboembolism Across Different Specialties: A Systematic Review.
Source
Annals of surgery. (no pagination), 2023. Date of Publication: 13 Mar
2023.
Author
Lobastov K.; Urbanek T.; Stepanov E.; Lal B.K.; Marangoni J.; Krauss E.S.;
Cronin M.; Dengler N.; Segal A.; Welch H.; Gianesini S.; Chen X.; Caprini
J.
Institution
(Lobastov, Stepanov) Pirogov Russian National Research Medical University,
Moscow, Russian Federation
(Urbanek) Medical University of Silesia, Katowice, Poland
(Lal) University of Maryland School of Medicine, Baltimore, United States
(Marangoni) Legacy Good Samaritan Medical Center, Portland, United States
(Krauss, Cronin, Dengler, Segal) Department of Orthopaedic Surgery,
Syosset Hospital, Northwell Health, Syosset, NY, United States
(Welch) Division of Vascular Surgery, Lahey Hospital and Medical Center,
Burlington, United States
(Gianesini) University of Ferrara, Ferrara, Italy
(Chen) Department of Respiratory and Critical Care Medicine, Beijing
Shijitan Hospital, Capital Medical University, Beijing, China
(Caprini) Pritzker School of Medicine, Chicago, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Estimation of the specific thresholds of the Caprini risk score
(CRS) that are associated with the increased incidence of venous
thromboembolism (VTE) across different specialties, including identifying
the highest level of risk. BACKGROUND: Accurate risk assessment remains an
important but often challenging aspect of VTE prophylaxis. One
well-established risk assessment model is CRS, which has been validated in
thousands of patients from many different medical and surgical
specialties. METHOD(S): A search of MEDLINE and the Cochrane Library
was performed in March 2022. Manuscripts that reported on 1) patients
admitted to medical or surgical departments and 2) had their VTE risk
assessed by CRS and 3) reported on the correlation between the score and
VTE incidence, were included in the analysis. RESULT(S): A total of
4562 references were identified, and the full text of 202 papers was
assessed for eligibility. The correlation between CRS and VTE incidence
was reported in 68 studies that enrolled 4,207,895 patients. In all
specialties, a significant increase in VTE incidence was observed in
patients with a CRS of >=5. In most specialties thresholds of >=7, >=9,
and >=11-12 were associated with dramatically increased incidences of VTE.
In COVID-19, cancer, trauma, vascular, general, head and neck, and
thoracic surgery patients with >=9 and >=11-12 scores the VTE incidence
was extremely high (ranging from 13% to 47%). CONCLUSION(S): The
Caprini score is being used increasingly to predict VTE in many medical
and surgical specialties. In most cases the VTE risk for individual
patients increases dramatically at a threshold CRS of 7-11. Copyright
© 2023 Wolters Kluwer Health, Inc. All rights reserved.

<73>
Accession Number
2023349688
Title
A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EVALUATION OF THE CORRELATION
BETWEEN THE VARIOUS PARAMETERS MONITORED DURING CARDIOTHORACIC SURGERY,
VARIOUS DRUGS, AND POST-OPERATIVE RECOVERY.
Source
Acta Medica Mediterranea. 39(2) (pp 535-544), 2023. Date of Publication:
2023.
Author
Lu G.; Guo Y.; Zhang H.
Institution
(Lu, Guo, Zhang) School of Nursing, Anhui Medical University, Anhui, Hefei
230601, China
(Lu, Guo, Zhang) Anhui Vocational College of City Management, Anhui, Hefei
230601, China
Publisher
A. CARBONE Editore
Abstract
Purpose: To evaluate the correlation between different physiological
parameters monitored and optimized during cardiothoracic surgical nursing,
like the mean arterial pressure, ECG, temperature, respiratory rate, blood
pressure, fluid balance, heart rate, cardiac rhythm, respiratory rate,
central venous oxygen saturation (Svo2), hemodynamic parameters, and left
ventricular ejection fraction of the patients, and the usage of supporting
drugs like corticosteroids, muscle relaxants, and small ribonucleic
acid-based drugs with the fast and healthy recovery of patients.
 Method(s): Electronic searches were conducted in PubMed, MEDLINE,
CENTRAL databases, and the Cochrane Library from 2000 to 2022 using the
appropriate keywords as per the PRISMA guidelines. Demographic summary and
event data for the success rate of monitoring and optimization of
different physiological parameters and effects of drugs in both
experimental and control groups were extracted from the included studies
and meta-analysis was performed using the RevMan software. Result(s):
Twelve studies with a total of 1989 patients who underwent cardiothoracic
surgery were meta-analyzed. Meta-analysis provides the pooled odds ratio
(OR) value of 1.24 (95% CI 1.01-1.53) with heterogenous results of a Tau2
value of 0.08, a chi2 value of 28.06, a df value of 11, an I2 value of
61%, the Z value of 2.01, and a p-value less than 0.05. Similarly, the
pooled relative risk value of 1.11 (95% CI 1.0-1.23) and heterogeneity of
the Tau2 value of 0.02, Chi2 value of 26.03, DF value of 11, I2 value of
58%, Z value of 2.01, and p-value less than 0.05 are comparable.
 Conclusion(s): The present meta-analysis showed that the close
monitoring and optimization of different physiological parameters and the
use of supportive drugs are highly beneficial for the fast and healthy
recovery of cardiothoracic surgery patients. Copyright © 2023 by
the authors.

<74>
Accession Number
2022039499
Title
Effect of Preoperative Administration of Intravenous Ferric Carboxymaltose
in Patients with Iron Deficiency Anemia after Off-Pump Coronary Artery
Bypass Grafting: A Randomized Controlled Trial.
Source
Journal of Clinical Medicine. 12(5) (no pagination), 2023. Article Number:
1737. Date of Publication: March 2023.
Author
Kim H.-H.; Park E.H.; Lee S.H.; Yoo K.-J.; Youn Y.-N.
Institution
(Kim) Department of Cardiothoracic Surgery, Ilsan Hospital, National
Health Insurance Service, Goyang-si 10444, South Korea
(Park, Lee, Yoo, Youn) Division of Cardiovascular Surgery, Severance
Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei
University Health System, Seoul 03722, South Korea
Publisher
MDPI
Abstract
Patients scheduled for cardiac surgery often have anemia and iron
deficiency. We investigated the effect of the preoperative administration
of intravenous ferric carboxymaltose (IVFC) in patients with iron
deficiency anemia (IDA) who were due to undergo off-pump coronary artery
bypass grafting (OPCAB). Patients who were due to undergo elective OPCAB
between February 2019 and March 2022 who had IDA (n = 86) were included in
this single center, randomized, parallel-group controlled study. The
participants were randomly assigned (1:1) to receive either IVFC or
placebo treatment. Postoperative hematologic parameters [hemoglobin (Hb),
hematocrit, serum iron concentration, total iron-binding capacity,
transferrin saturation, transferrin concentration, and ferritin
concentration] and the changes in these parameters during the follow-up
period were the primary and secondary outcomes, respectively. The tertiary
endpoints were early clinical outcomes, such as the volume of mediastinal
drainage and the need for blood transfusions. IVFC treatment significantly
reduced the need for red blood cell (RBC) and platelet transfusions.
Despite receiving fewer RBC transfusions, patients in the treatment group
had higher levels of Hb, hematocrit, and serum iron and ferritin
concentrations during weeks 1 and 12 after surgery. No serious adverse
events occurred during the study period. Preoperative IVFC treatment in
patients with IDA undergoing OPCAB improved the values of the hematologic
parameters and iron bioavailability. Therefore, is a useful strategy for
stabilizing patients prior to OPCAB. Copyright © 2023 by the
authors.

<75>
Accession Number
2022039316
Title
Systematic Review and Meta-Analysis of Efficiency and Safety of
Double-Lumen Tube and Bronchial Blocker for One-Lung Ventilation.
Source
Journal of Clinical Medicine. 12(5) (no pagination), 2023. Article Number:
1877. Date of Publication: March 2023.
Author
Palaczynski P.; Misiolek H.; Szarpak L.; Smereka J.; Pruc M.; Rydel M.;
Czyzewski D.; Bialka S.
Institution
(Palaczynski, Misiolek, Bialka) Department of Anaesthesiology and
Intensive Care, Faculty of Medical Sciences in Zabrze, Medical University
of Silesia, Zabrze 41-800, Poland
(Szarpak) Henry JN Taub Department of Emergency Medicine, Baylor College
of Medicine, Houston, TX 77030, United States
(Szarpak) Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center,
Bialystok 15-027, Poland
(Smereka) Department of Emergency Medical Service, Wroclaw Medical
University, Wroclaw 51-616, Poland
(Pruc) Research Unit, Polish Society of Disaster Medicine, Warsaw 05-806,
Poland
(Rydel, Czyzewski) Department of Thoracic Surgery, Faculty of Medical
Sciences in Zabrze, Medical University of Silesia, Zabrze 41-800, Poland
Publisher
MDPI
Abstract
One-lung ventilation is also used in some thoracic or cardiac surgery,
vascular surgery and oesophageal procedures. We conducted a search of the
literature for relevant studies in PubMed, Web of Science, Embase, Scopus
and Cochrane Library. The final literature search was performed on 10
December 2022. Primary outcomes included the quality of lung collapse.
Secondary outcome measures included: the success of the first intubation
attempt, malposition rate, time for device placement, lung collapse and
adverse events occurrence. Twenty-five studies with 1636 patients were
included. Excellent lung collapse among DLT and BB groups was 72.4% vs.
73.4%, respectively (OR = 1.20; 95%CI: 0.84 to 1.72; p = 0.31). The
malposition rate was 25.3% vs. 31.9%, respectively (OR = 0.66; 95%CI: 0.49
to 0.88; p = 0.004). The use of DLT compared to BB was associated with a
higher risk of hypoxemia (13.5% vs. 6.0%, respectively; OR = 2.27; 95%CI:
1.14 to 4.49; p = 0.02), hoarseness (25.2% vs. 13.0%; OR = 2.30; 95%CI:
1.39 to 3.82; p = 0.001), sore throat (40.3% vs. 23.3%; OR = 2.30; 95%CI:
1.68 to 3.14; p < 0.001), and bronchus/carina injuries (23.2% vs. 8.4%; OR
= 3.45; 95%CI: 1.43 to 8.31; p = 0.006). The studies conducted so far on
comparing DLT and BB are ambiguous. In the DLT compared to the BB group,
the malposition rate was statistically significantly lower, and time to
tube placement and lung collapse was shorter. However, the use of DLT
compared to BB can be associated with a higher risk of hypoxemia,
hoarseness, sore throat and bronchus/carina injuries. Multicenter
randomized trials on larger groups of patients are needed to draw
definitive conclusions regarding the superiority of any of these
devices. Copyright © 2023 by the authors.

<76>
Accession Number
2022028973
Title
Patients' Perceptions of Experiences of Postoperative Chest Drain Tube
Insertion: A Pilot Survey.
Source
International Journal of Environmental Research and Public Health. 20(5)
(no pagination), 2023. Article Number: 3773. Date of Publication: March
2023.
Author
Kruk A.; Dziedzic R.; Terech-Skora S.; Piotrkowska R.; Medrzycka-Dabrowska
W.
Institution
(Kruk, Terech-Skora, Piotrkowska) Department of Surgical Nursing, Medical
University of Gdansk, Debinki 7, Gdansk 80-211, Poland
(Kruk, Dziedzic) Thoracic Surgery Department, Medical University of
Gdansk, Smoluchowskiego 17, Gdansk 80-211, Poland
(Medrzycka-Dabrowska) Department of Anaesthesiology Nursing and Intensive
Care, Medical University of Gdansk, Debinki 7, Gdansk 80-211, Poland
Publisher
MDPI
Abstract
Background: Pleural drainage is a routine procedure conducted after
thoracotomy and thoracoscopy. It is used to remove air or excess fluid
from a pleural cavity and enables proper lung expansion. Essential
elements of care provided during hospitalization and treatment include
meeting patients' growing expectations and continually improving quality
while optimizing safety. Aim(s): This study aimed to explore
patients' experiences with pleural drainage after thoracic surgery and
their correlation with socio-demographic data. Method(s): A pilot
survey with an exploratory design was conducted at a large teaching
hospital in Poland, in the Department of Thoracic Surgery at the
University Clinical Centre in Gdansk. The study involved the analysis of
100 randomly selected subjects with a chest tube drain. A self-designed
questionnaire was used to collect social, demographic, and clinical data.
Twenty-three questions related to experiences with pleural drainage,
ailments, limitations in daily functioning, and security with a chest tube
were evaluated using a 5-point Likert scale. Patients completed the
questionnaire on the third postoperative day. Result(s): Individuals
fitted with a traditional water-seal drainage system felt safer than those
from the digital drainage group (p = 0.017). Statistically significant
differences were found in the assessment of nursing assistance (p =
0.025); the number of satisfied patients was greater in a group of
unemployed people. No correlation was found between demographic and social
factors and the patients' sense of security (gender: p = 0.348, age: p =
0.172, education level: p = 0.154, professional activity: p = 0.665).
 Conclusion(s): Demographic and social characteristics did not
significantly affect patients' sense of safety with chest drainage types.
Patients with traditional drainage felt significantly safer than patients
with digital drainage. Patient knowledge of pleural drainage management
was not satisfactory, with a number of patients indicating a lack of
knowledge in this area. This is important information that should be
considered when planning measures to improve the quality of
care. Copyright © 2023 by the authors.

<77>
Accession Number
2023301967
Title
Effect of High-Dose Selenium on Postoperative Organ Dysfunction and
Mortality in Cardiac Surgery Patients: The SUSTAIN CSX Randomized Clinical
Trial.
Source
JAMA Surgery. 158(3) (pp 235-244), 2023. Date of Publication: 08 Mar 2023.
Author
Stoppe C.; McDonald B.; Meybohm P.; Christopher K.B.; Fremes S.; Whitlock
R.; Mohammadi S.; Kalavrouziotis D.; Elke G.; Rossaint R.; Helmer P.;
Zacharowski K.; Gunther U.; Parotto M.; Niemann B.; Boning A.; Mazer C.D.;
Jones P.M.; Ferner M.; Lamarche Y.; Lamontagne F.; Liakopoulos O.J.;
Cameron M.; Muller M.; Zarbock A.; Wittmann M.; Goetzenich A.; Kilger E.;
Schomburg L.; Day A.G.; Heyland D.K.
Institution
(Stoppe, McDonald) University of Ottawa Heart Institute, Ottawa, ON,
Canada
(Meybohm, Helmer) Department of Anaesthesiology Intensive Care, Emergency,
and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
(Christopher) Division of Renal Medicine, Brigham and Women's Hospital,
Boston, MA, United States
(Fremes) Sunnybrook Research Institute, Toronto, ON, Canada
(Whitlock) Hamilton Health Sciences, Hamilton, ON, Canada
(Mohammadi, Kalavrouziotis) Quebec Heart and Lung Institute, Laval
University, Quebec City, QC, Canada
(Elke) University Hospital Schleswig-Holstein, Kiel, Germany
(Rossaint, Goetzenich) University Hospital Aachen, Aachen, Germany
(Zacharowski) University Hospital Frankfurt, Frankfurt, Germany
(Gunther) Oldenburg Clinic, University of Oldenburg, Oldenburg, Germany
(Parotto) Department of Anesthesiology and Pain Medicine, Toronto General
Hospital, Toronto, ON, Canada
(Parotto) Division of Critical Care Medicine, Department of Anesthesia,
Interdepartmental University of Toronto, Toronto, ON, Canada
(Niemann, Boning) University Hospital of Giessen, Giessen, Germany
(Mazer) Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto,
ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, Department of
Physiology, University of Toronto, Toronto, ON, Canada
(Jones) London Health Sciences Centre, London, ON, Canada
(Ferner) University Medical Center, Johannes Gutenberg-University Mainz,
Mainz, Germany
(Lamarche) Hopital du Sacre-Coeur de Montreal, Montreal, QC, Canada
(Lamarche) Montreal Heart Institute, Montreal, QC, Canada
(Lamontagne) Hopital Fleurimont (CHUS), Sherbrooke, QC, Canada
(Liakopoulos) Department of Cardiothoracic Surgery, Heart Center,
University Hospital of Cologne, Cologne, Germany
(Cameron) Jewish General Hospital, Montreal, QC, Canada
(Muller) University Heart Center Freiburg Bad Krozingen, Bad Krozingen,
Germany
(Zarbock) University Hospital Munster, Munster, Germany
(Wittmann) University Hospital Bonn, Bonn, Germany
(Goetzenich) Abiomed Europe GmbH, Aachen, Germany
(Kilger) Ludwig Maximilian University of Munich, Munich, Germany
(Schomburg) Institute for Experimental Endocrinology,
Charite-Universitatsmedizin Berlin, Berlin, Germany
(Day, Heyland) Clinical Evaluation Research Unit, Queen's University,
Kingston, ON, Canada
(Heyland) Department of Critical Care Medicine, Queen's University,
Kingston, ON, Canada
(Stoppe) Department of Anaesthesiology, Intensive Care, Emergency, and
Pain Medicine, University Hospital Wuerzburg, Oberduerrbacher Str. 6,
Wuerzburg 97080, Germany
Publisher
American Medical Association
Abstract
Importance: Selenium contributes to antioxidative, anti-inflammatory, and
immunomodulatory pathways, which may improve outcomes in patients at high
risk of organ dysfunctions after cardiac surgery. Objective(s): To
assess the ability of high-dose intravenous sodium selenite treatment to
reduce postoperative organ dysfunction and mortality in cardiac surgery
patients. Design, Setting, and Participant(s): This multicenter,
randomized, double-blind, placebo-controlled trial took place at 23 sites
in Germany and Canada from January 2015 to January 2021. Adult cardiac
surgery patients with a European System for Cardiac Operative Risk
Evaluation II score-predicted mortality of 5% or more or planned combined
surgical procedures were randomized. Intervention(s): Patients were
randomly assigned (1:1) by a web-based system to receive either
perioperative intravenous high-dose selenium supplementation of 2000 mug/L
of sodium selenite prior to cardiopulmonary bypass, 2000 mug/L immediately
postoperatively, and 1000 mug/L each day in intensive care for a maximum
of 10 days or placebo. Main Outcomes and Measures: The primary end
point was a composite of the numbers of days alive and free from organ
dysfunction during the first 30 days following cardiac surgery.
 Result(s): A total of 1416 adult cardiac surgery patients were
analyzed (mean [SD] age, 68.2 [10.4] years; 1043 [74.8%] male). The median
(IQR) predicted 30-day mortality by European System for Cardiac Operative
Risk Evaluation II score was 8.7% (5.6%-14.9%), and most patients had
combined coronary revascularization and valvular procedures. Selenium did
not increase the number of persistent organ dysfunction-free and alive
days over the first 30 postoperative days (median [IQR], 29 [28-30] vs 29
[28-30]; P =.45). The 30-day mortality rates were 4.2% in the selenium and
5.0% in the placebo group (odds ratio, 0.82; 95% CI, 0.50-1.36; P =.44).
Safety outcomes did not differ between the groups. Conclusions and
Relevance: In high-risk cardiac surgery patients, perioperative
administration of high-dose intravenous sodium selenite did not reduce
morbidity or mortality. The present data do not support the routine
perioperative use of selenium for patients undergoing cardiac surgery.
Trial Registration: ClinicalTrials.gov Identifier:
NCT02002247. Copyright © 2023 American Medical Association. All
rights reserved.

<78>
Accession Number
2023301965
Title
Cost-effectiveness of Fibrinogen Concentrate vs Cryoprecipitate for
Treating Acquired Hypofibrinogenemia in Bleeding Adult Cardiac Surgical
Patients.
Source
JAMA Surgery. 158(3) (pp 245-253), 2023. Date of Publication: 08 Mar 2023.
Author
Abrahamyan L.; Tomlinson G.; Callum J.; Carcone S.; Grewal D.; Bartoszko
J.; Krahn M.; Karkouti K.
Institution
(Abrahamyan, Tomlinson, Carcone, Krahn, Karkouti) Toronto General Hospital
Research Institute, University Health Network, 10th Floor Eaton North,
Room 237, 200 Elizabeth St, Toronto, ON M5G 2C4, Canada
(Abrahamyan, Carcone, Krahn) Toronto Health Economics and Technology
Assessment (THETA) Collaborative, University Health Network, Toronto, ON,
Canada
(Abrahamyan, Tomlinson, Bartoszko, Krahn, Karkouti) Institute of Health
Policy Management and Evaluation, University of Toronto, Toronto, ON,
Canada
(Tomlinson) Biostatistics Research Unit, University Health Network,
Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre, Queen's University, Kingston, ON, Canada
(Grewal, Bartoszko, Karkouti) Department of Anesthesia and Pain
Management, Sinai Health System, Women's College Hospital, University
Health Network, Toronto, ON, Canada
(Bartoszko, Karkouti) Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Bartoszko, Karkouti) Peter Munk Cardiac Centre, University Health
Network, Toronto, ON, Canada
Publisher
American Medical Association
Abstract
Importance: Excessive bleeding requiring fibrinogen replacement is a
serious complication of cardiac surgery. However, the relative
cost-effectiveness of the 2 available therapies - fibrinogen concentrate
and cryoprecipitate - is unknown. Objective(s): To determine
cost-effectiveness of fibrinogen concentrate vs cryoprecipitate for
managing active bleeding in adult patients who underwent cardiac surgery.
 Design, Setting, and Participant(s): A within-trial economic
evaluation of the Fibrinogen Replenishment in Surgery (FIBERS) randomized
clinical trial (February 2017 to November 2018) that took place at 4
hospitals based in Ontario, Canada, hospitals examined all in-hospital
resource utilization costs and allogeneic blood product (ABP) transfusion
costs incurred within 28 days of surgery. Participants included a subset
of 495 adult patients from the FIBERS trial who underwent cardiac surgery
and developed active bleeding and acquired hypofibrinogenemia requiring
fibrinogen replacement. Intervention(s): Fibrinogen concentrate (4 g
per dose) or cryoprecipitate (10 units per dose) randomized (1:1) up to 24
hours postcardiopulmonary bypass. Main Outcomes and Measures:
Effectiveness outcomes included number of ABPs administered within 24
hours and 7 days of cardiopulmonary bypass. ABP transfusion (7-day) and
in-hospital resource utilization (28-day) costs were evaluated and a
multivariable net benefit regression model built for the full sample and
predefined subgroups. Result(s): Patient level costs for 495 patients
were evaluated (mean [SD] age 59.2 [15.4] years and 69.3% male.)
Consistent with FIBERS, ABP transfusions and adverse events were similar
in both treatment groups. Median (IQR) total 7-day ABP cost was CAD $2280
(US dollars [USD] $1697) (CAD $930 [USD $692]-CAD $4970 [USD $3701]) in
the fibrinogen concentrate group and CAD $2770 (USD $1690) (IQR, CAD $1140
[USD $849]-CAD $5000 [USD $3723]) in the cryoprecipitate group. Median
(interquartile range) total 28-day cost was CAD $38180 (USD $28431) $(IQR,
CAD $26350 [USD $19622]-CAD $65080 [USD $48463]) in the fibrinogen
concentrate group and CAD $38790 (USD $28886) (IQR, CAD $26180 [USD
$19495]-CAD $70380 [USD $52409]) in the cryoprecipitate group. After
exclusion of patients who were critically ill before surgery (11%) due to
substantial variability in costs, the incremental net benefit of
fibrinogen concentrate vs cryoprecipitate was positive (probability of
being cost-effective 86% and 97% at $0 and CAD $2000 (USD $1489)
willingness-to-pay, respectively). Net benefit was highly uncertain for
nonelective and patients with critical illness. Conclusions and
Relevance: Fibrinogen concentrate is cost-effective when compared with
cryoprecipitate in most bleeding adult patients who underwent cardiac
surgery with acquired hypofibrinogenemia requiring fibrinogen replacement.
The generalizability of these findings outside the Canadian health system
needs to be verified. Copyright © 2023 American Medical
Association. All rights reserved.

<79>
Accession Number
2023184274
Title
Left Atrial Appendage Occlusion in the Elderly: Insights From PROTECT-AF,
PREVAIL, and Continuous Access Registries.
Source
JACC: Clinical Electrophysiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Sulaiman S.; Roy K.; Wang H.; de Backer O.; Alloco D.; Reddy V.Y.; Holmes
D.R.; Alkhouli M.
Institution
(Sulaiman, Holmes, Alkhouli) Department of Cardiovascular Disease, Mayo
Clinic, Rochester, MN, United States
(Roy, Wang, Alloco) Boston Scientific Corporation, Marlborough, MA, United
States
(de Backer) Department of Cardiology, The Heart Center, Copenhagen
University Hospital, Copenhagen, Rigshospitalet, Denmark
(Reddy) Helmsley Electrophysiology Center, Department of Cardiology, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Data on the safety and efficacy of left atrial appendage
occlusion (LAAO) in elderly patients are limited. Objective(s): We
aimed to compare the outcomes of LAAO between patients >=80 and <80 years
of age. Method(s): We included patients enrolled in randomized trials
and nonrandomized registries of the Watchman 2.5 device. The primary
efficacy endpoint was a composite of cardiovascular/unknown death, stroke,
or systemic embolism at 5 years. Secondary endpoints included
cardiovascular/unknown death, stroke, systemic embolism, and major and
nonprocedural bleeding. Survival analyses were performed using the
Kaplan-Meier, Cox proportional hazards, and competing risk analysis
methods. Interaction terms were used to compare the 2 age groups. We also
estimated the average treatment effect of the device with the use of
inverse probability weighting. Result(s): We studied 2,258 patients,
of whom 570 (25.2%) were >=80 years old, and 1,688 (74.8%) were <80 years
old. Procedural complications at 7 days were similar in both age groups.
The primary endpoint occurred in 12.0% in the device group vs 13.8% in the
control group (HR: 0.9; 95% CI: 0.6-1.4) among patients <80 years of age
and in 25.3% vs 21.7%, respectively (HR: 1.2; 95% CI: 0.7-2.0) among
patients >=80 (interaction P value = 0.48). There was no interaction
between age and treatment effect for any of the secondary outcomes. The
average treatment effects of LAAO (compared with warfarin) were similar in
the elderly population (compared with younger patients).
 Conclusion(s): Despite the higher event rates, octogenarians derive
similar benefits from LAAO as their younger counterparts. Age alone should
not preclude LAAO in otherwise suitable candidates. Copyright ©
2023 American College of Cardiology Foundation

<80>
Accession Number
2021850541
Title
Cardiac Rehabilitation After TAVI -A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(3) (no pagination), 2023. Article
Number: 101531. Date of Publication: March 2023.
Author
Oz A.; Tsoumas I.; Lampropoulos K.; Xanthos T.; Karpettas N.; Papadopoulos
D.
Institution
(Oz, Tsoumas, Lampropoulos, Xanthos, Karpettas, Papadopoulos) European
University Cyprus, School of medicine, Nicosia, Cyprus
Publisher
Elsevier Inc.
Abstract
Despite the increasing popularity of Transcatheter aortic valve
implantation (TAVI) in patients with high surgical risk, there is no
current guideline for the management of patients following the
intervention. This systematic review and meta-analysis aims to summarize
and analyse all clinical data and evidence regarding the effectiveness and
outcomes of CR following TAVI. The first meta-analysis measured the walked
distance in the Six-Minute Walk Test (6MWT) and the second meta-analysis
included studies that showed the Barthel Index (BI) before and after CR.
The mean distance walked prior to CR was 235.88 +/- 69.36 m increased to
292.12 +/- 54.92 m after rehabilitation, signifying a moderate clinically
relevant effect size (0.593 (0.42, 0.76); P=0.00). The mean BI score
before CR was 76.6 +/- 11.5 which increased to 89.8 +/- 5.5 after the
programme and similarly demonstrated a significant standardized mean
improvement (0.75 (0.57, 0.93); I= 0.00). Exercise-based CR in patients
with aortic stenosis treated with TAVI demonstrated a significant
improvement in exercise tolerance and functional independence shown by the
6MWT and BI. Copyright © 2022 Elsevier Inc.

<81>
Accession Number
2022548729
Title
Efficacy of high dose tranexamic acid (TXA) for hemorrhage: A systematic
review and meta-analysis.
Source
Injury. 54(3) (pp 857-870), 2023. Date of Publication: March 2023.
Author
Hmidan Simsam M.; Delorme L.; Grimm D.; Priestap F.; Bohnert S.;
Descoteaux M.; Hilsden R.; Laverty C.; Mickler J.; Parry N.; Rochwerg B.;
Sherman C.; Smith S.; Toole J.; Vogt K.; Wilson S.; Ball I.
Institution
(Hmidan Simsam) Schulich School of Medicine and Dentistry, Western
University, 1397 Medway Park Dr, London, ON N6G 0Z6, Canada
(Delorme, Grimm) Faculty of Medicine, Queen's University, Kingston, ON,
Canada
(Priestap, Hilsden, Parry, Smith, Vogt, Ball) London Health Sciences
Centre Trauma Program, London, ON, Canada
(Rochwerg) Department of Medicine, MacMaster University, Hamilton, ON,
Canada
(Rochwerg) Department of Health Research Methods, Evidence and Impact,
McMaster University, Hamilton, ON, Canada
(Bohnert, Mickler) Defence Research and Development Canada, Canada
(Descoteaux, Hilsden, Laverty, Sherman, Smith, Toole, Wilson, Ball) Royal
Canadian Medical Service, Canada
(Hilsden, Parry, Smith, Vogt) Department of Surgery, Western University,
London, ON, Canada
(Hilsden, Parry, Smith, Ball) Office of Academic Military Medicine,
Western University, London, ON, Canada
(Ball) Department of Medicine, Western University, London, ON, Canada
(Ball) Department of Epidemiology and Biostatistics, Western University,
London, ON, Canada
Publisher
Elsevier Ltd
Abstract
Background: Standard dose (<= 1 g) tranexamic acid (TXA) has established
mortality benefit in trauma patients. The role of high dose IV TXA (>=2 g
or >=30 mg/kg as a single bolus) has been evaluated in the surgical
setting, however, it has not been studied in trauma. We reviewed the
available evidence of high dose IV TXA in any setting with the goal of
informing its use in the adult trauma population. Method(s): We
searched MEDLINE, EMBASE and unpublished sources from inception until July
27, 2022 for studies that compared standard dose with high dose IV TXA in
adults (>= 16 years of age) with hemorrhage. Screening and data
abstraction was done independently and in duplicate. We pooled trial data
using a random effects model and considered randomized controlled trials
(RCTs) and observational cohort studies separately. We assessed the
individual study risk of bias using the Cochrane Risk of Bias for RCTs and
the Newcastle-Ottawa Scale for observational cohort studies. The overall
certainty of evidence was assessed using the GRADE approach (Grading of
Recommendations Assessment, Development and Evaluation). Result(s):
We included 20 studies with a combined total of 12,523 patients. Based on
pooled RCT data, and as compared to standard dose TXA, high dose IV TXA
probably decreases transfusion requirements (odds ratio [OR] 0.86, 95%
confidence interval [CI] 0.76 to 0.97, moderate certainty) but with
possibly no effect on blood loss (mean difference [MD] 43.31 ml less, 95%
CI 135.53 to 48.90 ml less, low certainty), and an uncertain effect on
thromboembolic events (OR 1.33, 95% CI 0.86 to 2.04, very low certainty)
and mortality (OR 0.70, 95% CI 0.37 to 1.32, very low certainty).
 Conclusion(s): When compared to standard dose, high dose IV TXA
probably reduces transfusion requirements with an uncertain effect on
thromboembolic events and mortality. Level of Evidence: Systematic
review and meta-analysis, level IV. Copyright © 2023 Elsevier Ltd

<82>
Accession Number
2022478384
Title
Intraoperative electroencephalographic marker of preoperative frailty: A
prospective cohort study.
Source
Journal of Clinical Anesthesia. 86 (no pagination), 2023. Article Number:
111069. Date of Publication: June 2023.
Author
Boncompte G.; Sun H.; Elgueta M.F.; Benavides J.; Carrasco M.; Morales
M.I.; Calderon N.; Contreras V.; Westover M.B.; Cortinez L.I.; Akeju O.;
Pedemonte J.C.
Institution
(Boncompte) Neurodynamics of Cognition Laboratory, Department of
Psychiatry, Faculty of Medicine, Pontificia Universidad Catolica de Chile,
Santiago, Chile
(Boncompte, Elgueta, Benavides, Calderon, Contreras, Cortinez, Pedemonte)
Division de Anestesiologia, Escuela de Medicina, Pontificia Universidad
Catolica de Chile, Santiago, Chile
(Sun, Westover) Department of Neurology, Beth Israel Deaconess Medical
Center, Boston, MA, United States
(Carrasco, Morales) Seccion de Geriatria, Facultad de Medicina, Pontificia
Universidad Catolica de Chile, Santiago, Chile
(Contreras) Departamento del Adulto, Escuela de Enfermeria, Pontificia
Universidad Catolica de Chile, Santiago, Chile
(Akeju) Department of Anesthesia, Critical Care and Pain Medicine, Boston,
MA, United States
(Pedemonte) Programa de Farmacologia y Toxicologia, Facultad de Medicina,
Pontificia Universidad Catolica de Chile, Santiago, Chile
(Sun, Westover) Department of Neurology, Massachusetts General Hospital,
Boston, MA, United States
(Sun, Westover, Akeju) Henry and Allison McCance Center for Brain Health,
Boston, MA, United States
(Sun, Westover) Clinical Data Animation Center (CDAC), Massachusetts
General Hospital, Boston, MA, United States
Publisher
Elsevier Inc.

<83>
Accession Number
2023020014
Title
Methodological transparency of preoperative clinical practice guidelines
for elective surgery. Systematic review.
Source
PLoS ONE. 18(2 Feburary) (no pagination), 2023. Article Number: e0272756.
Date of Publication: February 2023.
Author
Angel G.; Trujillo C.; Mallama M.; Alonso-Coello P.; Klimek M.; Calvache
J.A.
Institution
(Angel, Trujillo, Mallama, Calvache) Department of Anesthesiology,
Universidad del Cauca, Cauca, Colombia
(Alonso-Coello) Iberoamerican Cochrane Centre, Clinical Epidemiology and
Public Health Department, Hospital de la Santa Creu i Sant Pau,
Universitat Autonoma de Barcelona, Barcelona, Spain
(Klimek, Calvache) Department of Anesthesiology, Erasmus University
Medical Centre Rotterdam, Rotterdam, Netherlands
Publisher
Public Library of Science
Abstract
Background Clinical practice guidelines (CPG) are statements that provide
recommendations regarding the approach to different diseases and aim to
increase quality while decreasing the risk of complications in health
care. Numerous guidelines in the field of perioperative care have been
published in the previous decade but their methodological quality and
transparency are relatively unknown. Objective To critically evaluate the
transparency and methodological quality of published CPG in the
preoperative assessment and management of adult patients undergoing
elective surgery. Design Systematic review and methodological appraisal
study. Data sources We searched for eligible CPG published in English or
Spanish between January 1, 2010, and June 30, 2022, in Pubmed MEDLINE,
TRIP Database, Embase, the Cochrane Library, as well as in
representatives' medical societies of Anaesthesiology and developers of
CPG. Eligibility criteria CPG dedicated on preoperative fasting, cardiac
assessment for non-cardiac surgery, and the use of routine preoperative
tests were included. Methodological quality and transparency of CPG were
assessed by 3 evaluators using the 6 domains of the AGREE-II tool. Results
We included 20 CPG of which 14 were classified as recommended guidelines.
The domain of "applicability" scored the lowest (44%), while the domains
"scope and objective" and "editorial interdependence" received the highest
median scores of 93% and 97% respectively. The remaining domains received
scores ranging from 44% to 84%. The top mean scored CPG in preoperative
fasting was ASA 2017 (93%); among cardiac evaluation, CPG for noncardiac
surgery were CCS 2017 (91%), ESC-ESA 2014 (90%), and AHA-ACC 2014 (89%);
in preoperative testing ICSI 2020 (97%). Conclusions In the last ten
years, most published CPG in the preoperative assessment or management of
adult patients undergoing elective surgery focused on preoperative
fasting, cardiac assessment for non-cardiac surgery, and use of routine
preoperative tests, present moderate to high methodological quality and
can be recommended for their use or adaptation. Applicability and
stakeholder involvement domains must be improved in the development of
future guidelines. Copyright © 2023 Angel et al. This is an open
access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<84>
[Use Link to view the full text]
Accession Number
2023123837
Title
Hematic Antegrade Repriming Reduces Emboli on Cardiopulmonary Bypass: A
Randomized Controlled Trial.
Source
ASAIO Journal. 69(3) (pp 324-331), 2023. Date of Publication: 01 Mar 2023.
Author
Blanco-Morillo J.; Salmeron Martinez D.; Morillo-Cuadrado D.V.;
Arribas-Leal J.M.; Puis L.; Verdu-Verdu A.; Martinez-Molina M.;
Tormos-Ruiz E.; Sornichero-Caballero A.; Ramirez-Romero P.; Farina P.;
Canovas-Lopez S.
Institution
(Blanco-Morillo) Cardiovascular Surgery, Extracorporeal Therapies Group,
Virgen de la Arrixaca University Hospital, Murcia, Spain
(Blanco-Morillo) Biomedical Research Institute of Murcia (IMIB), Murcia,
Spain
(Salmeron Martinez) Department of Health and Social Sciences, Murcia
University, Murcia, Spain
(Salmeron Martinez) IMIB-Arrixaca, Murcia, Spain
(Morillo-Cuadrado) Network-Based Biomedical Research Consortium, Area of
Mental Health (CiberSAM), Carlos III Health Institute, Madrid, Spain
(Morillo-Cuadrado) World Health Organization, Collaborating Centre for
Research and Training in Mental Health, Department of Psychiatry,
Autonomous University of Madrid, Spain
(Arribas-Leal, Canovas-Lopez) Cardiovascular Surgery, Virgen de la
Arrixaca University Hospital, Murcia, Spain
(Puis) Department of ExtraCorporeal Circulation, UZ Gasthuisberg, KU
Leuven, Belgium
(Ramirez-Romero) General and Experimental Surgery and Transplantation
Departments, Virgen de la Arrixaca University Hospital, University of
Murcia, Murcia, Spain
(Farina) Cardiovascular Surgery, Agostino Gemelli University Policlinc,
Rome, Italy
(Salmeron Martinez) CIBER Epidemiology and Public Health, CIBERESP,
Madrid, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
Particulate and gaseous microemboli (GME) are side effects of cardiac
surgery that interfere with postoperative recovery by causing endothelial
dysfunction and vascular blockages. GME sources during surgery are
multiple, and cardiopulmonary bypass (CPB) is contributory to this embolic
load. Hematic antegrade repriming (HAR) is a novel procedure that combines
the benefits of repriming techniques with additional measures, by
following a standardized procedure to provide a reproducible hemodilution
of 300 ml. To clarify the safety of HAR in terms of embolic load delivery,
a prospective and controlled study was conducted, by applying Doppler
probes to the extracorporeal circuit, to determine the number and volume
of GME released during CPB. A sample of 115 patients (n = 115) was
considered for assessment. Both groups were managed under strict
normothermia, and similar clinical conditions and protocols, receiving the
same open and minimized circuit. Significant differences in GME volume
delivery (control group [CG] = 0.28 ml vs. HAR = 0.08 ml; p = 0.004) and
high embolic volume exposure (>1 ml) were found between the groups (CG =
30.36% vs. HAR = 4.26%; p = 0.001). The application of HAR did not
represent an additional embolic risk and provided a four-fold reduction in
the embolic volume delivered to the patient (coefficient, 0.24; 95% CI,
0.08-0.72; p = 0.01), which appears to enhance GME clearance of the
oxygenator before CPB initiation. Copyright © 2023 Lippincott
Williams and Wilkins. All rights reserved.

<85>
Accession Number
2023103891
Title
Severe Aortic Stenosis in Patients With Chronic Liver Disease: A
Comprehensive Review.
Source
Current Problems in Cardiology. 48(6) (no pagination), 2023. Article
Number: 101639. Date of Publication: June 2023.
Author
Craig D.; Bond A.J.; Ahmad L.; Stanley M.; Asfaw A.; Latham S.B.; Ibebuogu
U.N.
Institution
(Craig, Bond, Ahmad, Stanley, Asfaw, Latham, Ibebuogu) Department of
Medicine, University of Tennessee Health Science Center, Memphis, TN,
United States
Publisher
Elsevier Inc.

<86>
Accession Number
2022038727
Title
Overall morbidity after total minimally invasive keyhole oesophagectomy
versus hybrid oesophagectomy (the MICkey trial): study protocol for a
multicentre randomized controlled trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 175. Date of
Publication: December 2023.
Author
Klotz R.; Diener M.K.; Schmidt T.; Hackert T.; Graf S.; Fuchs H.F.;
Grimminger P.; Egberts J.-H.; Gockel I.; van der Sluis P.C.; Doerr-Harim
C.; Klose C.; Feisst M.; Mihaljevic A.L.
Institution
(Klotz, Hackert) Department of General, Visceral and Transplantation
Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 420,
Heidelberg 69120, Germany
(Diener) Department of Surgery, Medical Center University Hospital
Freiburg, Hugstetter Strase 55, Freiburg 79106, Germany
(Schmidt, Fuchs) Department of General, Visceral, Tumor and
Transplantation Surgery, University Hospital Cologne, Kerpener Str. 65,
Cologne 50923, Germany
(Graf, Doerr-Harim, Mihaljevic) Department of General and Visceral Surgery
and Clinical Trial Centre Department of Surgery (ulmCARES), University
Hospital Ulm, Albert-Einstein-Allee 23, Ulm 89081, Germany
(Grimminger) Department of General, Visceral and Transplantation Surgery,
Universitatsmedizin der Johannes Gutenberg-Universitat Mainz,
Langenbeckstrase 1, Mainz 55131, Germany
(Egberts) Department of Surgery, Israelitisches Krankenhaus Hamburg,
Orchideenstieg 14, Hamburg 22297, Germany
(Gockel) Clinic and Polyclinic for Visceral, Transplant, Thoracic and
Vascular Surgery, University Hospital Leipzig, Liebigstrase 20, Leipzig
04103, Germany
(van der Sluis) Erasmus Medical Centre, Dr. Molewaterplein 40, Rotterdam
3015 GD, Netherlands
(Klose, Feist) Institute of Medical Biometry (IMBI), University of
Heidelberg, Im Neuenheimer Feld 130.3, Heidelberg 69120, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Oesophageal cancer (EC) is the sixth leading cause of cancer
death worldwide. Oesophageal resection is the only curative treatment
option for EC which is frequently performed via an abdominal and right
thoracic approach (Ivor-Lewis operation). This 2-cavity operation is
associated with a high risk of major complications. To reduce
postoperative morbidity, several minimally invasive techniques have been
developed that can be broadly classified into either hybrid oesophagectomy
(HYBRID-E) via laparoscopic/robotic abdominal and open thoracic surgery or
total minimally invasive oesophagectomy (MIN-E). Both, HYBIRD-E and MIN-E,
compare favourable to open oesophagectomy. However, there is still an
evidence gap comparing HYBRID-E with MIN-E with regard to postoperative
morbidity. Method(s): The MICkey trial is a multicentre randomized
controlled superiority trial with two parallel study groups. A total of
152 patients with oesophageal cancer scheduled for elective oesophagectomy
will be randomly assigned 1:1 to the control group (HYBRID-E) or to the
intervention group (MIN-E). The primary endpoint will be overall
postoperative morbidity assessed via the comprehensive complication index
(CCI) within 30 days after surgery. Specific perioperative parameters, as
well as patient-reported and oncological outcomes, will be analysed as
secondary outcomes. Discussion(s): The MICkey trial will address the
yet unanswered question whether the total minimally invasive
oesophagectomy (MIN-E) is superior to the HYBRID-E procedure regarding
overall postoperative morbidity. Trial registration: DRKS00027927
U1111-1277-0214. Registered on 4th July 2022 Copyright © 2023,
The Author(s).

<87>
Accession Number
2021228793
Title
Effectiveness of Yiqi Fumai lyophilized injection for acute heart failure:
Rationale and design of the AUGUST-AHF cohort study.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1074406. Date of Publication: 10 Jan 2023.
Author
Zhang X.; Kang J.; Zhang J.; Chen Y.; Dai H.; Hu M.; Liu Y.; Shang H.
Institution
(Zhang, Kang, Zhang, Chen, Dai, Hu, Liu, Shang) Key Laboratory of Chinese
Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing
University of Chinese Medicine, Beijing, China
(Zhang) College of Traditional Chinese Medicine, College of Integrated
Chinese and Western Medicine, Nanjing University of Chinese Medicine,
Nanjing, China
(Chen) School of Public Health, Department of Global Health, Peking
University, Beijing, China
(Dai) Department of Traditional Chinese Medicine, The Sixth Medical Center
of the General Hospital of the Chinese People's Liberation Army, Beijing,
China
Publisher
Frontiers Media S.A.
Abstract
Introduction: The effect of Yiqi Fumai lyophilized injection (YQFM) on
acute heart failure (AHF) patients has been evaluated in a large sample,
randomized, controlled trial (AUGUST-AHF RCT study). However, restrictive
eligibility criteria from a randomized clinical trial may raise concerns
about the generalizability of the results to under-represented groups or
complex patients with multimorbidity. Therefore, we intend to conduct the
AUGUST-AHF cohort study which aims to assess the effectiveness of YQFM in
patients with AHF in a real-world setting and compare the results with
AUGUST-AHF RCT study. Methods and analysis: This prospective, multicenter
cohort study will be conducted at 50 secondary and tertiary hospitals in
China and comprise 1,200 patients with AHF. The participants will be
followed for up to at least 180 days. The primary outcome is a composite
of 90-day all-cause mortality or readmission for heart failure. The
secondary outcomes include length of hospital stay, cardiac-specific
death, MACE, NYHA cardiac function classification. Cox
proportional-hazards regression models will be used to estimate the
association between YQFM use and the primary outcome. The primary analysis
will use propensity-score matching methods to balance the differences in
baseline variables between treatment cohorts. Ethics and dissemination:
Approval for the study has been obtained from the Ethical Committee of
Dongzhimen Hospital (approval No. 2022DZMEC-327-02) and registered at
ClinicalTrials.gov (NCT05586048). The study results will be published in
peer-reviewed journals and presented at scientific
conferences. Copyright © 2023 Zhang, Kang, Zhang, Chen, Dai, Hu,
Liu and Shang.

<88>
Accession Number
2021228785
Title
Takotsubo cardiomyopathy after cardiac surgery: A case-series and
systematic review of literature.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1067444. Date of Publication: 10 Jan 2023.
Author
Laghlam D.
Institution
(Laghlam) Research and Innovation Department, RICAP, CMC Ambroise Pare,
Neuilly-sur-Seine, France
Publisher
Frontiers Media S.A.
Abstract
Background: Takotsubo cardiomyopathy (TTC) is a rare entity after cardiac
surgery. Aim(s): To describe patients' profile who developed
postoperative TTC after cardiac surgery, management, and outcomes.
 Method(s): We performed a systematic literature search to extract
cases of TTC after adult cardiac surgery (from 1990 to 2021).
Additionally, we extracted all cases of TTC in a prospective single-center
cohort database of 10,000+ patients (from 2007 to 2019). We then combined
all cases in a single cohort to describe its clinical features.
 Result(s): From 694 screened articles, we retained 71 individual
cases published in 20 distinct articles (19 cases reports and 1
case-series). We combined these to 10 cases extracted from our cohort
[among 10,682 patients (0.09%)]. Overall, we included 81 cases. Patients
were aged 68 +/- 10 years-old and 64/81 (79%) were women. Surgery
procedures included mitral valve and/or tricuspid valve surgery in 70/81,
86%. TTC was diagnosed in the first days after surgery [median 4 (1-4)
days]. Incidence of cardiogenic shock, defined as requirement of
vasopressor and/or inotropic support was 24/29, 83% (data available on
29/81 patients). Refractory cardiogenic appeared in 5/81, 6% who required
implantation of arterio-venous extra-corporeal membrane oxygenation, and
6/81, 7%, intra-aortic balloon pump. In-hospital mortality was 5/81, 6%.
 Conclusion(s): This systematic review, based on case reports and case
series, showed that postoperative TTC appears as a rare complication after
cardiac surgery and mainly occurred after mitral and/or tricuspid valve
repair procedures. In this population, TTC is associated with high rate of
cardiogenic shock. Copyright © 2023 Laghlam, Touboul, Herry,
Estagnasie, Dib, Baccouche, Brusset, Nguyen and Squara.

<89>
Accession Number
2017718195
Title
Performance of Radiomics Models Based on Coronary Computed Tomography
Angiography in Predicting The Risk of Major Adverse Cardiovascular Events
Within 3 Years: A Comparison Between the Pericoronary Adipose Tissue Model
and the Epicardial Adipose Tissue Model.
Source
Academic Radiology. 30(3) (pp 390-401), 2023. Date of Publication: March
2023.
Author
You H.; Zhang R.; Hu J.; Sun Y.; Li X.; Hou J.; Pei Y.; Zhao L.; Zhang L.;
Yang B.
Institution
(You, Zhang, Zhao) Jinzhou Medical University General Hospital of Northern
Theater Command Postgraduate Training Base, No.83 Wenhua Road, Shenhe
District, Liaoning Province, Shenyang, China
(Sun, Li, Hou, Zhang, Yang) Department of Radiology, General Hospital of
Northern Theater Command, No.83 Wenhua Road, Shenhe District, Liaoning
Province, Shenyang, China
(Sun, Li, Hou, Zhang, Yang) Key Laboratory of Cardiovascular Imaging and
Research, No.83 Wenhua Road, Shenhe District, Liaoning Province, China
(Hu) General Electric Healthcare, No.1 Tongji south Road, Daxing District,
Beijing, China
(Pei) Department of Nuclear Medicine, General Hospital of Northern Theater
Command, No.83 Wenhua Road, Shenhe District, Liaoning Province, Shenyang,
China
Publisher
Elsevier Inc.
Abstract
Rationale and Objectives: To compare the prediction performance of the
epicardial adipose tissue (EAT) and pericoronary adipose tissue (PCAT)
radiomics models based on coronary computed tomography angiography for
major adverse cardiovascular events (MACE) within 3 years.
 Material(s) and Method(s): Our study included 288 patients (144 with
MACE and 144 without MACE within 3 years) by matching age, gender, body
mass index, and medication intake. Patients were randomly assigned either
to the training (n = 201) or validation cohort (n = 87). A total of 184
radiomics features were extracted from EAT and PCAT images. Spearman's
rank correlation coefficient and the gradient boosting decision tree
algorithm were performed for feature selection. Five models were
established based on PCAT or EAT radiomics features and clinical factors,
including PCAT, EAT, clinical, PCAT-clinical, and EAT-clinical model
(M<inf>PCAT</inf>, M<inf>EAT</inf>, M<inf>clinical</inf>,
M<inf>PCAT-clinical</inf>, and M<inf>EAT-clinical</inf>). Receiver
operating characteristic curves, calibration curves, and the decision
curve analysis were plotted to evaluate the model performance.
 Result(s): The M<inf>PCAT</inf> achieved an area under the curve
(AUC) of 0.703 in the validation cohort, which was better than
M<inf>EAT</inf> with AUC of 0.538. The M<inf>PCAT-clinical</inf> showed
better performance (AUC = 0.781) in predicting MACE than the
M<inf>clinical</inf> (AUC = 0.748) or M<inf>EAT-clinical</inf> (AUC =
0.745). Conclusion(s): Our results showed that the PCAT was better
than the EAT in both single modality and combined models, and the
M<inf>PCAT-clinical</inf> had the most significant clinical value in
predicting the occurrence of MACE within 3 years. Copyright ©
2022

<90>
Accession Number
2023227352
Title
Intrathoracic vacuum therapy for the therapy of pleural empyema-a
systematic review and analysis of the literature.
Source
Journal of Thoracic Disease. 15(2) (pp 780-790), 2023. Date of
Publication: February 2023.
Author
Stuben B.-O.; Plitzko G.A.; Reeh M.; Melling N.; Izbicki J.R.; Bachmann
K.; Tachezy M.
Institution
(Stuben, Plitzko, Reeh, Melling, Izbicki, Bachmann, Tachezy) Department of
General, Visceral and Thoracic Surgery, University Medical Centre
Hamburg-Eppendorf, Hamburg, Germany
Publisher
AME Publishing Company
Abstract
Background: Pleural empyema is a serious and potentially deadly disease
leading to a significant burden on health care systems. Conservative and
surgical treatment results remain poor, with high morbidity and mortality
rates. Patients with pleural empyema are often multimorbid and poor
candidates for surgery. Therefore, it appears sensible to explore
alternative, less invasive treatment options. Recently, the
well-established vacuum sponge therapy has been adopted in the treatment
of pleural infections. The goal of this systematic review was to identify
the existing literature and reported results of vacuum therapy for pleural
empyema. Method(s): A systematic search of MEDLINE and the Cochrane
Database was performed independently by two reviewers using predefined
criteria according to the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) 2020 guidelines. In addition, abstracts from
selected conference proceedings were screened and reference scanning of
the search results was performed. Single case reports were excluded.
 Result(s): Fourteen studies met the selection criteria and were
reviewed. A total of 165 patients were treated with vacuum therapy in the
studies reviewed. 61.2% of the patients had pleural empyema secondary to
thoracic surgery. In 71.5% of the patients, vacuum therapy was applied
following open window thoracostomy (OWT). Mortality rates of 0-33% were
reported for vacuum therapy after OWT and 0-9.3% for vacuum therapy
without OWT. Length of hospital stay (LOHS) ranged from 44-217 days for
patients after OWT and could not be analysed for vacuum therapy without
OWT due to lacking data. Median treatment time was 7-14 days. Treatment
related complications were rare overall. Success rates defined as
infection resolution were high irrespective of previous treatment and
cause of empyema. Conclusion(s): The current literature shows that
pleural vacuum therapy is a promising, safe, and feasible treatment
alternative to existing treatment modalities for pleural empyema. However,
the evidence for vacuum therapy without OWT is poor, and further data,
optimally prospective or randomised control trials comparing the
conventional surgical approach of video-assisted thoracoscopic surgery
(VATS) decortication and minimally invasive vacuum therapy, are
needed. Copyright © Journal of Thoracic Disease. All rights
reserved.

<91>
Accession Number
2021959343
Title
Characteristics, Treatment Patterns, and Clinical Outcomes After Heart
Failure Hospitalizations During the COVID-19 Pandemic, March to October
2020.
Source
Mayo Clinic Proceedings. 98(1) (pp 31-47), 2023. Date of Publication:
January 2023.
Author
Yousufuddin M.; Yamani M.H.; Kashani K.B.; Zhu Y.; Wang Z.; Seshadri A.;
Blocker K.R.; Peters J.L.; Doss J.M.; Karam D.; Khandelwal K.; Sharma
U.M.; Dudenkov D.V.; Mehmood T.; Pagali S.R.; Nanda S.; Abdalrhim A.D.;
Cummings N.; Dugani S.B.; Smerina M.; Prokop L.J.; Keenan L.R.; Bhagra S.;
Jahangir A.; Bauer P.R.; Fonarow G.C.; Murad M.H.
Institution
(Yousufuddin, Blocker, Peters, Doss, Karam, Khandelwal) Division of
Hospital Internal Medicine, Mayo Clinic Health System, Austin, MN
(Seshadri) Division of Psychiatry, Mayo Clinic Health System, Austin, MN
(Keenan) Division of Cardiology, Mayo Clinic Health System, Austin, MN
(Bhagra) Division of Endocrinology, Mayo Clinic Health System, Austin, MN
(Yamani) Division of Cardiology, Mayo Clinic, Jacksonville, FL
(Dudenkov, Smerina) Division of General Internal Medicine, Mayo Clinic,
Jacksonville, FL
(Kashani) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
MN, United States
(Zhu, Wang, Murad) Robert D. and Patricia E. Kern Center for the Science
of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
(Mehmood, Pagali, Dugani) Division of Hospital Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Nanda, Abdalrhim) Division of General Internal Medicine, Mayo Clinic,
Rochester, MN, United States
(Prokop) Library and Public Services, Mayo Clinic, Rochester, MN, United
States
(Bauer) Division of Pulmonary and Critical Care Medicine, Mayo Clinic,
Rochester, MN, United States
(Murad) Division of Preventive and Occupational Medicine, Mayo Clinic,
Rochester, MN, United States
(Sharma) Hospital Internal Medicine, Mayo Clinic, Phoenix, AZ
(Cummings) Division of Hospital Internal Medicine, St. Cloud Hospital, St.
Cloud, MN
(Jahangir) Aurora Cardiovascular and Thoracic Services, Aurora St. Luke's
Medical Center, Milwaukee, WI, United States
(Fonarow) Division of Cardiology, University of California Los Angeles,
Los Angeles, CA, United States
Publisher
Elsevier Ltd
Abstract
Objective: To compare clinical characteristics, treatment patterns, and
30-day all-cause readmission and mortality between patients hospitalized
for heart failure (HF) before and during the coronavirus disease 2019
(COVID-19) pandemic. Patients and Methods: The study was conducted at
16 hospitals across 3 geographically dispersed US states. The study
included 6769 adults (mean age, 74 years; 56% [5033 of 8989] men) with
cumulative 8989 HF hospitalizations: 2341 hospitalizations during the
COVID-19 pandemic (March 1 through October 30, 2020) and 6648 in the
pre-COVID-19 (October 1, 2018, through February 28, 2020) comparator
group. We used Poisson regression, Kaplan-Meier estimates, multivariable
logistic, and Cox regression analysis to determine whether prespecified
study outcomes varied by time frames. Result(s): The adjusted 30-day
readmission rate decreased from 13.1% (872 of 6648) in the pre-COVID-19
period to 10.0% (234 of 2341) in the COVID-19 pandemic period (relative
risk reduction, 23%; hazard ratio, 0.77; 95% CI, 0.66 to 0.89).
Conversely, all-cause mortality increased from 9.7% (645 of 6648) in the
pre-COVID-19 period to 11.3% (264 of 2341) in the COVID-19 pandemic period
(relative risk increase, 16%; number of admissions needed for one
additional death, 62.5; hazard ratio, 1.19; 95% CI, 1.02 to 1.39). Despite
significant differences in rates of index hospitalization, readmission,
and mortality across the study time frames, the disease severity, HF
subtypes, and treatment patterns remained unchanged (P>0.05).
 Conclusion(s): The findings of this large tristate multicenter cohort
study of HF hospitalizations suggest lower rates of index hospitalizations
and 30-day readmissions but higher incidence of 30-day mortality with
broadly similar use of HF medication, surgical interventions, and devices
during the COVID-19 pandemic compared with the pre-COVID-19 time
frame. Copyright © 2022 The Authors

<92>
Accession Number
2020658088
Title
Artificial intelligence for the prediction of acute kidney injury during
the perioperative period: systematic review and Meta-analysis of
diagnostic test accuracy.
Source
BMC Nephrology. 23(1) (no pagination), 2022. Article Number: 405. Date of
Publication: December 2022.
Author
Zhang H.; Wang A.Y.; Wu S.; Ngo J.; Feng Y.; He X.; Zhang Y.; Wu X.; Hong
D.
Institution
(Zhang, Wu, Feng, Zhang, Wu, Hong) School of Medicine, University of
Electronic Science and Technology of China, Chengdu, China
(Zhang, Wu, Feng, He, Wu, Hong) Department of Nephrology, Sichuan
Provincial People's Hospital, University of Electronic Science and
Technology of China, Chengdu, China
(Wang) The faculty of medicine and health sciences, Macquarie University,
Sydney, NSW, Australia
(Ngo) Concord Clinical School, University of Sydney, Sydney, Australia
(He) Department of Nephrology, Affiliated Hospital of Southwest Medical
University, Luzhou, China
(Wu) Department of Pharmacy, Sichuan Provincial Peoples Hospital, School
of Medicine, University of Electronic Science and Technology of China,
Chengdu, China
(Hong) Renal Department and Nephrology Institute, Sichuan Provincial
People's Hospital, School of Medicine, University of Electronic Science
and Technology of China, Chengdu, China
Publisher
BioMed Central Ltd
Abstract
Background: Acute kidney injury (AKI) is independently associated with
morbidity and mortality in a wide range of surgical settings. Nowadays,
with the increasing use of electronic health records (EHR), advances in
patient information retrieval, and cost reduction in clinical informatics,
artificial intelligence is increasingly being used to improve early
recognition and management for perioperative AKI. However, there is no
quantitative synthesis of the performance of these methods. We conducted
this systematic review and meta-analysis to estimate the sensitivity and
specificity of artificial intelligence for the prediction of acute kidney
injury during the perioperative period. Method(s): Pubmed, Embase,
and Cochrane Library were searched to 2nd October 2021. Studies presenting
diagnostic performance of artificial intelligence in the early detection
of perioperative acute kidney injury were included. True positives, false
positives, true negatives and false negatives were pooled to collate
specificity and sensitivity with 95% CIs and results were portrayed in
forest plots. The risk of bias of eligible studies was assessed using the
PROBAST tool. Result(s): Nineteen studies involving 304,076 patients
were included. Quantitative random-effects meta-analysis using the Rutter
and Gatsonis hierarchical summary receiver operating characteristics
(HSROC) model revealed pooled sensitivity, specificity, and diagnostic
odds ratio of 0.77 (95% CI: 0.73 to 0.81),0.75 (95% CI: 0.71 to 0.80), and
10.7 (95% CI 8.5 to 13.5), respectively. Threshold effect was found to be
the only source of heterogeneity, and there was no evidence of publication
bias. Conclusion(s): Our review demonstrates the promising
performance of artificial intelligence for early prediction of
perioperative AKI. The limitations of lacking external validation
performance and being conducted only at a single center should be
overcome. Trial registration: This study was not registered with
PROSPERO. Copyright © 2022, The Author(s).

<93>
Accession Number
2022853757
Title
Clinical characteristics of various arrhythmogenic cardiomyopathy
phenotypes in the pediatric population: a systematic review and
meta-analysis.
Source
Russian Journal of Cardiology. 27(4S) (pp 35-43), 2022. Article Number:
5146. Date of Publication: 2022.
Author
Alekseeva D.Yu.; Kofeynikova O.A.; Marapov D.I.; Vasichkina E.S.
Institution
(Alekseeva, Kofeynikova, Vasichkina) Almazov National Medical Research
Center, St. Petersburg, Russian Federation
(Alekseeva) Turner National Medical Research Center for Shildren's
Orthopedics and Trauma Surgery, Pushkin, Russian Federation
(Marapov) Kazan State Medical University, Kazan, Russian Federation
Publisher
Silicea-Poligraf
Abstract
Arrhythmogenic cardiomyopathy (ACM) is a progressive disease with a high
risk of sudden cardiac death (SCD), which is very rare in the pediatric
population. Aim. To study the clinical course, outcomes and prognosis in
various ACM phenotypes in pediatric patients. Material and methods. During
the initial selection, 144 publications were found in the PubMed database.
From the initially identified results, an analysis of 7 works was carried
out. Results. Positive family history for ACM was revealed in 90% of
cases. Every second patient had symptoms of the disease (49,2% (95%
confidence interval (CI): 19,3-79,1)). Frequent clinical manifestations of
ACM were palpitations, heart failure symptoms, and syncope. The incidence
of SCD and sudden cardiac arrest was 7,1% (95% CI: 1,7-12,4) and 5,1% (95%
CI: 1,5-8,7), respectively. Implantation of an implantable-cardioverter
defibrillator was performed in 40% of cases. Conclusion. We did not reveal
any specificity of clinical signs depending on ACM phenotype. However, an
earlier onset and an unfavorable course are characteristic of
non-classical ACM types. ACM is characterized by a high risk of SCD, so it
is extremely important to make a timely diagnosis. Copyright ©
2022, Silicea-Poligraf. All rights reserved.

<94>
Accession Number
2020842102
Title
Hyperglycemia is associated with worse 3-year survival in older patients
admitted to the intensive care unit after non-cardiac surgery: Post hoc
analysis of a randomized trial.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 1003186.
Date of Publication: 12 Dec 2022.
Author
Li M.; Deng C.-M.; Su X.; Zhang D.-F.; Ding M.; Ma J.-H.; Wang D.-X.
Institution
(Li, Deng, Su, Zhang, Ding, Ma, Wang) Department of Anesthesiology and
Critical Care Medicine, Peking University First Hospital, Beijing, China
(Wang) Outcomes Research Consortium, Cleveland, OH, United States
(Zhang) Department of Anesthesiology, Fujian Medical University Union
Hospital, Fuzhou, China
Publisher
Frontiers Media S.A.
Abstract
Objective: Hyperglycemia is common in critically ill patients after
surgery and is associated with worse perioperative outcomes. Yet, the
impact of postoperative hyperglycemia on long-term outcomes remains
unclear. We therefore analyzed the association between early postoperative
hyperglycemia and 3-year overall survival in older patients who were
admitted to the intensive care unit after surgery. Method(s): This
was a post hoc analysis of database obtained from a previous randomized
trial and 3-year follow-up. The underlying trial enrolled 700 patients
aged 65 years or older who were admitted to the intensive care unit after
elective non-cardiac surgery. Early postoperative time-weighted average
blood glucose was calculated and was divided into three levels, i.e., <8.0
mmol/L, from 8.0 to 10.0 mmol/L, and >10.0 mmol/L. The primary outcome was
3-year overall survival. The association between time-weighted average
blood glucose level and 3-year overall survival was analyzed with Cox
proportional hazard regression models. Subgroup analyses were also
performed in patients with or without diabetes, and in patients following
cancer or non-cancer surgery. Result(s): A total of 677 patients
(mean age 74 years, 60% male sex) were included in the final analysis.
Within 3 years after surgery, deaths occurred in 22.1% (30/136) of
patients with time-weighted average blood glucose <8.0 mmol/L, compared
with 35.7% (81/227) of those from 8.0 to 10.0 mmol/L (unadjusted hazard
ratio 1.75, 95% CI 1.15 to 2.67, P = 0.009), and 36.9% (116/314) of those
>10.0 mmol/L (unadjusted hazard ratio 1.91, 95% CI 1.28 to 2.85, P =
0.002). After adjustment for confounding factors, the risk of 3-year
mortality remained higher in patients with time-weighted average blood
glucose from 8.0 to 10.0 mmol/L (adjusted hazard ratio 2.28, 95% CI 1.47
to 3.54, P < 0.001) and in those >10.0 mmol/L (adjusted hazard ratio 2.00,
95% CI 1.29 to 3.10, P = 0.002). Similar results were obtained in the
subgroups of patients without diabetes and patients following cancer
surgery. Conclusion(s): For older patients admitted to the intensive
care unit after elective non-cardiac surgery, high early blood glucose
(time-weighted average blood glucose >= 8.0 mmol/L) was associated with
poor 3-year overall survival. The impact of moderate glycemic control on
long-term survival deserves further investigation. Copyright ©
2022 Li, Deng, Su, Zhang, Ding, Ma and Wang.

<95>
Accession Number
2022876342
Title
Low-Dose vs Standard Warfarin After Mechanical Mitral Valve Replacement: A
Randomized Trial.
Source
Annals of Thoracic Surgery. 115(4) (pp 929-938), 2023. Date of
Publication: April 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, Washington
(Gerdisch) Franciscan St. Francis Health, Indianapolis, IN, United States
(Damiano) Washington University in St. Louis, St. Louis, Missouri, United
States
(Smith) The Heart Hospital Baylor Plano, Plano, Texas, United States
(Keeling) Emory University Hospital Midtown, Georgia, Atlanta, Georgia
(Wait) University of Texas Southwestern Medical Center (St. Paul's),
Dallas, Texas, United States
(Hagberg) Hartford Hospital, Hartford, Connecticut, United States
(Quinn) Maine Medical Center, Portland, Maine
(Sethi) Tucson Heart Center, University of Arizona, Tucson, AZ, United
States
(Floridia) Loma Linda University Medical Center, Loma Linda, California,
United States
(Barreiro) Sentara Norfolk General Hospital, Norfolk, Virginia
(Pruitt) St. Joseph Mercy Hospital, Ann Arbor, MI, United States
(Accola) Florida Hospital, Orlando, Florida, United States
(Dagenais) Institut universitaire de cardiologie et de pneumologie de
Quebec (IUCPQ), Quebec City, QC, Canada
(Markowitz) University Hospitals-Cleveland, Cleveland, Ohio, United States
(Ye) St. Paul's and Vancouver General Hospital, Vancouver, BC, Canada
(Sekela) University of Kentucky, Lexington, Kentucky
(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, New York,
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, North Carolina, United
States
(Puskas) Mount Sinai Saint Luke's, New York, New York, 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

<96>
Accession Number
2021679348
Title
Outcomes with plug-based versus suture-based vascular closure device after
transfemoral transcatheter aortic valve replacement: A systematic review
and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 101(4) (pp 817-827),
2023. Date of Publication: 01 Mar 2023.
Author
Sedhom R.; Dang A.T.; Elwagdy A.; Megaly M.; Elgendy I.Y.; Zahr F.; Gafoor
S.; Mamas M.; Elbadawi A.
Institution
(Sedhom) Division of Cardiology, Loma Linda University Health, Loma Linda,
CA, United States
(Dang) Department of Internal Medicine, University of Texas Medical
Branch, Galveston, TX, United States
(Elwagdy) Department of Internal Medicine, Rochester General Hospital,
Rochester, NY, United States
(Megaly) Division of Cardiology, Henry Ford Hospital, Detroit, MI, United
States
(Elgendy) Division of Cardiovascular Medicine, Gill Heart Institute,
University of Kentucky, Lexington, KY, United States
(Zahr) Division of Cardiology, Oregon Health and Science University,
Portland, OR, United States
(Gafoor) Swedish Heart and Vascular Institute, Seattle, WA, United States
(Mamas) Centre for Prognosis Research, Keele Cardiovascular Research
Group, Keele University, Keele, United Kingdom
(Mamas) Department of Cardiology, Royal Stoke University Hospital,
Stoke-on-Trent, United Kingdom
(Elbadawi) Division of Cardiology, Baylor College of Medicine, Houston,
TX, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Studies comparing plug-based (i.e., MANTA) with suture-based
(i.e., ProStar XL and ProGlide) vascular closure devices (VCDs) for
large-bore access closure after transcatheter aortic valve replacement
(TAVR) have yielded mixed results. Aim(s): To examine the comparative
safety and efficacy of both types of VCDs among TAVR recipients.
 Method(s): An electronic database search was performed through March
2022 for studies comparing access-site related vascular complications with
plug-based versus suture-based VCDs for large-bore access site closure
after transfemoral (TF) TAVR. Result(s): Ten studies (2 randomized
controlled trials [RCTs] and 8 observational studies) with 3113 patients
(MANTA = 1358, ProGlide/ProStar XL = 1755) were included. There was no
difference between plug-based and suture-based VCD in the incidence of
access-site major vascular complications (3.1% vs. 3.3%, odds ratio [OR]:
0.89; 95% confidence interval [CI]: 0.52-1.53). The incidence of VCD
failure was lower in plug-based VCD (5.2% vs. 7.1%, OR: 0.64; 95% CI:
0.44-0.91). There was a trend toward a higher incidence of unplanned
vascular intervention in plug-based VCD (8.2% vs. 5.9%, OR: 1.35; 95% CI:
0.97-1.89). Length of stay was shorter with MANTA. Subgroup analyses
suggested significant interaction based on study designs such that there
was higher incidence of access-site vascular complications and bleeding
events with plug-based versus suture-based VCD among RCTs.
 Conclusion(s): In patients undergoing TF-TAVR, large-bore access site
closure with plug-based VCD was associated with a similar safety profile
as suture-based VCD. However, subgroup analysis showed that plug-based VCD
was associated with higher incidence of vascular and bleeding
complications in RCTs. Copyright © 2023 The Authors.
Catheterization and Cardiovascular Interventions published by Wiley
Periodicals LLC.

<97>
Accession Number
2020699980
Title
Outcomes of concomitant aortic valve procedures and left ventricular
assist device implantation: A systematic review and meta-analysis.
Source
Artificial Organs. 47(3) (pp 470-480), 2023. Date of Publication: March
2023.
Author
Iqbal K.; Arif T.B.; Rathore S.S.; Ahmed J.; Kumar P.; Shahid I.; Iqbal
A.; Shariff M.; Kumar A.
Institution
(Iqbal, Arif, Ahmed, Kumar, Iqbal) Department of Internal Medicine, Dow
Medical College, Dow University of Health Sciences, Karachi, Pakistan
(Rathore) Department of Internal Medicine, Dr. Sampurnanand Medical
College, Jodhpur, India
(Shahid) Department of Internal Medicine, Ziauddin Medical University,
Karachi, Pakistan
(Shariff) Department of Surgery, Mayo Clinic, Rochester, NY, United States
(Kumar) Department of Internal Medicine, Cleveland Clinic Akron General,
Akron, OH, United States
(Kumar) Section of Cardiovascular Research, Heart, Vascular and Thoracic
Department, Cleveland Clinic Akron General, Akron, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Left ventricular assist device (LVAD) implantation is
frequently employed in patients with end-stage heart failure. The outcomes
of addressing the repair of all substantial aortic valvular disease at the
time of LVAD implantation remain unclear. We sought to assess the clinical
outcomes in patients undergoing LVAD implantation concomitant with aortic
valve procedures (AVPs) compared with isolated LVAD implantation.
 Method(s): A literature search was performed using PubMed, Embase,
and Cochrane library from inception till June 2022. Primary outcomes
included short-term mortality and long-term survival. Random effects
models were used to compute mean differences and odds ratios with 95%
confidence intervals (CIs). Result(s): A total of 14 observational
studies (N = 52 693) met our inclusion criteria. Concomitant LVAD
implantation and AVPs were associated with higher short-term mortality (OR
= 1.61 [95% CI, 1.06-2.42]; p = 0.02) and mean CPBt (MD = 43.25 [95% CI,
22.95-63.56]; p < 0.0001), and reduced long-term survival (OR = 0.70 [95%
CI, 0.55-0.88]; p = 0.003) compared with isolated LVAD implantation. No
difference in the odds of cerebrovascular accident (OR = 1.05 [95% CI,
0.79-1.39]; p = 0.74) and mean length of hospital stay (MD = 2.89 [95% CI,
-4.04 to 9.82]; p = 0.41) was observed between the two groups. On adjusted
analysis, short-term mortality was significantly higher in the LVAD group
with concurrent AVPs when compared with the isolated LVAD group (aHR =
1.50 [95% CI, 1.20-1.87]; p = 0.0004). Conclusion(s): Concurrent AVPs
were associated with higher short-term mortality and reduced long-term
survival in patients undergoing LVAD implantation compared with isolated
LVAD implantation. Copyright © 2022 The Authors. Artificial
Organs published by International Center for Artificial Organ and
Transplantation (ICAOT) and Wiley Periodicals LLC.

<98>
Accession Number
640542968
Title
In a secondary analysis from a randomised, double-blind placebo-controlled
trial Dexmedetomidine blocks cholinergic dysregulation in delirium
pathogenesis in patients with major surgery.
Source
Scientific reports. 13(1) (pp 3971), 2023. Date of Publication: 09 Mar
2023.
Author
Jacob Y.; Schneider B.; Spies C.; Heinrich M.; von Haefen C.; Kho W.;
Pohrt A.; Muller A.
Institution
(Jacob, Schneider, Spies, Heinrich, von Haefen, Kho, Muller) Department of
Anesthesiology and Operative Intensive Care Medicine (CCM, Charite -
Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin,
Berlin Institute of Health, Humboldt-Universitat Zu BerlinCharite Platz 1,
Berlin 10117, Germany
(Heinrich) Berlin Institute of Health (BIH), Berlin 10178, Germany
(Pohrt) Institute of Biometry and Clinical Epidemiology, Charite -
Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin,
Humboldt-Universitat Zu Berlin, Berlin, Germany
Publisher
NLM (Medline)
Abstract
Dexmedetomidine is an alpha-2 adrenoreceptor agonist with
anti-inflammatory and anti-delirogenic properties. Pathogenesis of
postoperative delirium (POD) includes cholinergic dysfunction and
deregulated inflammatory response to surgical trauma. Acetylcholinesterase
(AChE) and butyrylcholinesterase (BChE) are discussed as biomarkers for
both POD and severity in acute inflammation. To show whether there is a
link between blood cholinesterase activities and dexmedetomidine, we
performed a secondary analysis of a randomised, double-blind,
placebo-controlled trial that recently showed a lower incidence of POD in
the dexmedetomidine group. Abdominal or cardiac surgical patients aged>=60
years were randomised to receive dexmedetomidine or placebo intra- and
postoperatively in addition to standard general anaesthesia. We analysed
the course of perioperative cholinesterase activities of 56 patients,
measured preoperatively and twice postoperatively. Dexmedetomidine
resulted in no change in AChE activity and caused a rapid recovery of BChE
activity after an initial decrease, while placebo showed a significant
decrease in both cholinesterase activities. There were no significant
between-group differences at any point in time. From these data it can be
assumed that dexmedetomidine could alleviate POD via altering the
cholinergic anti-inflammatory pathway (CAIP). We advocate for further
investigations to show the direct connection between dexmedetomidine and
cholinesterase activity. Copyright © 2023. The Author(s).

<99>
Accession Number
2023047390
Title
FEASIBILITY OF TRANSCATHETER EDGE TO EDGE REPAIR IN HYPERTROPHIC
OBSTRUCTIVE CARDIOMYOPATHY.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1088), 2023. Date of
Publication: 07 Mar 2023.
Author
Bandyopadhyay D.; Krishnan S.; Malik A.; Goel A.; Gupta R.; Naidu S.S.
Institution
(Bandyopadhyay, Krishnan, Malik, Goel, Gupta, Naidu) Westchester Medical
Center at New York Medical College, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background Transcatheter edge-to-edge repair (TEER) of the mitral valve
was approved for patients with secondary mitral regurgitation (MR).
Systolic anterior motion (SAM) of anterior mitral valve leaflet in
patients with hypertrophic cardiomyopathy (HCM) is responsible for
secondary MR. There are some case reports and case series illustrating the
feasibility of TEER in patients with HCM to reduce the MR and, thereby,
left-ventricular outflow tract (LVOT) obstruction. However, there is no
large-scale study to demonstrate the outcomes of TEER in patients with
HCM. Methods We used National Inpatient Sample from 2014-19 to include all
admissions where TEER was performed using the ICD-10-CM/PCS. Then we
compared TEER patients who had preexisting HCM vs. those who did not have
HCM. The primary outcome of interest was in-hospital mortality. Secondary
outcomes were the development of cardiogenic, acute kidney injury (AKI),
ventilator use, vasopressor use, and use of mechanical support devices.
Results Amongst 32300 TEER admissions, 115 patients had concomitant HCM.
The mean age and duration of the hospital stay were similar in both
groups. There was a higher proportion of females in the HCM group. The
distribution of comorbidities, including AF, HTN, DM, CKD, COPD, coronary
artery disease, history of revascularization, and peripheral vascular
disease, was not significantly different in both groups. There was an
increase in the number of TEER procedures in patients with HCM in
2018-2019. In-hospital mortality was significantly higher in HCM patients
[8.7% vs. 2%, P=0.024; aOR: 5.06, 95% CI: 1.25-20.4; P=0.03]. There was no
significant difference between the two groups in terms of cardiogenic
shock, AKI, use of a mechanical ventilator, use of vasopressor, or
mechanical support devices. Conclusion We have noticed higher in-hospital
mortality in patients who are undergoing TEER with concomitant HCM
compared to the patients who did not have HCM. However, other in-hospital
complications were not statistically significant between both groups. We
need further randomized controlled trials to demonstrate the impact of
preexisting HCM in patients undergoing TEER procedures for secondary
MR. Copyright © 2023 American College of Cardiology Foundation

<100>
Accession Number
2022026311
Title
The Role of Preservation Solutions upon Saphenous Vein Endothelial
Integrity and Function: Systematic Review and UK Practice Survey.
Source
Cells. 12(5) (no pagination), 2023. Article Number: 815. Date of
Publication: March 2023.
Author
Layton G.R.; Ladak S.S.; Abbasciano R.; McQueen L.W.; George S.J.; Murphy
G.J.; Zakkar M.
Institution
(Layton, Ladak, McQueen, Murphy, Zakkar) Department of Cardiovascular
Sciences, University of Leicester, Leicester LE1 7RH, United Kingdom
(Abbasciano) Department of Cardiac Surgery, Imperial College London,
London SW7 2BX, United Kingdom
(George) Department of Translational Health Sciences, Bristol Medical
School, University of Bristol, Bristol BS2 1UDD, United Kingdom
Publisher
MDPI
Abstract
The long saphenous vein is the most used conduit in cardiac surgery, but
its long-term patency is limited by vein graft disease (VGD). Endothelial
dysfunction is a key driver of VGD; its aetiology is multi-factorial.
However emerging evidence identifies vein conduit harvest technique and
preservation fluids as causal in their onset and propagation. This study
aims to comprehensively review published data on the relationship between
preservation solutions, endothelial cell integrity and function, and VGD
in human saphenous veins harvested for CABG. The review was registered
with PROSPERO (CRD42022358828). Electronic searches of Cochrane Central
Register of Controlled Trials, MEDLINE, and EMBASE databases were
undertaken from inception until August 2022. Papers were evaluated in line
with registered inclusion and exclusion criteria. Searches identified 13
prospective, controlled studies for inclusion in the analysis. All studies
used saline as a control solution. Intervention solutions included
heparinised whole blood and saline, DuraGraft, TiProtec, EuroCollins,
University of Wisconsin (UoW), buffered, cardioplegic and Pyruvate
solutions. Most studies demonstrated that normal saline appears to have
negative effects on venous endothelium and the most effective preservation
solutions identified in this review were TiProtec and DuraGraft. The most
used preservation solutions in the UK are heparinised saline or autologous
whole blood. There is substantial heterogeneity both in practice and
reporting of trials evaluating vein graft preservation solutions, and the
quality of existing evidence is low. There is an unmet need for high
quality trials evaluating the potential for these interventions to improve
long-term patency in venous bypass grafts. Copyright © 2023 by
the authors.

<101>
Accession Number
2023161452
Title
Efficacy of dexmedetomidine on myocardial ischemia/reperfusion injury in
patients undergoing cardiac surgery with cardiopulmonary bypass: A
protocol for systematic review and meta-analysis.
Source
Medicine (United States). 102(9) (pp E33025), 2023. Date of Publication:
03 Mar 2023.
Author
Liang G.; Li Y.; Li S.; Huang Z.
Institution
(Liang, Li) Department of Emergency, Affiliated Hospital of Youjiang
Medical University for Nationalities, Guangxi, China
(Li) Department of Intervention Medicine, Affiliated Hospital of Youjiang
Medical University for Nationalities, Guangxi, China
(Huang) Graduate School, Youjiang Medical University for Nationalities,
Guangxi, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Cardiac surgery using cardiopulmonary bypass has been shown to
cause reversible postischemic cardiac dysfunction and is associated with
reperfusion injury and myocardial cell death. Therefore, it is very
important to have a series of measures in place to reduce oxygen
consumption and provide myocardial protection. We performed a protocol for
systematic review and meta-analysis to evaluate the effect of
dexmedetomidine administration on myocardial ischemia/reperfusion injury
in patients undergoing cardiac surgery with cardiopulmonary bypass.
 Method(s): This review protocol is registered in the PROSPERO
International Prospective Register of systematic reviews, registration
number CRD42023386749. A literature search is performed in January 2023
without restriction to regions, publication types or languages. The
primary sources were the electronic databases of PubMed, Embase, Web of
Science, the Cochrane Central Register of Controlled Trials, Chinese
National Knowledge Infrastructure database, Chinese Biomedical Database,
and Chinese Science and Technology Periodical database. Risk of bias will
be assessed according to the Cochrane Risk of Bias Tool. The meta-analysis
is performed using Reviewer Manager 5.4. Result(s): The results of
this meta-analysis will be submitted to a peer-reviewed journal for
publication. Conclusion(s): This meta-analysis will evaluate the
efficacy and safety of dexmedetomidine in patients undergoing cardiac
surgery with cardiopulmonary bypass. Copyright © 2023 Lippincott
Williams and Wilkins. All rights reserved.

<102>
Accession Number
2021840185
Title
Outcomes of isolated tricuspid valve replacement: a systematic review and
meta-analysis of 5,316 patients from 35 studies.
Source
EuroIntervention. 18(10) (pp 840-851), 2022. Date of Publication: November
2022.
Author
Scotti A.; Sturla M.; Granada J.F.; Kodali S.K.; Coisne A.; Mangieri A.;
Godino C.; Ho E.; Goldberg Y.; Chau M.; Jorde U.P.; Garcia M.J.; Maisano
F.; Bapat V.N.; Ailawadi G.; Latib A.
Institution
(Scotti, Sturla, Granada, Coisne, Ho, Goldberg, Chau, Jorde, Garcia,
Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
(Scotti, Granada, Coisne) Cardiovascular Research Foundation, New York,
NY, United States
(Kodali) Division of Cardiology, New York-Presbyterian Hospital, Columbia
University Irving Medical Center, New York, NY, United States
(Mangieri) Department of Biomedical Sciences, Humanitas University, Pieve
Emanuele, Italy
(Mangieri) Cardio Center, Humanitas Research Hospital IRCCS, Rozzano,
Italy
(Godino, Maisano) Cardio-Thoracic-Vascular Department, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Bapat) Minneapolis Heart Institute, Abbott Northwestern Hospital,
Minneapolis, MN, United States
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
Publisher
Europa Group
Abstract
Background: Transcatheter tricuspid valve replacement (TTVR) is rapidly
emerging as a therapeutic option amongst patients with secondary tricuspid
regurgitation. Historical data from surgical tricuspid valve replacement
(TVR) studies may serve as a benchmark for the development of TTVR trials.
 Aim(s): The aim of the study was to investigate the early and late
outcomes following isolated surgical TVR. Method(s): Multiple
electronic databases were searched to identify studies on isolated
surgical TVR. The prespecified primary endpoint was operative mortality;
secondary endpoints were early and late outcomes. Overall estimates of
proportions and incidence rates with 95% confidence intervals (CI) were
calculated using random-effects models. Multiple sensitivity analyses
accounting for baseline characteristics, country and the operative period
were applied. Result(s): A total of 35 studies (5,316 patients) were
included in this meta-analysis. The operative period ranged from 1974 to
2019. The overall rate of operative mortality was 12% (95% CI: 9-15), with
higher mortality for patients who were operated on before 1995, who had
prior cardiac surgeries, or who had liver disease. The most frequent
clinical events were pacemaker implantation (10% [95% CI: 6-16]), bleeding
(12% [95% CI: 8-17]), acute kidney injury (15% [95% CI: 9-24]) and
respiratory complications (15% [95% CI: 12-20]). At follow-up analysis of
the bioprosthetic TVR, there was an incidence rate per 100 person-years of
6 (95% CI: 2-13) for death and 8 (95% CI: 5-13) for recurrence of
significant tricuspid regurgitation. Conclusion(s): This
meta-analysis provides an overview of the historical clinical outcomes
following isolated surgical TVR. These findings can support the
development of future clinical trials in the tricuspid space by providing
thresholds for clinical outcomes. Copyright © Europa Digital &
Publishing 2022. All rights reserved.

<103>
Accession Number
2021915804
Title
Association of liver dysfunction with outcomes after cardiac surgery - a
meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 35(6) (no pagination),
2022. Article Number: ivac280. Date of Publication: 01 Dec 2022.
Author
Kirov H.; Caldonazo T.; Audisio K.; Rahouma M.; Bryce Robinson N.;
Cancelli G.; Soletti G.J.; Demetres M.; Ibrahim M.; Faerber G.; Gaudino
M.; Doenst T.
Institution
(Kirov, Caldonazo, Faerber, Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Germany
(Audisio, Rahouma, Bryce Robinson, Cancelli, Soletti, Gaudino) Department
of Cardiothoracic Surgery, New York Presbyterian, Weill Cornell Medical
Center, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Ibrahim) Department of General Surgery, Maimonides Medical Center,
Brooklyn, NY, United States
(Ibrahim) Nuffield Department of Surgical Sciences, University of Oxford,
Oxford, United Kingdom
Publisher
Oxford University Press
Abstract
OBJECTIVES: The aim of this study was to perform a meta-analysis of
studies reporting outcomes in patients with liver dysfunction addressed by
the model of end-stage liver disease and Child-Turcotte-Pugh 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 to patients
with no or mild liver dysfunction undergoing cardiac surgery (stratified
in high and low score group based on the study cut-offs). 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 [odds
ratio (OR) 3.72, 95% confidence interval (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 (incidence risk ratio
1.29, 95% CI 1.14-1.46, P < 0.001) 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. Copyright © 2022 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<104>
Accession Number
2021900960
Title
Reply to Urso et al.
Source
European Journal of Cardio-thoracic Surgery. 62(4) (no pagination), 2022.
Article Number: ezac436. Date of Publication: 01 Oct 2022.
Author
Gaudino M.; Dimagli A.
Institution
(Gaudino, Dimagli) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, New York, NY, United States
Publisher
European Association for Cardio-Thoracic Surgery

<105>
Accession Number
2023258187
Title
A Systematic Review of Periprocedural Risk Prediction Scores in Chronic
Total Occlusion Percutaneous Coronary Intervention.
Source
American Journal of Cardiology. 193 (pp 118-125), 2023. Date of
Publication: 15 Apr 2023.
Author
Simsek B.; Rempakos A.; Kostantinis S.; Karacsonyi J.; Rangan B.V.;
Mastrodemos O.C.; Patel U.A.; Allana S.; Azzalini L.; Kearney K.E.; Hirai
T.; Sandoval Y.; Burke M.N.; Brilakis E.S.
Institution
(Simsek, Rempakos, Kostantinis, Karacsonyi, Rangan, Mastrodemos, Allana,
Sandoval, Burke, Brilakis) Center for Coronary Artery Disease, Minneapolis
Heart Institute and Minneapolis Heart Institute Foundation, Minneapolis,
MN, United States
(Patel) School of Medicine, Pramukhswami Medical College, Gujarat,
Karamsad, India
(Azzalini, Kearney) Division of Cardiology, Department of Medicine,
University of Washington, Seattle, WA, United States
(Hirai) Division of Cardiovascular Medicine, University of Missouri,
Columbia, Missouri, United States
Publisher
Elsevier Inc.
Abstract
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is
associated with high incidence of complications. We queried PubMed and the
Cochrane Library (last search: October 26, 2022) for CTO PCI-specific
periprocedural complication risk scores. We identified 8 CTO PCI-specific
risk scores: (1) Angiographic coronary artery perforation (OPEN-CLEAN
[Outcomes, Patient Health Status, and Efficiency iN (OPEN) Chronic Total
Occlusion (CTO) Hybrid Procedures - CABG, Length (occlusion), EF <50%,
Age, CalcificatioN] perforation, c-statistic 0.75): previous coronary
artery bypass graft surgery, occlusion length 20 to 60 mm or >=60 mm, left
ventricular ejection fraction (LVEF) <50%, age 50 to 70 years or >=70
years, heavy calcification. (2) Major adverse cardiovascular events (MACE)
(PROGRESS-CTO complication, c-statistic 0.76): age >65 years, lesion
length >=23 mm, retrograde strategy, and (3) MACE (PROGRESS-CTO MACE,
c-statistic 0.74): age >=65 years, female gender, moderate/severe
calcification, blunt/no stump, anterograde dissection and re-entry (ADR)
or retrograde strategy. (4) All-cause mortality (PROGRESS-CTO mortality,
c-statistic 0.80): age >=65, moderate/severe calcification, LVEF <=45%,
ADR or retrograde strategy. (5) Perforation requiring pericardiocentesis
(PROGRESS-CTO pericardiocentesis, c-statistic 0.78): age >=65 years,
moderate/severe calcification, female gender, ADR or retrograde strategy.
(6) Acute myocardial infarction (PROGRESS-CTO acute myocardial infarction,
c-statistic 0.72): previous coronary artery bypass graft surgery, atrial
fibrillation, blunt/no stump. (7) Perforation requiring any treatment
(PROGRESS-CTO perforation, c-statistic 0.74): age >=65 years,
moderate/severe calcification, blunt/no stump, ADR, or retrograde
strategy. (8) Contrast-induced acute kidney injury (c-statistic 0.84): age
>=75, LVEF <40%, serum creatinine >1.5 mg/100 ml, serum albumin <=30,
30<albumin<=40 or >40 g/L. There are 8 CTO PCI periprocedural risk scores
that may facilitate risk assessment and procedural planning in patients
who underwent CTO PCI. Copyright © 2023 Elsevier Inc.

<106>
Accession Number
2023110367
Title
Meta-Analysis of Cerebral Embolic Protection During Transcatheter Aortic
Valve Replacement.
Source
American Journal of Cardiology. 192 (pp 255-257), 2023. Date of
Publication: 01 Apr 2023.
Author
Al-Abdouh A.; Mhanna M.; Jabri A.; Ahmed T.; Altibi A.M.; Ghanem F.;
Alhuneafat L.; Albadawi A.; Barbarawi M.; Dewaswala N.; Bhopalwala H.;
Kundu A.; Elgendy I.Y.
Institution
(Al-Abdouh, Ahmed, Bhopalwala) Department of Medicine, University of
Kentucky, Lexington, Kentucky
(Mhanna) Department of Cardiovascular Medicine, University of Iowa, Iowa
City, IA, United States
(Jabri) Department of Cardiology, Case Western University (Metrohealth),
Cleveland, Ohio, United States
(Altibi) Division of Cardiology, Oregon Health and Science University,
Portland, Oregon, United States
(Ghanem) Department of Internal Medicine, East Tennessee State University,
Johnson City, TN, United States
(Alhuneafat) Department of Internal Medicine, Allegheny Health Network,
Pittsburgh, PA, United States
(Albadawi) Division of Cardiology UT Southwestern Dallas, TX, United
States
(Barbarawi, Kundu) Department of Cardiology, University of Connecticut,
Framingham, CT, United States
(Dewaswala, Elgendy) Division of Cardiovascular Medicine, Gill Heart
Institute, University of Kentucky, Lexington, Kentucky
Publisher
Elsevier Inc.

<107>
Accession Number
2022040851
Title
Surgical versus interventional coronary revascularization in kidney
transplant recipients: a systematic review and meta-analysis.
Source
International Urology and Nephrology. (no pagination), 2023. Date of
Publication: 2023.
Author
El-Qushayri A.E.; Reda A.
Institution
(El-Qushayri) Faculty of Medicine, Minia University, Minia, Egypt
(Reda) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Publisher
Springer Science and Business Media B.V.
Abstract
Aim: To study the most beneficial coronary revascularization strategy in
kidney transplant recipients (KTR). Method(s): In 16th June 2022 and
updated on 26th February 2023, we searched in five databases including
PubMed for relevant articles. The odds ratio (OR) together with the 95%
confidence interval (95%CI) were used to report the results.
 Result(s): Percutaneous coronary intervention (PCI) was significantly
associated with significant lower in-hospital mortality (OR 0.62; 95%CI
0.51-0.75) and 1-year mortality (OR 0.81; 95%CI 0.68-0.97), but not
overall mortality (mortality at the last follow-up point) (OR 1.05; 95%CI
0.93-1.18) rather than coronary artery bypass graft (CABG). Moreover, PCI
was significantly associated with lower acute kidney injury prevalence (OR
0.33; 95%CI 0.13-0.84) compared to CABG. One study indicated that
non-fatal graft failure prevalence did not differ between the PCI and the
CABG group until 3 years of follow up. Moreover, one study demonstrated a
short hospital length of stay in the PCI group rather than the CABG group.
 Conclusion(s): Current evidence indicated the superiority of PCI than
CABG as a coronary revascularization procedure in short- but not long-term
outcomes in KTR. We recommend further randomized clinical trials for
demonstrating the best therapeutic modality for coronary revascularization
in KTR. Copyright © 2023, The Author(s).

<108>
Accession Number
2021906013
Title
Optimum heparin dose in off-pump coronary artery bypass grafting: A
systematic review and meta-analysis.
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
2023.
Author
Khalil M.A.; Kaddoura R.; Omar A.S.; Abohamar A.D.; Izham M.
Institution
(Khalil) Anesthesia Department, Faculty of Medicine, Cairo University,
Giza, Egypt
(Kaddoura) Department of Clinical pharmacy, Hamad Medical Corporation,
Doha, Qatar
(Omar) Department of Cardiothoracic Surgery/Cardiac Anesthesia & ICU,
Heart Hospital, Hamad Medical Corporation, Doha, Qatar
(Omar) Department of Critical Care Medicine, Beni-Suef University, Beni
Suef, Egypt
(Omar) Weill Cornell Medical College, Ar-Rayyan, Qatar
(Abohamar) Anesthesia Department, Faculty of Medicine, Tanta University,
Tanta, Egypt
(Izham) Faculty of Pharmacy, Qatar University, Doha, Qatar
Publisher
SAGE Publications Ltd
Abstract
Introduction: Off-pump coronary artery bypass grafting (OPCABG) was
introduced many years ago aiming to reduce the known complications of
conventional on-pump coronary surgeries. Heparin is required during the
procedures, but the available protocols have diverse dosage regimens. The
primary objective of this systematic review is to examine the effect of
different heparin doses on the outcomes of OPCABG. Evidence
Acquisition: MEDLINE and EMBASE were searched. Four reviewers identified
eligible clinical trials. Two reviewers extracted data and independently
assessed the risk of bias using Cochrane tool. The primary outcome was the
activated clotting time (ACT) at three minutes. The secondary outcomes
were proportion of patients requiring blood products and the length of
hospital stay. An aggregate data approach was used. Evidence
Synthesis: Three single-center randomized studies recruiting 256 patients
were included. The studies compared low-dose (1.5-2 mg/kg) and high-dose
(3 mg/kg) heparin boluses. The overall mean difference for ACT after three
minutes between low- and high-dose heparin is - 126.16 (95% CI: - 142.19,
- 110.14). The proportion of patients requiring blood products after
surgery [odd ratio 1.27 (95% CI: 0.69, 2.32)] or the overall length of
stay [mean difference -0.15 (95% CI: -0.84, 0.53)] did not differ between
the heparin doses. Conclusion(s): In OPCABG, high-dose compared with
low-dose heparin did not affect the utilization of more blood products or
increased the overall length of stay. Unsurprisingly, ACT values were
higher in the high-dose heparin group. Larger and adequately powered
randomized clinical trials are indicated to resolve the
uncertainty. Copyright © The Author(s) 2023.

<109>
Accession Number
640554853
Title
The role of high-fidelity simulation in the acquisition of endovascular
surgical skills: a systematic review.
Source
Annals of vascular surgery. (no pagination), 2023. Date of Publication:
09 Mar 2023.
Author
Gomaa A.-R.; Grafton-Clarke C.; Saratzis A.; Davies R.S.M.
Institution
(Gomaa) Human Anatomy Resource Centre (HARC), University of Liverpool,
Liverpool, United Kingdom
(Grafton-Clarke) School of Medicine, University of Leicester, Leicester,
United Kingdom
(Saratzis, Davies) Leicester Vascular Institute, University Hospitals of
Leicester NHS Trust, Leicester, UK; Department of Cardiovascular Sciences,
University of Leicester, Leicester, UK
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The widespread introduction of minimally invasive
endovascular techniques in cardiovascular surgery has necessitated a
transition in the psychomotor skillset of trainees and surgeons.
Simulation has previously been used in surgical training; however, there
is limited high quality evidence regarding the role of simulation-based
training on the acquisition of endovascular skills. This systematic review
aimed to systematically appraise the currently available evidence
regarding endovascular high-fidelity simulation interventions, to describe
the overarching strategies used, the learning outcomes addressed, the
choice of assessment methodology, and the impact of education on learner
performance. METHOD(S): A comprehensive literature review was
performed in accordance with the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) statement using relevant keywords to
identify studies evaluating simulation in the acquisition of endovascular
surgical skills. References of review articles were screened for
additional studies. RESULT(S): A total of 1081 studies were
identified (474 after removal of duplicates). There was marked
heterogeneity in methodologies and reporting of outcomes. Quantitative
analysis was deemed inappropriate due to the risk of serious confounding
and bias. Instead, a descriptive synthesis was performed, summarising key
findings and quality components. Eighteen studies were included in the
synthesis (15 observational, 2 case-control and 1 randomised control
studies). Most studies measured procedure time, contrast usage, and
fluoroscopy time. Other metrics were recorded to a lesser extent.
Significant reductions were noted in both procedure and fluoroscopy times
with the introduction of simulation-based endovascular training.
 CONCLUSION(S): The evidence regarding the use of high-fidelity
simulation in endovascular training is very heterogeneous. The current
literature suggests simulation-based training leads to improvements in
performance, mostly in terms of procedure and fluoroscopy time.
High-quality randomised control trials are needed to establish the
clinical benefits of simulation training, sustainability of improvements,
transferability of skills and its cost-effectiveness. Copyright ©
2023 The Author(s). Published by Elsevier Inc. All rights reserved.

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