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<1>
Accession Number
2021652189
Title
Postoperative morbidity and mortality in pediatric indigenous populations:
a scoping review and meta-analysis.
Source
Pediatric Surgery International. 39(1) (no pagination), 2023. Article
Number: 129. Date of Publication: December 2023.
Author
Livergant R.J.; Fraulin G.; Stefanyk K.; Binda C.; Maleki S.; Joharifard
S.; Hillier T.; Joos E.
Institution
(Livergant, Fraulin) Faculty of Medicine and Dentistry, University of
Alberta, Edmonton, AB, Canada
(Stefanyk) Faculty of Medicine, University of British Columbia, Prince
George, BC, Canada
(Binda) Faculty of Medicine, University of British Columbia, Terrace, BC,
Canada
(Maleki) Lower Mainland Pharmacy Services, Vancouver General Hospital,
Faculty of Pharmaceutical Sciences, University of British Columbia,
Vancouver, BC, Canada
(Joharifard) Department of Pediatric and Thoracic Surgery, British
Columbia Children's Hospital, University of British Columbia, Vancouver,
Canada
(Hillier) Mi'kmaq Qalipu First Nation, Faculty of Medicine and Dentistry,
University of Alberta, Edmonton, AB, Canada
(Joos) Division of General Surgery, Trauma and Acute Care Surgery,
Vancouver General Hospital, University of British Columbia, 767 West 12th
Avenue, Vancouver, BC V5Z 1M9, Canada
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Mounting evidence suggests that childhood health is an important predictor
of wellness as an adult. Indigenous peoples worldwide suffer worse health
outcomes compared to settler populations. No study comprehensively
evaluates surgical outcomes for Indigenous pediatric patients. This review
evaluates inequities between Indigenous and non-Indigenous children
globally for postoperative complications, morbidities, and mortality. Nine
databases were searched for relevant subject headings including
"pediatric", "Indigenous", "postoperative", "complications", and related
terms. Main outcomes included postoperative complications, mortality,
reoperations, and hospital readmission. A random-effects model was used
for statistical analysis. The Newcastle Ottawa Scale was used for quality
assessment. Fourteen studies were included in this review, and 12 met
inclusion criteria for meta-analysis, representing 4793 Indigenous and
83,592 non-Indigenous patients. Indigenous pediatric patients had a
greater than twofold overall (OR 2.0.6, 95% CI 1.23-3.46) and 30-day
postoperative mortality (OR 2.23, 95% CI 1.23-4.05) than non-Indigenous
populations. Surgical site infections (OR 1.05, 95% CI 0.73-1.50),
reoperations (OR 0.75, 95% CI 0.51-1.11), and length of hospital stay (SMD
= 0.55, 95% CI - 0.55-1.65) were similar between the two groups. There was
a non-significant increase in hospital readmissions (OR 6.09, 95% CI
0.32-116.41, p = 0.23) and overall morbidity (OR 1.13, 95% CI 0.91-1.40)
for Indigenous children. Indigenous children worldwide experience
increased postoperative mortality. It is necessary to collaborate with
Indigenous communities to promote solutions for more equitable and
culturally appropriate pediatric surgical care.<br/>Copyright &#xa9; 2023,
The Author(s).

<2>
Accession Number
2021340106
Title
Cardiovascular Outcomes of Older versus Newer Generation Transcatheter
Aortic Valve Replacement Recipients: A Systematic Review & Meta-analysis.
Source
Current Problems in Cardiology. 48(2) (no pagination), 2023. Article
Number: 101467. Date of Publication: February 2023.
Author
Sattar Y.; Prakash P.; Almas T.; Mir T.; Titus A.; Ahmad S.; Khan M.S.;
Aggarwal A.; Ullah W.; Alhharbi A.; Kakouros N.; Alraies M.C.; Qureshi
W.T.
Institution
(Sattar, Alhharbi) Department of Cardiology, West Virginia University,
Morgantown, WV, United States
(Prakash, Mir) Department of Internal Medicine, Detroit Medical center,
Wayne State University, Detroit, MI, United States
(Almas) Royal College of Surgeons in Ireland, Dublin, Ireland
(Titus) Department of Internal Medicine, Saint Vincent Hospital,
Worcester, MA
(Ahmad) Department of Internal Medicine, Icahn School of Medicine at Mount
Sinai - Elmhurst Hospital, Queens, NY, United States
(Khan) Department of Internal Medicine, Mercy St Vincent Medical Centre,
Toledo Ohio
(Aggarwal) Department of Internal Medicine, Ascension providence Rochester
(Ullah) Department of Internal Medicine, Abington Jefferson Health,
Abington, PA
(Kakouros, Qureshi) Division of Cardiology, University of Massachusetts
School of Medicine, Worcester, MA
(Alraies) Department of Interventional Cardiology, Detroit Medical Center,
DMC Heart Hospital, Detroit, MI, United States
Publisher
Elsevier Inc.
Abstract
Newer generation transcatheter heart valves (THV) are presumed to yield
better clinical efficacy and postprocedural complication profile as
compared to transcatheter aortic valve replacement (TAVR) using older
generation THVs. The real impact of newer generation valves on TAVR
outcomes is not well known. Studies comparing older and newer generation
THVs were identified from online databases including PubMed, EMBASE,
Cochrane, and ClinicalTrials.gov from inception until August 2020. The
primary outcome of the study was to compare mortality. Secondary outcomes
included cerebrovascular events, myocardial infarction, major vascular
complications, major bleeding, acute kidney injury, paravalvular leak, and
post-procedural pacemaker implantation. Statistical analysis was performed
using the Mantel-Haenszel random effect model with an odds ratio (OR), 95%
confidence interval (CI), and p-value significance <=0.05. A total of 14
studies were included with a combined patient population of 5697 patients
(older generation n=1996; newer generation n=3701). Newer generation
valves showed statistically significant results favoring lower major
vascular complications (OR=2.05; 95% CI, 1.33-3.18; P = 0.00), major
bleeding (OR=1.99; 95% CI, 1.35-2.93; P = 0.00), acute kidney injury
(OR=1.71; 95% CI, 1.13-2.59; P = 0.01), paravalvular leak (OR=2.41; 95%
CI, 1.11-5.28; P = 0.03) and mortality (OR=1.50; 95% CI, 1.10-2.06; P =
0.01) as compared to older generation valves. Cerebrovascular events,
myocardial infarction, and pacemaker placement rates were found to be
similar between older and newer generation valves. TAVR outcomes using
newer generation valves are superior to those of older generation valves
in terms of major vascular complications, acute kidney injury,
paravalvular leak, and mortality.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<3>
Accession Number
2020454564
Title
The Impact of Bariatric Surgery on Cardiac Structure, and Systolic and
Diastolic Function in Patients with Obesity: A Systematic Review and
Meta-analysis.
Source
Obesity Surgery. 33(1) (pp 345-361), 2023. Date of Publication: January
2023.
Author
Esparham A.; Shoar S.; Kheradmand H.R.; Ahmadyar S.; Dalili A.; Rezapanah
A.; Zandbaf T.; Khorgami Z.
Institution
(Esparham, Kheradmand, Ahmadyar) Student Research Committee, College of
Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Shoar) Department of Clinical Research, ScientificWriting Corp, Houston,
TX, United States
(Dalili, Rezapanah) Department of Surgery, School of Medicine, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Dalili, Rezapanah) Surgical Oncology Research Center, Imam Reza Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Zandbaf) Department of Surgery, School of Medicine, Islamic Azad
University, Mashhad, Iran, Islamic Republic of
(Khorgami) Department of Surgery, University of Oklahoma College of
Community Medicine, Tulsa, OK, United States
(Khorgami) Harold Hamm Diabetes Center, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, United States
Publisher
Springer
Abstract
The purpose of this study was to provide pooled data from all studies on
the impact of bariatric surgery on cardiac structure, and systolic and
diastolic function evaluated by either echocardiography or cardiac
magnetic resonance. PubMed, Web of Science, Embase, and Scopus databases
were searched. Almost all of cardiac left-side structural indices improved
significantly after bariatric surgery. However, right-side structural
indices did not change significantly. Left ventricular ejection fraction
and most of the diastolic function indices improved significantly after
the bariatric surgery. The subgroup analysis showed that the left
ventricular mass index decreased more in long-term follow-up (>= 12
months). In addition, subgroup analysis of studies based on surgery type
did not reveal any difference in outcomes between gastric bypass and
sleeve gastrectomy groups.<br/>Copyright &#xa9; 2022, The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<4>
Accession Number
2020249129
Title
Higher blood pressure versus normotension targets to prevent acute kidney
injury: a systematic review and meta-regression of randomized controlled
trials.
Source
Critical Care. 26(1) (no pagination), 2022. Article Number: 364. Date of
Publication: December 2022.
Author
Tran P.N.T.; Kusirisin P.; Kaewdoungtien P.; Phannajit J.; Srisawat N.
Institution
(Tran, Kusirisin, Kaewdoungtien, Phannajit, Srisawat) Division of
Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn
University, Bangkok, Thailand
(Tran, Kusirisin, Kaewdoungtien, Srisawat) Excellence Center for Critical
Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
(Kusirisin, Kaewdoungtien, Srisawat) Center of Excellence in Critical Care
Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok,
Thailand
(Kusirisin) Division of Nephrology, Department of Internal Medicine,
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
(Phannajit) Division of Clinical Epidemiology, Department of Medicine,
Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
(Kaewdoungtien) Division of Nephrology, Police General Hospital, Royal
Thai Police Headquarters, Bangkok, Thailand
(Srisawat) Academy of Science, Royal Society of Thailand, Bangkok,
Thailand
(Tran) Department of Internal Medicine, Faculty of Medicine, Can Tho
University of Medicine and Pharmacy, Cantho, Vietnam
Publisher
BioMed Central Ltd
Abstract
Background: Renal hypoperfusion is one of the most common causes of acute
kidney injury (AKI), especially in shock and perioperative patients. An
optimal blood pressure (BP) target to prevent AKI remains undetermined. We
conducted a systematic review and meta-analysis of available randomized
clinical trial (RCT) results to address this knowledge gap.
<br/>Method(s): From inception to May 13, 2022, we searched Ovid Medline,
EMBASE, Cochrane Library, SCOPUS, clinicaltrials.gov, and WHO ICTRP for
RCTs comparing higher BP target versus normotension in hemodynamically
unstable patients (shock, post-cardiac arrest, or surgery patients). The
outcomes of interest were post-intervention AKI rate and renal replacement
therapy (RRT) rate. Two investigators independently screened the citations
and reviewed the full texts for eligible studies according to a predefined
form. <br/>Result(s): Twelve trials were included, enrolling a total of
5759 participants, with shock, non-cardiac, and cardiac surgery patients
accounting for 3282 (57.0%), 1687 (29.3%) and 790 (13.7%) patients,
respectively. Compared to lower mean arterial blood pressure (MAP) targets
that served as normotension, targeting higher MAP had no significant
effect on AKI rates in shock (RR [95% CI] = 1.10 [0.93, 1.29]), in
cardiac-surgery (RR [95% CI] = 0.87 [0.73, 1.03]) and non-cardiac surgery
patients (RR [95% CI] = 1.25 [0.98, 1.60]) using random-effects
meta-analyses. In shock patients with premorbid hypertension, however,
targeting MAP above 70 mmHg resulted in significantly lower RRT risks, RR
[95%CI] = 1.20 [1.03, 1.41], p < 0.05. <br/>Conclusion(s): Targeting a
higher MAP in shock or perioperative patients may not be superior to
normotension, except in shock patients with premorbid hypertension.
Further studies are needed to assess the effects of a high MAP target to
preventing AKI in hypertensive patients across common settings of
hemodynamic instability. Trial registration This systematic review has
been registered on PROSPERO (CRD42021286203) on November 19, 2021, prior
to data extraction and analysis.<br/>Copyright &#xa9; 2022, The Author(s).

<5>
Accession Number
2020248915
Title
Impacts of metabolic disorders on short- and long-term mortality after
coronary artery surgery in the elderly.
Source
BMC Cardiovascular Disorders. 22(1) (no pagination), 2022. Article Number:
504. Date of Publication: December 2022.
Author
Fan Y.; Liu J.; Jin L.; Liu Z.; Han L.; Wang Y.; Zhang Y.; Shen P.; Li Z.
Institution
(Fan, Liu, Zhang) Department of Cardiovascular Surgery, Shanghai Chest
Hospital, Shanghai Jiao Tong University, 241 Huaihai Road, Shanghai
200030, China
(Liu) Department of Cardiology, Wuxi People's Hospital Affiliated to
Nanjing Medical University, Wuxi, China
(Jin, Shen) Department of Critical Care Medicine, Shanghai Chest Hospital,
Shanghai Jiao Tong University, 241 Huaihai Road, Shanghai 200030, China
(Han, Li) Department of Cardiovascular Surgery, Jiangsu Province Hospital,
The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou
Road, Nanjing 210029, China
(Wang) Outpatient Clinic, East Hospital, Tongji University School of
Medicine, Shanghai, China
Publisher
BioMed Central Ltd
Abstract
Background: Elderly patients undergoing cardiac operation often suffer
various metabolic comorbidities, such as diabetes mellitus (DM) and
obesity. The metabolic disorders in these individuals are widely
considered to be possible predisposing factors for unfavourable prognosis.
This retrospective study was aimed to determine the association of
metabolic diseases with the mortality of elderly patients after coronary
artery bypass grafting (CABG) and to identify the protective or risk
factors related to their short- and long-term survival. <br/>Method(s):
Totally 684 patients aged 75 years or above undergoing isolated CABG were
evaluated retrospectively. There were two groups depending on the body
mass index (BMI): an overweight and obesity group (n = 354) and a normal
weight and lean group (n = 330). Propensity score matching (PSM) was
performed to adjust baseline clinical characteristics, which reduced
confounding bias. The short-term postoperative mortality was tested via
logistic regression. Kaplan-Meier and Cox regression analyses were done to
compute the overall survival in each group and to identify relevant
variables associated with all-cause mortality, respectively.
<br/>Result(s): The prevalence rates of metabolic comorbidities in the
total cohort were: diabetes mellitus (32.5%), overweight or obesity
(51.8%) and hypertension (72.8%). The 30-day postoperative mortality was
5.1% and the long-term mortality was 15.25% at a median 46.2-month
follow-up (1.0-178.6 months). The 30-day postoperative mortality was
relevant to DM, diseased coronary arteries, New York Heart Association
class, intra-aortic balloon pump and emergency surgery. The long-term
mortality was negatively associated with overweight and obesity.
Univariate and multivariate logistic regression recognized DM as an
adverse factor related with 30-day postoperative mortality whether before
or after PSM. The long-term mortality was not significantly relevant with
DM (HR = 0.753, 95% CI 0.402-1.411). Overweight or obesity was not the
risk factor of 30-day postoperative mortality (OR = 1.284, 95% CI
0.426-3.868), but was the protective factor of long-term survival (HR =
0.512, 95% CI 0.279-0.939). <br/>Conclusion(s): The "obesity paradox"
exists regarding the prognosis of individuals aged >= 75, which was
presented as lower long-term mortality no matter from all cause or
cardio-cerebrovascular cause in patients with BMI >= 24. Trial
registration ChiCTR2200061869 (05/07/2022).<br/>Copyright &#xa9; 2022, The
Author(s).

<6>
Accession Number
2020231670
Title
Special Care Patients and Caries Prevalence in Permanent Dentition: A
Systematic Review.
Source
International Journal of Environmental Research and Public Health. 19(22)
(no pagination), 2022. Article Number: 15194. Date of Publication:
November 2022.
Author
Pecci-Lloret M.R.; Pecci-Lloret M.P.; Rodriguez-Lozano F.J.
Institution
(Pecci-Lloret, Pecci-Lloret, Rodriguez-Lozano) Special Care in Dentistry
and Gerodontology Unit, Meseguer Hospital, Faculty of Medicine, University
of Murcia, Murcia 30100, Spain
Publisher
MDPI
Abstract
Due to the increase in the population with special needs and the
significant difficulty in their dental management, it is essential to
analyze the caries prevalence in this group of patients. The systematic
review was conducted following the PRISMA statement. A search was
performed on 9 May 2022 and updated on 5 June 2022, in three databases:
Pubmed, Scielo, and Cochrane library. Studies involving the analysis of
caries in permanent teeth in patients with special needs were included. A
total of 1277 studies were analyzed and 21 studies were selected. Quality
assessments were performed using an adapted version of the STROBE
guidelines. Among the analyzed groups (intellectual disabilities, human
immunodeficiency virus infection, schizophrenia, down syndrome, drug
addicts, adult heart transplant, kidney disease, diabetic, autism,
psychiatric patients, cerebral palsy, and hemophilia), the highest
prevalence of caries was observed in patients with intellectual
disability, without differences between genders. However, there is a need
for more studies with standardized methods for caries diagnosis to further
investigate the prevalence of caries in permanent teeth in patients with
special needs.<br/>Copyright &#xa9; 2022 by the authors.

<7>
Accession Number
2011038098
Title
Midterm outcomes with a sutureless aortic bioprosthesis in a prospective
multicenter cohort study.
Source
Journal of Thoracic and Cardiovascular Surgery. 164(6) (pp 1772-1780.e11),
2022. Date of Publication: December 2022.
Author
Fischlein T.; Meuris B.; Folliguet T.; Hakim-Meibodi K.; Misfeld M.;
Carrel T.; Zembala M.; Cerutti E.; Asch F.M.; Haverich A.; Zannis K.;
Pfeiffer S.; Santarpino G.; Shrestha M.; Sarikouch S.; Gummert J.F.; Mohr
F.W.; Dohmen P.; Stalder M.; Roost E.; Filipiak K.; Niklewski T.; Madonna
F.; Roques X.; Flameng W.J.; Laczkovics A.M.M.; Bechtel M.; Prat A.G.;
Banfi C.; Dapunt O.E.; Eichstaedt H.C.; Harringer W.; Carstens-Fitz U.;
Spyt T.J.; Wimmer-Greinecker J.G.; Machner M.; Tan E.S.H.; Casselman
F.P.A.; Yilmaz A.; Sonker U.; Bleiziffer S.; Oberwalder P.J.; Kocher A.A.;
Seitelberger R.; Treede H.; Conradi L.; Cocchieri R.; De Mol B.; Roussel
J.-C.; Despins P.; Jakob H.G.; Wendt D.
Institution
(Fischlein) Klinikum Nurnberg, Cardiovascular Center, Paracelsus Medical
University, Nuremberg, Germany
(Meuris) Cardiac Surgery, UZ Gasthuisberg, Leuven, Belgium
(Folliguet) Cardiac Surgery and Transplantation, Hopital Henri Mondor
assistance Publique Hopitaux de Paris, Paris, France
(Hakim-Meibodi) Department of Thoracic and Cardiovascular Surgery, Herz-
und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany
(Misfeld) Department of Cardiac Surgery, Herzzentrum Universitaet Leipzig,
Klinik fur Herzchirurgie, Leipzig, Germany
(Misfeld) Department of Cardiothoracic Surgery, Royal Prince Alfred
Hospital, Sydney, Australia
(Carrel) Cardiovascular Surgery, Inselspital, Bern, Switzerland
(Zembala) Department of Cardiac, Vascular and Endovascular Surgery and
Transplantology, School of Medicine, Silesian Center for Heart Diseases,
Zabrze, Poland
(Cerutti) Clinical Affairs Department, LivaNova plc, London, United
Kingdom
(Asch) MedStar Health Research Institute, Washington Hospital Center,
Washington, DC
(Haverich) Cardio-thoracic, Transplantation and Vascular Surgery, Hannover
Medical School, Hannover, Germany
Publisher
Elsevier Inc.
Abstract
Objective: The objective of this study was to report midterm clinical
outcomes with a self-expandable sutureless aortic valve. <br/>Method(s):
Between 2010 and 2013, 658 patients at 25 European institutions received
the Perceval sutureless valve (LivaNova Plc, London, United Kingdom). Mean
follow-up was 3.8 years; late cumulative follow-up was 2325.2
patient-years. <br/>Result(s): The mean age of the population was 78.3 +/-
5.6 years and 40.0% (n = 263) were 80 years of age or older; mean Society
of Thoracic Surgeons-Predicted Risk of Mortality score was 7.2 +/- 7.4.
Concomitant procedures were performed in 31.5% (n = 207) of patients.
Overall duration of cardiopulmonary bypass time was 64.8 +/- 25.2 minutes
and aortic cross-clamping time was 40.7 +/- 18.1 minutes. Thirty-day
all-cause mortality was 3.7% (23 patients), with an observed:expected
ratio of 0.51. Overall survival was 91.6% at 1 year, 88.5% at 2 years, and
72.7% at 5 years. Peak and mean gradients remained stable during
follow-up, and were 17.8 +/- 11.3 mm Hg and 9.0 +/- 6.3 mm Hg,
respectively, at 5 years. Preoperatively, 33.4% of those who received the
Perceval valve (n = 210) were in New York Heart Association functional
class I or II versus 93.1% (n = 242) at 5 years. <br/>Conclusion(s): This
series, representing, to our knowledge, the longest follow-up with
sutureless technology in a prospective, multicenter study, shows that
aortic replacement using sutureless valves is associated with low
mortality and morbidity and good hemodynamic performance.<br/>Copyright
&#xa9; 2021 The American Association for Thoracic Surgery

<8>
Accession Number
2019950106
Title
Use of Cytokine Filters During Cardiopulmonary Bypass: Systematic Review
and Meta-Analysis.
Source
Heart Lung and Circulation. 31(11) (pp 1493-1503), 2022. Date of
Publication: November 2022.
Author
Naruka V.; Salmasi M.Y.; Arjomandi Rad A.; Marczin N.; Lazopoulos G.;
Moscarelli M.; Casula R.; Athanasiou T.
Institution
(Naruka, Salmasi, Arjomandi Rad, Marczin, Moscarelli, Athanasiou)
Department of Surgery and Cancer, Imperial College, London, United Kingdom
(Naruka, Casula, Athanasiou) Department of Cardiothoracic Surgery,
Hammersmith Hospital, London, United Kingdom
(Lazopoulos) Department of Cardiothoracic Surgery, University Hospital of
Heraklion, Crete, Greece
Publisher
Elsevier Ltd
Abstract
Introduction: Cardiac surgery involving cardiopulmonary bypass (CPB)
activates an inflammatory response releasing cytokines that are associated
with less favourable outcomes. This study aims to compare i) CPB during
cardiac surgery (control) versus ii) CPB with haemoadsorption therapy; and
assess the effect of adding this therapy in reducing the inflammatory
cytokines burden. <br/>Method(s): A systematic literature review with
meta-analysis was conducted regarding the main outcomes (operative
mortality, ventilation duration, intensive care unit [ICU] and hospital
stays) and day-1 inflammatory markers levels post-surgery. Fifteen (15)
studies were included for final analysis (eight randomised controlled
trials, seven observational studies) with no evidence of publication bias.
<br/>Result(s): Subgroup analysis of non-elective surgeries across
observational studies (emergency and infective endocarditis) significantly
favoured cytokine filters in terms of 30-day mortality (OR 0.40, 95% CI
0.20, 0.83; p=0.01) and shorter ICU stay (MD -42.36, 95% CI -68.07,
-16.65; p=0.001). At day-1 post-surgery, there was a significant
difference favouring the cytokine filter group in c-reactive protein (CRP)
(MD -0.71, 95% CI -0.84, -0.59; p<0.001) with no differences in white
blood count (WBC), procalcitonin (PCT), tumour necrosis factor-alpha
(TNF-alpha), IL-6, IL-8 and lactate. When comparing cytokine filters and
control across all studies there was no significant difference in
operative mortality, ventilation duration, hospital stay and ICU length of
stay. Also, there were no statistical differences in randomised controlled
trials (RCTs) using haemadsorption filters. <br/>Conclusion(s): A
significant reduction in 30-day mortality and ICU stay could be obtained
by using haemadsorption therapy during non-elective cardiac surgery,
especially emergency surgery and in patients with higher inflammatory
burden such as infective endocarditis.<br/>Copyright &#xa9; 2022

<9>
Accession Number
2019330593
Title
Feasibility and preliminary efficacy of perioperative interventions in
patients undergoing coronary artery bypass grafting: The randomized
controlled I-COPE trial.
Source
European Journal of Cardio-thoracic Surgery. 62(1) (no pagination), 2022.
Article Number: ezac041. Date of Publication: 01 Jul 2022.
Author
Sadlonova M.; Nagel J.; Becker S.; Neumann S.; Staab J.; Meyer T.; Celano
C.M.; Amonoo H.L.; Fangauf S.V.; Herrmann-Lingen C.; Kutschka I.;
Friedrich M.
Institution
(Sadlonova, Nagel, Becker, Neumann, Staab, Meyer, Fangauf,
Herrmann-Lingen) Department of Psychosomatic Medicine and Psychotherapy,
University Medical Centre Gottingen, Gottingen, Germany
(Sadlonova, Kutschka, Friedrich) Department of Cardiovascular and Thoracic
Surgery, University Medical Centre Gottingen, Gottingen, Germany
(Sadlonova, Staab, Meyer, Herrmann-Lingen, Kutschka, Friedrich) Dzhk
(German Centre for Cardiovascular Research), Partner Site, Gottingen,
Germany
(Sadlonova, Celano) Department of Psychiatry, Massachusetts General
Hospital, Boston, MA, United States
(Sadlonova, Celano, Amonoo) Department of Psychiatry, Harvard Medical
School, Boston, MA, United States
(Amonoo) Department of Psychiatry, Brigham and Women's Hospital, Boston,
MA, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Patients undergoing coronary artery bypass graft (CABG)
surgery are exposed to multiple treatment-related stressors, which can
impact coping and health-related quality of life (HRQoL). The objective of
this trial was to analyse the feasibility and preliminary efficacy of a
multi-component intervention that combines psychological support and
reduction of hospital-specific stressors on HRQoL, length of hospital and
intensive care unit stay, self-efficacy, and plasma interleukin (IL)-6 and
-8 levels in CABG patients. <br/>METHOD(S): This three-arm, randomized
controlled, single-centre pilot trial assessed the Intervention for CABG
to Optimize Patient Experience in 88 patients undergoing elective CABG.
Standard medical care (SMC, n = 29) was compared with 2 intervention
groups: (i) psychological interventions to optimize treatment expectations
(IA group, n = 30) and (ii) multi-component intervention (IB group, n =
29) with psychological interventions plus an additional treatment package
(light therapy, noise reduction, music, and if desired, 360degree images
delivered via virtual reality). <br/>RESULT(S): The implementation of
psychological interventions in routine medical treatment was feasible
(91.5% of participants completed all intervention sessions). Both
interventions were associated with significantly shorter hospital stay
compared to SMC (IA/IB 9.8/9.3 days vs SMC 12.5 days). Self-efficacy
expectations at post-surgery were significantly higher compared to SMC
both in the IA group (P = 0.011) and marginally in the IB group (P =
0.051). However, there were no treatment effects of the interventions on
HRQoL and plasma levels of IL-6 or IL-8 after CABG. <br/>CONCLUSION(S): A
perioperative multi-component intervention may lead to shorter hospital
stay and higher self-efficacy after CABG. Further studies are needed to
determine its impact on HRQoL and inflammation. CLINICAL TRIAL
REGISTRATION NUMBER: Ethical approval (# 21/2/18) for the study was
obtained from the Research Ethics Committee of the University of Gottingen
Medical Center, and the trial was registered in the German Clinical Trials
Register (DRKS00015309,
https://www.drks.de/drks_web/setLocale_EN.do).<br/>Copyright &#xa9; 2022
The Author(s). Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<10>
Accession Number
640418672
Title
Outcomes of Transcatheter Aortic Valve Implantation Comparing Medtronic's
Evolut PRO and Evolut R: A Systematic Review and Meta-Analysis of
Observational Studies.
Source
International journal of environmental research and public health. 20(4)
(no pagination), 2023. Date of Publication: 15 Feb 2023.
Author
Gozdek M.; Kuzma L.; Dabrowski E.J.; Janiak M.; Pietrzak M.; Skonieczna
K.; Woznica M.; Wydeheft L.; Makhoul M.; Matteucci M.; Litwinowicz R.;
Kowalowka A.; Wanha W.; Pasierski M.; Ronco D.; Massimi G.; Jiritano F.;
Fina D.; Martucci G.; Raffa G.M.; Suwalski P.; Lorusso R.; Meani P.;
Kowalewski M.
Institution
(Gozdek) Department of Cardiology, Hospital of the Ministry of Interior,
72-122 Bydgoszcz, Poland
(Gozdek, Janiak, Pietrzak, Skonieczna, Woznica, Wydeheft, Makhoul,
Matteucci, Litwinowicz, Kowalowka, Wanha, Pasierski, Ronco, Massimi,
Jiritano, Fina, Martucci, Raffa, Suwalski, Meani, Kowalewski) Thoracic
Research Centre, Collegium Medicum Nicolaus Copernicus University,
Innovative Medical Forum, Bydgoszcz 85-094, Poland
(Kuzma, Dabrowski) Department of Invasive Cardiology, Medical University
of Bialystok, Bialystok 15-540, Poland
(Makhoul) Department of Cardiac Surgery, Harefield Hospital, London UB9
6JH, United Kingdom
(Matteucci) Cardiac Surgery Unit, ASST dei Sette Laghi, Department of
Medicine and Surgery, University of Insubria, Varese 21100, Italy
(Matteucci, Ronco, Massimi, Lorusso, Kowalewski) Cardiothoracic Surgery
Department, Heart and Vascular Centre, Maastricht University Medical
Centre (MUMC), Cardiovascular Research Institute Maastricht (CARIM), ER
Maastricht 6229, Netherlands
(Litwinowicz) Department of Cardiac Surgery, Regional Specialist Hospital,
86-300 Grudziadz, Poland
(Kowalowka) Department of Cardiac Surgery, Upper-Silesian Heart Center,
Katowice 40-752, Poland
(Kowalowka) Department of Cardiac Surgery, Faculty of Medical Sciences,
Medical University of Silesia, Katowice 40-752, Poland
(Wanha) Department of Cardiac Surgery, School of Medicine in Katowice,
Medical University of Silesia, Katowice 40-752, Poland
(Pasierski, Suwalski, Kowalewski) Department of Cardiac Surgery and
Transplantology, Central Clinical Hospital of the Ministry of Interior,
Centre of Postgraduate Medical Education, Warsaw 02-507, Poland
(Jiritano) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro 88100, Italy
(Fina, Meani) Department of Cardiothoracic, Vascular Anesthesia and
Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientifico
(IRCCS) Policlinico, San Donato Milanese, 20097 Milan, Italy
(Martucci) Department of Anesthesia and Intensive Care, Istituto
Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione
(IRCCS-ISMETT), Palermo 90100, Italy
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, Istituto di Ricovero e Cura a
Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad
Alta Specializzazione (IRCCS-ISMETT), Palermo 90100, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become a
broadly acceptable alternative to AV surgery in patients with aortic
stenosis (AS). New valve designs are becoming available to address the
shortcomings of their predecessors and improve clinical outcomes.
<br/>METHOD(S): A systematic review and meta-analysis was carried out to
compare Medtronic's Evolut PRO, a new valve, with the previous Evolut R
design. Procedural, functional and clinical endpoints according to the
VARC-2 criteria were assessed. <br/>RESULT(S): Eleven observational
studies involving N = 12,363 patients were included. Evolut PRO patients
differed regarding age (p < 0.001), sex (p < 0.001) and STS-PROM estimated
risk. There was no difference between the two devices in terms of
TAVI-related early complications and clinical endpoints. A 35% reduction
of the risk of moderate-to-severe paravalvular leak (PVL) favoring the
Evolut PRO was observed (RR 0.66, 95%CI, [0.52, 0.86] p = 0.002; I2 = 0%).
Similarly, Evolut PRO-treated patients demonstrated a reduction of over
35% in the risk of serious bleeding as compared with the Evolut R (RR
0.63, 95%CI, [0.41, 0.96]; p = 0.03; I2 = 39%), without differences in
major vascular complications. <br/>CONCLUSION(S): The evidence shows good
short-term outcomes of both the Evolut PRO and Evolut R prostheses, with
no differences in clinical and procedural endpoints. The Evolut PRO was
associated with a lower rate of moderate-to-severe PVL and major bleeding.

<11>
Accession Number
640414834
Title
Methodological transparency of preoperative clinical practice guidelines
for elective surgery. Systematic review.
Source
PloS one. 18(2) (pp e0272756), 2023. Date of Publication: 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
NLM (Medline)
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. <br/>OBJECTIVE(S): 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.
<br/>RESULT(S): 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 non-cardiac surgery were CCS 2017 (91%),
ESC-ESA 2014 (90%), and AHA-ACC 2014 (89%); in preoperative testing ICSI
2020 (97%). <br/>CONCLUSION(S): 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.<br/>Copyright: &#xa9;
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.

<12>
Accession Number
2021778092
Title
Peri-Operative Risk Factors Associated with Post-Operative Cognitive
Dysfunction (POCD): An Umbrella Review of Meta-Analyses of Observational
Studies.
Source
Journal of Clinical Medicine. 12(4) (no pagination), 2023. Article Number:
1610. Date of Publication: February 2023.
Author
Travica N.; Lotfaliany M.; Marriott A.; Safavynia S.A.; Lane M.M.; Gray
L.; Veronese N.; Berk M.; Skvarc D.; Aslam H.; Gamage E.; Formica M.;
Bishop K.; Marx W.
Institution
(Travica, Lotfaliany, Lane, Berk, Aslam, Gamage, Marx) IMPACT-The
Institute for Mental and Physical Health and Clinical Translation, Food &
Mood Centre, School of Medicine, Barwon Health, Deakin University,
Geelong, VIC 3220, Australia
(Marriott, Formica, Bishop) Barwon Health, Department of Anaesthesia and
Pain, University Hospital Geelong, Geelong, VIC 3220, Australia
(Safavynia) Department of Anesthesiology, Weill Cornell Medical College,
New York, NY 10065, United States
(Gray) Faculty of Health, School of Medicine, Deakin University, Waurn
Ponds, VIC 3216, Australia
(Veronese) Geriatrics Section, Department of Internal Medicine, University
of Palermo, Palermo 90133, Italy
(Skvarc) Faculty of Health, School of Psychology, Deakin University,
Geelong, VIC 3220, Australia
Publisher
MDPI
Abstract
This umbrella review aimed to systematically identify the peri-operative
risk factors associated with post-operative cognitive dysfunction (POCD)
using meta-analyses of observational studies. To date, no review has
synthesised nor assessed the strength of the available evidence examining
risk factors for POCD. Database searches from journal inception to
December 2022 consisted of systematic reviews with meta-analyses that
included observational studies examining pre-, intra- and post-operative
risk factors for POCD. A total of 330 papers were initially screened.
Eleven meta-analyses were included in this umbrella review, which
consisted of 73 risk factors in a total population of 67,622 participants.
Most pertained to pre-operative risk factors (74%) that were predominantly
examined using prospective designs and in cardiac-related surgeries (71%).
Overall, 31 of the 73 factors (42%) were associated with a higher risk of
POCD. However, there was no convincing (class I) or highly suggestive
(class II) evidence for associations between risk factors and POCD, and
suggestive evidence (class III) was limited to two risk factors
(pre-operative age and pre-operative diabetes). Given that the overall
strength of the evidence is limited, further large-scale studies that
examine risk factors across various surgery types are
recommended.<br/>Copyright &#xa9; 2023 by the authors.

<13>
Accession Number
2023067458
Title
Cardioplegia in Open Heart Surgery: Age Matters.
Source
Journal of Clinical Medicine. 12(4) (no pagination), 2023. Article Number:
1698. Date of Publication: February 2023.
Author
Bradic J.; Andjic M.; Novakovic J.; Jeremic N.; Jakovljevic V.
Institution
(Bradic, Andjic, Novakovic, Jeremic) Department of Pharmacy, Faculty of
Medical Sciences, University of Kragujevac, Svetozara Markovica 69,
Kragujevac 34000, Serbia
(Bradic, Andjic, Novakovic, Jeremic, Jakovljevic) Center of Excellence for
Redox Balance Research in Cardiovascular and Metabolic Disorders,
Svetozara Markovica 69, Kragujevac 34000, Serbia
(Jeremic) 1st Moscow State Medical, University IM Sechenov, Trubetskaya
8/2, Moscow 119991, Russian Federation
(Jakovljevic) Department of Physiology, Faculty of Medical Sciences,
University of Kragujevac, Svetozara Markovica 69, Kragujevac 34000, Serbia
(Jakovljevic) Department of Human Pathology, 1st Moscow State Medical,
University IM Sechenov, Trubetskaya 8/2, Moscow 119991, Russian Federation
Publisher
MDPI
Abstract
Introduction: Cardioplegia is a pharmacological approach essential for the
protection of the heart from ischemia-reperfusion (I-R) injury. Over the
years, numerous cardioplegic solutions have been developed, with each
cardioplegic approach having its advantages and disadvantages.
Cardioplegic solutions can be divided into crystalloid and blood
cardioplegic solutions, and an experienced surgeon chooses the type of
solution based on the individual needs of patients in order to provide
optimal heart protection. Importantly, the pediatric immature myocardium
is structurally, physiologically, and metabolically different from the
adult heart, and consequently its needs to achieve cardioplegic arrest
strongly differ. Therefore, the present review aimed to provide a summary
of the cardioplegic solutions available to pediatric patients with a
special focus on emphasizing differences in heart injury after various
cardioplegic solutions, the dosing strategies, and regimens.
<br/>Material(s) and Method(s): The PubMed database was searched using the
terms cardioplegia, I-R, and pediatric population, and studies that
investigated the influence of cardioplegic strategies on markers of
cardiac muscle damage were further analyzed in this review.
<br/>Conclusion(s): A large body of evidence suggested more prominent
benefits achieved with blood compared to those with crystalloid
cardioplegia in pediatric myocardium preservation. However, standardized
and uniform protocols have not been established so far, and an experienced
surgeon chooses the type of cardioplegia solution based on the individual
needs of patients, while the severity of myocardial damage strongly
depends on the type and duration of the surgical procedure, overall
patient condition, and presence of comorbidities, etc.<br/>Copyright
&#xa9; 2023 by the authors.

<14>
Accession Number
2021874437
Title
3D liver model-based surgical education improves preoperative
decision-making and patient satisfaction-a randomized pilot trial.
Source
Surgical Endoscopy. (no pagination), 2023. Date of Publication: 2023.
Author
Giehl-Brown E.; Dennler S.; Garcia S.A.; Seppelt D.; Oehme F.; Schweipert
J.; Weitz J.; Riediger C.
Institution
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger)
Department of Visceral, Thoracic and Vascular Surgery, University Hospital
Carl Gustav Carus, Technische Universitat Dresden, Dresden, Germany
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger)
National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger) German
Cancer Research Center (DKFZ), Heidelberg, Germany
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger) Faculty
of Medicine, University Hospital Carl Gustav Carus, Technische Universitat
Dresden, Dresden, Germany
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger)
Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
(Seppelt) Department of Radiology, University Hospital Carl Gustav Carus
Dresden, Technische Universitat Dresden, Dresden, Germany
Publisher
Springer
Abstract
Objective: Hepatobiliary surgery bares obstacles to informed consent for
the patients due to its complexity and related risk of postoperative
complications. 3D visualization of the liver has been proven to facilitate
comprehension of the spatial relationship between anatomical structures
and to assist in clinical decision-making. Our objective is to utilize
individual 3D-printed liver models to enhance patient satisfaction with
surgical education in hepatobiliary surgery. Design, setting: We conducted
a prospective, randomized pilot study comparing 3D liver model-enhanced
(3D-LiMo) surgical education against regular patient education during
preoperative consultation at the department of Visceral, Thoracic and
Vascular Surgery, University Hospital Carl Gustav Carus, Dresden, Germany.
<br/>Participant(s): Of 97 screened patients, undergoing hepatobiliary
surgery, 40 patients were enrolled from July 2020 to January 2022.
<br/>Result(s): The study population (n = 40) was predominantly of male
gender (62.5%) with a median age of 65.2 years and a high prevalence of
preexisting diseases. Underlying disease, warranting hepatobiliary
surgery, was malignancy in the majority of cases (97.5%). Patients in the
3D-LiMo group were more likely to feel very thoroughly educated and
exhibited a higher level of satisfaction following surgical education than
the control group (80 vs. 55%, n.s.; 90 vs. 65%, n.s.; respectively).
Applying 3D models was also associated with enhanced understanding of the
underlying disease with regard to amount (100% vs. 70%, p = 0.020) and
location of liver masses (95 vs. 65%, p = 0.044). 3D-LiMo patients also
demonstrated enhanced understanding of the surgical procedure (80 vs. 55%,
n.s.), leading to better awareness for the occurrence of postoperative
complications (88.9, vs. 68.4%, p = 0.052). Adverse event profiles were
similar. <br/>Conclusion(s): In conclusion, individual 3D-printed liver
models increase patient satisfaction with surgical education and
facilitate patients' understanding of the surgical procedure as well as
awareness of postoperative complications. Therefore, the study protocol is
feasible to apply to an adequately powered, multicenter, randomized
clinical trial with minor modifications.<br/>Copyright &#xa9; 2023, The
Author(s).

<15>
Accession Number
2021799115
Title
Performance of CardioCel in Cardiac Surgery: A Systematic Review.
Source
World Journal for Pediatric and Congenital Heart Surgery. (no
pagination), 2023. Date of Publication: 2023.
Author
Patukale A.A.; Suna J.; Anand A.; Betts K.S.; Karl T.R.; Venugopal P.;
Marathe S.P.; Alphonso N.
Institution
(Patukale, Suna, Anand, Karl, Venugopal, Marathe, Alphonso) Queensland
Paediatric Cardiac Service (QPCS), Queensland Children's Hospital,
Brisbane, Australia
(Patukale, Suna, Anand, Karl, Venugopal, Marathe, Alphonso) School of
Clinical Medicine, Children's Health Queensland Clinical Unit, University
of Queensland, Brisbane, Australia
(Patukale, Suna, Anand, Karl, Venugopal, Marathe, Alphonso) Centre for
Child Health Research, University of Queensland, Brisbane, Australia
(Betts) School of Population Health, Curtin University, Perth, Australia
Publisher
SAGE Publications Inc.
Abstract
A systematic review was performed for evaluation of the performance of
CardioCel in cardiac surgery. The review included all studies
published from January 2013 to December 2020. We conclude that CardioCel
is a strong, flexible tissue substitute with good handling characteristics
and a low incidence of thrombosis, aneurysm formation, infection, or
structural degeneration. It can be used for a variety of intracardiac and
extracardiac repairs of congenital heart defects in all age groups with
good durability at mid-term follow-up. However, the use of CardioCel in
certain positions requires caution. Information on the long-term
performance of CardioCel is lacking.<br/>Copyright &#xa9; The Author(s)
2023.

<16>
Accession Number
2021799114
Title
Common Inflammatory Markers and Outcome After Pediatric Cardiac Surgery
With High Thoracic Epidural Anesthesia: A Randomized Controlled Study.
Source
World Journal for Pediatric and Congenital Heart Surgery. (no
pagination), 2023. Date of Publication: 2023.
Author
Kumar A.; Ghotra G.S.; Dwivedi D.; Bhargava D.V.; Joshi A.; Tiwari N.;
Ramamurthy H.R.
Institution
(Kumar, Joshi) Department of Anaesthesia & Critical Care, Army Hospital
(Research & Referral), New Delhi, India
(Ghotra, Bhargava) Department of Anaesthesia & Critical Care, Army
Institute of Cardiothoracic Sciences, Pune, India
(Dwivedi) Department of Anaesthesia & Critical Care, Department of
Anaesthesia & Critical Care, Command Hospital (Eastern command), Kolkata,
India
(Tiwari) Department of Cardiothoracic Surgery, Army Hospital (Research &
Referral), New Delhi, India
(Ramamurthy) Department of Paediatrics, Army Hospital (Research &
Referral), New Delhi, India
Publisher
SAGE Publications Inc.
Abstract
Background: High thoracic epidural analgesia (HTEA) plays a pivotal role
in reducing stress and neuroendocrine response in cardiac surgeries.
<br/>Aim(s): The primary objective is to assess the effect of HTEA, in
pediatric cardiac surgery, on inflammatory markers (interleukin [IL]-6,
IL-8, and tumor necrosis factor-alpha). The secondary objectives are to
assess its effect on various organ systems, that is, pulmonary (PaO2, P/F
ratio), renal (Creatinine clearance, somatic near infrared spectroscopy
[NIRS], serum neutrophil gelatinase-associated lipocalin values), cardiac
(cardiac index, serum Trop-I, and lactate levels), mechanical ventilation
duration, and length of stay in hospital (LOS). <br/>Method(s): The study
included 188 pediatric patients, who underwent, on-pump cardiac surgery
randomized into the Epidural Group (n = 92) and Non-Epidural Group (n =
96). After general anesthesia, a 23 G epidural catheter was placed at the
T4-5 level with a Bupivacaine infusion while the Non-epidural Group
received fentanyl infusion. Blood samples were collected at four-time
points, T0(preop), T1(4 h), and on the first and second postoperative days
(T2 and T3). <br/>Result(s): The inflammatory markers were reduced, while
the outcomes variables of mechanical ventilation (MV) duration had lower
values in the epidural group (19.5 h vs 47.3 h, P =.002). LOS was shorter
(10.1 days vs 13.3 days, P =.016). pO2, PF ratio, and renal NIRS values
were better in the Epidural Gp, while other parameters were comparable.
Non-epidural Gp had more complications esp. Acute kidney injury requires
RRT. <br/>Conclusion(s): HTEA use in pediatric, on-pump cardiac surgery
offers a favorable profile in terms of reduction in the inflammatory
markers and positive effect on the organ systems with lesser MV duration
and the LOS.<br/>Copyright &#xa9; The Author(s) 2023.

<17>
Accession Number
2022680052
Title
Factors associated with lack of tracheal sealing by a cuff inflated to
more than 30 cmH<inf>2</inf> O during mechanical ventilation: A
cross-sectional study.
Source
Pakistan Journal of Medical Sciences. 39(2) (pp 460-466), 2023. Date of
Publication: March-April 2023.
Author
Wu H.-L.; Shi H.-Y.; Shi J.-H.; Shen W.-Q.
Institution
(Wu) Nursing Department, Affiliated Hospital of Nantong University,
Nantong University, Jiangsu Province 226001, China
(Shi) Nursing Department, The People's Hospital of Rugao and Affiliated
Rugao Hospital of Nantong University, Jiangsu Province, Nantong City
226001, China
(Shi) Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong
University, Jiangsu Province 226001, China
(Shen) Nursing Department, Nantong University, Jiangsu Province 226001,
China
Publisher
Professional Medical Publications
Abstract
Objectives: The cuff pressures > 30 cmH<inf>2</inf> O may create a seal in
the trachea. The objective of this study was to identify risk factors
associated with lack of tracheal sealing by an endotracheal cuff inflated
to > 30 cmH<inf>2</inf> O in patients undergoing mechanical ventilation.
<br/>Method(s): This prospective cross-sectional study was conducted from
2019 to 2020 in the cardiothoracic intensive care unit and respiratory
medical care unit of a Hospital in Nantong, China. Patients aged >16 years
undergoing cardiothoracic surgery with mechanical ventilation using
endotracheal intubation were included. Patient characteristics and
ventilator parameters were analyzed. Cuff pressure was maintained with the
minimum leak technique (MLT) and measured with a cuff pressure gauge. Cuff
pressure was measured for 30 seconds when ventilation was accompanied by
no leak, simultaneously detected by the ventilator or auscultation with a
stethoscope. <br/>Result(s): Of 352 patients undergoing mechanical
ventilation, 51 patients (14.5%) had a cuff pressure of >30
cmH<inf>2</inf> O. Multivariable analysis showed that cuff manufacturer
(Guangzhou Weili) and nasal endotracheal intubation significantly
increased the risk of an unsealed trachea. Peak inspiratory pressure, cuff
diameter and male sex had a strong inverse association with an unsealed
trachea. <br/>Conclusion(s): These findings suggest that an endotracheal
cuff pressure of 20 to 30 cmH<inf>2</inf> O is adequate for most patients,
but lack of a tracheal seal still occurs in a small number of people. An
unsealed trachea is most likely because cuff and tracheal diameters do not
match.<br/>Copyright &#xa9; 2023, Professional Medical Publications. All
rights reserved.

<18>
Accession Number
639562239
Title
Prothrombin complex concentrate in cardiac surgery for the treatment of
coagulopathic bleeding.
Source
Cochrane Database of Systematic Reviews. 2022(11) (no pagination), 2022.
Article Number: CD013551. Date of Publication: 21 Nov 2022.
Author
Hayes K.; Fernando M.C.; Jordan V.
Institution
(Hayes, Fernando) Department of Cardiothoracic and ORL Anaesthesia,
Auckland City Hospital, Auckland, New Zealand
(Jordan) Department of Obstetrics and Gynaecology, Faculty of Medical and
Health Sciences, The University of Auckland, Auckland, New Zealand
Publisher
John Wiley and Sons Ltd
Abstract
Background: Coagulopathy following cardiac surgery is associated with
considerable blood product transfusion and high morbidity and mortality.
The treatment of coagulopathy following cardiac surgery is challenging,
with the replacement of clotting factors being based on transfusion of
fresh frozen plasma (FFP). Prothrombin complex concentrate (PCCs) is an
alternative method to replace clotting factors and warrants evaluation.
PCCs are also an alternative method to treat refractory ongoing bleeding
post-cardiac surgery compared to recombinant factor VIIa (rFVIIa) and also
warrants evaluation. <br/>Objective(s): Assess the benefits and harms of
PCCs in people undergoing cardiac surgery who have coagulopathic
non-surgical bleeding. <br/>Search Method(s): We searched the Cochrane
Central Register of Controlled Trials (CENTRAL) in the Cochrane Library,
MEDLINE, Embase and Conference Proceedings Citation Index-Science (CPCI-S)
on the Web of Science on 20 April 2021. We searched Clinicaltrials.gov
(www.clinicaltrials.gov), and the World Health Organisation (WHO)
International Clinical Trials Registry Platform (ICTRP;
apps.who.int/trialsearch/), for ongoing or unpublished trials. We checked
the reference lists for additional references. We did not limit the
searches by language or publication status. <br/>Selection Criteria: We
included randomised controlled trials (RCTs) and non-randomised trials
(NRSs). <br/>Data Collection and Analysis: We used standard methodological
procedures expected by Cochrane. <br/>Main Result(s): Eighteen studies
were included (4993 participants). Two were RCTs (151 participants) and 16
were NRSs. Both RCTs had low risk of bias (RoB) in almost all domains. Of
the 16 NRSs, 14 were retrospective cohort analyses with one prospective
study and one case report. The nine studies used in quantitative analysis
were judged to have critical RoB, three serious and three moderate. 1. PCC
versus standard treatment. Evidence from RCTs showed PCCs are likely to
reduce the number of units transfused compared to standard care (MD -0.89,
95% CI -1.78 to 0.00; participants = 151; studies = 2; moderate-quality
evidence). Evidence from NRSs agreed with this, showing that PCCs may
reduce the mean number of units transfused compared to standard care but
the evidence is uncertain (MD -1.87 units, 95% CI -2.53 to -1.20;
participants = 551; studies = 2; very low-quality evidence). There was no
evidence from RCTs showing a difference in the incidence of red blood cell
(RBC) transfusion compared to standard care (OR 0.53, 95% CI 0.20 to 1.40;
participants = 101; studies = 1; low-quality evidence). Evidence from NRSs
disagreed with this, showing that PCCs may reduce the mean number of units
transfused compared to standard care but the evidence is uncertain (OR
0.54, 95% CI 0.30 to 0.98; participants = 1046; studies = 4; low-quality
evidence). There was no evidence from RCTs showing a difference in the
number of thrombotic events with PCC compared to standard care (OR 0.68
95% CI 0.20 to 2.31; participants = 152; studies = 2; moderate-quality
evidence). This is supported by NRSs, showing that PCCs may have no effect
on the number of thrombotic events compared to standard care but the
evidence is very uncertain (OR 1.32, 95% CI 0.87 to 1.99; participants =
1359; studies = 7; very low-quality evidence). There was no evidence from
RCTs showing a difference in mortality with PCC compared to standard care
(OR 0.53, 95% CI 0.12 to 2.35; participants = 149; studies = 2;
moderate-quality evidence). This is supported by evidence from NRSs,
showing that PCCs may have little to no effect on mortality compared to
standard care but the evidence is very uncertain (OR 1.02, 95% CI 0.69 to
1.51; participants = 1334; studies = 6; very low-quality evidence).
Evidence from RCTs indicated that there was little to no difference in
postoperative bleeding (MD -107.05 mLs, 95% CI -278.92 to 64.83;
participants = 151, studies = 2; low-quality evidence). PCCs may have
little to no effect on intensive care length of stay (RCT evidence: MD
-0.35 hours, 95% CI -19.26 to 18.57; participants = 151; studies = 2;
moderate-quality evidence) (NRS evidence: MD -18.00, 95% CI -43.14 to
7.14; participants = 225; studies = 1; very low-quality evidence) or
incidence of renal replacement therapy (RCT evidence: OR 0.72, 95% CI 0.14
to 3.59; participants = 50; studies = 1; low-quality evidence) (NRS
evidence: OR 1.46, 95% CI 0.71 to 2.98; participants = 684; studies = 2;
very low-quality evidence). No studies reported on additional adverse
outcomes. 2. PCC versus rFVIIa. For this comparison, all evidence was
provided from NRSs. PCC likely results in a large reduction of RBCs
transfused intra-operatively in comparison to rFVIIa (MD-4.98 units, 95%
CI -6.37 to -3.59; participants = 256; studies = 2; moderate-quality
evidence). PCC may have little to no effect on the incidence of RBC units
transfused comparative to rFVIIa; evidence is very uncertain (OR 0.16, 95%
CI 0.02 to 1.56; participants = 150; studies = 1; very low-quality
evidence). PCC may have little to no effect on the number of thrombotic
events comparative to rFVIIa; evidence is very uncertain (OR 0.51, 95% CI
0.23 to 1.16; participants = 407; studies = 4; very low-quality evidence).
PCC may have little to no effect on the incidence of mortality (OR 1.07,
95% CI 0.38 to 3.03; participants = 278; studies = 3; very low-quality
evidence) or intensive care length of stay comparative to rFVIIa (MD -40
hours, 95% CI -110.41 to 30.41; participants = 106; studies = 1; very
low-quality evidence); evidence is very uncertain. PCC may reduce bleeding
(MD -674.34 mLs, 95% CI -906.04 to -442.64; participants = 150; studies =
1; very low-quality evidence) and incidence of renal replacement therapy
(OR 0.29, 95% CI 0.12 to 0.71; participants = 106; studies = 1; very
low-quality evidence) comparative to rFVIIa; evidence is very uncertain.
No studies reported on other adverse events. Authors' conclusions: PCCs
could potentially be used as an alternative to standard therapy for
coagulopathic bleeding post-cardiac surgery compared to FFP as shown by
moderate-quality evidence and it may be an alternative to rFVIIa in
refractory non-surgical bleeding but this is based on moderate to very low
quality of evidence.<br/>Copyright &#xa9; 2022 The Cochrane Collaboration.
Published by John Wiley & Sons, Ltd.

<19>
Accession Number
2019158312
Title
Dulaglutide and cardiovascular and heart failure outcomes in patients with
and without heart failure: a post-hoc analysis from the REWIND randomized
trial.
Source
European Journal of Heart Failure. 24(10) (pp 1805-1812), 2022. Date of
Publication: October 2022.
Author
Branch K.R.H.; Dagenais G.R.; Avezum A.; Basile J.; Conget I.; Cushman
W.C.; Jansky P.; Lakshmanan M.; Lanas F.; Leiter L.A.; Pais P.; Pogosova
N.; Raubenheimer P.J.; Ryden L.; Shaw J.E.; Sheu W.H.H.;
Temelkova-Kurktschiev T.; Bethel M.A.; Gerstein H.C.; Chinthanie R.;
Probstfield J.L.
Institution
(Branch, Probstfield) University of Washington Heart Institute, Seattle,
WA, United States
(Dagenais) Institut Universitaire de Cardiologie et Pneumologie de Quebec,
Universite Laval, Quebec City, QC, Canada
(Avezum) International Research Center, Hospital Alemao Oswaldo Cruz, Sao
Paulo, Brazil
(Basile) Medical University of South Carolina, Ralph H Johnson VA Medical
Center, Charleston, SC, United States
(Conget) Endocrinology and Nutrition Department, Hospital Clinic i
Universitari, Barcelona, Spain
(Cushman) University of Tennessee Health Science Center, Memphis, TN,
United States
(Jansky) University Hospital Motol, Prague, Czechia
(Lakshmanan, Bethel) Eli Lilly & Co, Indianapolis, IN, United States
(Lanas) Universidad de La Fontera, Temuco, Chile
(Leiter) Li Ka Shing Knowledge Institute, St. Michael's Hospital,
University of Toronto, Toronto, ON, Canada
(Pais) St. John's Research Institute, Bangalore, India
(Pogosova) National Medical Research Center of Cardiology, Moscow, Russian
Federation
(Raubenheimer) Division of Endocrinology, University of Cape Town, Cape
Town, South Africa
(Ryden) Department of Medicine K2, Karolinska Institute, Stockholm, Sweden
(Shaw) Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
(Sheu) Division of Endocrinology and Metabolism, Taipei Veterans General
Hospital, Taipei, Taiwan (Republic of China)
(Temelkova-Kurktschiev) Robert Koch Medical Center, Sofia, Bulgaria
(Gerstein, Chinthanie) Population Health Research Institute, Hamilton
Health Sciences and McMaster University, Hamilton, ON, Canada
Publisher
John Wiley and Sons Ltd
Abstract
Aims: People with diabetes are at high risk for cardiovascular events
including heart failure (HF). We examined the effect of the glucagon-like
peptide 1 agonist dulaglutide on incident HF events and other
cardiovascular outcomes in those with or without prior HF in the
randomized placebo-controlled Researching Cardiovascular Events with a
Weekly Incretin in Diabetes (REWIND) trial. <br/>Methods and Results: The
REWIND major adverse cardiovascular event (MACE) outcome was the first
occurrence of a composite endpoint of non-fatal myocardial infarction,
non-fatal stroke, or death from cardiovascular causes (including unknown
causes). In this post-hoc analysis, a HF event was defined as an
adjudication-confirmed hospitalization or urgent evaluation for HF. Of the
9901 participants studied over a median follow-up of 5.4 years, 213/4949
(4.3%) randomly assigned to dulaglutide and 226/4952 (4.6%) participants
assigned to placebo experienced a HF event (hazard ratio [HR] 0.93, 95%
confidence interval [CI] 0.77-1.12; p = 0.456). In the 853 (8.6%)
participants with HF at baseline, there was no change in either MACE or HF
events with dulaglutide as compared to participants without HF (p = 0.44
and 0.19 for interaction, respectively). Combined cardiovascular death and
HF events were marginally reduced with dulaglutide compared to placebo (HR
0.88, 95% CI 0.78-1.00; p = 0.050) but unchanged in patients with and
without HF at baseline (p = 0.31). <br/>Conclusion(s): Dulaglutide was not
associated with a reduction in HF events in patients with type 2 diabetes
regardless of baseline HF status over 5.4 years of
follow-up.<br/>Copyright &#xa9; 2022 European Society of Cardiology.

<20>
Accession Number
2021221517
Title
Effect of 5 years of exercise training on the cardiovascular risk profile
of older adults: The Generation 100 randomized trial.
Source
European Heart Journal. 43(21) (pp 2065-2075), 2022. Date of Publication:
01 Jun 2022.
Author
Letnes J.M.; Berglund I.; Johnson K.E.; Dalen H.; Nes B.M.; Lydersen S.;
Viken H.; Hassel E.; Steinshamn S.; Vesterbekkmo E.K.; Stoylen A.; Reitlo
L.S.; Zisko N.; Baekkerud F.H.; Tari A.R.; Ingebrigtsen J.E.; Sandbakk
S.B.; Carlsen T.; Anderssen S.A.; Singh M.A.F.; Coombes J.S.; Helbostad
J.L.; Rognmo O.; Wisloff U.; Stensvold D.
Institution
(Letnes, Berglund, Johnson, Dalen, Nes, Viken, Steinshamn, Vesterbekkmo,
Stoylen, Reitlo, Zisko, Baekkerud, Tari, Sandbakk, Carlsen, Rognmo,
Wisloff, Stensvold) Department of Circulation and Medical Imaging, Faculty
of Medicine and Health Sciences, Norwegian University of Science and
Technology, Post Box 8905, Trondheim 7491, Norway
(Letnes, Dalen, Nes, Vesterbekkmo, Stoylen, Rognmo, Stensvold) Department
of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3,
Trondheim 7030, Norway
(Letnes, Dalen) Levanger Hospital, Nord-Trondelag Health Trust, Kirkegata
2, Levanger 7600, Norway
(Lydersen) Regional Centre for Child and Youth Mental Health and Child
Welfare, Norwegian University of Science and Technology, Post Box 8905,
Trondheim 7491, Norway
(Hassel) Norwegian Armed Forces Occupational Health Service, Post Box 800,
Lillehammer 2617, Norway
(Hassel, Steinshamn) Department of Thoracic Medicine, Clinic of Thoracic
and Occupational Medicine, St Olavs University Hospital, Prinsesse
Kristinas gate 3, Trondheim 7030, Norway
(Ingebrigtsen) Department of Sociology and Political Science, Faculty of
Social and Educational Sciences, Norwegian University of Science and
Technology, Post Box 8905, Trondheim 7491, Norway
(Sandbakk) Department of Teacher Education, Faculty of Social and
Educational Sciences, Norwegian University of Science and Technology, Post
Box 8905, Trondheim 7491, Norway
(Anderssen) Department of Sports Medicine, The Norwegian School of Sport
Sciences, Sognsveien 220, Oslo 0863, Norway
(Singh) Sydney School of Health Sciences and Sydney Medical School,
Faculty of Medicine and Health, The University of Sydney, NSW 2006,
Australia
(Singh) Hinda and Arthur Marcus Institute for Aging Research, Hebrew
SeniorLife, 1200 Centre St, Boston, MA 02131, United States
(Coombes, Wisloff) School of Human Movement and Nutrition Science,
University of Queensland, Human Movement Studies Building, St Lucia, QLD
4067, Australia
(Helbostad) Department of Neuromedicine and Movement Science, Faculty of
Medicine and Health Sciences, Norwegian University of Science and
Technology, Post Box 8905, Trondheim 7491, Norway
Publisher
Oxford University Press
Abstract
Aims: The aim of this study was to compare the effects of 5 years of
supervised exercise training (ExComb), and the differential effects of
subgroups of high-intensity interval training (HIIT) and
moderate-intensity continuous training (MICT), with control on the
cardiovascular risk profile in older adults. <br/>Methods and Results:
Older adults aged 70-77 years from Trondheim, Norway (n = 1567, 50%
women), able to safely perform exercise training were randomized to 5
years of two weekly sessions of HIIT [~90% of peak heart rate (HR), n =
400] or MICT (~70% of peak HR, n = 387), together forming ExComb (n =
787), or control (instructed to follow physical activity recommendations,
n = 780). The main outcome was a continuous cardiovascular risk score
(CCR), individual cardiovascular risk factors, and peak oxygen uptake
(VO2peak). CCR was not significantly lower [-0.19, 99% confidence interval
(CI) -0.46 to 0.07] and VO2peak was not significantly higher (0.39
mL/kg/min, 99% CI -0.22 to 1.00) for ExComb vs. control. HIIT showed
higher VO2peak (0.76 mL/kg/min, 99% CI 0.02-1.51), but not lower CCR
(-0.32, 99% CI -0.64 to 0.01) vs. control. MICT did not show significant
differences compared to control or HIIT. Individual risk factors mostly
did not show significant between-group differences, with some exceptions
for HIIT being better than control. There was no significant effect
modification by sex. The number of cardiovascular events was similar
across groups. The healthy and fit study sample, and contamination and
cross-over between intervention groups, challenged the possibility of
detecting between-group differences. <br/>Conclusion(s): Five years of
supervised exercise training in older adults had little effect on
cardiovascular risk profile and did not reduce cardiovascular
events.<br/>Copyright &#xa9; The Author(s) 2021.

<21>
Accession Number
2018431087
Title
Computer-aided anatomy recognition in intrathoracic and -abdominal
surgery: a systematic review.
Source
Surgical Endoscopy. 36(12) (pp 8737-8752), 2022. Date of Publication:
December 2022.
Author
den Boer R.B.; de Jongh C.; Huijbers W.T.E.; Jaspers T.J.M.; Pluim J.P.W.;
van Hillegersberg R.; Van Eijnatten M.; Ruurda J.P.
Institution
(den Boer, de Jongh, Huijbers, van Hillegersberg, Ruurda) Department of
Surgery, University Medical Center Utrecht, Heidelberglaan 100, Utrecht
3584 CX, Netherlands
(Jaspers, Pluim, Van Eijnatten) Department of Biomedical Engineering,
Eindhoven University of Technology, Groene Loper 3, Eindhoven 5612 AE,
Netherlands
Publisher
Springer
Abstract
Background: Minimally invasive surgery is complex and associated with
substantial learning curves. Computer-aided anatomy recognition, such as
artificial intelligence-based algorithms, may improve anatomical
orientation, prevent tissue injury, and improve learning curves. The study
objective was to provide a comprehensive overview of current literature on
the accuracy of anatomy recognition algorithms in intrathoracic and
-abdominal surgery. <br/>Method(s): This systematic review is reported
according to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guideline. Pubmed, Embase, and IEEE Xplore were
searched for original studies up until January 2022 on computer-aided
anatomy recognition, without requiring intraoperative imaging or
calibration equipment. Extracted features included surgical procedure,
study population and design, algorithm type, pre-training methods, pre-
and post-processing methods, data augmentation, anatomy annotation,
training data, testing data, model validation strategy, goal of the
algorithm, target anatomical structure, accuracy, and inference time.
<br/>Result(s): After full-text screening, 23 out of 7124 articles were
included. Included studies showed a wide diversity, with six possible
recognition tasks in 15 different surgical procedures, and 14 different
accuracy measures used. Risk of bias in the included studies was high,
especially regarding patient selection and annotation of the reference
standard. Dice and intersection over union (IoU) scores of the algorithms
ranged from 0.50 to 0.98 and from 74 to 98%, respectively, for various
anatomy recognition tasks. High-accuracy algorithms were typically trained
using larger datasets annotated by expert surgeons and focused on
less-complex anatomy. Some of the high-accuracy algorithms were developed
using pre-training and data augmentation. <br/>Conclusion(s): The accuracy
of included anatomy recognition algorithms varied substantially, ranging
from moderate to good. Solid comparison between algorithms was complicated
by the wide variety of applied methodology, target anatomical structures,
and reported accuracy measures. Computer-aided intraoperative anatomy
recognition is an upcoming research discipline, but still at its infancy.
Larger datasets and methodological guidelines are required to improve
accuracy and clinical applicability in future research. Trial
registration: PROSPERO registration number: CRD42021264226.<br/>Copyright
&#xa9; 2022, The Author(s).

<22>
Accession Number
2022989783
Title
Assessment of a Quantra-Guided Hemostatic Algorithm in High-Bleeding-Risk
Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Zlotnik D.; Abdallah G.A.; Lang E.; Boucebci K.-J.; Gautier C.-H.;
Francois A.; Gaussem P.; Godier A.
Institution
(Zlotnik, Abdallah, Gaussem, Godier) Universite Paris Cite, INSERM,
Innovative Therapies in Haemostasis, Paris, France
(Zlotnik, Abdallah, Lang, Boucebci, Godier) Service d'Anesthesie
Reanimation, AP-HP, Hopital Europeen Georges Pompidou, Paris, France
(Gautier) AP-HP, Federation de Chirurgie Cardiovasculaire, Service de
Chirurgie Cardiaque, Hopital Europeen Georges Pompidou, Paris, France
(Francois) Etablissement Francais Du Sang (EFS), Hopital Europeen Georges
Pompidou, Paris F-75015, France
(Gaussem) AP-HP, Service d'Hematologie Biologique, Hopital Europeen
Georges Pompidou, Paris, France
Publisher
W.B. Saunders
Abstract
Objectives: To assess whether a Quantra-guided hemostatic algorithm would
reduce transfusion requirement and major bleeding compared with
laboratory-guided testing in patients facing high-bleeding-risk cardiac
surgery. <br/>Design(s): Single-center before-and-after study.
<br/>Setting(s): University hospital. <br/>Participant(s): Patients facing
high-bleeding-risk cardiac surgery with cardiopulmonary bypass.
<br/>Intervention(s): Hemostatic algorithm was based on standard
laboratory testing during the control period, then on the Quantra during
the Quantra period. The primary endpoint was the number of red blood cell
(RBC) units transfused on day 1 after surgery. <br/>Measurements and Main
Results: After propensity-score matching, 66 patients were included in the
Quantra group and 117 in the control group. The Quantra group received
fewer RBC units on day 1 than the control group (2 [0-5] v 4 [2-6], p =
0.016, respectively). Intraoperatively, the Quantra group received fewer
RBC (2 [0-3] v 3 [1-5], p = 0.005), less fresh frozen plasma (0 [0-3] v
3[2-5], p < 0.0001), and fewer platelet units (7.5 [0-10] v 8.2
[6.3-11.7], p = 0.014). The intraoperative rates of RBC, plasma, and
platelet transfusion were reduced (64% v 78%, p = 0.05; 41% v 85%, p <
0.001; 55% v 82%, p = 0.001, respectively). The RBC and plasma
transfusions were reduced on days 1, 2, and 7. The incidence of major
bleeding on day 1 also was reduced (36% v 56%, p = 0.014). In multivariate
analysis, implementation of the Quantra-guided hemostatic algorithm was
associated independently with reductions in major bleeding.
<br/>Conclusion(s): Implementation of a Quantra-based hemostatic algorithm
was associated with a decrease in transfusion requirement and major
bleeding after high-bleeding-risk cardiac surgery. Randomized trials are
needed to confirm these results.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<23>
Accession Number
2022945147
Title
The effect of using illustrated materials for communication on the anxiety
and comfort of cardiac surgery patients receiving mechanical ventilator
support: A randomized controlled trial.
Source
Heart and Lung. 59 (pp 157-164), 2023. Date of Publication: 01 May 2023.
Author
Kolcak B.; Ayhan H.; Tastan S.
Institution
(Kolcak) Vocational School Of Health Services, Yuksek Ihtisas University,
Ankara, Turkey
(Ayhan) Gulhane Faculty of Nursing, University of Health Sciences Turkey,
Turkey
(Tastan) Department of Nursing, Faculty of Health Sciences, Eastern
Mediterranean University, North Cyprus via Mersin 10, Famagusta, Turkey
Publisher
Elsevier Inc.
Abstract
Background: Using illustrated communication materials with patients
receiving mechanical ventilation support increases patient satisfaction
and reduces communication difficulties. However, there are no randomized
controlled clinical studies showing the effect of the use of these
materials on patient care outcomes. <br/>Objective(s): To determine the
effect of using illustrated communication materials on the anxiety and
comfort levels of patients receiving mechanical ventilation support.
<br/>Method(s): In this controlled clinical trial, patients were randomly
assigned to either the intervention group that used illustrated
communication materials or the control group that used routine
communication methods. In the first minute of contact with patients in the
intensive care unit, then at 30 min and 60 min, patients' numerical
pain-rating scale scores, hemodynamic values, and face-anxiety scale
scores were recorded. Satisfaction with communication and perianesthesia
comfort scale scores were obtained the day after operation.
<br/>Result(s): After 30 min of communication, the percentage of
face-anxiety points difference decreased in the intervention group
(-14.16) compared to the control group (-6.11), and the difference was
statistically significant (p < 0.05). In terms of perceived comfort during
postoperative mechanical ventilation, the mean score of the patients in
the intervention group (106.10) was higher than the control group (88.53),
and the difference was statistically significant (p < 0.05). Furthermore,
90% of the patients in the intervention group and 30% of the patients in
the control group were satisfied with the communication method used, and
the difference between the groups was statistically significant.
<br/>Conclusion(s): Using illustrated communication materials reduces
anxiety and increases patient satisfaction and comfort levels. In
communicating with intubated patients, the use of illustrated
communication materials is recommended.<br/>Copyright &#xa9; 2023 Elsevier
Inc.

<24>
Accession Number
2021764657
Title
Effect of Prolonged and Substantial Weight Loss on Incident Atrial
Fibrillation: A Systematic Review and Meta-Analysis.
Source
Nutrients. 15(4) (no pagination), 2023. Article Number: 940. Date of
Publication: February 2023.
Author
Pontiroli A.E.; Centofanti L.; Le Roux C.W.; Magnani S.; Tagliabue E.;
Folli F.
Institution
(Pontiroli, Centofanti, Folli) Dipartimento di Scienze della Salute,
Universita degli Studi di Milano, Milan 20133, Italy
(Le Roux) Diabetes Complications Research Centre, University College
Dublin, Dublin D04 V1W8, Ireland
(Magnani) Ospedale San Paolo, Milan 20142, Italy
(Tagliabue) IRCCS MultiMedica, Value-Based Healthcare Unit, Milan 20099,
Italy
Publisher
MDPI
Abstract
Background. Overweight and obesity are associated with atrial fibrillation
(AF), and bariatric surgery (BS), able to induce sustained and prolonged
weight loss, might represent the ideal treatment in the prevention of AF.
Previous studies could not definitely establish a role for weight loss and
BS in preventing incident AF so far. During the last few years, several
studies on the effect of bariatric surgery on cardiovascular diseases have
been published, and we performed a systematic review and meta-analysis to
evaluate the role of weight loss through BS in the prevention of incident
AF in obesity. Methods. This meta-analysis followed the PRISMA guideline.
Eligible studies were controlled trials evaluating the appearance of
atrial fibrillation in patients undergoing weight loss through BS as
compared with patients receiving medical treatment. Quality of studies was
assessed according to the Newcastle-Ottawa Quality Assessment Scale, and
risk-of-bias was evaluated employing the Egger's test. All analyses were
run by a random-effects model according to Hartung and Knapp and
sensitivity analyses were performed. Heterogeneity was assessed through Q
and I² statistics for each comparison, and potential
publication bias was formally investigated. Results. Ten studies were
included in the meta-analysis, and the overall result was statistically
significant [OR = 0.665 (0.475-0.929), p = 0.017], with significant
heterogeneity (Q = 48.98, p < 0.001; I² = 81.6%), but with no
publication bias. In sensitivity analyses, the amount of weight loss,
percentage of patients with diabetes and value of the Newcastle-Ottawa
Quality Assessment Scale, were all associated with significance of effect.
Since age was different in one study, a sensitivity analysis was performed
by excluding this study; OR was similar [OR = 0.608 (0.454-0.814), p <
0.001]; heterogeneity was reduced but still significant (Q = 35.74, p <
0.001, I² = 77.6%) and again no publication bias was detected.
Conclusions. Bariatric surgery as compared to medical treatment is
associated with reduced appearance of incident AF.<br/>Copyright &#xa9;
2023 by the authors.

<25>
Accession Number
2021719571
Title
Performance and usability of pre-operative prediction models for 30-day
peri-operative mortality risk: a systematic review.
Source
Anaesthesia. (no pagination), 2023. Date of Publication: 2023.
Author
Vernooij J.E.M.; Koning N.J.; Geurts J.W.; Holewijn S.; Preckel B.;
Kalkman C.J.; Vernooij L.M.
Institution
(Vernooij, Koning, Geurts) Department of Anaesthesia, Rijnstate Hospital,
Netherlands
(Holewijn) Department of Vascular Surgery, Rijnstate Hospital, Netherlands
(Preckel) Department of Anaesthesia, Amsterdam UMC, Amsterdam, Netherlands
(Kalkman) University Medical Centre, Utrecht, Netherlands
(Vernooij) Department of Anaesthesia, University Medical Centre Utrecht,
Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Estimating pre-operative mortality risk may inform clinical
decision-making for peri-operative care. However, pre-operative mortality
risk prediction models are rarely implemented in routine clinical
practice. High predictive accuracy and clinical usability are essential
for acceptance and clinical implementation. In this systematic review, we
identified and appraised prediction models for 30-day postoperative
mortality in non-cardiac surgical cohorts. PubMed and Embase were searched
up to December 2022 for studies investigating pre-operative prediction
models for 30-day mortality. We assessed predictive performance in terms
of discrimination and calibration. Risk of bias was evaluated using a tool
to assess the risk of bias and applicability of prediction model studies.
To further inform potential adoption, we also assessed clinical usability
for selected models. In all, 15 studies evaluating 10 prediction models
were included. Discrimination ranged from a c-statistic of 0.82
(MySurgeryRisk) to 0.96 (extreme gradient boosting machine learning
model). Calibration was reported in only six studies. Model performance
was highest for the surgical outcome risk tool (SORT) and its external
validations. Clinical usability was highest for the surgical risk
pre-operative assessment system. The SORT and risk quantification index
also scored high on clinical usability. We found unclear or high risk of
bias in the development of all models. The SORT showed the best
combination of predictive performance and clinical usability and has been
externally validated in several heterogeneous cohorts. To improve clinical
uptake, full integration of reliable models with sufficient face validity
within the electronic health record is imperative.<br/>Copyright &#xa9;
2023 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf
of Association of Anaesthetists.

<26>
Accession Number
640417870
Title
Central Blood Pressure as a Predictor of Cardiovascular Risk.
Source
Pulse. Conference: Pulse of Asia 2021. Seoul South Korea. 9(Supplement 1)
(pp 4), 2021. Date of Publication: June 2021.
Author
Li Y.
Institution
(Li) Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai
Jiaotong University, China
Publisher
S. Karger AG
Abstract
Objective High blood pressure (BP) confers cardiovascular risk. However,
the clinical value of central BP remains uncertain. Design and Method
Among 5608 participants enrolled in the International Database of Central
Arterial Properties for Risk Stratification (IDCARS), 255 primary
composite cardiovascular endpoints occurred during a median of 4.1 years
follow-up. A multicenter placebo-controlled randomized clinical trial on
isolated central hypertension (ANTICIPATE, www.chictr.org.cn/
ChiCTR2000035758) has been initiated and is ongoing in China. Results The
multivariable- adjusted hazard ratios for the composite cardiovascular
endpoint, expressing the risk per 1-SD increment in BP, were 1.50 (95%
confidence interval, 1.33-1.70) for central systolic BP, 1.36 (1.19-1.54)
for central pulse pressure, 1.49 (1.33-1.67) for brachial systolic BP, and
1.34 (1.19-1.51) for brachial pulse pressure (P<0.001). Adding a central
or brachial BP to a base model increased the model fit (P<0.001) with
generalized R2 increments ranging from 0.37 to 0.74%. In the ANTICIPATE
trial, 2000 patients with coronary heart disease and isolated central
arterial hypertension, defined as a normal non-invasive brachial BP
(<140/90 mmHg) but a high central SBP of at least 130 mmHg measured with
invasive catheters, will be randomly assigned into the active treatment
with alisartan or amlodipine besilate or to their placebos for 48 weeks.
The primary composite outcome includes myocardial infarction, stroke,
cardiac revascularization procedures, hospitalization due to heart failure
or angina, or death from cardiovascular causes. Conclusions The IDCARS
study indicated that increased central and peripheral BPs were all
associated with adverse outcomes with a similar strength. The ANTICIPATE
trial might help to elucidate the clinical value of central BP and whether
controlling central BP could bring benefit to patients with coronary heart
disease.

<27>
Accession Number
2022851299
Title
Percutaneous MitraClip Device or Surgical Mitral Valve Repair in Patients
With Primary Mitral Regurgitation Who Are Candidates for Surgery: Design
and Rationale of the REPAIR MR Trial.
Source
Journal of the American Heart Association. 12(4) (no pagination), 2023.
Article Number: e027504. Date of Publication: 21 Feb 2023.
Author
McCarthy P.M.; Whisenant B.; Asgar A.W.; Ailawadi G.; Hermiller J.;
Williams M.; Morse A.; Rinaldi M.; Grayburn P.; Thomas J.D.; Martin R.;
Asch F.M.; Shu Y.; Sundareswaran K.; Moat N.; Kar S.
Institution
(McCarthy, Thomas) Northwestern Medicine, Chicago, IL, United States
(Whisenant) Intermountain Healthcare, Murray, UT, United States
(Asgar) Montreal Heart Institute, Montreal, QC, Canada
(Ailawadi) University of Michigan Hospital, Ann Arbor, MI, United States
(Hermiller) St. Vincent's Hospital, Indianapolis, IN, United States
(Williams) New York University Medical Center, New York, NY, United States
(Morse) St. Thomas Hospital, Nashville, TN, United States
(Rinaldi) Sanger Heart and Vascular Institute, Charlotte, NC, United
States
(Grayburn) Baylor Scott and White Hospital, Plano, TX, United States
(Martin) Emory University, Atlanta, GA, United States
(Asch) Medstar Health Research Institute, Washington, DC, United States
(Shu, Sundareswaran, Moat) Abbott, Santa Clara, CA, United States
(Kar) Los Robles Medical Center, Thousand Oaks, CA, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The current standard of care for the treatment of patients
with primary mitral regurgitation (MR) is surgical mitral valve repair.
Transcatheter edge-to-edge repair with the MitraClip device provides a
less invasive treatment option for patients with both primary and
secondary MR. Worldwide, >150 000 patients have been treated with the
MitraClip device. However, in the United States, MitraClip is approved for
use only in primary patients with MR who are at high or prohibitive risk
for mitral valve surgery. The REPAIR MR (Percutaneous MitraClip Device or
Surgical Mitral Valve Repair in Patients With Primary Mitral Regurgitation
Who Are Candidates for Surgery) trial is designed to compare early and
late outcomes associated with tran-scatheter edge-to-edge repair with the
MitraClip and surgical repair of primary MR in older or moderate surgical
risk patients. METHODS AND RESULTS: The REPAIR MR trial is a prospective,
randomized, parallel-controlled, open-label multicenter, noninfe-riority
trial for the treatment of severe primary MR (verified by an independent
echocardiographic core laboratory). Patients with severe MR and
indications for surgery because of symptoms (New York Heart Association
class II- IV), or without symptoms with left ventricular ejection fraction
<=60%, pulmonary artery systolic pressure >50 mm Hg, or left ventricular
end-systolic diameter >=40 mm are eligible for the trial provided they
meet the moderate surgical risk criteria as follows: (1) >=75 years of
age, or (2) if <75 years of age, then the subject has a Society of
Thoracic Surgeons Predicted Risk Of Mortality score of >=2% for mitral
repair (or Society of Thoracic Surgeons replacement score of >=4%), or the
presence of a comorbidity that may introduce a surgery-specific risk. The
local surgeon must determine that the mitral valve can be surgically
repaired. Additionally, an independent eligibility committee will confirm
that the MR can be reduced to mild or less with both the MitraClip and
surgical mitral valve repair with a high degree of certainty. A total of
500 eligible subjects will be randomized in a 1:1 ratio to receive the
MitraClip device or to undergo surgical mitral valve repair (control
group). There are 2 co- primary end points for the trial, both of which
will be evaluated at 2 years. Each subject will be followed for 10 years
after enrollment. The study has received approval from both the Food and
Drug Administration and the Centers for Medicare and Medicaid Services,
and enrolled its first subject in July 2020. <br/>CONCLUSION(S): The
REPAIR MR trial will determine the safety and effectiveness of
transcatheter edge-to-edge repair with the MitraClip in patients with
primary MR who are at moderate surgical risk and are candidates for
surgical MV repair. The trial will generate contemporary comparative
clinical evidence for the MitraClip device and surgical MV repair.
REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT04198870;
NCT04198870.<br/>Copyright &#xa9; 2023 The Authors.

<28>
Accession Number
2023026258
Title
Anesthetic Management of Patients With Kartagener Syndrome: A Systematic
Review of 99 Cases.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Cheng L.; Dong Y.; Liu S.
Institution
(Cheng, Dong, Liu) Department of Anesthesiology, Shengjing Hospital of
China Medical University, Shenyang, China
Publisher
W.B. Saunders
Abstract
KARTAGENER SYNDROME (KS) is characterized by the triad of chronic
sinusitis, bronchiectasis, and situs inversus. The mirrored anatomy and
respiratory infections in patients with KS patients pose great challenges
for anesthetic management. The aim of this review is to summarize
published cases with the hope of helping anesthesiologists perform
anesthesia in patients with KS more safely. A comprehensive literature
search for all cases of anesthetic management of KS patients was performed
in Pubmed, EMBASE, CNKI, and Wanfang Database. The extracted data included
age, sex, type of surgery, preoperative treatment, type of anesthesia,
anesthetic agents, airway management, central venous catheterization,
transesophageal echocardiogram, reversal of neuromuscular blockade,
adverse events during the surgery, and postoperative complications. The
study authors included 82 single-case reports, 3 case series, and 1 case
cohort, with a total number of 99 patients. The most common surgical
procedures were thoracic surgery (51.5%), which was followed by ear, nose,
and throat surgery (16.5%), and general surgery (14.5%). The preoperative
treatment of the patients was reported in only 20 patients, and included
antibiotics, bronchodilators, steroids, chest physiotherapy, and postural
drainage. General anesthesia was performed for 85.4% of the surgeries, and
regional anesthesia was performed in 14.6% of the cases. For nonthoracic
surgery, an endotracheal tube was the most commonly used airway device.
For thoracic surgery, a double-lumen tube was the most commonly used
airway device. The intraoperative process was uneventful in most patients,
and most patients recovered smoothly in the postoperative
course.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<29>
Accession Number
640421462
Title
Nociception Control of Bilateral Single-Shot Erector Spinae Plane Block
Compared to No Block in Open Heart Surgery-A Post Hoc Analysis of the NESP
Randomized Controlled Clinical Trial.
Source
Medicina (Kaunas, Lithuania). 59(2) (no pagination), 2023. Date of
Publication: 30 Jan 2023.
Author
Balan C.; Tomescu D.R.; Bubenek-Turconi S.I.
Institution
(Balan, Bubenek-Turconi) Cardiac Anesthesiology and Intensive Care
Department I, Prof. Dr. C.C. Iliescu Emergency Institute for
Cardiovascular Diseases, Bucharest 022328, Romania
(Balan, Tomescu, Bubenek-Turconi) Anesthesiology and Intensive Care
Department, Carol Davila University of Medicine and Pharmacy, Bucharest
050474, Romania
(Tomescu) 3rd Department of Anesthesiology and Intensive Care, Fundeni
Clinical Institute, Bucharest 022328, Romania
Publisher
NLM (Medline)
Abstract
Background and Objectives: The erector spinae plane block (ESPB) is an
analgesic adjunct demonstrated to reduce intraoperative opioid consumption
within a Nociception Level (NOL) index-directed anesthetic protocol. We
aimed to examine the ESPB effect on the quality of intraoperative
nociception control evaluated with the NOL index. <br/>Material(s) and
Method(s): This is a post hoc analysis of the NESP (Nociception Level
Index-Directed Erector Spinae Plane Block in Open Heart Surgery)
randomized controlled trial. Eighty-five adult patients undergoing on-pump
cardiac surgery were allocated to group 1 (Control, n = 43) and group 2
(ESPB, n = 42). Both groups received general anesthesia. Preoperatively,
group 2 received bilateral single-shot ESPB (1.5 mg/kg/side 0.5%
ropivacaine mixed with dexamethasone 8 mg/20 mL). Until cardiopulmonary
bypass (CPB) was initiated, fentanyl administration was individualized
using the NOL index. The NOL index was compared at five time points:
pre-incision (T1), post-incision (T2), pre-sternotomy (T3),
post-sternotomy (T4), and pre-CPB (T5). On a scale from 0 (no nociception)
to 100 (extreme nociception), a NOL index > 25 was considered an
inadequate response to noxious stimuli. <br/>Result(s): The average NOL
index across the five time points in group 2 to group 1 was 12.78 +/- 0.8
vs. 24.18 +/- 0.79 (p < 0.001). The NOL index was significantly lower in
the ESPB-to-Control group at T2 (12.95 +/- 1.49 vs. 35.97 +/- 1.47), T3
(13.28 +/- 1.49 vs. 24.44 +/- 1.47), and T4 (15.52 +/- 1.49 vs. 34.39 +/-
1.47) (p < 0.001) but not at T1 and T5. Compared to controls,
significantly fewer ESPB patients reached a NOL index > 25 at T2 (4.7% vs.
79%), T3 (0% vs. 37.2%), and T4 (7.1% vs. 79%) (p < 0.001).
<br/>Conclusion(s): The addition of bilateral single-shot ESPB to general
anesthesia during cardiac surgery improved the quality of intraoperative
nociception control according to a NOL index-based evaluation.

<30>
Accession Number
640421014
Title
Efficacy of Phrenic Nerve Block and Suprascapular Nerve Block in
Amelioration of Ipsilateral Shoulder Pain after Thoracic Surgery: A
Systematic Review and Network Meta-Analysis.
Source
Medicina (Kaunas, Lithuania). 59(2) (no pagination), 2023. Date of
Publication: 31 Jan 2023.
Author
Pipanmekaporn T.; Leurcharusmee P.; Punjasawadwong Y.; Khorana J.;
Samerchua A.; Sukhupragarn W.; Sukuam I.; Bunchungmongkol N.; Saokaew S.
Institution
(Pipanmekaporn, Leurcharusmee, Punjasawadwong, Samerchua, Sukhupragarn,
Bunchungmongkol) Department of Anesthesiology, Faculty of Medicine, Chiang
Mai University, Chiang Mai 50200, Thailand
(Pipanmekaporn, Khorana) Clinical Epidemiology and Statistic Center,
Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
(Khorana) Department of Surgery, Faculty of Medicine, Chiang Mai
University, Chiang Mai 50200, Thailand
(Sukuam) Maeramat Hospital, Tak 63140, Thailand
(Saokaew) Unit of Excellence on Clinical Outcomes Research and IntegratioN
(UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao
56000, Thailand
(Saokaew) Center of Health Outcomes Research and Therapeutic Safety
(Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao
56000, Thailand
(Saokaew) Division of Social and Administrative Pharmacy, Department of
Pharmaceutical Care, School of Pharmaceutical Sciences, University of
Phayao, Phayao 56000, Thailand
Publisher
NLM (Medline)
Abstract
Background and Objectives: Ipsilateral shoulder pain (ISP) is a common
complication after thoracic surgery. Severe ISP can cause ineffective
breathing and impair shoulder mobilization. Both phrenic nerve block (PNB)
and suprascapular nerve block (SNB) are anesthetic interventions; however,
it remains unclear which intervention is most effective. The purpose of
this study was to compare the efficacy and safety of PNB and SNB for the
prevention and reduction of the severity of ISP following thoracotomy or
video-assisted thoracoscopic surgery. <br/>Material(s) and Method(s):
Studies published in PubMed, Embase, Scopus, Web of Science, Ovid Medline,
Google Scholar and the Cochrane Library without language restriction were
reviewed from the publication's inception through 30 September 2022.
Randomized controlled trials evaluating the comparative efficacy of PNB
and SNB on ISP management were selected. A network meta-analysis was
applied to estimate pooled risk ratios (RRs) and weighted mean difference
(WMD) with 95% confidence intervals (CIs). <br/>Result(s): Of 381 records
screened, eight studies were eligible. PNB was shown to significantly
lower the risk of ISP during the 24 h period after surgery compared to
placebo (RR 0.44, 95% CI 0.34 to 0.58) and SNB (RR 0.43, 95% CI 0.29 to
0.64). PNB significantly reduced the severity of ISP during the 24 h
period after thoracic surgery (WMD -1.75, 95% CI -3.47 to -0.04), but
these effects of PNB were not statistically significantly different from
SNB. When compared to placebo, SNB did not significantly reduce the
incidence or severity of ISP during the 24 h period after surgery.
<br/>Conclusion(s): This study suggests that PNB ranks first for
prevention and reduction of ISP severity during the first 24 h after
thoracic surgery. SNB was considered the worst intervention for ISP
management. No evidence indicated that PNB was associated with a
significant impairment of postoperative ventilatory status.

<31>
Accession Number
640415247
Title
The TEAMMATE Trial: Study Design and Rationale Tacrolimus and Everolimus
Against TACROLIMUS and MMF in Pediatric Heart Transplantation Using the
Major Adverse Transplant Event (MATE) Score.
Source
American heart journal. (no pagination), 2023. Date of Publication: 22
Feb 2023.
Author
Almond C.S.; Sleeper L.A.; Rossano J.W.; Bock M.J.; Pahl E.; Auerbach S.;
Lal A.; Hollander S.A.; Miyamoto S.D.; Castleberry C.; Lee J.; Barkoff
L.M.; Gonzales S.; Klein G.; Daly K.P.
Institution
(Almond, Lee, Barkoff, Gonzales) Departments of Pediatrics (Cardiology),
Stanford University School of Medicine
(Sleeper, Klein, Daly) Department of Cardiology, Boston Children's
Hospital and the Department of Pediatrics, Harvard Medical School
(Rossano) Department of Cardiology, Children's Hospital of Philadelphia,
University of Pennsylvania School of Medicine
(Bock) Division of Pediatric Cardiology, Loma Linda University Children's
Hospital, Loma Linda University School of Medicine
(Pahl) Department of Pediatrics, Lurie Children's Hospital, Northwestern
School of Medicine
(Auerbach, Hollander, Miyamoto) Children's Hospital Colorado Heart
Institute, University of Colorado, Anschutz Medical Campus
(Lal) Department of Pediatrics Primary Children's Hospital, University of
Utah School of Medicine
(Castleberry) Departments of Pediatrics, St. Louis Children's Hospital,
Washington University in Saint Louis
Publisher
NLM (Medline)
Abstract
BACKGROUND: Currently there are no immunosuppression regimens FDA-approved
to prevent rejection in pediatric heart transplantation (HT). In recent
years, everolimus (EVL) has emerged as a potential alternative to standard
tacrolimus (TAC) as the primary immunosuppressant to prevent rejection
that may also reduce the risk of cardiac allograft vasculopathy (CAV),
chronic kidney disease (CKD) and cytomegalovirus (CMV) infection. However,
the two regimens have never been compared head-to-head in a randomized
trial. The study design and rationale are reviewed in light of the
challenges inherent in rare disease research. <br/>METHOD(S): The TEAMMATE
trial (NCT03386539, IND 127980) is the first multicenter randomized
clinical trial (RCT) in pediatric HT. The primary purpose is to evaluate
the safety and efficacy of EVL and low-dose TAC (LD-TAC) compared to
standard-dose TAC and mycophenolate mofetil (MMF). Children aged <21 years
at HT were randomized (1:1 ratio) at six months post-HT to either regimen,
and followed for 30 months. Children with recurrent rejection, multi-organ
transplant recipients, and those with an estimated glomerular filtration
rate (eGFR) <30 ml/min/1.73m2 were excluded. The primary efficacy
hypothesis is that, compared to TAC/MMF, EVL/LD-TAC is more effective in
preventing 3 MATEs: acute cellular rejection (ACR), CKD and CAV. The
primary safety hypothesis is that EVL/LD-TAC does not have a higher
cumulative burden of 6 MATEs (antibody mediated rejection [AMR],
infection, and post-transplant lymphoproliferative disorder [PTLD] in
addition to the 3 above). The primary endpoint is the MATE score, a
composite, ordinal surrogate endpoint reflecting the frequency and
severity of MATEs that is validated against graft loss. The study had a
target sample size of 210 patients across 25 sites and is powered to
demonstrate superior efficacy of EVL/LD-TAC. Trial enrollment is complete
and participant follow-up will be completed in 2023. <br/>CONCLUSION(S):
The TEAMMATE trial is the first multicenter RCT in pediatric HT. It is
anticipated that the study will provide important information about the
safety and efficacy of everolimus- vs tacrolimus-based regimens and will
provide valuable lessons into the design and conduct of future trials in
pediatric HT.<br/>Copyright &#xa9; 2023. Published by Elsevier Inc.

<32>
Accession Number
640402935
Title
Association Between Serum Albumin and Outcomes in Heart Failure and
Secondary Mitral Regurgitation: The COAPT Trial.
Source
European journal of heart failure. (no pagination), 2023. Date of
Publication: 23 Feb 2023.
Author
Feng K.Y.; Ambrosy A.P.; Zhou Z.; Li D.; Kong J.; Zaroff J.G.; Mishell
J.M.; Ku I.A.; Scotti A.; Coisne A.; Redfors B.; Mack M.J.; Abraham W.T.;
Lindenfeld J.; Stone G.W.
Institution
(Feng, Ambrosy, Kong, Zaroff, Mishell, Ku) Department of Cardiology,
Kaiser Permanente San Francisco Medical Center, San Francisco, CA, United
States
(Ambrosy) Division of Research, Kaiser Permanente Northern California,
Oakland, CA, United States
(Zhou, Li, Scotti, Coisne, Redfors) Clinical Trials Center, Cardiovascular
Research Foundation, New York, NY
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Mack) Department of Cardiothoracic Surgery, Baylor Scott & White Health,
Plano, TX, United States
(Abraham) Division of Cardiovascular Medicine, Ohio State University
Medical Center, Columbus, OH, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY
Publisher
NLM (Medline)
Abstract
AIMS: Low serum albumin levels are associated with poor prognosis in
numerous chronic disease states but the relationship between albumin and
outcomes in patients with heart failure (HF) and secondary mitral
regurgitation (SMR) has not been described. METHODS AND RESULTS: The
randomized COAPT trial evaluated the safety and effectiveness of
transcatheter edge-to-edge repair (TEER) with the MitraClip plus
guideline-directed medical therapy (GDMT) versus GDMT alone in patients
with symptomatic HF and moderate-to-severe or severe SMR. Baseline serum
albumin levels were measured at enrollment. Among 614 patients enrolled in
COAPT, 559 (91.0%) had available baseline serum albumin levels (median 4.0
g/dL, IQR 3.7-4.2 g/dL). Patients with albumin <4.0 g/dL compared with
>=4.0 g/dL were older and more likely to have ischemic cardiomyopathy and
a hospitalization within the year prior to enrollment. After multivariable
adjustment, patients with albumin <4.0 g/dL had higher 4-year rates of
all-cause death (63.7% vs. 47.6%; adjusted HR 1.34, 95% CI 1.02-1.74;
p=0.032), but there were no significant differences in heart failure
hospitalizations (HFH) or all-cause hospitalizations according to baseline
serum albumin level. The relative effectiveness of TEER plus GDMT versus
GDMT alone was consistent in patients with low and high albumin levels
(Pinteraction =0.19 and 0.35 for death and HFH, respectively).
<br/>CONCLUSION(S): Low baseline serum albumin levels were independently
associated with reduced 4-year survival in patients with HF and severe SMR
enrolled in the COAPT trial, but not with HFH. Patients treated with TEER
derived similarly robust reductions in both death and HFH regardless of
baseline albumin level. This article is protected by copyright. All rights
reserved.

<33>
Accession Number
2019458618
Title
Coronary flow reserve and cardiovascular outcomes: a systematic review and
meta-analysis.
Source
European Heart Journal. 43(16) (pp 1582-1593), 2022. Date of Publication:
21 Apr 2022.
Author
Kelshiker M.A.; Seligman H.; Howard J.P.; Rahman H.; Foley M.; Nowbar
A.N.; Rajkumar C.A.; Shun-Shin M.J.; Ahmad Y.; Sen S.; Al-Lamee R.;
Petraco R.
Institution
(Kelshiker, Seligman, Howard, Rahman, Foley, Nowbar, Rajkumar, Sen,
Al-Lamee, Petraco) National Heart and Lung Institute, Imperial College
London, Hammersmith Campus, 72 Du Cane Road, London W12 0HS, United
Kingdom
(Ahmad) Yale School of Medicine, Yale University, 333 Cedar St, New Haven,
CT 06510, United States
Publisher
Oxford University Press
Abstract
Aims This meta-analysis aims to quantify the association of reduced
coronary flow with all-cause mortality and major adverse cardiovascular
events (MACE) across a broad range of patient groups and pathologies.
Methods and results We systematically identified all studies between 1
January 2000 and 1 August 2020, where coronary flow was measured and
clinical outcomes were reported. The endpoints were all-cause mortality
and MACE. Estimates of effect were calculated from published hazard ratios
(HRs) using a random-effects model. Seventy-nine studies with a total of
59 740 subjects were included. Abnormal coronary flow reserve (CFR) was
associated with a higher incidence of all-cause mortality [HR: 3.78, 95%
confidence interval (CI): 2.39-5.97] and a higher incidence of MACE (HR
3.42, 95% CI: 2.92-3.99). Each 0.1 unit reduction in CFR was associated
with a proportional increase in mortality (per 0.1 CFR unit HR: 1.16, 95%
CI: 1.04-1.29) and MACE (per 0.1 CFR unit HR: 1.08, 95% CI: 1.04-1.11). In
patients with isolated coronary microvascular dysfunction, an abnormal CFR
was associated with a higher incidence of mortality (HR: 5.44, 95% CI:
3.78-7.83) and MACE (HR: 3.56, 95% CI: 2.14-5.90). Abnormal CFR was also
associated with a higher incidence of MACE in patients with acute coronary
syndromes (HR: 3.76, 95% CI: 2.35-6.00), heart failure (HR: 6.38, 95% CI:
1.95-20.90), heart transplant (HR: 3.32, 95% CI: 2.34-4.71), and diabetes
mellitus (HR: 7.47, 95% CI: 3.37-16.55). Conclusion Reduced coronary flow
is strongly associated with increased risk of all-cause mortality and MACE
across a wide range of pathological processes. This finding supports
recent recommendations that coronary flow should be measured more
routinely in clinical practice, to target aggressive vascular risk
modification for individuals at higher risk.<br/>Copyright &#xa9; 2022
Oxford University Press. All rights reserved.

<34>
Accession Number
2007596702
Title
The efficacy and safety of chinese medicine fufang zhenzhu tiaozhi capsule
(Ftz) in the treatment of diabetic coronary heart disease: Study protocol
for multicenter, randomized, double-blind, placebo-controlled clinical
trial.
Source
Diabetes, Metabolic Syndrome and Obesity. 14 (pp 2651-2659), 2021. Date of
Publication: 2021.
Author
Wang L.; Xiang L.; Piao S.; Gong X.; Zhou W.; Feng W.; Li H.; Li L.; Wei
A.; Zhu Q.; Rong X.; Guo J.
Institution
(Wang, Xiang, Piao, Zhu, Rong, Guo) Guangdong Metabolic Diseases Research
Center of Integrated Chinese and Western Medicine, Key Laboratory of
Glucolipid Metabolic Disorder, Ministry of Education of China, Institute
of Chinese Medicine, Guangdong Pharmaceutical University, Guangdong TCM
Key Laboratory for Metabolic Diseases, Guangzhou, China
(Xiang, Guo) The First Affiliated Hospital of Guangdong Pharmaceutical
University, Guangzhou, China
(Gong) School of Public Health, Guangdong Pharmaceutical University,
Guangzhou, China
(Zhou) Department of Internal Cardiology, The First Affiliated Hospital of
Guangdong Pharmaceutical University, Guangzhou, China
(Feng) Famous Doctor's Studio, Qingyuan Hospital of Traditional Chinese
Medicine, Qingyuan, China
(Li) Department of Endocrinology, Shenzhen Traditional Chinese Medicine
Hospital, The Fourth Clinical Medical College of Guangzhou University of
Chinese Medicine, Shenzhen, China
(Li) Department of Endocrinology, Zhongshan Hospital of Traditional
Chinese Medicine, Zhongshan, China
(Wei) Department of Endocrinology, Foshan Hospital of Traditional Chinese
Medicine, Foshan, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Diabetic coronary heart disease (DCHD), the main macrovascular
complication of type 2 diabetes mellitus (T2DM), is greatly harmful to
T2DM patients. Traditional Chinese medicine (TCM) is an alternative and
effective therapy to delay the development of macro-vascular diseases, but
the existing evidence of its efficacy and safety is insufficient. The aim
of this multicenter, randomized, double-blind, placebo-controlled trial is
to evaluate the efficacy and safety of Chinese Medicine Fufang Zhenzhu
Tiaozhi capsule (FTZ) in treating DCHD. <br/>Patients and Methods: This
study includes a 2-week run-in, 52-week treatment, and 52-week
post-treatment follow-up. A total of 160 participants will be recruited
and randomized into two groups. The treatment group will receive FTZ and
basic treatment, while the control group will receive the placebo and
basic treatment. The primary outcome is the combined outcome including the
major adverse cardiovascular events, coronary restenosis, and unplanned
revascularization. The combined secondary outcomes include all-cause
mortality, acute coronary syndrome, ischemic stroke, heart failure,
unplanned re-hospitalization mainly caused by acute complications of
diabetes, other thromboembolic events, and TCM symptom indicators. The
safety outcomes and adverse events will also be evaluated in this trial.
<br/>Discussion(s): This trial evaluates the clinical effectiveness and
safety of FTZ in patients with DCHD. The results are important to further
explore the effectiveness of the comprehensive strategy "Tiao Gan Qi Shu
Hua Zhuo" (modulating Gan, trigging key metabolic system to resolve
pathogenic factors such as phlegm retention and dampness) in the
prevention and control of glucolipid metabolic disorders (GLMD) including
DCHD and T2DM. On the other hand, this study is the first trial of FTZ to
observe cardiovascular outcomes through long-term follow-up after
treatment of DCHD, which is of great value. Trial Registration: This trial
was registered in the Chinese Clinical Trial Registry on April 07, 2019
(No. ChiCTR1900022345).<br/>Copyright &#xa9; 2021 Wang et al.

<35>
Accession Number
612009522
Title
General management of nonagenarian patients: A review of the literature.
Source
Swiss Medical Weekly. 144 (no pagination), 2014. Article Number: w14059.
Date of Publication: 2014.
Author
Rivoirard R.; Chargari C.; Tronec J.-C.; Falk A.T.; Guy J.-B.; Eddekkaoui
H.; Lahmar R.; Pacaut C.; Mery B.; Assouline A.; Auberdiac P.; Moriceau
G.; Gonthier R.; Guillota A.; Merrouche Y.; Magne N.
Institution
(Rivoirard, Pacaut, Mery, Moriceau, Guillota, Merrouche) Department of
Medical Oncology, Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez,
France
(Chargari) Department of Radiotherapy, Instruction Armed Val-de-Grace
Hospital, Paris, France
(Tronec, Guy, Eddekkaoui, Lahmar, Magne) Department of Radiotherapy,
Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez, France
(Falk) Department of Radiotherapy, Centre Antoine Lacassagne, Nice, France
(Assouline) Department of Radiotherapy, Clinical Centre of Porte de Saint
Cloud, Boulogne-Billancourt, France
(Auberdiac) Department of Radiotherapy, Clinique Claude Bernard, Albi,
France
(Gonthier) Department of Clinical Gerontology, University Hospital of
Saint-Etienne, Charity Hospital, France
(Magne) Department of Radiotherapy, Institut de Cancerologie Lucien
Neuwirth, 108 bis, avenue Albert Raimond - BP 60008, Saint-Priest en Jarez
Cedex FR-42271, France
Publisher
EMH Schweizerischer Arzteverlag AG
Abstract
The number of nonagenarian people in the world is steadily growing. This
phenomenon will increase in future years: in 2050, world population
prospects estimate 71.16 million people aged 90 years or older. The two
main causes of death among people aged 85 years or more in Europe in 2003
were cardiovascular and cerebrovascular diseases and cancers. However, the
elderly are often excluded from clinical trials; they are underrepresented
in clinical registries and especially nonagenarians. Care (medical,
surgical, oncology) of these very elderly is currently insufficiently
based on scientific recommendations. For the physician, the choice to
treat or not to treat very elderly patients (for fear of side effects) is
difficult. Oncology is particularly affected by this problem. Here we
review these different fields of internal medicine management of
nonagenarian patients with a special focus on oncology and on
comprehensive geriatric assessment as a base for all care decision taking.

<36>
Accession Number
2021286060
Title
Use of sodium-glucose co-transporter 2 inhibitors in solid organ
transplant recipients with pre-existing type 2 or post-transplantation
diabetes mellitus: A systematic review.
Source
Transplantation Reviews. 37(1) (no pagination), 2023. Article Number:
100729. Date of Publication: January 2023.
Author
Lin Y.; Mok M.; Harrison J.; Battistella M.; Farrell A.; Leung M.; Cheung
C.
Institution
(Lin) Vancouver General Hospital, Vancouver, BC, Canada
(Mok) Richmond Health Services, Richmond, BC, Canada
(Harrison, Battistella) Leslie Dan Faculty of Pharmacy, University of
Toronto, Toronto, ON, Canada
(Harrison) Ajmera Transplant Centre, Toronto General Hospital, University
Health Network, Toronto, ON, Canada
(Battistella) Nephrology, University Health Network, Toronto, ON, Canada
(Farrell) Library and Information Services, University Health Network,
Toronto, ON, Canada
(Leung) Faculty of Pharmaceutical Sciences, University of British
Columbia, Vancouver, BC, Canada
(Leung) St. Paul's Hospital, Providence Healthcare, Vancouver, BC V6Z 1Y6,
Canada
(Cheung) Fraser Health Post Transplant Clinic, Surrey, BC, Canada
Publisher
Elsevier Inc.
Abstract
Introduction: Sodium-Glucose Co-Transporter 2 (SGLT2) inhibitors have
demonstrated kidney, cardiovascular and mortality benefits in the general
population; however, the evidence is limited in solid organ transplant
recipients. The aim of this systematic review was to evaluate the current
efficacy and safety data of SGLT2 inhibitors in adult kidney, heart, lung,
and liver transplant recipients with pre-existing type 2 or
post-transplantation diabetes mellitus. <br/>Method(s): We searched
MEDLINE, MEDLINE Epub, CENTRAL, CDSR, EMBASE, CINAHL, and sources of
unpublished literature. All primary interventional and observational
studies on SGLT2 inhibitors in transplant recipients were included.
Clinical outcomes included mortality, cardiovascular and kidney events,
and adverse events such as graft rejection. Surrogate markers including
hemoglobin A1c (HbA1c) and weight reduction were also evaluated.
<br/>Result(s): Of the 17 studies that were included in this systematic
review, there were 15 studies on kidney transplant recipients (n = 2417
patients) and two studies on heart transplant recipients (n = 122
patients). There was only one randomized controlled trial which evaluated
49 kidney transplant patients over 24 weeks. Overall, studies were
heterogeneous in study design, sample size, duration of diabetes, time to
SGLT2 inhibitor initiation post-transplantation (ranging from 0.88 to 11
years post kidney transplant; five to 5.7 years post heart transplant) and
follow-up (ranging from 0.4 to 5.25 years in kidney transplant patients;
0.75 to one year in heart transplant patients). Only one retrospective
study evaluated mortality as a part of a composite outcome in kidney
transplant patients; however, study limitations restrict generalizability
of results. Overall, studies could not confirm clinical cardiovascular and
kidney benefits in the transplant population. Findings suggested that
SGLT2 inhibitors may improve glycemic control; however, they are
associated with urinary tract infection. Diabetic ketoacidosis and acute
kidney injury also occurred in these studies, with precipitating factors
such as infection and acute heart failure exacerbation.
<br/>Conclusion(s): While SGLT2 inhibitors are promising agents with
expanding indications in the non-transplant population, these agents may
not be suitable for all solid organ transplant recipients, and close
monitoring (e.g. for urinary tract infections) and patient education (e.g.
sick day management) are essential if these agents are initiated. Evidence
is based on short-term findings and suggests an association with
hemoglobin A1c reduction and increased adverse events. Further long-term
randomized controlled trials are needed to evaluate the effect of SGLT2
inhibitors on clinically important outcomes, including mortality
reduction, in solid organ transplant recipients.<br/>Copyright &#xa9; 2022

<37>
Accession Number
2021223645
Title
Risk factors of postoperative low cardiac output syndrome in children with
congenital heart disease: A systematic review and meta-analysis.
Source
Frontiers in Pediatrics. 10 (no pagination), 2023. Article Number: 954427.
Date of Publication: 10 Jan 2023.
Author
Wang P.; Fu C.; Bai G.; Cuan L.; Tang X.; Jin C.; Jin H.; Zhu J.; Xie C.
Institution
(Wang, Cuan, Tang, Zhu) Department of Pediatric Surgery, The Children's
Hospital, Zhejiang University School of Medicine, National Clinical
Research Center for Child Health, Hangzhou, China
(Fu) Department of Nursing, The Children's Hospital, Zhejiang University
School of Medicine, National Clinical Research Center for Child Health,
Hangzhou, China
(Bai, Jin) The Children's Hospital, Zhejiang University School of
Medicine, National Clinical Research Center for Child Health, Hangzhou,
China
(Jin) Cardiac Intensive Care Unit, The Children's Hospital, Zhejiang
University School of Medicine, National Clinical Research Center for Child
Health, Hangzhou, China
(Xie) Department of Cardiovascular Medicine, The Children's Hospital,
Zhejiang University School of Medicine, National Clinical Research Center
for Child Health, Hangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: Low cardiac output syndrome (LCOS) is the most common
complication after cardiac surgery, which is associated with the extension
of postoperative hospital stay and postoperative death in children with
congenital heart disease (CHD). Although there are some studies on the
risk factors of LCOS in children with CHD, an unified conclusion is lack
at present. <br/>Purpose(s): To synthesize the risk factors of LCOS after
CHD in children, and to provide evidence-based insights into the early
identification and early intervention of LCOS. <br/>Method(s): The
databases of the China National Knowledge Infrastructure (CNKI), Wanfang
Database, China Science and Technology Journal Database (VIP), PubMed,
Cochrane Library, Embase and Web of Science were searched for relevant
articles that were published between the establishing time of each
database and January 2022. Based on retrospective records or cohort
studies, the influencing factors of postoperative low cardiac output in
children with congenital heart disease were included in Meta analysis.This
study followed the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines. The risk of bias was evaluated
according to the Newcastle-Ottawa Scale (NOS). RevMan 5.4 software was
used to conduct the meta-analysis. <br/>Result(s): A total of 1,886
records were screened, of which 18 were included in the final review. In
total, 37 risk factors were identified in the systematic review. Meta-
analysis showed that age, type of CHD, cardiac reoperation, biventricular
shunt before operation, CPB duration, ACC duration, postoperative residual
shunt, cTn-1 level 2 h after CPB > 14 ng/ml and postoperative 24 h
MR-ProADM level > 1.5 nmol/l were independent risk factors of LCOS.
Additionally, the level of blood oxygen saturation before the operation
was found to have no statistically significant relationship with LOCS.
<br/>Conclusion(s): The risk factors of postoperative LCOS in children
with CHD are related to disease condition, intraoperative time and
postoperative related indexes, so early prevention should be aimed at
high-risk children. Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/, identifier:
CRD42022323043.<br/>Copyright 2023 Wang, Chuan, Tang and Zhu.

<38>
[Use Link to view the full text]
Accession Number
2022689144
Title
Type D Personality as a Risk Factor for Adverse Outcome in Patients With
Cardiovascular Disease: An Individual Patient-Data Meta-analysis.
Source
Psychosomatic Medicine. 85(2) (pp 188-202), 2023. Date of Publication: 01
Feb 2023.
Author
Lodder P.; Wicherts J.M.; Antens M.; Albus C.; Bessonov I.S.; Conden E.;
Dulfer K.; Gostoli S.; Grande G.; Hedberg P.; Herrmann-Lingen C.; Jaarsma
T.; Koo M.; Lin P.; Lin T.-K.; Meyer T.; Pushkarev G.; Rafanelli C.; Raykh
O.I.; Schaan De Quadros A.; Schmidt M.; Sumin A.N.; Utens E.M.W.J.; Van
Veldhuisen D.J.; Wang Y.; Kupper N.
Institution
(Lodder, Wicherts) Department of Methodology and Statistics, Tilburg
University, Tilburg, Netherlands
(Lodder, Antens, Kupper) Center of Research on Psychology in Somatic
Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg
University, Tilburg, Netherlands
(Albus) Department of Psychosomatics and Psychotherapy, University of
Cologne, Medical Faculty and University Hospital, Cologne, Germany
(Bessonov, Pushkarev) Tyumen Cardiology Research Center, Tomsk National
Research Medical Center, Russian Academy of Science, Tyumen, Russian
Federation
(Conden) Uppsala University, Centre for Clinical Research, Hospital of
Vastmanland, Vastmanland, Sweden
(Dulfer) Intensive Care Unit, Department of Pediatrics and Pediatric
Surgery, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam,
Netherlands
(Gostoli, Rafanelli) Department of Psychology, University of Bologna,
Bologna, Italy
(Grande) Brandenburgische Technische Universitat Cottbus-Senftenberg,
Cottbus, Germany
(Hedberg) Department of Clinical Physiology and Centre for Clinical
Research, Uppsala University, Vastmanland County Hospital, Vasteras,
Sweden
(Herrmann-Lingen, Meyer) Department of Psychosomatic Medicine and
Psychotherapy, University of Gottingen Medical Center, German Center for
Cardiovascular Research (DZHK), Gottingen, Germany
(Jaarsma) Department of Health, Medicine and Caring Sciences, Linkoping
University, Linkoping, Sweden
(Koo) Graduate Institute of Long-term Care, Tzu Chi University of Science
and Technology, Hualien, Hualien City, Taiwan (Republic of China)
(Koo) Dalla Lana School of Public Health, University of Toronto, Toronto,
ON, Canada
(Lin) College of Nursing of Harbin Medical University, The Second
Affiliated Hospital of Harbin Medical University, Harbin, China
(Lin) Division of Cardiology, Department of Internal Medicine, Dalin Tzu
Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
(Republic of China)
(Lin) School of Medicine, Tzu Chi University, Hualien, Hualien City,
Taiwan (Republic of China)
(Raykh, Sumin) Laboratory of Comorbidity in Cardiovascular Diseases, Fed.
State Budgetary Sci. Inst. research Institute for Complex Issues of
Cardiovascular Diseases, Moscow, Russian Federation
(Schaan De Quadros, Schmidt) Institute of Cardiology, University
Foundation of Cardiology, Rio Grande do Sul, Porto Alegre, Brazil
(Utens) Research Institute of Child Development and Education, Amsterdam
UMC/ Level, Amsterdam, Netherlands
(Van Veldhuisen) Department of Cardiology, University of Groningen,
University Medical Center Groningen, Groningen, Netherlands
(Wang) Department of Cardiology, The Second Affiliated Hospital of Harbin
Medical University, Harbin, China
Publisher
Lippincott Williams and Wilkins
Abstract
Objective Type D personality, a joint tendency toward negative affectivity
and social inhibition, has been linked to adverse events in patients with
heart disease, although with inconsistent findings. Here, we apply an
individual patient-data meta-analysis to data from 19 prospective cohort
studies (N = 11,151) to investigate the prediction of adverse outcomes by
type D personality in patients with acquired cardiovascular disease.
Method For each outcome (all-cause mortality, cardiac mortality,
myocardial infarction, coronary artery bypass grafting, percutaneous
coronary intervention, major adverse cardiac event, any adverse event), we
estimated type D's prognostic influence and the moderation by age, sex,
and disease type. Results In patients with cardiovascular disease,
evidence for a type D effect in terms of the Bayes factor (BF) was strong
for major adverse cardiac event (BF = 42.5; odds ratio [OR] = 1.14) and
any adverse event (BF = 129.4; OR = 1.15). Evidence for the null
hypothesis was found for all-cause mortality (BF = 45.9; OR = 1.03),
cardiac mortality (BF = 23.7; OR = 0.99), and myocardial infarction (BF =
16.9; OR = 1.12), suggesting that type D had no effect on these outcomes.
This evidence was similar in the subset of patients with coronary artery
disease (CAD), but inconclusive for patients with heart failure (HF).
Positive effects were found for negative affectivity on cardiac and
all-cause mortality, with the latter being more pronounced in male than
female patients. Conclusion Across 19 prospective cohort studies, type D
predicts adverse events in patients with CAD, whereas evidence in patients
with HF was inconclusive. In both patients with CAD and HF, we found
evidence for a null effect of type D on cardiac and all-cause
mortality.<br/>Copyright &#xa9; Lippincott Williams & Wilkins.

<39>
[Use Link to view the full text]
Accession Number
2022653673
Title
Effects of anesthetic depth on postoperative pain and delirium: A
meta-analysis of randomized controlled trials with trial sequential
analysis.
Source
Chinese Medical Journal. 135(23) (pp 2805-2814), 2022. Date of
Publication: 05 Dec 2022.
Author
Long Y.; Feng X.; Liu H.; Shan X.; Ji F.; Peng K.
Institution
(Long, Shan, Ji, Peng) Department of Anesthesiology, First Affiliated
Hospital of Soochow University, Jiangsu, Suzhou 215006, China
(Long, Shan, Ji, Peng) Institute of Anesthesiology, Soochow University,
Jiangsu, Suzhou 215006, China
(Feng) Department of Anesthesiology, University of Utah Health, Salt Lake
City, UT, United States
(Liu) Department of Anesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Whether anesthetic depth affects postoperative outcomes remains
controversial. This meta-analysis aimed to evaluate the effects of deep
vs. light anesthesia on postoperative pain, cognitive function, recovery
from anesthesia, complications, and mortality. <br/>Method(s):PubMed,
EMBASE, and Cochrane CENTRAL databases were searched until January 2022
for randomized controlled trials comparing deep and light anesthesia in
adult surgical patients. The co-primary outcomes were postoperative pain
and delirium (assessed using the confusion assessment method). We
conducted a meta-analysis using a random-effects model. We assessed
publication bias using the Begg's rank correlation test and Egger's linear
regression. We evaluated the evidence using the trial sequential analysis
and Grading of Recommendations Assessment, Development and Evaluation
(GRADE) methodology. We conducted subgroup analyses for pain scores at
different postoperative time points and delirium according to cardiac or
non-cardiac surgery. <br/>Result(s):A total of 26 trials with 10,743
patients were included. Deep anesthesia compared with light anesthesia (a
mean difference in bispectral index of -12 to -11) was associated with
lower pain scores at rest at 0 to 1 h postoperatively (weighted mean
difference = -0.72, 95% confidence interval [CI] = -1.25 to -0.18, P =
0.009; moderate-quality evidence) and an increased incidence of
postoperative delirium (24.95% vs. 15.92%; risk ratio = 1.57, 95% CI =
1.28-1.91, P < 0.0001; high-quality evidence). No publication bias was
detected. For the exploratory secondary outcomes, deep anesthesia was
associated with prolonged postoperative recovery, without affecting
neurocognitive outcomes, major complications, or mortality. In the
subgroup analyses, the deep anesthesia group had lower pain scores at rest
and on movement during 24 h postoperatively, without statistically
significant subgroup differences, and deep anesthesia was associated with
an increased incidence of delirium after non-cardiac and cardiac
surgeries, without statistically significant subgroup differences.
<br/>Conclusion(s):Deep anesthesia reduced early postoperative pain but
increased postoperative delirium. The current evidence does not support
the use of deep anesthesia in clinical practice.<br/>Copyright &#xa9; 2022
Lippincott Williams and Wilkins. All rights reserved.

<40>
Accession Number
2020508955
Title
Fractional Flow Reserve versus Angiography-Guided Management of Coronary
Artery Disease: A Meta-Analysis of Contemporary Randomised Controlled
Trials.
Source
Journal of Clinical Medicine. 11(23) (no pagination), 2022. Article
Number: 7092. Date of Publication: December 2022.
Author
Maznyczka A.M.; Matthews C.J.; Blaxill J.M.; Greenwood J.P.; Mozid A.M.;
Rossington J.A.; Veerasamy M.; Wheatcroft S.B.; Curzen N.; Bulluck H.
Institution
(Maznyczka, Matthews, Blaxill, Greenwood, Mozid, Rossington, Veerasamy,
Wheatcroft, Bulluck) Yorkshire Heart Centre, Leeds General Infirmary,
Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, United Kingdom
(Blaxill, Greenwood, Mozid, Rossington, Veerasamy, Wheatcroft, Bulluck)
Leeds Institute of Cardiovascular and Metabolic Medicine, University of
Leeds, Leeds LS1 3EX, United Kingdom
(Curzen) Faculty of Medicine, University of Southampton, Southampton SO17
1BJ, United Kingdom
(Curzen) Coronary Research Group, University Hospital Southampton NHS
Trust, Southampton SO17 1BJ, United Kingdom
Publisher
MDPI
Abstract
Background and Aims: Randomised controlled trials (RCTs) comparing
outcomes after fractional flow reserve (FFR)-guided versus
angiography-guided management for obstructive coronary artery disease
(CAD) have produced conflicting results. We investigated the efficacy and
safety of an FFR-guided versus angiography-guided management strategy
among patients with obstructive CAD. <br/>Method(s): A systematic
electronic search of the major databases was performed from inception to
September 2022. We included studies of patients presenting with angina or
myocardial infarction (MI), managed with medications, percutaneous
coronary intervention, or bypass graft surgery. A meta-analysis was
performed by pooling the risk ratio (RR) using a random-effects model. The
endpoints of interest were all-cause mortality, MI and unplanned
revascularisation. <br/>Result(s): Eight RCTs, with outcome data from 5077
patients, were included. The weighted mean follow up was 22 months. When
FFR-guided management was compared to angiography-guided management, there
was no difference in all-cause mortality [3.5% vs. 3.7%, RR: 0.99 (95%
confidence interval (CI) 0.62-1.60), p = 0.98, heterogeneity
(I²) 43%], MI [5.3% vs. 5.9%, RR: 0.93 (95%CI 0.66-1.32), p =
0.69, I² 42%], or unplanned revascularisation [7.4% vs. 7.9%,
RR: 0.92 (95%CI 0.76-1.11), p = 0.37, I² 0%]. However, the
number patients undergoing planned revascularisation by either stent or
surgery was significantly lower with an FFR-guided strategy [weighted mean
difference: 14 (95% CI 3 to 25)%, p =< 0.001]. <br/>Conclusion(s): In
patients with obstructive CAD, an FFR-guided management strategy did not
impact on all-cause mortality, MI and unplanned revascularisation, when
compared to an angiography-guided management strategy, but led to up to a
quarter less patients needing revascularisation.<br/>Copyright &#xa9; 2022
by the authors.

<41>
Accession Number
2018648587
Title
Effect of Exercise Interventions on Health-Related Quality of Life in
Patients with Fibromyalgia Syndrome: A Systematic Review and Network
Meta-Analysis.
Source
Journal of Pain Research. 15 (pp 3639-3656), 2022. Date of Publication:
2022.
Author
Zhang K.-D.; Wang L.-Y.; Zhang Z.-H.; Zhang D.-X.; Lin X.-W.; Meng T.; Qi
F.
Institution
(Zhang, Wang, Zhang, Zhang, Meng, Qi) Department of Anesthesiology, Qilu
Hospital of Shandong University, Jinan, China
(Lin) Department of Pain Management, Shandong Provincial Hospital
Affiliated to Shandong First Medical University, Jinan, China
Publisher
Dove Medical Press Ltd
Abstract
Objective: Several guidelines highlight the beneficial impact of exercise
on the management of symptoms and health-related quality of life (HRQOL)
in patients with fibromyalgia syndrome (FMS). However, few analyses have
compared different types of exercise. We, therefore, intent to compare the
effects of different exercise types on improving the overall HRQOL and
typical symptoms in patients with FMS. <br/>Method(s): Medline, Embase,
the Cochrane Register of Clinical Trials, and NIH ClinicalTrials.gov were
searched from inception to April 21, 2022. Randomized clinical trials
(RCTs) were included to assess the impact of exercise intervention on
health parameters in adult FMS patients. Data were extracted independently
and a frequentist network meta-analyses (NMA) was performed to rank the
effects of interventions according to P-scores. The NMA evidence certainty
was assessed using the method recommended by Grading of Recommendations
Assessment, Development, and Evaluation Working Group. <br/>Result(s): A
total of 57 RCTs were identified, including 3319 participants, involving 9
interventions (7 types of exercise, 2 controls). Of all treatments
compared with usual care in efficacy outcomes, Mind-body exercise was
associated with the best HRQOL (SMD, -12.12; 95% CI, -15.79 to -8.45). On
the other characteristic symptom dimensions, based on moderate quality
evidence, sensorimotor training was associated with minimal pain scores
compared with usual care (SMD, -1.81; 95% CI, -2.81 to -0.82), whole body
vibration therapy was most promising for improving sleep quality (SMD,
-6.95; 95% CI, -10.03 to -3.87), pool-based aerobic exercise was most
likely to ease anxiety (SMD, -4.83; 95% CI, -7.47 to -2.19), and whole
body vibration was most likely to improve depression (SMD, -10.44; 95% CI,
-22.00 to 1.12). <br/>Conclusion(s): Mind-body exercise seems to be the
most effective exercise to improve the overall HRQOL of patients with FMS.
But at the same time, clinicians still need to develop individualized
exercise plans for patients according to their symptoms and
accessibility.<br/>Copyright &#xa9; 2022 Zhang et al.

<42>
Accession Number
2018277480
Title
Prevention of sudden death in heart failure with reduced ejection
fraction: do we still need an implantable cardioverter-defibrillator for
primary prevention?.
Source
European Journal of Heart Failure. 24(9) (pp 1460-1466), 2022. Date of
Publication: September 2022.
Author
Abdelhamid M.; Rosano G.; Metra M.; Adamopoulos S.; Bohm M.; Chioncel O.;
Filippatos G.; Jankowska E.A.; Lopatin Y.; Lund L.; Milicic D.; Moura B.;
Ben Gal T.; Ristic A.; Rakisheva A.; Savarese G.; Mullens W.; Piepoli M.;
Bayes-Genis A.; Thum T.; Anker S.D.; Seferovic P.; Coats A.J.S.
Institution
(Abdelhamid) Faculty of Medicine, Kasr Al Ainy, Cardiology Department,
Cairo University, Cairo, Egypt
(Rosano) St George's Hospitals, NHS Trust, University of London, London,
United Kingdom
(Metra) Institute of Cardiology, ASST Spedali Civili di Brescia and
Department of Medical and Surgical Specialties, Radiological Sciences, and
Public Health, University of Brescia, Brescia, Italy
(Adamopoulos) Heart Failure - Transplant - Mechanical Circulatory Support
Unit, Onassis Cardiac Surgery Center, Athens, Greece
(Bohm) Universitatsklinikum des Saarlandes, Klinik fur Innere Medizin III,
Saarland University, Kardiologie, Angiologie und Internistische
Intensivmedizin, Homburg, Saar, Germany
(Chioncel) Emergency Institute for Cardiovascular Diseases 'Prof. C.C.
Iliescu', University of Medicine Carol Davila, Bucharest, Romania
(Filippatos) National and Kapodistrian University of Athens, School of
Medicine, University Hospital Attikon, Athens, Greece
(Jankowska) Institute of Heart Diseases, Wroclaw Medical University,
Wroclaw, Poland
(Lopatin) Volgograd State Medical University, Regional Cardiology Centre,
Volgograd, Russian Federation
(Lund, Savarese) Department of Medicine, Karolinska Institutet, and Heart
and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden
(Milicic) University of Zagreb School of Medicine, Zagreb, Croatia
(Moura) Armed Forces Hospital, Porto, & Faculty of Medicine, University of
Porto, Porto, Portugal
(Ben Gal) Department of Cardiology, Rabin Medical Center, Petah Tikva,
Israel, & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv,
Israel
(Ristic) Department of Cardiology, University Clinical Center of Serbia,
Belgrade University School of Medicine, Belgrade, Serbia
(Rakisheva) Scientific Research Institute of Cardiology and Internal
Medicine, Almaty, Kazakhstan
(Mullens) Cardiovascular Physiology, Hasselt University, Belgium, & Heart
Failure and Cardiac Rehabilitation Specialist, Ziekenhuis Oost-Limburg,
Genk, Belgium
(Piepoli) Cardiac Unit, Guglielmo da Saliceto Hospital, University of
Parma, Piacenza, Italy
(Bayes-Genis) Heart Institute, Hospital Universitari Germans Trias i
Pujol, Badalona & CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
(Thum) Institute of Molecular and Therapeutic Strategies, Hannover &
Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover,
Germany
(Anker) Department of Cardiology (CVK), and Berlin Institute of Health
Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular
Research (DZHK) partner site Berlin, Charite Universitatsmedizin, Berlin,
Germany
(Seferovic) Department Faculty of Medicine, University of Belgrade,
Belgrade & Serbian Academy of Sciences and Arts, Belgrade, Serbia
(Coats) University of Warwick, Coventry, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Sudden death is a devastating complication of heart failure (HF). Current
guidelines recommend an implantable cardioverter-defibrillator (ICD) for
prevention of sudden death in patients with HF and reduced ejection
fraction (HFrEF) specifically those with a left ventricular ejection
fraction <=35% after at least 3 months of optimized HF treatment. The
benefit of ICD in patients with symptomatic HFrEF caused by coronary
artery disease has been well documented; however, the evidence for a
benefit of prophylactic ICD implantation in patients with HFrEF of
non-ischaemic aetiology is less strong. Angiotensin-converting enzyme
inhibitors or angiotensin receptor blockers, beta-blockers (BB), and
mineralocorticoid receptor antagonists (MRA) block the deleterious actions
of angiotensin II, norepinephrine, and aldosterone, respectively.
Neprilysin inhibition potentiates the actions of endogenous natriuretic
peptides that mitigate adverse ventricular remodelling. BB, MRA,
angiotensin receptor-neprilysin inhibitor (ARNI) have a favourable effect
on reduction of sudden cardiac death in HFrEF. Recent data suggest a
beneficial effect of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in
reducing serious ventricular arrhythmias and sudden cardiac death in
patients with HFrEF. So, in the current era of new drugs for HFrEF and
with the optimal use of disease-modifying therapies (BB, MRA, ARNI and
SGLT2i), we might need to reconsider the need and timing for use of ICD as
primary prevention of sudden death, especially in HF of non-ischaemic
aetiology.<br/>Copyright &#xa9; 2022 European Society of Cardiology.

<43>
Accession Number
2018723594
Title
Digital Education in General Thoracic Surgery: A Narrative Review.
Source
Annals of Thoracic Surgery. 115(3) (pp 787-794), 2023. Date of
Publication: March 2023.
Author
Tokuno J.; Fried G.M.
Institution
(Tokuno, Fried) Division of Experimental Surgery, McGill University,
Montreal, QC, Canada
(Tokuno, Fried) Steinberg Centre for Simulation and Interactive Learning,
Faculty of Medicine and Health Science, Montreal, QC, Canada
(Fried) Department of Surgery, McGill University, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: Since advanced technologies were introduced into surgical
education, a variety of new programs have been developed. However, a
comprehensive review of digital education in general thoracic surgery has
not been performed. This narrative review was conducted was to identify
the current applications of digital education in general thoracic surgery.
<br/>Method(s): A literature search was performed using keywords related
to general thoracic surgery and digital education, including e-learning
and virtual simulation, up to September 2021. Studies published in English
investigating the effect of digital education in general thoracic surgery
were included. <br/>Result(s): Thirteen studies met the criteria. The
settings were in undergraduate (n = 6) and postgraduate education
(residency) (n = 5) and mixed audience with other disciplines (n = 2).
Theoretical knowledge (n = 5), technical skills (n = 4), and both
knowledge and technical skills (n = 4) were the stated educational
objectives for the studies. The didactic materials were transferred to
hardware, software, or online platforms and delivered with multimedia
materials. Technical skills training for bronchoscopy and chest tube
insertion (n = 5) were offered using virtual reality and computer-based
simulations. Subjective evaluation was done in 10 studies. Although after
the digital education training there was observed improvement in knowledge
or skills in 8 studies, studies were not designed to test for superiority
compared with controls through randomized controlled studies.
<br/>Conclusion(s): This review summarizes the current applications of
digital education in general thoracic surgery and helps establish the
needs for future studies in this field.<br/>Copyright &#xa9; 2023 The
Society of Thoracic Surgeons

<44>
Accession Number
2022895749
Title
Meta-Analysis on Transcarotid Versus Transfemoral and Other Alternate
Accesses for Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. 192 (pp 196-205), 2023. Date of
Publication: 01 Apr 2023.
Author
Abraham B.; Sous M.; Sedhom R.; Megaly M.; Roman S.; Sweeney J.; Alkhouli
M.; Pollak P.; El Sabbagh A.; Garcia S.; Goel S.S.; Saad M.; Fortuin D.
Institution
(Abraham, Sweeney, Fortuin) Department of Cardiovascular Disease, Mayo
Clinic Hospital, Phoenix, Arizona
(Sous) Department of Medicine, Amita Health Saint Francis Hospital,
Evanston, IL, United States
(Sedhom) Department of Medicine, Albert Einstein Medical Center,
Philadelphia, Pennsylvania, United States
(Megaly) Department of Cardiovascular Disease, Willis-Knighton Health
System, Shreveport, LA, United States
(Roman) Department of Medicine, St Joseph's University, Clifton, New
Jersey, United States
(Alkhouli, Pollak) Department of Cardiovascular Disease, Mayo Clinic
Hospital, Rochester, Minnesota, United States
(El Sabbagh) Department of Cardiovascular Disease, Mayo Clinic Hospital,
Jacksonville, Florida, United States
(Garcia) Department of Cardiovascular Disease, the Christ Hospital,
Cincinnati, Ohio, United States
(Goel) Department of Cardiovascular Disease, Houston Methodist Hospital,
Houston, Texas, United States
(Saad) Department of Medicine, Division of Cardiovascular Disease, Warren
Alpert Medical School of Brown University, Providence, Rhode Island,
United States
Publisher
Elsevier Inc.
Abstract
Transcarotid access has emerged as the preferred access site for
transcatheter aortic valve implantation (TAVI) in patients with
prohibitive iliofemoral anatomy. This study aimed to compare outcomes with
transcarotid with those of other accesses in patients who underwent TAVI.
Cochrane, EMBASE, and MEDLINE databases were searched for all published
studies that compared outcomes with transcarotid with those of other
accesses (transfemoral, transaxillary/subclavian, transaortic, and
transapical) in patients who underwent TAVI. The primary outcome was
all-cause mortality. Secondary outcomes included major bleeding, major
vascular complications, stroke, myocardial infarction, permanent pacemaker
implantation, and peri-aortic valve insufficiency. We included 22
observational studies with a total of 11,896 patients. Outcomes were
reported during hospitalization and at 1-month follow-up. The transcarotid
approach had higher mortality at 1 month (3.7% vs 2.6%, p = 0.02) but
lower major vascular complications during hospitalization (1.5% vs 3.4%, p
= 0.04) than did transfemoral access. The transcarotid approach had lower
major vascular complications (2% vs 2.3%, p = 0.04) than did the
transaxillary/subclavian but higher major bleeding (5.3% vs 2.6%, p =
0.03). The transaortic approach was associated with higher in-hospital
(11.7% vs 1.9%, p = 0.02) and 1-month mortality (14.4% vs 3.9%, p = 0.007)
rates than was transcarotid access. The transcarotid approach numerically
reduced mortality and the risk of major vascular complications and major
bleeding compared with the transapical approach; however, this did not
reach statistical significance. The transcarotid approach did not increase
the risk of stroke compared with transfemoral or the other alternative
accesses. In conclusion, the transcarotid or transaxillary/subclavian
approach had associated comparable outcomes that were better than those of
the transapical and transaortic approaches. There was no difference in
stroke risk between transcarotid access and other accesses.<br/>Copyright
&#xa9; 2023 Elsevier Inc.

<45>
Accession Number
640393721
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 : official journal of the
International Academy of Clinical and Applied Thrombosis/Hemostasis. 29
(pp 10760296231158585), 2023. Date of Publication: 01 Jan 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
NLM (Medline)
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.

<46>
Accession Number
2021048561
Title
Sex Differences in Periprocedural and Long-Term Outcomes Following
Transcatheter Left Atrial Appendage Occlusion: A Systematic Review and
Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 48 (pp 23-31), 2023. Date of
Publication: March 2023.
Author
Mathai S.V.; Sohal S.; Flatow E.; Nagaraj S.; Hajra A.; Chugh Y.;
Palaiodimos L.; Lee H.J.; Ansari J.; Cohen M.; Volgman A.S.; Faillace R.
Institution
(Mathai, Flatow, Nagaraj, Hajra, Palaiodimos, Faillace) Department of
Medicine, NYC Health +Hospitals/Jacobi Medical Center, 1400 Pelham Pkwy S,
Bronx, NY 10461, United States
(Sohal, Lee, Ansari, Cohen) Division of Cardiology, Department of
Medicine, RWJ-BH Newark Beth Israel Medical Center, 201 Lyons Ave, Newark,
NJ 07112, United States
(Chugh) Division of Interventional and Structural Cardiology, Department
of Medicine, Minneapolis Heart Institute, Minneapolis, MN, United States
(Volgman) Division of Cardiology, Department of Medicine, Rush University
Medical Center, 1620 W Harrison St, Chicago, IL 60612, United States
Publisher
Elsevier Inc.
Abstract
Background: Atrial fibrillation (AF) is among the most common arrhythmias
associated with an increased risk of cardioembolic phenomena, including
stroke. Percutaneous left atrial appendage occlusion (LAAO) has proven
beneficial in reducing stroke and mortality in patients with atrial
fibrillation who have contraindications to anticoagulation. However, the
sex differences in outcomes following LAAO have not been studied
systematically. <br/>Method(s): Electronic databases PUBMED, Embase, and
Web of Science were systematically searched until March 2022 for studies
evaluating patient outcomes following LAAO for AF. The primary outcomes of
interest were the risks of periprocedural stroke, major bleeding,
pericardial complications, and all-cause mortality. Secondary outcomes
included stroke risks, major bleeding, device-related thrombus,
cardiovascular and all-cause mortality on long-term follow-up. A
random-effects model meta-analysis was conducted, and heterogeneity was
assessed using the I-squared test. <br/>Result(s): Sixteen studies were
included in the final analysis encompassing 111,775 patients, out of which
45,441 (40.7 %) were women. Women had a significantly higher risk of
peri-procedural complications including all-cause mortality [relative risk
(RR), 95 % confidence intervals (CI); RR 1.94, 95 % CI 1.40-2.69], stroke
[RR 1.85, 95 % CI 1.29-2.67], major bleeding [RR 1.63, 95 % CI 1.08-2.44],
and pericardial events [RR 1.80, 95 % CI 1.58-2.05]. However, there were
no statistically significant differences between sexes in terms of risk of
stroke, major bleeding, device-related thrombus, cardiovascular and
all-cause mortality on long-term follow-up. <br/>Conclusion(s): Among
patients undergoing LAAO implantation, women were at higher risk of
periprocedural complications than men. This risk was not significant on
long-term follow-up.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<47>
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. <br/>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). <br/>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.
<br/>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).<br/>Copyright &#xa9; 2023

<48>
Accession Number
2022788823
Title
The Effect and Possible Mechanism of Cardiac Rehabilitation in Partial
Revascularization Performed on Multiple Coronary Artery Lesions.
Source
Clinical Interventions in Aging. 18 (pp 235-248), 2023. Date of
Publication: 2023.
Author
Gao Y.; Yue L.; Hao W.; Miao Z.; Wang F.; Wang S.; Luan B.
Institution
(Gao, Hao, Miao, Luan) Department of Cardiology, The People's Hospital of
Liaoning Province, Liaoning Province, Shenyang, China
(Yue) Department of Ultrasound, The Fourth Affiliated Hospital of China
Medical University, Liaoning Province, Shenyang, China
(Wang, Wang) Department of Cardiology, The First Affiliated Hospital of
Liaoning University of Traditional Chinese Medicine, Liaoning Province,
Shenyang, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: To observe the effect of cardiac rehabilitation (CR) in patients
with partial revascularization performed on multiple coronary artery
lesions and explore its possible mechanism. <br/>Patients and Methods: A
total of 400 patients with multiple coronary artery lesions were enrolled
and randomly divided into a complete revascularization group and a CR
group, with 200 cases in each group. Target lesion revascularization was
performed radically in the complete revascularization group, while it was
partially completed in the CR group, and postoperative CR was performed.
All the patients were put under conventional treatment. Left ventricular
end diastolic dimension (LVEDD), left ventricular ejection fraction
(LVEF), 6-minute walking distance (6-MWD), quality-of-life scores, safety
and levels of serum nitric oxide (NO), nitric oxide synthase (NOS),
superoxide dismutase (SOD), and vascular endothelial growth factor (VEGF)
were evaluated and compared between two groups before and after training.
<br/>Result(s): There was no significant difference in LVEDD, LVEF, 6-MWD,
quality-of-life scores, levels of serum NO, NOS, SOD, and VEGF between two
groups before training (p>0.05). 1 year later, compared with the complete
revascularization group, the occurrence of major adverse events in the CR
group declined (p>0.05); the measurements of LVEDD decreased and LVEF
increased (p>0.05), 6-MWD increased significantly (p<0.05),
quality-of-life scores were higher (p<0.05), the levels of serum NO, NOS,
and SOD increased noticeably, and the levels of serum VEGF decreased
significantly in the CR group (p<0.05). There were significant differences
within the same group, before and after training (p<0.05).
<br/>Conclusion(s): Cardiac rehabilitation training, not increase in the
incidence of adverse events, is effective and safe after partial
revascularization in patients with multiple coronary artery lesions, which
has notable clinical advantages in promoting patients' exercise endurance
and quality-of-life by improving the nitric oxide synthase system and
antioxidant system and reducing the level of VEGF.<br/>Copyright &#xa9;
2023 Gao et al. This work is published and licensed by Dove Medical Press
Limited.

<49>
Accession Number
2022994449
Title
Testing for EGFR Variants in Pleural and Pericardial Effusion Cell-Free
DNA in Patients with Non-Small Cell Lung Cancer.
Source
JAMA Oncology. 9(2) (pp 261-265), 2023. Date of Publication: 16 Feb 2023.
Author
Lee K.W.C.; Li M.S.C.; Gai W.; Lau Y.M.; Chan A.K.C.; Chan O.S.H.; Lee
C.K.; Yeung R.M.W.; Fung S.Y.H.; Cheung W.F.; Chan V.W.; Leung L.; Kam
K.N.P.; Mok T.S.K.
Institution
(Lee, Li, Chan, Mok) Department of Clinical Oncology, The Chinese
University of Hong Kong, Hong Kong, Hong Kong
(Li, Mok) State Key Laboratory of Translational Oncology, The Chinese
University of Hong Kong, Hong Kong, Hong Kong
(Gai, Chan, Fung, Cheung) Department of Chemical Pathology, The Chinese
University of Hong Kong, Hong Kong, Hong Kong
(Lau, Leung, Kam) Department of Clinical Oncology, Prince of Wales
Hospital, Hong Kong, Hong Kong
(Chan, Yeung) Department of Clinical Oncology, Pamela Youde Nethersole
Eastern Hospital, Hong Kong, Hong Kong
(Lee) National Health and Medical Research Council (NHMRC), Clinical
Trials Centre, The University of Sydney, Sydney, NSW, Australia
Publisher
American Medical Association
Abstract
Importance: Molecular testing in non-small cell lung cancer (NSCLC) is
commonly limited by inadequate tumor sample. Plasma cell-free DNA (cfDNA)
genotyping as a complementary test is specific but only moderately
sensitive. Genotyping of cfDNA in pleural and pericardial effusion
(PE-cfDNA) can further optimize molecular diagnostic yield and reduce the
need for repeated biopsies. <br/>Objective(s): To prospectively validate
droplet digital polymerase chain reaction (ddPCR) for detection of
sensitizing EGFR variants and acquired Thr790Met variant (T790M) from
PE-cfDNA in patients with NSCLC. <br/>Design, Setting, and Participant(s):
This prospective diagnostic validation study was conducted between
September 6, 2016, and January 21, 2021 at 2 major Hong Kong cancer
centers. Patients with advanced NSCLC with both wild-type and variant EGFR
status and exudative PE who underwent thoracocentesis or
pericardiocentesis were randomly enrolled. Patients were either
EGFR-tyrosine kinase inhibitor (TKI) naive (cohort 1) or EGFR-TKI treated
but osimertinib naive (cohort 2). Enrolled patients underwent pleural- or
pericardial-fluid and blood sampling for ddPCR EGFR testing. EGFR status
results with ddPCR testing of PE-cfDNA and blood were compared with EGFR
status in matched tumor biopsy or PE cell block samples. <br/>Main
Outcomes and Measures: Specificity, sensitivity, and concordance of
PE-cfDNA for detection of sensitizing EGFR variants and acquired T790M
variation. <br/>Result(s): Among 171 patients (54% female) enrolled, there
were 104 in cohort 1 and 67 in cohort 2. In cohort 1, 37% (38/102) were
EGFR-variant positive; PE-cfDNA showed 97% sensitivity (95% CI, 92%-100%),
97% specificity (95% CI, 93%-100%), and 97% concordance (k = 0.94, P
<.001) for the detection of sensitizing EGFR variants. It was more
sensitive than plasma in detecting sensitizing EGFR variants (97% vs 74%,
P <.001). In cohort 2, 38% (15 of 40) were positive for the EGFR T790M
variant; PE-cfDNA showed 87% sensitivity (95% CI, 69%-100%), 60%
specificity (95% CI, 41%-79%), and 70% concordance (k = 0.42, P =.004) for
acquired T790M. The EGFR T790M variant was detected in 51% of PE-cfDNA vs
25% of PE cell block samples. <br/>Conclusions and Relevance: In this
diagnostic study, EGFR variants could be accurately detected from PE-cfDNA
in patients with NSCLC. More EGFR T790M was detected in PE-cfDNA than in
guideline-recommended PE cell block preparations. These results suggest
that PE-cfDNA can complement plasma and tumor genotyping for detecting
EGFR variants in patients with advanced NSCLC..<br/>Copyright &#xa9; 2023
American Medical Association. All rights reserved.

<50>
Accession Number
2022993286
Title
Large volume acute normovolemic hemodilution in patients undergoing
cardiac surgery with intermediate-high risk of transfusion: A randomized
controlled trial.
Source
Journal of Clinical Anesthesia. 87 (no pagination), 2023. Article Number:
111082. Date of Publication: August 2023.
Author
Ming Y.; Zhang F.; Yao Y.; Cheng Z.; Yu L.; Sun D.; Sun K.; Yu Y.; Liu M.;
Ma L.; HuangYang Y.; Yan M.
Institution
(Ming, Zhang, Yao, Cheng, Yu, Sun, Sun, Liu, Ma, HuangYang, Yan)
Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang
University, Hangzhou, Zhejiang 330100, China
(Yu) School of Anesthesiology, Weifang Medical University, Shandong,
Weifang 261053, China
(Yan) Key Laboratory of The Diagnosis and Treatment of Severe Trauma and
Burn of Zhejiang Province, Leading Health Talents of Zhejiang Province,
Zhejiang Health Office No. 18(2020), China
Publisher
Elsevier Inc.
Abstract
Study Objective: To investigate whether large volume acute normovolemic
hemodilution (L-ANH), compared with moderate acute normovolemic
hemodilution (M-ANH), can reduce perioperative allogeneic blood
transfusion in patients with intermediate-high risk of transfusion during
cardiac surgery with cardiopulmonary bypass (CPB). <br/>Design(s):
Prospective randomized controlled trial. <br/>Setting(s): University
hospital. <br/>Patient(s): Patients with transfusion risk understanding
scoring tool ("TRUST") >=2 points undergoing cardiac surgery with CPB in
the Second Affiliated Hospital of Zhejiang University from May 2020 to
January 2021 were included. <br/>Intervention(s): The patients were
randomly assigned with a 1:1 ratio to M-ANH (5 to 8 mL/kg) or L-ANH (12 to
15 mL/kg). Measurements: The primary outcome was perioperative red blood
cell (RBC) transfusion units. The composite outcome included new-onset
atrial fibrillation, pulmonary infection, cardiac surgery associated acute
kidney injury (CSA-AKI) class >=2, surgical incision infection,
postoperative excessive bleeding, and resternotomy. <br/>Main Result(s):
Total 159 patients were screened and 110 (55 L-ANH and 55 M-ANH) were
included for final analysis. Removed blood volume of L-ANH is
significantly higher than M-ANH (886 +/- 152 vs. 395 +/- 86 mL, P <
0.001). Perioperative RBC transfusion was median 0 unit ([25th, 75th]
percentiles: 0-4.4) in M-ANH group vs. 0 unit ([25th, 75th] percentiles:
0-2.0) in L-ANH group (P = 0.012) and L-ANH was associated with lower
incidence of transfusion (23.6% vs. 41.8%, P = 0.042, rate difference:
0.182, 95% confidence interval [0.007-0.343]). The incidence of
postoperative excessive bleeding was significantly lower in L-ANH vs.
M-ANH (3.6% vs. 18.2%, P = 0.029, rate difference: 0.146, 95% confidence
interval [0.027-0.270]) without significant difference for other second
outcomes. The volume of ANH was inversely related to perioperative RBC
transfusion units (Spearman r = -0.483, 95% confidence interval [-0.708 to
-0.168], P = 0.003), and L-ANH in cardiac surgery was associated with a
significantly reduced risk of perioperative RBC transfusion (odds ratio:
0.43, 95% confidence interval: 0.19-0.98, P = 0.044). <br/>Conclusion(s):
Compared with M-ANH, L-ANH during cardiac surgery inclined to be
associated with reduced perioperative RBC transfusion and the volume of
RBC transfusion was inversely proportional to the volume of ANH. In
addition, LANH during cardiac surgery was associated with a lower
incidence of postoperative excessive bleeding.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<51>
Accession Number
2022988495
Title
Impact of Prosthesis-Patient Mismatch After Transcatheter Aortic Valve
Replacement: Meta-Analysis of Kaplan-Meier-Derived Individual Patient
Data.
Source
JACC: Cardiovascular Imaging. 16(3) (pp 298-310), 2023. Date of
Publication: March 2023.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Tasoudis P.; Dokollari A.;
Torregrossa G.; Sicouri S.; Clavel M.-A.; Pibarot P.; Ramlawi B.
Institution
(Sa, Torregrossa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Sa, Tasoudis, Dokollari, Torregrossa, 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
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Faculty of Medicine, Universite
Laval, Quebec City, Quebec, Canada
Publisher
Elsevier Inc.
Abstract
Background: It remains controversial whether prosthesis-patient mismatch
(PPM) (in general considered moderate if indexed effective orifice area is
0.65-0.85 cm²/m² and severe when <0.65
cm²/m²) affects the outcomes after transcatheter
aortic valve replacement (TAVR). <br/>Objective(s): The purpose of this
study is to evaluate the time-varying effects and association of PPM with
the risk of overall mortality. <br/>Method(s): Study-level meta-analysis
of reconstructed time-to-event data from Kaplan-Meier curves of studies
published by December 30, 2021. <br/>Result(s): In total, 23 studies met
our eligibility criteria and included a total of 81,969 patients included
in the Kaplan-Meier curves (19,612 with PPM and 62,357 without PPM).
Patients with moderate/severe PPM had a significantly higher risk of
mortality compared with those without PPM (HR: 1.09 [95% CI: 1.04-1.14]; P
< 0.001). In the first 30 months after the procedure, mortality rates were
significantly higher in the moderate/severe PPM group (HR: 1.1 [95% CI:
1.05-1.16]; P < 0.001). In contrast, the landmark analysis beyond 30
months yielded a reversal of the HR (0.83 [95% CI: 0.68-1.01]; P = 0.064),
but without statistical significance. In the sensitivity analysis,
although the authors observed that severe PPM showed higher risk of
mortality in comparison with no PPM (HR: 1.25 [95% CI: 1.16-1.36]; P <
0.001), they did not observe a statistically significant difference for
mortality between moderate PPM and no PPM (HR: 1.03 [95% CI: 0.96-1.10]; P
= 0.398). <br/>Conclusion(s): Severe PPM, but not moderate PPM, was
associated with higher risk of mortality following TAVR. These results
provide support to implementation of preventive strategies to avoid severe
PPM following TAVR.<br/>Copyright &#xa9; 2023 American College of
Cardiology Foundation

<52>
[Use Link to view the full text]
Accession Number
2022956869
Title
Clear cell "sugar" tumor of the lung: Diagnostic characteristics of a rare
pulmonary tumor: A case report and review of literature.
Source
Medicine (United States). 102(7) (pp E33035), 2023. Date of Publication:
17 Feb 2023.
Author
Wang B.; Xu X.; Zhao Z.
Institution
(Wang, Xu, Zhao) Department of Pathology, Xingtai People's Hospital
Affiliated to Hebei Medical University, Hebei, Xingtai, China
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Clear cell tumors of the lung (CCTLs), also known as "sugar
tumors" for an abundant cellular glycogen concentration, are an extremely
rare type pulmonary neoplasm. Often, they are incidentally found on chest
roentgenogram or computed tomography scan during routine examination.
CCTLs usually present with nonspecific symptoms that pose a diagnostic
challenge to clinicians. Accordingly, histopathology remains the gold
standard for diagnosing. Moreover, some of them can present with either
appearances or histopathological features similar to other pulmonary
neoplasms under the light microscope, including pulmonary malignancy,
thereby causing misdiagnosis prior to or after surgery. Accordingly,
herein, we describe a rare case of CCTL, review the literature has been
published, and then discuss the benign versus malignant nature of this
rare tumor. Patient concerns: A 59-year-old man presented due to a
high-density chest nodule in the left diaphragm. The patient's medical
history was unremarkable and he also denied smoking in the past.
Diagnosis: Physical examination, there were no noted signs. A new chest
contrast-enhanced computed tomography revealed a 3.2 x 2.5 cm, solitary,
circular nodule with a smooth edge located in the beside of the left
thoracic aorta. Postoperative pathological and immunohistochemical
examinations of the surgical specimens revealed a final diagnosis of
CCTLs. <br/>Intervention(s): The patient underwent video-assisted
thoracoscopic surgery. A wedge resection of left lower lung lobe was
carried out and the tumor node was successfully removed alongside normal
surrounding parenchyma. <br/>Outcome(s): The operation was successful.
Then the patient recovered completely and continued to do well on
postsurgical thoracic surgical clinic visits. The tumor was a benign
tumor, and the patient did not require any additional treatment. The
patient had been followed-up regularly for 4 years after surgery; she did
not experience any complications and remained disease-free.
<br/>Conclusion(s): CCTLs should be considered in the differential
diagnosis if a patient shows a solitary, circular chest nodule with a
smooth edge. They are extremely rare lung tumors that must be
differentiated from other lung tumors, especially the malignant tumors.
Although pathological and immunohistochemical findings are important for
making the diagnosis, the varying histopathological features on microscope
make diagnosis difficult. The current case highlights the importance of
physicians being aware of and suspecting CCTLs in similar cases, along
with knowing the characteristics of CCTLs for the diagnosis and
differential diagnosis.<br/>Copyright &#xa9; 2023 Authors. All rights
reserved.

<53>
[Use Link to view the full text]
Accession Number
2022956832
Title
Perioperative Tracking of Intravenous Iron in Patients Undergoing On-Pump
Cardiac Surgery: A Prospective, Single-Center Pilot Trial.
Source
Anesthesia and Analgesia. 136(3) (pp 578-587), 2023. Date of Publication:
01 Mar 2023.
Author
Olivier R.M.R.; Macke M.; Muller J.C.; Schrader L.; Eveslage M.; Rauer M.;
Wempe C.; Martens S.; Zarbock A.; Wagner N.-M.; Karst U.; Dogan D.Y.;
Steinbicker A.U.
Institution
(Olivier, Schrader, Rauer, Wempe, Zarbock, Wagner, Dogan, Steinbicker)
Department of Anaesthesiology, Intensive Care and Pain Medicine,
University Hospital Muenster, University of Muenster, Muenster, Germany
(Macke, Muller, Karst) Institute of Inorganic and Analytical Chemistry,
University of Muenster, Muenster, Germany
(Eveslage) Institute of Biostatistics and Clinical Research, University of
Muenster, Muenster, Germany
(Martens) Department of Thoracic, Heart and Vascular Surgery, University
Hospital Muenster, University of Muenster, Muenster, Germany
(Dogan, Steinbicker) Department of Anaesthesiology, Intensive Care
Medicine and Pain Therapy, University Hospital Frankfurt, Goethe
University, Frankfurt, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Preoperative intravenous iron administration is a frequently
used patient blood management procedure. If the timeframe of intravenous
iron administration before surgery is short, (1) the concentration of the
intravenous iron compound might still be high in patients' plasma when
undergoing surgery and (2) this iron in patients' plasma is at risk to be
lost due to blood loss. The aim of the current study was, therefore, to
track the iron compound ferric carboxymaltose (FCM) before, during, and
after cardiac surgery requiring cardiopulmonary bypass, with an emphasis
on intraoperative iron losses in shed blood and potential recovery through
autologous cell salvage. <br/>METHOD(S): Concentrations of FCM were
analyzed in patients' blood using a hyphenation of liquid chromatography
and inductively coupled plasma-mass spectrometry to distinguish between
pharmaceutical compound FCM and serum iron. In this prospective,
single-center pilot trial, 13 anemic and 10 control patients were
included. Anemic patients with hemoglobin levels <=12/13 g/dL in women and
men were treated with 500 milligrams (mg) intravenous FCM 12 to 96 hours
before elective on-pump cardiac surgery. Patients' blood samples were
collected before surgery and at days 0, 1, 3, and 7 after surgery. One
sample each was taken of the cardiopulmonary bypass, the autologous red
blood cell concentrate generated by cell salvage, and the cell salvage
disposal bag. <br/>RESULT(S): Patients who had received FCM <48 hours
before surgery had higher FCM serum levels (median [Q1-Q3], 52.9
[13.0-91.6]) compared to >=48 hours (2.1 [0.7-5.1] microg/mL, P =.008). Of
500-mg FCM administered <48 hours, 327.37 (257.96-402.48) mg were
incorporated compared to administration >=48 hours with 493.60
(487.78-496.70) mg. After surgery, patients' plasma FCM concentration in
the FCM <48 hours group was decreased (-27.1 [-30 to -5.9] microg/mL).
Little FCM was found in the cell salvage disposal bag (<48 hours, 4.2
[3.0-25.8] microg/mL, equivalent to 29.0 [19.0-40.7] mg total; equivalent
to 5.8% or 1/17th of the 500 mg FCM initially administered), almost none
in the autologous red blood cell concentrate (<48 hours, 0.1 [0.0-0.43]
microg/mL). <br/>CONCLUSION(S): The data generate the hypotheses that
nearly all FCM is incorporated into iron stores with administration >=48
hours before surgery. When FCM is given <48 hours of surgery, the majority
is incorporated into iron stores by the time of surgery, although a small
amount may be lost during surgical bleeding with limited recovery by cell
salvage.<br/>Copyright &#xa9; 2023 Authors. All rights reserved.

<54>
Accession Number
2021752061
Title
Virtual Reality Simulator versus Conventional Advanced Life Support
Training for Cardiopulmonary Resuscitation Post-Cardiac Surgery: A
Randomized Controlled Trial.
Source
Journal of Cardiovascular Development and Disease. 10(2) (no pagination),
2023. Article Number: 67. Date of Publication: February 2023.
Author
Peek J.J.; Max S.A.; Bakhuis W.; Huig I.C.; Rosalia R.A.; Sadeghi A.H.;
Mahtab E.A.F.
Institution
(Peek, Max, Bakhuis, Rosalia, Sadeghi, Mahtab) Department of
Cardiothoracic Surgery, Erasmus MC, University Medical Center Rotterdam,
Rotterdam 3015 GD, Netherlands
(Max) Medical Sciences Division, University of Oxford, Oxford OX1 2JD,
United Kingdom
(Huig) Department of Anesthesiology, Erasmus MC, University Medical Center
Rotterdam, Rotterdam 3015 GD, Netherlands
Publisher
MDPI
Abstract
External chest compressions are often ineffective for patients arresting
after cardiac surgery, for whom emergency resternotomy may be required. A
single-blinded randomized controlled trial (RCT) was performed, with
participants being randomized to a virtual reality (VR) Cardiac Surgical
Unit Advanced Life Support (CSU-ALS) simulator training arm or a
conventional classroom CSU-ALS training arm. Twenty-eight cardiothoracic
surgery (CTS) residents were included and subsequently assessed in a
moulage scenario in groups of two, either participating as a leader or
surgeon. The primary binary outcomes were two time targets: (1) delivering
three stacked shocks within 1 min and (2) resternotomy within 5 min.
Secondary outcomes were the number of protocol mistakes made and a
questionnaire after the VR simulator. The conventional training group
administered stacked shocks within 1 min in 43% (n = 6) of cases, and none
in the VR group reached this target, missing it by an average of 25 s. The
resternotomy time target was reached in 100% of the cases (n = 14) in the
conventional training group and in 83% of the cases (n = 10) in the VR
group. The VR group made 11 mistakes in total versus 15 for those who
underwent conventional training. Participants reported that the VR
simulator was useful and easy to use. The results show that the VR
simulator can provide adequate CSU-ALS training. Moreover, VR training
results in fewer mistakes suggesting that repetitive practice in an
immersive environment improves skills.<br/>Copyright &#xa9; 2023 by the
authors.

<55>
Accession Number
2021752047
Title
Does an eHealth Intervention Reduce Complications and Healthcare
Resources? A mHeart Single-Center Randomized-Controlled Trial.
Source
Journal of Cardiovascular Development and Disease. 10(2) (no pagination),
2023. Article Number: 77. Date of Publication: February 2023.
Author
Gomis-Pastor M.; Mirabet Perez S.; De Dios Lopez A.; Brossa Loidi V.;
Lopez Lopez L.; Pelegrin Cruz R.; Mangues Bafalluy M.A.
Institution
(Gomis-Pastor) Digital Health Department and Pharmacy Department, Hospital
de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona 08025, Spain
(Mirabet Perez, Brossa Loidi, Lopez Lopez) Heart Failure and Heart
Transplant Unit, Cardiology Department, Hospital de la Santa Creu i Santa
Pau and CIBER de Enfermedades Cardiovasculares (CIBER-CV), IIB Sant Pau,
Barcelona 08025, Spain
(De Dios Lopez, Pelegrin Cruz) Pharmacy Department, Hospital de la Santa
Creu i Santa Pau, Barcelona 08025, Spain
(Mangues Bafalluy) Pharmacy Department, Hospital de la Santa Creu i Santa
Pau and CIBER de Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN),
Barcelona 08025, Spain
Publisher
MDPI
Abstract
(1) Background: In the mHeart trial, we showed that an eHealth
intervention, mHeart, improved heart transplant (HTx) recipients'
adherence to immunosuppressive therapy compared with the standard of care.
Herein, we present the analysis assessing whether mHeart reduces
complication frequency and healthcare resource use, and whether this
reduction depends on patients' adherence. (2) Methods: The mHeart was a
single-center randomized-controlled trial (IIBSP-MHE-2014-55) in 134 adult
HTx recipients (n = 71 intervention; n = 63 controls). The endpoints were
mortality, complications, and resource use during follow-up (mean 1.6 +/-
0.6 years). (3) Results: A significantly lower proportion of HTx
recipients in mHeart had echocardiographic alteration (2.8% vs. 13.8%; p =
0.02), cardiovascular events (0.35% vs. 2.4%; p = 0.006), infections
(17.2% vs. 56%; p = 0.03), and uncontrolled Hba1c (40.8% vs. 59.6%; p =
0.03) than controls. In addition, a significantly lower proportion of
patients in the intervention needed hospital (32.4% vs. 56.9%; p = 0.004)
or urgent admissions (16.9% vs. 41.4%; p = 0.002) and emergency room
visits (50.7% vs. 69.0%; p = 0.03). Adherence status (measured by the
self-reported SMAQ) influenced only controls regarding hospitalizations
and emergency room visits. Differences were not significant on deaths
(intervention 4.2% vs. control 9.5%; p = 0.4) (4) <br/>Conclusion(s): the
mHeart strategy significantly reduced the occurrence of the studied
post-transplant complications and the need for medical attention in HTx
recipients. Adherence status influenced controls in their need for medical
care.<br/>Copyright &#xa9; 2023 by the authors.

<56>
Accession Number
2021752042
Title
Mechanical versus Bioprosthetic Aortic Valve Replacement in Middle-Aged
Adults: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiovascular Development and Disease. 10(2) (no pagination),
2023. Article Number: 90. Date of Publication: February 2023.
Author
Jiang Y.; Wang S.; Bian J.; Chen S.; Shao Y.
Institution
(Jiang, Wang, Bian, Shao) Department of Cardiovascular Surgery, The First
Affiliated Hospital of Nanjing Medical University, Guangzhou Road, No.
300, Nanjing 210000, China
(Chen) Department of Cardiovascular Surgery, Union Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Jiefang
Road, No. 1277, Wuhan 430022, China
Publisher
MDPI
Abstract
Background: Mechanical prostheses and bioprosthetic prostheses have their
own advantages and disadvantages. Mechanical ones are recommended for
younger patients (<50 years old), and bioprosthetic ones are recommended
for older patients (>70 years old). There is still debate regarding which
kind of prosthesis is better for middle-aged patients (50 to 70 years old)
receiving aortic valve replacement (AVR). To solve this problem, we
conducted this meta-analysis. Given that only one randomized controlled
trial (RCT) study was included, we conducted a subgroup analysis of RCT
and propensity score matching (PSM) retrospective studies to reduce the
bias. <br/>Method(s): We systematically searched articles related to
clinical outcomes of mechanical and bioprosthetic prostheses in
middle-aged patients receiving AVR in the PubMed, Cochrane Library, and
China National Knowledge Infrastructure (CNKI) databases. The published
date was up to 1 October 2022. Studies were excluded if not only
middle-aged patients were included, or if they lacked direct comparisons
between mechanical and bioprosthetic prostheses. <br/>Result(s): In total,
22 studies with 32,298 patients were included in the final analysis. The
results show that patients aged between 50 and 70 receiving AVR with
mechanical prostheses achieved better long-term survival and fewer
reoperations and valve-related events but suffered more with bleeding
events. No significant difference could be found in terms of early
mortality and long-term cardiac death. The same results could be observed
in the subgroup analysis of RCT and PSM retrospective studies.
<br/>Conclusion(s): Both mechanical and bioprosthetic prostheses are
beneficial to middle-aged patients undertaking AVR procedures. However,
mechanical prostheses show better clinical outcomes in long-term survival
and comorbidities. Individual recommendation is still
necessary.<br/>Copyright &#xa9; 2023 by the authors.

<57>
[Use Link to view the full text]
Accession Number
2022996330
Title
Association between Length of Storage of Transfused Packed RBC Units and
Outcome of Surgical Critically Ill Adults: A Subgroup Analysis of the Age
of Blood Evaluation Randomized Trial*.
Source
Critical Care Medicine. 51(3) (pp E73-E80), 2023. Date of Publication: 01
Mar 2023.
Author
Lehr A.R.; Hebert P.; Fergusson D.; Sabri E.; Lacroix J.
Institution
(Lehr) Department of Pediatrics, Montreal Children Hospital, McGill
University, Montreal, QC, Canada
(Hebert) Department of Medicine, Bruyere Research Institute, University of
Ottawa, Ottawa, ON, Canada
(Fergusson, Sabri) Ottawa Hospital Research Institute, Department of
Clinical Epidemiology Program and University of Ottawa, Ottawa, ON, Canada
(Sabri) Departments of Medicine, Surgery Epidemiology and Community
Medicine, University of Ottawa, Ottawa, ON, Canada
(Lacroix) Centre Hospitalier Universitaire Sainte Justine, Departement de
Pediatrie de l'Universite de Montreal, Montreal, QC, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: The Age of Blood Evaluation (ABLE) study reported no clinical
benefit in fresher compared with standard delivery RBC units (length of
storage: 6.9 +/- 4.1 vs 22.0 +/- 8.4 d, respectively). Perioperative
patients are often anemic, at risk of blood loss, and more exposed to RBC
transfusions. We address the question whether fresh RBC units are safer
than standard delivery RBC units in perioperative ICU patients.
<br/>Design(s): Subgroup analysis of surgical nontrauma adults enrolled in
the ABLE randomized controlled trial. <br/>Setting(s): ICUs.
<br/>Patient(s): Three hundred twenty surgical patients among the 2,510
ICU adults recruited in the ABLE study who had a request for a first RBC
transfusion in the first week in ICU stay and an anticipated length of
mechanical ventilation greater than or equal to 48 hours. We included
perioperative patients but excluded elective cardiac surgery and trauma.
<br/>Intervention(s): Surgical participants were allocated to receive
either RBC units stored less than or equal to 7 days or standard issue
RBC. MEASUREMENTS AND MAIN RESULTS: The primary outcome was 90-day
all-cause mortality. One hundred seventy-Two perioperative patients were
allocated to the fresh and 148 to the standard group. Baseline data were
similar. The length of storage was 7.2 +/- 6.4 in fresh and 20.6 +/- 8.4
days in standard group (p < 0.0001). The 90-day mortality was 29.7% and
28.4%, respectively (absolute risk difference: 0.01; 95% CI-0.09 to 0.11;
p = 0.803). No significant differences were observed for all secondary
outcomes, including 6-month mortality, even after adjustment for age,
country, and Acute Physiology and Chronic Health Evaluation score.
<br/>Conclusion(s): There was no evidence that fresh red cells improved
outcomes as compared to standard issue red cells in critically ill
surgical patients, consistent with other patients enrolled in the ABLE
trial.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins. All
rights reserved.

<58>
Accession Number
2022550400
Title
Valve repair in mitral endocarditis.
Source
Cirugia Cardiovascular. (no pagination), 2023. Date of Publication: 2023.
Author
Garzon-Furne A.I.; Ferreiro-Marzal A.; Rodriguez-Serrano F.;
Esteban-Molina M.; Garcia-Orta R.; Moreno-Escobar E.; Garcia-Delgado M.;
Sevilla-Martinez M.; Gomez-Luque J.M.; Ocete-Hita E.; Rodriguez-Vazquez
del Rey M.D.M.; Nuila-Duran L.M.; Garrido J.M.
Institution
(Garzon-Furne, Ferreiro-Marzal, Esteban-Molina, Nuila-Duran, Garrido)
Servicio de Cirugia Cardiovascular, Hospital Universitario Virgen de las
Nieves, Granada, Spain
(Ferreiro-Marzal, Rodriguez-Serrano, Esteban-Molina, Garrido) Instituto de
Investigacion Biosanitaria (ibs.GRANADA), Granada, Spain
(Rodriguez-Serrano, Garrido) Instituto de Biopatologia y Medicina
Regenerativa (IBIMER), Universidad de Granada, Granada, Spain
(Garcia-Orta) Servicio de Cardiologia, Hospital Universitario Virgen de
las Nieves, Granada, Spain
(Moreno-Escobar) Servicio de Cardiologia, Hospital Universitario Clinico
San Cecilio, Granada, Spain
(Garcia-Delgado, Sevilla-Martinez) Servicio de Medicina Intensiva,
Hospital Universitario Virgen de las Nieves, Granada, Spain
(Gomez-Luque, Ocete-Hita) Unidad de Medicina Intensiva Pediatrica,
Hospital Universitario Virgen de las Nieves, Granada, Spain
(Rodriguez-Vazquez del Rey) Unidad de Cardiologia Pediatria, Hospital
Universitario Virgen de las Nieves, Granada, Spain
(Garrido) Departamento de Cirugia y sus Especialidades, Universidad de
Granada, Granada, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Introduction: Infective endocarditis (IE) is a pathology with a high
morbidity and mortality rate and represents a growing public health
problem. Surgical treatment is necessary in more than half of the cases,
and its main purpose is to completely remove the infected tissue and
reconstruct normal cardiac anatomy, including repair or replacement of the
affected valve(s). Objectives and methods: The present study focuses on
describing the most appropriate procedure for mitral repair surgery in
cases of IE, based on the literature and the extensive experience gained
by the surgical team. Likewise, we have compiled through a systematic
search of the literature the results that have been reported on reparative
surgery compared to mitral valve replacement. <br/>Result(s): The surgical
technique described requires a thorough study of the degree of involvement
and destructuring of the different valve segments. We consider resection
with pericardial patch interposition and/or Goretex neochord implantation
to be the standard technique that allows reproducible results. The
structured review of the available scientific evidence verifies the safety
of mitral repair for the treatment of IE, providing significant benefits
compared to valve replacement. <br/>Conclusion(s): The evaluated surgical
results suggest that mitral repair surgery should be considered the
procedure of choice for the surgical treatment of IE, whenever technically
feasible.<br/>Copyright &#xa9; 2022

<59>
Accession Number
2022474270
Title
Effect of BMI on patients undergoing transcatheter aortic valve
implantation: A systematic review and meta-analysis.
Source
Progress in Cardiovascular Diseases. (no pagination), 2023. Date of
Publication: 2023.
Author
Gupta R.; Mahmoudi E.; Behnoush A.H.; Khalaji A.; Malik A.H.; Sood A.;
Bandyopadhyay D.; Zaid S.; Goel A.; Sreenivasan J.; Patel C.; Vyas A.V.;
Lavie C.J.; Patel N.C.
Institution
(Gupta, Patel, Vyas, Patel) Department of Cardiology, Lehigh Valley Health
Network, Allentown, PA, United States
(Mahmoudi, Behnoush, Khalaji) Universal Scientific Education and Research
Network, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Malik, Bandyopadhyay) Department of Cardiology, Westchester Medical
Center and New York Medical College, Valhalla, NY, United States
(Sood) Department of Internal Medicine, The Wright Center for Graduate
Medical Education, Scranton, PA, United States
(Zaid, Goel) Department of Cardiology, Houston Methodist DeBakey Heart and
Vascular Institute, Houston, TX, United States
(Sreenivasan) Department of Cardiovascular Medicine, Yale University
School of Medicine, New Haven, CT, United States
(Lavie) John Ochsner Heart and Vascular Institute, Ochsner Clinical
School, The University of Queensland School of Medicine, New Orleans, LA,
United States
Publisher
W.B. Saunders
Abstract
Background: The relationship of body mass index (BMI) and an "obesity
paradox" with cardiovascular risk prediction is controversial. This
systematic review and meta-analysis aims to compare the associations of
different BMI ranges on transcatheter aortic valve implantation (TAVI)
outcomes. <br/>Method(s): International databases, including PubMed, the
Web of Science, and the Cochrane Library, were systematically searched for
observational and randomized controlled trial studies investigating TAVI
outcomes in any of the four BMI categories: underweight, normal weight,
overweight, and obese with one of the predefined outcomes. Primary
outcomes were in-hospital, 30-day, and long-term all-cause mortality.
Random-effects meta-analysis was performed to calculate the odds ratio
(OR) or standardized mean differences (SMD) with 95% confidence interval
(CI) for each paired comparison between two of the BMI categories.
<br/>Result(s): A total of 38 studies were included in our analysis,
investigating 99,829 patients undergoing TAVI. There was a trend toward
higher comorbidities such as hypertension, diabetes, and dyslipidemia in
overweight patients and individuals with obesity. Compared with
normal-weight, patients with obesity had a lower rate of 30-day mortality
(OR 0.42, 95% CI 0.25-0.72, p < 0.01), paravalvular aortic regurgitation
(OR 0.63, 95% CI 0.44-0.91, p = 0.01), 1-year mortality (OR 0.48, 95% CI
0.24-0.96, p = 0.04), and long-term mortality (OR 0.69, 95% CI 0.51-0.94,
p = 0.02). However, acute kidney injury (OR 1.16, 95% CI 1.04-1.30, p =
0.01) and permanent pacemaker implantation (OR 1.25, 95% CI 1.05-1.50, p =
0.01) odds were higher in patients with obesity. Noteworthy, major
vascular complications were significantly higher in underweight patients
in comparison with normal weight cases (OR 1.62, 95% CI 1.07-2.46, p =
0.02). In terms of left ventricular ejection fraction (LVEF), patients
with obesity had higher post-operative LVEF compared to normal-weight
individuals (SMD 0.12, 95% CI 0.02-0.22, p = 0.02). <br/>Conclusion(s):
Our results suggest the presence of the "obesity paradox" in TAVI outcomes
with higher BMI ranges being associated with lower short- and long-term
mortality. BMI can be utilized for risk prediction of patients undergoing
TAVI.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<60>
Accession Number
640400497
Title
An integrated approach to geographic validation helped scrutinize
prediction model performance and its variability.
Source
Journal of clinical epidemiology. (no pagination), 2023. Date of
Publication: 21 Feb 2023.
Author
Yordanov T.R.; Lopes R.R.; Ravelli A.C.J.; Vis M.; Houterman S.;
Marquering H.; Abu-Hanna A.
Institution
(Yordanov, Ravelli, Abu-Hanna) Amsterdam UMC location University of
Amsterdam, Medical Informatics, Meibergdreef 9, Amsterdam, The
Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The
Netherlands
(Lopes) Amsterdam UMC location University of Amsterdam, Biomedical
Engineering and Physics, Meibergdreef 9, Amsterdam, The Netherlands;
Amsterdam UMC location University of Amsterdam, Radiology and Nuclear
Medicine, Meibergdreef 9, Amsterdam, The Netherlands; Amsterdam
Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, The
Netherlands
(Vis) Amsterdam Public Health Research Institute, Amsterdam, The
Netherlands; Amsterdam UMC location University of Amsterdam, Cardiology,
Meibergdreef 9, Amsterdam, The Netherlands; Amsterdam Cardiovascular
Sciences, Atherosclerosis and Ischemic Syndromes, Amsterdam, The
Netherlands
(Houterman) UtrechtNetherlands
(Marquering) Amsterdam UMC location University of Amsterdam, Biomedical
Engineering and Physics, Meibergdreef 9, Amsterdam, The Netherlands;
Amsterdam UMC location University of Amsterdam, Radiology and Nuclear
Medicine, Meibergdreef 9, Amsterdam, The Netherlands; Amsterdam
Cardiovascular Sciences, Atherosclerosis and Ischemic Syndromes,
Amsterdam, The Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To illustrate in-depth validation of prediction models
developed on multicenter data. <br/>METHOD(S): For each hospital in a
multicenter registry, we evaluated predictive performance of a 30-day
mortality prediction model for transcatheter aortic valve implantation
(TAVI) using the Netherlands heart registration (NHR) dataset. We measured
discrimination and calibration per hospital in a leave-center-out analysis
(LCOA). Meta-analysis was used to calculate I2 values per performance
metric from the LCOA and to compute mean and confidence interval (CI)
estimates. Case-mix differences between studies were inspected using the
framework of Debray et al. for understanding external validation. We also
aimed to discover subgroups with high model prediction error and their
distribution over the centers. <br/>RESULT(S): We studied 16 hospitals
with 11,599 TAVI patients with an early mortality of 3.7%. The models'
AUCs had a wide range between hospitals from 0.59 to 0.79 and
miscalibration occurred in seven hospitals. Mean AUC from meta-analysis
was 0.68 (95%CI 0.65-0.70). I 2 values were 0%, 74%, and 0% for AUC,
calibration intercept and slope, respectively. Between-hospital case-mix
differences were substantial and model transportability was low. One
subgroup was discovered with marked global prediction error and was
associated with poor performance on validation centers.
<br/>CONCLUSION(S): The illustrated combination of approaches provides
useful insights to inspect multicenter-based prediction models, and
exposes their limitations in transportability and performance variability
when applied to different populations.<br/>Copyright &#xa9; 2023 The
Author(s). Published by Elsevier Inc. All rights reserved.

<61>
Accession Number
640400380
Title
A survey of solid organ transplant recipient attitudes and concerns
regarding contraception and pregnancy.
Source
Clinical transplantation. (pp e14948), 2023. Date of Publication: 23 Feb
2023.
Author
McIntosh T.; Puerzer P.; Li M.T.; Malat G.; Sammons C.; Norris M.; Fallah
T.; Trofe-Clark J.; DuBois J.M.; Iltis A.; Mohan S.; Sawinski D.
Institution
(McIntosh, DuBois) Bioethics Research Center, Department of Medicine,
Washington University School of Medicine, St. Louis, MO, United States
(Puerzer) School of Arts and Sciences, University of Pennsylvania,
Philadelphia, PA, United States
(Li, Mohan) Department of Medicine, Division of Nephrology, Columbia
University Vagelos College of Physicians and Surgeons, NY, New York, USA
(Malat, Sammons, Norris, Fallah, Trofe-Clark) Department of Pharmacy,
Hospital of the University of Pennsylvania, Philadelphia, PA, United
States
(Trofe-Clark) Renal, Hypertension Division, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, United States
(Trofe-Clark) Department of Surgery, Division of Transplantation, Perelman
School of Medicine, University of Pennsylvania, PA, United States
(Iltis) Center for Bioethics, Health and Society, Wake Forest University,
Winston-Salem, NC, United States
(Sawinski) Weill Cornell Medical College, Department of Medicine, Division
of Nephrology and Transplantation, NY, United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Many women who are solid organ transplant (SOT) recipients
wish to have children after transplantation. Contraception is an important
component of post-transplant planning and care, given the increased risk
associated with post-transplant pregnancies. We sought to understand
patient attitudes and concerns about post-transplant contraception and
pregnancy. <br/>METHOD(S): Following a comprehensive literature review,
our team developed a survey that was administered to female SOT recipients
of childbearing age. We used descriptive and inferential statistics to
characterize participant views. <br/>RESULT(S): 243 transplant recipients
completed the survey (80.7% response rate). The mean age of respondents
was 37.5 years (+/-8.1 years), 66.7% were kidney recipients, and 40.7%
were within the first year after transplant. The most common concerns
among respondents included fetal and maternal health complications.
Participants generally did not agree that transplant recipients should be
advised to avoid pregnancy. There was strong support for shared decision
making about pregnancy after transplantation. <br/>CONCLUSION(S):
Understanding patient perspectives can help transplant providers make
better care recommendations and support patient autonomy in reproductive
decisions post-transplant. Given that there are some differences in views
by transplant type, individualized conversations between patients and
providers are needed. This article is protected by copyright. All rights
reserved.

<62>
Accession Number
2022989968
Title
Head-to-head comparison between left atrial appendage occlusion and
non-vitamin K oral anticoagulants in non-valvular atrial fibrillation
patients: A systematic review and meta-analysis study.
Source
Trends in Cardiovascular Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Waranugraha Y.; Lin L.-Y.; Tsai C.-T.
Institution
(Waranugraha) Department of Cardiology and Vascular Medicine, Universitas
Brawijaya Faculty of Medicine and Hospital, Malang, Indonesia
(Lin, Tsai) Division of Cardiology, Department of Internal Medicine,
National Taiwan University College of Medicine and Hospital, Taipei,
Taiwan (Republic of China)
Publisher
Elsevier Inc.
Abstract
Left atrial appendage occlusion (LAAO) was found to be non-inferior to
warfarin. In non-valvular atrial fibrillation (AF), there is still a
scarcity of data comparing LAAO versus non-vitamin K oral anticoagulants
(NOACs). Our purpose was to compare the clinical benefits between LAAO and
NOACs in non-valvular AF patients. The patient, intervention, comparison,
and outcome principles were used to develop the research question in this
systematic review and meta-analysis. Literature searches were conducted in
online scientific databases such as ProQuest, PubMed, and ScienceDirect.
All important information was extracted. The random-effect model was
applied to estimate all pooled effects. The Mantel-Haenszel statistical
method was used to determine the pooled risk ratio (RR) and 95% confidence
interval (CI). A total of 4411 participants from 5 studies were involved.
LAAO significantly decreased the cardiovascular mortality risk compared to
NOACs (RR = 0.56; 95% CI = 0.42 to 0.75; p <0.01). Major bleeding risk in
the LAAO group was significantly lower than in the NOACs group (RR = 0.66;
RR = 0.53 to 0.82; p <0.01). A significantly lower risk of major bleeding
or non-major bleeding in the patients receiving LAAO than NOACs was also
observed in this meta-analysis (RR = 0.66; 95% CI = 0.54 to 0.81; p
<0.01). LAAO was superior to the NOACs in reducing cardiovascular
mortality, major bleeding, and major or non-major bleeding risks in
non-valvular AF patients. In high-risk thromboembolism and bleeding
patients, LAAO can be considered first as a long-term treatment
strategy.<br/>Copyright &#xa9; 2023

<63>
Accession Number
2022878437
Title
Use of machine learning in pediatric surgical clinical prediction tools: A
systematic review.
Source
Journal of Pediatric Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Bianco A.; Al-Azzawi Z.A.M.; Guadagno E.; Osmanlliu E.; Gravel J.; Poenaru
D.
Institution
(Bianco, Al-Azzawi, Poenaru) Faculty of Medicine and Health Sciences,
McGill University, Montreal, QC, Canada
(Guadagno, Poenaru) Harvey E. Beardmore Division of Pediatric Surgery, The
Montreal Children's Hospital, McGill University Health Centre, Montreal,
QC, Canada
(Osmanlliu) Department of Pediatrics, McGill University Health Centre,
Montreal, QC, Canada
(Gravel) Department of Pediatric Emergency Medicine, Sainte-Justine
Hospital, Universite de Montreal, Montreal, QC, Canada
Publisher
W.B. Saunders
Abstract
Purpose: Clinical prediction tools (CPTs) are decision-making instruments
utilizing patient data to predict specific clinical outcomes,
risk-stratify patients, or suggest personalized diagnostic or therapeutic
options. Recent advancements in artificial intelligence have resulted in a
proliferation of CPTs created using machine learning (ML)-yet the clinical
applicability of ML-based CPTs and their validation in clinical settings
remain unclear. This systematic review aims to compare the validity and
clinical efficacy of ML-based to traditional CPTs in pediatric surgery.
<br/>Method(s): Nine databases were searched from 2000 until July 9, 2021
to retrieve articles reporting on CPTs and ML for pediatric surgical
conditions. PRISMA standards were followed, and screening was performed by
two independent reviewers in Rayyan, with a third reviewer resolving
conflicts. Risk of bias was assessed using the PROBAST. <br/>Result(s):
Out of 8300 studies, 48 met the inclusion criteria. The most represented
surgical specialties were pediatric general (14), neurosurgery (13) and
cardiac surgery (12). Prognostic (26) CPTs were the most represented type
of surgical pediatric CPTs followed by diagnostic (10), interventional
(9), and risk stratifying (2). One study included a CPT for diagnostic,
interventional and prognostic purposes. 81% of studies compared their CPT
to ML-based CPTs, statistical CPTs, or the unaided clinician, but lacked
external validation and/or evidence of clinical implementation.
<br/>Conclusion(s): While most studies claim significant potential
improvements by incorporating ML-based CPTs in pediatric surgical
decision-making, both external validation and clinical application remains
limited. Further studies must focus on validating existing instruments or
developing validated tools, and incorporating them in the clinical
workflow. <br/>Type of Study: Systematic Review Level of Evidence: Level
III<br/>Copyright &#xa9; 2023 The Author(s)

<64>
Accession Number
640395145
Title
Aortic Stenosis and Aortic Valve Replacement Among Patients with Chronic
Kidney Disease: A Narrative Review.
Source
Cardiorenal medicine. (no pagination), 2023. Date of Publication: 22 Feb
2023.
Author
Rivera F.B.; Cu M.V.V.; Cua S.J.; De Luna D.V.; Lerma E.V.; McCullough
P.A.; Kazory A.; Collado F.M.S.
Publisher
NLM (Medline)
Abstract
BACKGROUND: Aortic stenosis (AS) can present with dyspnea, angina,
syncope, and palpitations and this presents a diagnostic challenge as
chronic kidney disease (CKD) and other commonly found comorbid conditions
may present similarly. While medical optimization is an important aspect
in management, aortic valve replacement (AVR) by surgical aortic valve
replacement (SAVR) or transcatheter aortic valve replacement (TAVR) is the
definitive treatment. Patients with concomitant CKD and AS require special
consideration as it is known that CKD is associated with progression of AS
and poor long-term outcomes. AIMS AND OBJECTIVES: To summarize and review
current existing literature on patients with both CKD and AS regarding
disease progression, dialysis method, surgical intervention, and post
operative outcomes. <br/>CONCLUSION(S): The incidence of aortic stenosis
increases with age but has also been independently associated with chronic
kidney disease and furthermore with hemodialysis. Regular dialysis with
hemodialysis vs. peritoneal dialysis and female gender have been
associated with progression of AS. Management of aortic stenosis is
multidisciplinary and requires planning and interventions by the
"Heart-Kidney Team" to decrease risk of further inducing kidney injury
among high-risk population. Both TAVR and SAVR are effective interventions
for patients with severe symptomatic AS, but TAVR has been associated with
better short-term renal and cardiovascular outcomes. IMPLICATIONS FOR
PRACTICE: Special consideration must be taken in patients with both CKD
and AS. The choice of whether to undergo hemodialysis (HD) vs. peritoneal
dialysis (PD) among patients with CKD is multifactorial but studies have
shown benefit regarding AS progression among those who undergo PD. The
choice regarding AVR approach is likewise the same. TAVR has been
associated with decreased complications among CKD patients, but the
decision is multifactorial and requires a comprehensive discussion with
the Heart-Kidney Team as many other factors play a role in the decision
including preference, prognosis, and other risk factors.<br/>Copyright The
Author(s). Published by S. Karger AG, Basel.

<65>
Accession Number
640393764
Title
Systematic Review of a Novel Approach to Prevent Pain After Chest Surgery.
Source
Journal of cardiothoracic and vascular anesthesia. (no pagination), 2023.
Date of Publication: 28 Jan 2023.
Author
Anwar S.
Institution
(Anwar) Barts Heart Centre, Barts Health NHS Trust, London, United
Kingdom; William Harvey Research Institute, NIHR Biomedical Research
Centre, London, United Kingdom; Cleveland Clinic London, London, United
Kingdom; Outcomes Research Consortium, Cleveland, OH
Publisher
NLM (Medline)

<66>
Accession Number
640393234
Title
Effect of menthol lozenges after extubation on thirst, nausea,
physiological parameters, and comfort in cardiovascular surgery patients:
A randomized controlled trial.
Source
Intensive & critical care nursing. 76 (pp 103415), 2023. Date of
Publication: 20 Feb 2023.
Author
Can S.; Gezginci E.; Yapici N.
Institution
(Can) Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and
Research Hospital, Istanbul, Turkey
(Gezginci) Hamidiye Faculty of Nursing, University of Health Sciences
Turkey, Istanbul, Turkey
(Yapici) Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Health
Application and Research Center, University of Health Sciences Turkey,
Istanbul, Turkey
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To determine the effect of post-extubation oral menthol
lozenges on thirst, nausea, physiological parameters, and comfort level in
patients undergoing cardiovascular surgery. RESEARCH METHODOLOGY/DESIGN:
The study was a single-centre, randomized controlled trial. SETTING: This
study included 119 patients undergoing coronary artery bypass graft
surgery in a training and research hospital. Patients in the intervention
group (n = 59) received menthol lozenges at 30, 60, and 90 min after
extubation. Patients in the control group (n = 60) received standard care
and treatment. MAIN OUTCOME MEASURES: The primary outcome of the study was
the change in post-extubation thirst assessed by Visual Analogue Scale
after using menthol lozenges compared to baseline. Secondary outcomes were
changes in post-extubation physiological parameters and nausea severity
assessed by Visual Analogue Scale compared to baseline, and comfort level
assessed with Shortened General Comfort Questionnaire. <br/>RESULT(S):
Between-group comparisons showed that the intervention group had
significantly lower thirst scores at all time points and nausea at the
first assessment (p < 0.05) and significantly higher comfort scores (p <
0.05) than the control group. There were no significant differences
between the groups in physiological parameters at baseline or any of the
postoperative assessments (p > 0.05). <br/>CONCLUSION(S): In patients
undergoing coronary artery bypass graft surgery, the use of menthol
lozenges effectively increased comfort level by reducing post-extubation
thirst and nausea, but had no effect on physiological parameters.
IMPLICATIONS FOR CLINICAL PRACTICE: Nurses should be vigilant for
complaints such as thirst, nausea, and discomfort in patients after
extubation. Nurses' administration of menthol lozenges to patients may
help reduce post-extubation thirst, nausea, and discomfort.<br/>Copyright
&#xa9; 2023 Elsevier Ltd. All rights reserved.

<67>
[Use Link to view the full text]
Accession Number
2020871887
Title
A Multicenter, Phase 2, Randomized, Placebo-Controlled, Double-Blind,
Parallel-Group, Dose-Finding Trial of the Oral Factor XIa Inhibitor
Asundexian to Prevent Adverse Cardiovascular Outcomes After Acute
Myocardial Infarction.
Source
Circulation. 146(16) (pp 1196-1206), 2022. Date of Publication: 18 Oct
2022.
Author
Rao S.V.; Kirsch B.; Bhatt D.L.; Coppolecchia R.; Eikelboom J.; James
S.K.; Jones W.S.; Keller L.; Hermanides R.S.; Campo G.; Ferreiro J.L.;
Mundl H.; Alexander J.H.; Hengstenberg C.; Steinwender C.; Alber H.;
Steringer-Mascherbauer R.; Schober A.; Auer J.; Roithinger F.X.; Von
Lewinski D.; Moertl D.; Huber K.; Coussement P.; Hoffer E.; Beauloye C.;
Janssens L.; Vranckx P.; De Raedt H.; Vanassche T.; Vrolix M.; Rokyta R.;
Parenica J.; Pelouch R.; Motovska Z.; Alan D.; Kettner J.; Polasek R.;
Cermak O.; Sedlon P.; Hanis J.; Novak M.; Belohlavek J.; Horacek T.;
Leggewie S.; Wenzel P.; Vom Dahl J.; Sievers B.; Pulz J.; Schellong S.;
Clemmensen P.; Muller-Hennessen M.; Rassaf T.; Falukozi J.; Ruzsa Z.;
Tomcsanyi J.; Csanadi Z.; Herczeg B.; Koszegi Z.; Vorobcsuk A.; Kiss R.;
Baranyai C.; Dezsi C.; Merkely B.; Lupkovics G.; Rossini R.; Scherillo M.;
Sergio Saba P.; Calo L.; Nassiacos D.; Quadri G.; Sciahbasi A.; Silvio
Marenzi G.C.; Reimers B.; Perna G.P.; Sacca S.; Fattore L.; Brunelli C.;
Picchi A.; Kuramochi T.; Kondo K.; Aoyama T.; Kudoh T.; Yamamoto T.;
Takaya T.; Mukai Y.; Fukui K.; Morioka N.; Ando K.; Yamamuro A.; Morita
Y.; Koga Y.; Watanabe T.; Sakamoto T.; Shibasaki T.; Maebuchi D.;
Takahashi A.; Yonetsu T.; Kakuta T.; Nishina H.; Oemrawsingh R.; Dorman
R.; Oude Ophius T.; Prins P.; Al Windy N.Y.Y.; Zoet-Nugteren S.K.;
Hermanides R.; Van Eck M.; Scherptong R.; Cornel J.H.; Damman P.; Bech G.;
Torquay R.; Kietselaer B.; Grzelakowski P.; Krzysztof D.; Budaj A.; Miekus
P.; Przybylski A.; Zarebinski M.; Balsam P.; Szachniewicz J.; Gierlotka
M.; Tycinska A.; Iniguez Romo A.; Fernandez Ortiz A.; Carrasquer Cucarella
A.; Sanmartin Fernandez M.; Sionis A.; Bueno Zamora H.; Ferreiro Gutierrez
J.L.; Almenar L.; Ferreira Gonzalez I.; Pascual Figal D.A.; Almendro Delia
M.; Jimenez Fernandez M.; Skeppholm M.; Zedigh C.; Angeras O.; Lauermann
J.; Erlinge D.; Gustafsson R.; Mooe T.; Utreras A.; James S.; Grimfjard
P.; Pedrazzini G.; Mach F.; Fournier S.; Haegeli L.; Beer J.H.; Leibundgut
G.; Kobza R.; Kaiser C.; Kunadian V.; Al-Lamee R.; Gorog D.; Khan S.;
Trevelyan J.; Toor I.; Smith J.; Purushottam B.; Treasure C.; Arena F.;
Vedere A.; Henderson D.; Gilani S.; Jones A.; Carrillo-Jimenez R.;
Gillespie E.; Marhefka G.; Wang D.; Olson C.; Bloom S.; Iftikhar F.;
Brabham D.; McGinty J.; Thompson C.; Talano J.; Ginete W.; Williams M.;
Masud A.; Ariani M.; Bitar F.; Wang T.; Samuelson B.
Institution
(Rao) New York University Langone Health System, New York, NY, United
States
(Jones, Alexander) Duke Clinical Research Institute, Duke University
School of Medicine, Durham, NC, United States
(Kirsch, Keller, Mundl) Bayer Ag, Wuppertal, Germany
(Bhatt) Brigham and Women's Hospital, Harvard Medical School, Boston, MA,
United States
(Budaj) Centre of Postgraduate Medical Education, Grochowski Hospital,
Warsaw, Poland
(Coppolecchia) Bayer Us Llc, Whippany, NJ, United States
(Eikelboom) Population Health Research Institute, McMaster University,
Hamilton, ON, Canada
(James) Department of Medical Sciences, Uppsala Clinical Research Center,
Uppsala University, Sweden
(Merkely) Heart and Vascular Center, Semmelweis University, Budapest,
Hungary
(Hermanides) Isala Hospital, Zwolle, Netherlands
(Campo) Cardiovascular Institute, Azienda Ospedaliero-Universitaria di
Ferrara, Cona, Italy
(Ferreiro) Department of Cardiology, Bellvitge University Hospital,
BIOHEART: Cardiovascular Diseases Group-IDIBELL, CIBERCV, l'Hospitalet de
Llobregat, Barcelona, Spain
(Shibasaki) Saitama Sekishinkai Hospital, Saitama, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Oral activated factor XI (FXIa) inhibitors may modulate
coagulation to prevent thromboembolic events without substantially
increasing bleeding. We explored the pharmacodynamics, safety, and
efficacy of the oral FXIa inhibitor asundexian for secondary prevention
after acute myocardial infarction (MI). <br/>Method(s): We randomized 1601
patients with recent acute MI to oral asundexian 10, 20, or 50 mg or
placebo once daily for 6 to 12 months in a double-blind,
placebo-controlled, phase 2, dose-ranging trial. Patients were randomized
within 5 days of their qualifying MI and received dual antiplatelet
therapy with aspirin plus a P2Y12 inhibitor. The effect of asundexian on
FXIa inhibition was assessed at 4 weeks. The prespecified main safety
outcome was Bleeding Academic Research Consortium type 2, 3, or 5 bleeding
comparing all pooled asundexian doses with placebo. The prespecified
efficacy outcome was a composite of cardiovascular death, MI, stroke, or
stent thrombosis comparing pooled asundexian 20 and 50 mg doses with
placebo. <br/>Result(s): The median age was 68 years, 23% of participants
were women, 51% had ST-segment-elevation MI, 80% were treated with aspirin
plus ticagrelor or prasugrel, and 99% underwent percutaneous coronary
intervention before randomization. Asundexian caused dose-related
inhibition of FXIa activity, with 50 mg resulting in >90% inhibition. Over
a median follow-up of 368 days, the main safety outcome occurred in 30
(7.6%), 32 (8.1%), 42 (10.5%), and 36 (9.0%) patients receiving asundexian
10 mg, 20 mg, or 50 mg, or placebo, respectively (pooled asundexian versus
placebo: hazard ratio, 0.98 [90% CI, 0.71-1.35]). The efficacy outcome
occurred in 27 (6.8%), 24 (6.0%), 22 (5.5%), and 22 (5.5%) patients
assigned asundexian 10 mg, 20 mg, or 50 mg, or placebo, respectively
(pooled asundexian 20 and 50 mg versus placebo: hazard ratio, 1.05 [90%
CI, 0.69-1.61]). <br/>Conclusion(s): In patients with recent acute MI, 3
doses of asundexian, when added to aspirin plus a P2Y12 inhibitor,
resulted in dose-dependent, near-complete inhibition of FXIa activity
without a significant increase in bleeding and a low rate of ischemic
events. These data support the investigation of asundexian at a dose of 50
mg daily in an adequately powered clinical trial of patients who
experienced acute MI.<br/>Copyright &#xa9; 2022 American Heart
Association, Inc.

<68>
Accession Number
2017704059
Title
Prehabilitation of elderly frail or pre-frail patients prior to elective
surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome
assessor-blinded trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 468. Date of
Publication: December 2022.
Author
Schaller S.J.; Kiselev J.; Loidl V.; Quentin W.; Schmidt K.; Morgeli R.;
Rombey T.; Busse R.; Mansmann U.; Spies C.; Marschall U.; Eckardt-Felmberg
R.; Landgraf I.; Schwantes U.
Institution
(Schaller, Kiselev, Schmidt, Morgeli, Spies) Department of Anesthesiology
and Operative Intensive Care Medicine (CVK/CCM), Charite -
Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin
and Humboldt-Universitat zu Berlin, Chariteplatz 1, Berlin 10117, Germany
(Loidl, Mansmann) Institute for Medical Information Processing, Biometry,
and Epidemiology - IBE, Ludwig-Maximilians-Universitat Munchen, Munich,
Germany
(Quentin, Rombey, Busse) Department of Health Care Management, Technische
Universitat Berlin, Berlin, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Frailty is expressed by a reduction in physical capacity,
mobility, muscle strength, and endurance. (Pre-)frailty is present in up
to 42% of the older surgical population, with an increased risk for peri-
and postoperative complications. Consequently, these patients often suffer
from a delayed or limited recovery, loss of autonomy and quality of life,
and a decrease in functional and cognitive capacities. Since frailty is
modifiable, prehabilitation may improve the physiological reserves of
patients and reduce the care dependency 12 months after surgery.
<br/>Method(s): Patients >= 70 years old scheduled for elective surgery or
intervention will be recruited in this multicenter, randomized controlled
study, with a target of 1400 participants with an allocation ratio of 1:1.
The intervention consists of (1) a shared decision-making process with the
patient, relatives, and an interdisciplinary and interprofessional team
and (2) a 3-week multimodal, individualized prehabilitation program
including exercise therapy, nutritional intervention, mobility or balance
training, and psychosocial interventions and medical assessment. The
frequency of the supervised prehabilitation is 5 times/week for 3 weeks.
The primary endpoint is defined as the level of care dependency 12 months
after surgery or intervention. <br/>Discussion(s): Prehabilitation has
been proven to be effective for different populations, including
colorectal, transplant, and cardiac surgery patients. In contrast,
evidence for prehabilitation in older, frail patients has not been clearly
established. To the best of our knowledge, this is currently the largest
prehabilitation study on older people with frailty undergoing general
elective surgery. Trial registration: ClinicalTrials.gov NCT04418271.
Registered on 5 June 2020. Universal Trial Number (UTN):
U1111-1253-4820<br/>Copyright &#xa9; 2022, The Author(s).

<69>
Accession Number
2017467724
Title
Retinopathy risk calculators in the prediction of sight-threatening
diabetic retinopathy in type 2 diabetes: A FIELD substudy.
Source
Diabetes Research and Clinical Practice. 186 (no pagination), 2022.
Article Number: 109835. Date of Publication: April 2022.
Author
Rao B.N.; Quinn N.; Januszewski A.S.; Peto T.; Brazionis L.; Aryal N.;
O'Connell R.L.; Li L.; Summanen P.; Scott R.; O'Day J.; Keech A.C.;
Jenkins A.J.
Institution
(Rao, Quinn, Januszewski, Aryal, O'Connell, Li, Keech, Jenkins) NHMRC
Clinical Trials Centre, The University of Sydney, Australia
(Rao) Faculty of Medicine, Nursing and Health Sciences, Monash University,
Australia
(Quinn, Peto, Jenkins) Centre for Public Health, Queens University,
Northern Ireland, Belfast, United Kingdom
(Brazionis, Jenkins) Department of Medicine, St. Vincent's Hospital
Campus, The University of Melbourne, Australia
(Summanen) Department of Ophthalmology, Helsinki University Hospital,
University of Helsinki, Finland
(Scott) Lipid and Diabetes Research Group, Christchurch Hospital,
Christchurch, New Zealand
(O'Day) Department of Ophthalmology, Royal Victorian Eye and Ear Hospital,
The University of Melbourne, Australia
Publisher
Elsevier Ireland Ltd
Abstract
Aims: To evaluate the risk algorithm by Aspelund et al. for predicting
sight-threatening diabetic retinopathy (STDR) in Type 2 diabetes (T2D),
and to develop a new STDR prediction model. <br/>Method(s): The Aspelund
et al. algorithm was used to calculate STDR risk from baseline variables
in 1012 participants in the Fenofibrate Intervention and Event Lowering in
Diabetes (FIELD) ophthalmological substudy, compared to on-trial STDR
status, and receiver operating characteristic analysis performed. Using
multivariable logistic regression, traditional risk factors and
fenofibrate allocation as STDR predictors were evaluated, with
bootstrap-based optimism-adjusted estimates of predictive performance
calculated. <br/>Result(s): STDR developed in 28 participants. The
Aspelund et al. algorithm predicted STDR at 2- and 5-years with area under
the curve (AUC) 0.86 (95% CI 0.77-0.94) and 0.86 (0.81-0.92),
respectively. In the second model STDR risk factors were any DR at
baseline (OR 24.0 [95% CI 5.53-104]), HbA1c (OR 1.95 [1.43-2.64]) and male
sex (OR 4.34 [1.32-14.3]), while fenofibrate (OR 0.13 [0.05-0.38]) was
protective. This model had excellent discriminatory ability (AUC = 0.89).
<br/>Conclusion(s): The algorithm by Aspelund et al. predicts STDR well in
the FIELD ophthalmology substudy. Logistic regression analysis found DR at
baseline, male sex, and HbA1c were predictive of STDR and, fenofibrate was
protective.<br/>Copyright &#xa9; 2022 Elsevier B.V.

<70>
Accession Number
2017205988
Title
A physiology-based trigger score to guide perioperative transfusion of
allogeneic red blood cells: A multicentre randomised controlled trial.
Source
Transfusion Medicine. 32(5) (pp 375-382), 2022. Date of Publication:
October 2022.
Author
Lu K.; Huang Z.; Liang S.; Pan F.; Zhang C.; Wei J.; Wei H.; Wang Y.; Liao
R.; Huang A.; Huang Y.
Institution
(Lu, Liang, Wei, Huang) Department of Anesthesiology, The Third Affiliated
Hospital of Guangxi Medical University, Guangxi, Nanning, China
(Huang, Pan, Zhang) Department of Anesthesiology, Affiliated Hospital of
Youjiang Medical University for Nationalities, Guangxi, Baise, China
(Wei, Wang, Huang) Department of Anesthesiology, People's Hospital of
Guangxi Zhuang Autonomous Region, Guangxi, Nanning, China
(Liao) Department of Anesthesiology, West China Hospital, Sichuan
University, Sichuan, Chengdu, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Restrictive blood transfusion is recommended by major
guidelines for perioperative management, but requires objective assessment
at 7-10 g/dl haemoglobin (Hb). A scoring system that considers the
physiological needs of the heart may simply the practice and reduce
transfusion. <br/>Method(s): Patients (14-65 years of age) undergoing
non-cardiac surgery were randomised at a 1:1 ratio to a control group
versus a Perioperative Transfusion Trigger Score (POTTS) group. POTTS
(maximum of 10) was calculated as 6 plus the following: adrenaline
infusion rate (0 for no infusion, 1 for <=0.05
mug.kg^-1.min^-1, and 2 for higher rate),
FiO<inf>2</inf> to keep SpO<inf>2</inf> at >=95% (0 for <=35%, 1 for
36%-50%, and 2 for higher), core temperature (0 for <38degreeC, 1 for
38-40degreeC, and 2 for higher), and angina history (0 for no, 1 for
exertional, and 2 for resting). Transfusion is indicated when actual Hb is
lower than the calculated POTTS in individual patients. Transfusion in the
control group was based on the 2012 American Association for Blood Banks
(AABB) guideline. The primary outcome was the proportion of the patients
requiring transfusion of allogeneic red blood cells (RBCs) during the
perioperative period (until discharge from hospital), as assessed in the
intention-to-treat (ITT) population (all randomised subjects).
<br/>Result(s): A total of 864 patients (mean age 44.4 years, 244 men and
620 women) were enrolled from December 2017 to January 2021 (433 in the
control and 431 in the POTTS group). Baseline Hb was 9.2 +/- 1.8 and 9.2
+/- 1.7 g/dl in the control and POTTS groups, respectively. In the ITT
analysis, the proportion of the patients receiving allogeneic RBCs was
43.9% (190/433) in the control group versus 36.9% (159/431) in the POTTS
group (p = 0.036). Lower rate of allogeneic RBCs transfusion in the POTTS
group was also evident in the per-protocol analysis (42.8% vs. 35.5%, p =
0.030). Transfusion volume was 4.0 (2.0, 6.0) and 3.5 (2.0, 5.5) units
(200 ml/unit) in the control and POTTS groups, respectively (p = 0.25).
The rate of severe postoperative complications (Clavien-Dindo grade IIIa
and higher) was 3.9% in the control group versus 1.2% in the POTTS group
(p = 0.010). <br/>Conclusion(s): Transfusion of allogeneic RBCs based on
the POTTS was safe and reduced the transfusion requirement in patients
undergoing non-cardiac surgery.<br/>Copyright &#xa9; 2022 The Authors.
Transfusion Medicine published by John Wiley & Sons Ltd on behalf of
British Blood Transfusion Society.

<71>
Accession Number
2020132798
Title
Differences in long-term survival outcomes after coronary artery bypass
grafting using single vs multiple arterial grafts: a meta-analysis with
reconstructed time-to-event data and subgroup analyses.
Source
General Thoracic and Cardiovascular Surgery. 71(2) (pp 77-89), 2023. Date
of Publication: February 2023.
Author
Magouliotis D.E.; Fergadi M.P.; Zotos P.-A.; Rad A.A.; Xanthopoulos A.;
Bareka M.; Spiliopoulos K.; Athanasiou T.
Institution
(Magouliotis, Zotos, Spiliopoulos) Department of Cardiothoracic Surgery,
University of Thessaly, Biopolis, Larissa 41110, Greece
(Fergadi) Department of Radiology, University of Thessaly, Larissa, Greece
(Rad, Athanasiou) Department of Surgery and Cancer, Imperial College
London, London, United Kingdom
(Xanthopoulos) Department of Cardiology, University of Thessaly, Larissa,
Greece
(Bareka) Department of Anesthesiology, University of Thessaly, Larissa,
Greece
Publisher
Springer
Abstract
Objective: We reviewed the available literature on patients with coronary
artery disease undergoing isolated coronary artery bypass grafting (CABG)
with either single (SAG) or multiple arterial grafting (MAG).
<br/>Method(s): Original research studies that evaluated the long-term
survival of MAG versus SAG were identified, from 1995 to 2022. The median
overall survival (OS) and event-free OS were the primary endpoints.
Comparison of median OS between the right internal mammary artery (RIMA)
and radial artery (RA) as a second arterial conduit was the secondary
endpoint. Subgroup analyses were performed regarding patients older than
70 years, with diabetes mellitus, and females. A sensitivity analysis was
performed with the leave-one-out method. <br/>Result(s): Forty-four
studies were included in the qualitative and thirty-nine in the
quantitative synthesis. After pooling data from 180 to 459 patients, the
MAG group demonstrated a higher OS (HR, 0.589; 95% CI, 0.58-0.60; p <
0.0001) and event-free OS compared with the SAG group (HR, 0.828; 95% CI,
0.80-0.86; p < 0.0001). In addition, RITA was associated with superior OS
compared with RA as a second arterial conduit (HR, 0.936; 95% CI,
0.89-0.98; p = 0.009). MAG was also superior to SAG in patients over 70
years, females, and patients with diabetes mellitus. Sensitivity analysis
demonstrated a small-size study effect on the female subgroup analysis.
<br/>Conclusion(s): The present meta-analysis indicates that MAG is
associated with enhanced survival outcomes compared to SAG for patients
undergoing isolated CABG.<br/>Copyright &#xa9; 2022, The Author(s).

<72>
Accession Number
2020398923
Title
Health-related information needs and preferences for information of
individuals with cardiovascular disease from underserved populations: A
systematic review.
Source
Patient Education and Counseling. 105(12) (pp 3398-3409), 2022. Date of
Publication: December 2022.
Author
Vanzella L.M.; Pakosh M.; Oh P.; Ghisi G.L.M.
Institution
(Vanzella, Oh, Ghisi) University Health Network, Toronto Rehabilitation
Institute, ON, Canada
(Pakosh) Library & Information Services, University Health Network,
Toronto Rehabilitation Institute, Toronto, ON, Canada
Publisher
Elsevier Ireland Ltd
Abstract
Objective: This systematic review aimed to identify the information needs
and preferences of individuals with CVD from underserved populations.
<br/>Method(s): Five databases were searched from data inception to
February 2022. Pilot and case report studies, non-peer-reviewed
literature, and studies published in a language other than English,
Portuguese, or Spanish were excluded. Structured and thematic analysis of
all included studies were performed. The Critical Appraisal Skills Program
and the Downs and Black Checklist were used to assess the quality of the
qualitative and quantitative studies, respectively. <br/>Result(s): Of
35,698 initial records, 19 studies were included, most in observational
design and classified as "fair" quality. Underserved populations - women,
people living in rural areas, ethnic minority groups, older people, and
those with low socioeconomic status - presented unique needs in four main
groups, with some similarities across them: information about CVD, primary
and secondary prevention of CVD, CVD management, and health care, policies
and practices. Across the studies there was a lack of standardization on
how individuals' needs were assessed and reported. <br/>Conclusion(s):
Underserved populations with CVD have unique information needs and
preferences that should be address during their care. Practical
implication: Information from this study may assist health care
professionals with the development of comprehensive strategies to improve
their provision of care for specific CVD patient groups.<br/>Copyright
&#xa9; 2022 Elsevier B.V.

<73>
Accession Number
2021221522
Title
Effect of a multi-domain lifestyle intervention on cardiovascular risk in
older people: the FINGER trial.
Source
European Heart Journal. 43(21) (pp 2054-2061), 2022. Date of Publication:
01 Jun 2022.
Author
Lehtisalo J.; Rusanen M.; Solomon A.; Antikainen R.; Laatikainen T.;
Peltonen M.; Strandberg T.; Tuomilehto J.; Soininen H.; Kivipelto M.;
Ngandu T.
Institution
(Lehtisalo, Rusanen, Solomon, Soininen) Institute of Clinical
Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
(Lehtisalo, Rusanen, Laatikainen, Peltonen, Tuomilehto, Kivipelto, Ngandu)
Department of Public Health and Welfare, Population Health Unit, Finnish
Institute for Health and Welfare, Helsinki, Finland
(Rusanen, Soininen) Department of Neurology, Kuopio University Hospital,
KYS Kuopio, Finland
(Solomon, Peltonen, Kivipelto, Ngandu) Division of Clinical Geriatrics,
Department of Neurobiology Care Sciences and Society, Karolinska
Institute, Stockholm, Sweden
(Solomon, Kivipelto) Ageing Epidemiology Research Unit, School of Public
Health, Imperial College London, London, United Kingdom
(Antikainen, Strandberg) Center for Life Course Health Research,
University of Oulu, Oulu, Finland
(Antikainen) Medical Research Center Oulu, Oulu University Hospital,
University of Oulu, Oulu, Finland
(Laatikainen, Kivipelto) Institute of Public Health and Clinical
Nutrition, University of Eastern Finland, Kuopio, Finland
(Laatikainen) Joint municipal authority for North Karelia Social and
Health Services (Siun sote), Development Unit, Joensuu, Finland
(Strandberg) Department of Medicine, University of Helsinki, Helsinki
University Central Hospital, Helsinki, Finland
(Tuomilehto) Department of Public Health, University of Helsinki,
Helsinki, Finland
(Tuomilehto) Diabetes Research Group, King Abdulaziz University, Jeddah,
Saudi Arabia
(Tuomilehto) South Ostrobothnia Central Hospital, Seinajoki, Finland
(Kivipelto) Theme Aging, Karolinska University Hospital, Solna, Sweden
Publisher
Oxford University Press
Abstract
Aims: Joint prevention of cardiovascular disease (CVD) and dementia could
reduce the burden of both conditions. The Finnish Geriatric Intervention
Study to Prevent Cognitive Impairment and Disability (FINGER) demonstrated
a beneficial effect on cognition (primary outcome) and we assessed the
effect of this lifestyle intervention on incident CVD (pre-specified
secondary outcome). <br/>Methods and Results: FINGER enrolled 1259
individuals aged 60-77 years (ClinicalTrials.gov NCT01041989). They were
randomized (1:1) to a 2-year multi-domain intervention with diet, physical
and cognitive activity, and vascular monitoring (n = 631), or general
health advice (n = 628). National registries provided data on CVD
including stroke, transient ischaemic attack (TIA), or coronary heart
event. During an average of 7.4 years, 229 participants (18%) had at least
one CVD diagnosis: 107 in the intervention group and 122 in the control
group. The incidence of cerebrovascular events was lower in the
intervention than the control group: hazard ratio (HR) for combined
stroke/TIA was 0.71 [95% confidence interval (CI): 0.51-0.99] after
adjusting for background characteristics. Hazard ratio for coronary events
was 0.84 (CI: 0.56-1.26) and total CVD events 0.80 (95% CI: 0.61-1.04).
Among those with history of CVD (n = 145), the incidence of both total CVD
events (HR: 0.50, 95% CI: 0.28-0.90) and stroke/TIA (HR: 0.40, 95% CI:
0.20-0.81) was lower in the intervention than the control group.
<br/>Conclusion(s): A 2-year multi-domain lifestyle intervention among
older adults was effective in preventing cerebrovascular events and also
total CVD events among those who had history of CVD.<br/>Copyright &#xa9;
2022 The Author(s).

<74>
Accession Number
2020996058
Title
The Fried Frailty Phenotype in Patients Undergoing Cardiac Surgery: A
Systematic Review and Meta-Analysis.
Source
Heart Surgery Forum. 25(5) (pp E652-E659), 2022. Date of Publication:
2022.
Author
Nguyenhuy M.; Chang J.; Xu R.; Virk S.; Saxena A.
Institution
(Nguyenhuy) Western Hospital, Melbourne, Footscray, VIC, Australia
(Chang) The Royal Melbourne Hospital, Melbourne, Parkville, VIC, Australia
(Xu) The University of Melbourne, Melbourne, Parkville, VIC, Australia
(Virk) Department of Cardiology, Concord Repatriation General Hospital,
Concord West, NSW, Australia
(Saxena) Department of Cardiothoracic Surgery and Transplantation, Fiona
Stanley Hospital, Murdoch, WA, Australia
Publisher
Forum Multimedia Publishing LLC
Abstract
Objective: Frailty is an increasingly recognized marker of poor surgical
outcomes in cardiac surgery. Frailty first was described in the seminal
"Fried" paper, which constitutes the longest-standing and most
well-recognized definition. This study aimed to assess the impact of the
Fried and modified Fried frailty classifications on patient outcomes
following cardiac surgery. <br/>Method(s): The PUBMED, MEDLINE, and EMBASE
databases were searched from January 2000 until August 2021 for studies
evaluating postoperative outcomes using the Fried or modified Fried
frailty indexes in open cardiac surgical procedures. Primary outcomes were
one-year survival and postoperative quality of life. Secondary outcomes
included postoperative complications, intensive care unit (ICU) length of
stay (LOS), total hospital LOS, and institutional discharge.
<br/>Result(s): Eight eligible studies were identified. Meta-analysis
identified that frailty was associated with an increased risk of one-year
mortality (Risk Ratio [RR]:2.23;95% confidence interval [CI]1.17-4.23),
postoperative complications (RR 1.78;95% CI 1.27 - 2.50), ICU LOS (Mean
difference [MD] 21.2 hours;95% CI 8.42 - 33.94), hospital LOS (MD 3.29
days; 95% CI 2.19 - 4.94), and institutional discharge (RR 3.29;95% CI
2.19 - 4.94). A narrative review of quality of life suggested an
improvement following surgery, with frail patients demonstrating a greater
improvement from baseline over non-frail patients. <br/>Conclusion(s):
Frailty is associated with a higher degree of surgical morbidity, and
frail patients are twice as likely to experience mortality within one-year
post-operatively. Despite this, quality of life also improves dramatically
in frail patients. Frailty, in itself, does not constitute a
contraindication to cardiac surgery.<br/>Copyright &#xa9; 2022 Forum
Multimedia Publishing, LLC.

<75>
Accession Number
2020982989
Title
Prediction of Survival After Implantation of a Fully Magnetically
Levitated Left Ventricular Assist Device.
Source
JACC: Heart Failure. 10(12) (pp 948-959), 2022. Date of Publication:
December 2022.
Author
Mehra M.R.; Nayak A.; Morris A.A.; Lanfear D.E.; Nemeh H.; Desai S.;
Bansal A.; Guerrero-Miranda C.; Hall S.; Cleveland J.C.; Goldstein D.J.;
Uriel N.; Chen L.; Bailey S.; Anyanwu A.; Heatley G.; Chuang J.; Estep
J.D.
Institution
(Mehra) Brigham and Women's Hospital, Boston, MA, United States
(Nayak, Morris) Emory University, Atlanta, GA, United States
(Lanfear, Nemeh) Henry Ford Hospital, Detroit, MI, United States
(Desai, Bansal) Ochsner Medical Center, New Orleans, LA, United States
(Guerrero-Miranda, Hall) Baylor University Medical Center, Dallas, TX,
United States
(Cleveland) University of Colorado School of Medicine, Aurora, CO, United
States
(Goldstein) Montefiore Einstein Center for Heart and Vascular Care, New
York, NY, United States
(Uriel) NewYork-Presbyterian Hospital, Columbia University College of
Physicians and Surgeons, New York, NY, United States
(Chen) University of Rochester Medical Center, Rochester, NY, United
States
(Bailey) Allegheny Health Network, Pittsburgh, PA, United States
(Anyanwu) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Heatley, Chuang) Abbott, Abbott Park, IL, United States
(Estep) Cleveland Clinic Florida, Weston, FL, United States
Publisher
Elsevier Inc.
Abstract
Background: Clinical trials inform on average efficacy, but individualized
risk assessments for outcome prediction are important in guiding treatment
implementation. <br/>Objective(s): The authors developed and validated a
patient-specific risk score to predict survival at 1 and 2 years after
HeartMate 3 (HM3) left ventricular assist device (LVAD) implantation.
<br/>Method(s): The MOMENTUM 3 (Multicenter Study of MagLev Technology in
Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate
3) trial includes 2,200 HM3 LVAD patients in the pivotal trial and
Continued Access Protocol study (2014-2018). The authors randomly assigned
all patients to a derivation cohort (n = 1,540) or validation cohort (n =
660). Univariate mortality predictors were screened for potential model
inclusion, stepwise selection was used to build the multivariable Cox
proportional hazards regression model, and performance (discrimination and
calibration) was evaluated. <br/>Result(s): Age, prior cardiac surgery
(coronary artery bypass grafting [CABG] or valve procedure), lower serum
sodium, higher blood urea nitrogen (BUN), small left ventricular size, and
right atrial pressure-to-pulmonary capillary wedge pressure (RAP/PCWP)
ratio >0.6 were significant risk factors for mortality. Receiver-operating
characteristic (ROC) analysis in the validation cohort demonstrated an
area under the curve (AUC) of 0.76 (95% CI: 0.70-0.81) at 1 year and 0.71
(95% CI: 0.66-0.77) at 2 years. Calibration between predicted and observed
survival of the risk quintiles was high, with Pearson correlation
coefficients of 0.986 and 0.994 at 1 and 2 years, respectively. Patients
were successfully stratified into tertiles with higher-than-average,
average, and lower-than-average survival, and observed mortality risk
increased by 2-fold from one tertile to the next. <br/>Conclusion(s): A
practical, easy-to-use HM3 Survival Risk Score with 6 components was
developed to accurately predict 1- and 2-year survival after HM3 LVAD
implantation. The survival risk score can be used to provide individual
survival estimates to facilitate shared decision making when considering
HM3 LVAD therapy. (MOMENTUM 3 Trial Portfolio; NCT02224755,
NCT02892955)<br/>Copyright &#xa9; 2022 The Authors

<76>
Accession Number
2018817000
Title
Technology and technique for left ventricular assist device optimization:
A Bi-Tech solution.
Source
Artificial Organs. 46(12) (pp 2486-2492), 2022. Date of Publication:
December 2022.
Author
Tarzia V.; Ponzoni M.; Giammarco G.D.; Maccherini M.; Maiani M.; Agostoni
P.; Bagozzi L.; Marinelli D.; Apostolo A.; Bernazzali S.; Ortis H.; Mauro
M.D.; Bortolussi G.; Sani G.; Bottio T.; Scuri S.; Livi U.; Alamanni F.;
Gerosa G.
Institution
(Tarzia, Ponzoni, Bagozzi, Bortolussi, Bottio, Scuri, Gerosa) Department
of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua,
Italy
(Giammarco, Marinelli, Mauro) Cardiac Surgery, University of Chieti,
Chieti, Italy
(Maccherini, Bernazzali, Sani) Cardiac Surgery, University of Siena,
Siena, Italy
(Maiani, Ortis, Livi) Cardiac Surgery, University of Udine, Udine, Italy
(Agostoni, Apostolo, Alamanni) Cardiac Surgery, University of Milan,
Milan, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: We investigated the synergistic effect of the new cone-bearing
design of Jarvik 2000 (Jarvik Heart Inc., NY) together with a
minimally-invasive approach to outcomes of LVAD patients. <br/>Method(s):
We retrospectively reviewed all patients from 5 institutions involved in
the Jarvik 2000 Italian Registry, from October 2008 to October 2016.
Patients were divided into three groups according to pump design and
implantation technique: pin-bearing design and conventional approach
(Group 1); cone-bearing and conventional approach (Group 2); cone-bearing
and minimally-invasive implantation (Group 3). <br/>Result(s): A total of
150 adult patients with end-stage heart failure were enrolled: 26 subjects
in Group 1, 74 in Group 2, and 50 in Group 3. Nineteen patients (73%) in
Group 1, 51 (69%) in Group 2, and 36 (72%) in Group 3 were discharged.
During follow-up, 22 patients underwent transplantation, while in 3
patients the LVAD was explanted. The overall 1-year survival was 58 +/-
10%, 64 +/- 6%, and 74% +/- 7% in Groups 1, 2, and 3, respectively (p =
0.034). The competing-risks-adjusted cumulative incidence rate for adverse
events was 42.1 [27-62.7] per 100 patient-years in Group 1, 35.4
[25.3-48.2] in Group 2, and 22.1 [12.4-36.4] in Group 3 (p = 0.046 for
Group 1 vs. 3). <br/>Conclusion(s): The association of the modern
cone-bearing configuration of Jarvik 2000 and minimally invasive surgery
improved survival and minimized the risk for cardiovascular events, as a
result of combining technology and technique.<br/>Copyright &#xa9; 2022
International Center for Artificial Organs and Transplantation and Wiley
Periodicals LLC.

<77>
Accession Number
2018431456
Title
Left ventricular assist devices: A historical perspective at the
intersection of medicine and engineering.
Source
Artificial Organs. 46(12) (pp 2343-2360), 2022. Date of Publication:
December 2022.
Author
Goodman D.; Stulak J.; Rosenbaum A.N.
Institution
(Goodman) College of Osteopathic Medicine, Des Moines University, Des
Moines, IA, United States
(Stulak) Division of Cardiovascular Surgery, Mayo Clinic, Rochester, MN,
United States
(Rosenbaum) Department of Cardiovascular Diseases, Mayo Clinic Minnesota,
Rochester, MN, United States
Publisher
John Wiley and Sons Inc
Abstract
Over the last half-century, left ventricular assist device (LVAD)
technology has progressed from conceptual therapy for failed
cardiopulmonary bypass weaning to an accepted destination therapy for
advanced heart failure. The history of LVAD engineering is defined by an
initial development phase, which demonstrated the feasibility of such an
approach, to the more recent three major generations of commercial
devices. In this review, we explore the engineering challenges of LVADs,
how they were addressed over time, and the clinical outcomes that resulted
from each major technological development. The first generation of
commercial LVADs were pulsatile devices, which lacked the appropriate
durability due to their number of moving components and hemocompatibility.
The second generation of LVADs was defined by replacement of complex,
pulsatile pumps with primarily axial, continuous-flow systems with an
impeller in the blood passageway. These devices experienced significant
commercial success, but the presence of excessive trauma to the blood and
in-situ bearing resulted in an unacceptable burden of adverse events.
Third generation centrifugal-flow pumps use magnetically suspended rotors
within the pump chamber. Superior outcomes with this newest generation of
devices have been observed, particularly with respect to
hemocompatibility-related adverse events including pump thrombosis, with
fully magnetically levitated devices. The future of LVAD engineering
includes wireless charging foregoing percutaneous drivelines and more
advanced pump control mechanisms, including synchronization of the pump
flow with the native cardiac cycle, and varying pump output based on
degree of physical exertion using sensor or advanced device-level data
triggers.<br/>Copyright &#xa9; 2022 International Center for Artificial
Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.

<78>
Accession Number
2021107092
Title
Effect of TAVR Approach and Other Baseline Factors on the Incidence of
Acute Kidney Injury: A Systematic Review and Meta-Analysis.
Source
Journal of Interventional Cardiology. 2022 (no pagination), 2022. Article
Number: 3380605. Date of Publication: 2022.
Author
Alzu'bi H.; Rmilah A.A.; Haq I.-U.; Kheiri B.; Al-Abdouh A.; Hasan B.;
Elsekaily O.; Jaber S.; Qaisi I.; Yagmour A.; Dajani H.; Ahmed A.; Ahmed
Elhag; Kashani K.; Deshmukh A.
Institution
(Alzu'bi, Rmilah, Elsekaily, Ahmed, Deshmukh) Department of Cardiovascular
Medicine, Mayo Clinic, Rochester, MN, United States
(Haq) Department of Internal Medicine, Mayo Clinic, Rochester, MN, United
States
(Kheiri) Knight Cardiovascular Institute, Oregon Health & Science
University, Portland, OR, United States
(Al-Abdouh) Department of Medicine, Ascension Saint Agnes Hospital,
Baltimore, MD, United States
(Hasan) Evidence-Based Practice Research Program, Mayo Clinic, Rochester,
MN, United States
(Jaber, Ahmed Elhag) Department of Internal Medicine, Dr. Sulaiman Al
Habib Hospital, Riyadh, Saudi Arabia
(Qaisi, Dajani) An-Najah National University School of Medicine, Nablus,
Palestine
(Yagmour) Al Quds University School of Medicine, Hebron, Palestine
(Kashani) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
MN, United States
Publisher
Hindawi Limited
Abstract
Background. Acute kidney injury (AKI) is a well-known complication
following a transcatheter aortic valve replacement (TAVR) and is
associated with higher morbidity and mortality. Objective. We aim to
compare the risk of developing AKI after transfemoral (TF), transapical
(TA), and transaortic (TAo) approaches following TAVR. Methods. We
searched Medline and EMBASE databases from January 2009 to January 2021.
We included studies that evaluated the risk of AKI based on different TAVR
approaches. After extracting each study's data, we calculated the risk
ratio and 95% confidence intervals using RevMan software 5.4. Publication
bias was assessed by the forest plot. Results. Thirty-six (36) studies,
consisting of 70,406 patients undergoing TAVR were included. Thirty-five
studies compared TF to TA, and only seven investigations compared TF to
TAo. AKI was documented in 4,857 out of 50,395 (9.6%) patients that
underwent TF TAVR compared to 3,155 out of 19,721 (16%) patients who
underwent TA-TAVR, with a risk ratio of 0.49 (95% CI, 0.36-0.66;
p<0.00001). Likewise, 273 patients developed AKI out of the 1,840 patients
(14.8%) that underwent TF-TAVR in contrast to 67 patients out of the 421
patients (15.9%) that underwent TAo-TAVR, with a risk ratio of 0.51 (95%
CI, 0.27-0.98; p = 0.04). There was no significant risk when we compared
TA to TAo approaches, with a risk ratio of 0.89 (95% CI, 0.29-2.75; p =
0.84). Conclusion. The risk of post-TAVR AKI is significantly lower in
patients who underwent TF-TAVR than those who underwent TA-TAVR or
TAo-TAVR.<br/>Copyright &#xa9; 2022 Hossam Alzu'bi et al.

<79>
Accession Number
2018635316
Title
15-year outcomes of the JOCRI study (JOCRIED study): a randomised
comparison of off-pump and on-pump multiple arterial coronary
revascularisation.
Source
General Thoracic and Cardiovascular Surgery. 71(3) (pp 151-157), 2023.
Date of Publication: March 2023.
Author
Tadokoro N.; Fukushima S.; Minami K.; Shimahara Y.; Kawamoto N.; Kakuta
T.; Numata S.; Yaku H.; Takemura H.; Iino K.; Ochi M.; Ishii Y.; Wada H.;
Minematsu N.; Shimizu H.; Kobayashi J.; Fujita T.
Institution
(Tadokoro, Fukushima, Shimahara, Kawamoto, Kakuta, Kobayashi, Fujita)
Department of Cardiovascular Surgery, National Cerebral and Cardiovascular
Center, 6-1 Kishibeshimmachi, Osaka, Suita, Japan
(Tadokoro, Shimizu) Department of Cardiovascular Surgery, Keio University
School of Medicine, Shinjuku-ku, Tokyo, Japan
(Minami) Department of Surgical Intensive Care, National Cerebral and
Cardiovascular Center, Osaka, Suita, Japan
(Numata, Yaku) Division of Cardiovascular Surgery, Kyoto Prefectural
University of Medicine, Kyoto, Kyoto, Japan
(Takemura, Iino) Department of Thoracic, Cardiovascular and General
Surgery, Kanazawa University, Takara-machi, Kanazawa, Japan
(Ochi, Ishii) Department of Cardiovascular Surgery, Nippon Medical School,
Bunkyo-Ku, Tokyo, Japan
(Wada, Minematsu) Department of Cardiovascular Surgery, Fukuoka
University, Fukuoka, Japan
Publisher
Springer
Abstract
Objective: The Japanese Off-Pump Coronary Revascularization Investigation
(JOCRI) study reported a non-significant difference in early outcomes and
graft patency between off-pump coronary artery bypass grafting and on-pump
coronary artery bypass grafting in 2005. The JOCRIED study aimed to review
the long-term outcomes of the JOCRI study participants. Method and
results: The JOCRIED study enrolled 123 of the JOCRI study participants
completing the clinical follow-up between August 2018 and August 2020; 61
patients in the off-pump group and 62 patients in the on-pump group. The
follow-up period was 13.8 +/- 2.8 years. The groups were compared
regarding mortality, the incidence of major adverse cardiac and
cerebrovascular events and repeat revascularisation. The 15-year
cumulative survival rate (off-pump vs on-pump, respectively; 77.7% vs
75.3%; p = 0.85), major adverse events-free survival rate (62.5% vs 55.6%;
p = 0.27) and repeat revascularisation-free rate (84.8% vs 78.0%; p =
0.16) were not significantly different between the two groups.
Revascularisation was the most common major adverse events in the JOCRIED
participants. Although percutaneous coronary intervention was performed in
8 patients (13%) in the off-pump group and in 14 patients (23%) in the
on-pump group (p = 0.23), no patients underwent redo coronary artery
bypass grafting. <br/>Conclusion(s): Off-pump coronary artery bypass
grafting provides comparable 15-year outcomes to on-pump coronary artery
bypass grafting.<br/>Copyright &#xa9; 2022, The Author(s), under exclusive
licence to The Japanese Association for Thoracic Surgery.

<80>
Accession Number
2018072753
Title
A single, peri-operative antibiotic can persistently alter the
post-operative gut microbiome after Roux-en-Y gastric bypass.
Source
Surgical Endoscopy. 37(2) (pp 1476-1486), 2023. Date of Publication:
February 2023.
Author
Fernando D.G.; Saravia F.L.; Atkinson S.N.; Barron M.; Kirby J.R.; Kindel
T.L.
Institution
(Fernando, Barron, Kindel) Department of Surgery, Medical College of
Wisconsin, 8900 W. Doyne Avenue, Milwaukee, WI 53226, United States
(Saravia, Atkinson, Kirby) Department of Microbiology & Immunology,
Medical College of Wisconsin, 8900 W. Doyne Avenue, Milwaukee, WI 53226,
United States
(Atkinson) Center for Microbiome Research, Medical College of Wisconsin,
8900 W. Doyne Avenue, Milwaukee, WI 53226, United States
Publisher
Springer
Abstract
Introduction: Roux-en-Y gastric bypass (RYGB) significantly alters the gut
microbiome and may be a mechanism for post-operative cardiovascular
disease improvement. We have previously found an association between the
class of peri-operative, intravenous antibiotic administered at the time
of RYGB and the resolution rate of hypertension suggesting the gut
microbiome as a mechanism. In this study, we performed a prospective study
of RYGB to determine if a single intravenous antibiotic could alter the
gastrointestinal microbial composition. <br/>Method(s): Patients
undergoing RYGB were randomized to a single, peri-operative antibiotic of
intravenous cefazolin (n = 8) or clindamycin (n = 8). Stool samples were
collected from four-time points: 2 weeks pre-op (- 2w), 2 days pre-op (-
2d), 2 weeks post-op (+ 2w) and 3 months post-op (+ 3m). Stool samples
were processed for genomic DNA followed by Illumina 16S rRNA gene
sequencing and shotgun metagenomic sequencing (MGS). <br/>Result(s): A
total of 60 stool samples (- 2w, n = 16; - 2d, n = 15; + 2w, n = 16; + 3m,
n = 13) from 16 patients were analyzed. 87.5% of patients were female with
an average age of 48.6 +/- 12.2 years and pre-operative BMI of 50.9 +/-
23.3 kg/m². RYGB induced statistically significant differences
in alpha and beta diversity. There were statistically significant
differences in alpha diversity at + 2w and beta diversity at + 3m due to
antibiotic treatment. MGS revealed significantly distinct gut microbiota
with 11 discriminatory metagenomic assembled genomes driven by antibiotic
treatment at 3 months post-op, including increased Bifidobacterium spp.
with clindamycin. <br/>Conclusion(s): RYGB induces significant changes in
the gut microbiome at 2 weeks that are maintained 3 months after surgery.
However, the single peri-operative dose of antibiotic administered at the
time of RYGB induces unique and persisting changes to the gut microbiome
that are antibiotic-specific. Increased Bifidobacterium spp. with
clindamycin administration may improve the metabolic efficacy of RYGB when
considering gut-microbiome driven mechanisms for blood pressure
resolution. Graphical abstract: [Figure not available: see
fulltext.]<br/>Copyright &#xa9; 2022, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<81>
Accession Number
640374595
Title
Tricuspid repair in mitral regurgitation surgery: a systematic review and
meta-analysis.
Source
Journal of cardiothoracic surgery. 18(1) (pp 76), 2023. Date of
Publication: 17 Feb 2023.
Author
Cardoso J.L.; Ferraz Costa G.N.; Neves F.; Goncalves L.; Teixeira R.
Institution
(Cardoso, Neves) Servico de Cardiotoracica, Centro Hospitalar Vila Nova de
Gaia/Espinho, Rua Conceicao Fernandes, Vila Nova de Gaia 4434-502,
Portugal
(Ferraz Costa, Goncalves, Teixeira) Servico de Cardiologia, Centro
Hospitalar E Universitario de Coimbra, Coimbra, Portugal
(Goncalves, Teixeira) Faculdade de Medicina da Universidade de Coimbra,
Coimbra, Portugal
(Goncalves, Teixeira) Coimbra Institute for Clinical and Biomedical
Research (iCBR), Coimbra, Portugal
Publisher
NLM (Medline)
Abstract
BACKGROUND: Concomitant tricuspid repair in MR surgery is indicated in
patients with severa tricuspid regurgitation, however, concomitant repair
in less-than-severe TR patients is still a matter of debate.
<br/>METHOD(S): In December 2021, we systematically searched PubMed,
Embase and Cochrane databases for randomised control trials (RCTs)
comparing isolated MR surgery versus MR surgery with concomitant TR
annuloplasty. Four studies were included, resulting in 651 patients (323
in the prophylactic tricuspid intervention group and 328 in the no
tricuspid intervention group). <br/>RESULT(S): Our meta-analysis showed a
similar all-cause mortality and perioperative mortality for concomitant
prophylactic tricuspid repair when compared with no tricuspid intervention
(pooled odds ratio (OR), 0.54; 95% confidence interval (CI): 0.25-1.15,
P=0.11; I2=0% and pooled OR, 0.54; 95% CI: 0.25-1.15, P=0.11; I2=0%,
respectively) in patients undergoing MV surgery. despite a significantly
lower TR progression (pooled OR, 0.06; 95% CI: 0.02-0.24, P<0.01; I2=0%).
Additionally, similar New York Heart Association (NYHA) classes III and IV
were identified in both concomitant prophylactic tricuspid repair and no
tricuspid intervention, despite a lower trend in the tricuspid
intervention group (pooled OR, 0.63; 95% CI: 0.38-1.06, P=0.08; I2=0%).
<br/>CONCLUSION(S): Our pooled analyses suggested that TV repair at the
time of MV surgery in patients with moderate or less-than-moderate TR did
not impact on perioperative or postoperative all-cause mortality, despite
reducing TR severity and TR progression following the
intervention.<br/>Copyright &#xa9; 2023. The Author(s).

<82>
Accession Number
2021079245
Title
Fate of iatrogenic atrial septal defects following mitral transcatheter
edge-to-edge repair - a subanalysis of the MITHRAS trial.
Source
International Journal of Cardiovascular Imaging. 39(3) (pp 519-530), 2023.
Date of Publication: March 2023.
Author
Blazek S.; Unterhuber M.; Rommel K.-P.; Kresoja K.-P.; Kister T.; Besler
C.; Fengler K.; Rosch S.; Daehnert I.; Thiele H.; Lurz P.; von Roeder M.
Institution
(Blazek, Unterhuber, Rommel, Kresoja, Kister, Besler, Fengler, Rosch,
Thiele, Lurz, von Roeder) Department of Internal Medicine/Cardiology,
Heart Center Leipzig at Leipzig University, Struempellstrasse 39, Leipzig
04289, Germany
(Rosch, Thiele, Lurz) Leipzig Heart Institute, Leipzig, Germany
(Daehnert) Department of Pediatric Cardiology, Heart Center Leipzig at
Leipzig University, Leipzig, Germany
Publisher
Springer Science and Business Media B.V.
Abstract
Persisting iatrogenic atrial septal defects (iASD) after transcatheter
mitral edge-to-edge repair (M-TEER) are associated with impaired outcomes.
We investigated the natural history of relevant iASDs with left-to-right
shunting post-M-TEER, predictors of spontaneous closure of iASD between 1
and 6 months post-M-TEER, and outcomes (heart failure [HF]
hospitalization) in patients with spontaneous closure versus those with
persistent iASD 6 months post-M-TEER. Patients with a relevant iASD
1-month post-M-TEER, who were treated conservatively in the randomized
controlled MITHRAS trial, underwent clinical follow-up including
transesophageal echocardiography 6 months post-M-TEER. Overall, 36
patients (median 77 [interquartile range 65-81] years; 36% women)
completed the 6-months follow-up. Six (17%) patients had a spontaneous
closure of the iASD. The eccentricity index of the iASD 1-month after
M-TEER was the strongest predictor for spontaneous closure (Odds ratio
3.78; 95% confidence interval 1.26-11.33, p = 0.01) and an eccentricity
index of < 1.9 provided a sensitivity of 77% at a specificity of 83% for
iASD persistence (Area under the curve 0.83, p < 0.001) within 6-months
post M-TEER. At follow-up, a numerical difference in the endpoint of HF
hospitalization between the spontaneous closure and the residual shunt
group (0% vs. 20%, p = 0.25) was observed. The eccentricity of the iASD
was the strongest predictor for spontaneous closure at 1-months and an
eccentricity index of < 1.9 is associated with a high persistence rate for
6 month after M-TEER. Clinical Trial Registration ClinicalTrials.gov
https://clinicaltrials.gov/ct2/show/NCT03024268 Identifier: NCT03024268.
Graphical Abstract: a (red) is reflecting the mayor lengthwise dimension
and b (blue) the mayor oblique dimension. The eccentricity index is
calculated by dividing a through b. (Open circle) is depicting an example
for a round iASD and (Open rhombus) an example for an eccentric iASD 1
month after M-TEER.[Figure not available: see fulltext.]<br/>Copyright
&#xa9; 2022, The Author(s).

<83>
Accession Number
2022850486
Title
Exercise-based cardiac rehabilitation for coronary heart disease: a
meta-analysis.
Source
European Heart Journal. 44(6) (pp 452-469), 2023. Date of Publication: 07
Feb 2023.
Author
Dibben G.O.; Faulkner J.; Oldridge N.; Rees K.; Thompson D.R.; Zwisler
A.-D.; Taylor R.S.
Institution
(Dibben, Taylor) MRC/CSO Social and Public Health Sciences Unit, Institute
of Health and Well Being, University of Glasgow, Glasgow, United Kingdom
(Faulkner) School of Sport, Health and Community, Faculty Health and
Wellbeing, University of Winchester, Winchester, United Kingdom
(Oldridge) College of Health Sciences, University of Wisconsin-Milwaukee,
Milwaukee, WI, United States
(Rees) Division of Health Sciences, Warwick Medical School, University of
Warwick, Coventry, United Kingdom
(Thompson) School of Nursing and Midwifery, Queen's University Belfast,
Belfast, United Kingdom
(Zwisler) REHPA, The Danish Knowledge Centre for Rehabilitation and
Palliative Care, Odense University Hospital, Nyborg, Denmark
(Zwisler) Department of Clinical Research, University of Southern Denmark,
Odense, Denmark
(Zwisler) Department of Cardiology, Odense University Hospital, Odense,
Denmark
(Taylor) Robertson Centre for Biostatistics, Institute of Health and Well
Being, University of Glasgow, Glasgow, United Kingdom
Publisher
Oxford University Press
Abstract
Aims Coronary heart disease is the most common reason for referral to
exercise-based cardiac rehabilitation (CR) globally. However, the
generalizability of previous meta-analyses of randomized controlled trials
(RCTs) is questioned. Therefore, a contemporary updated meta-analysis was
undertaken. Methods Database and trial registry searches were conducted to
September 2020, seeking RCTs of exercise-based interventions with and
results >=6-month follow-up, compared with no-exercise control for adults
with myocardial infarction, angina pectoris, or following coronary artery
bypass graft, or percutaneous coronary intervention. The outcomes of
mortality, recurrent clinical events, and health-related quality of life
(HRQoL) were pooled using random-effects meta-analysis, and
cost-effectiveness data were narratively synthesized. Meta-regression was
used to examine effect modification. Study quality was assessed using the
Cochrane risk of bias tool. A total of 85 RCTs involving 23 430
participants with a median 12-month follow-up were included. Overall,
exercise-based CR was associated with significant risk reductions in
cardiovascular mortality [risk ratio (RR): 0.74, 95% confidence interval
(CI): 0.64-0.86, number needed to treat (NNT): 37], hospitalizations (RR:
0.77, 95% CI: 0.67-0.89, NNT: 37), and myocardial infarction (RR: 0.82,
95% CI: 0.70-0.96, NNT: 100). There was some evidence of significantly
improved HRQoL with CR participation, and CR is cost-effective. There was
no significant impact on overall mortality (RR: 0.96, 95% CI: 0.89-1.04),
coronary artery bypass graft (RR: 0.96, 95% CI: 0.80-1.15), or
percutaneous coronary intervention (RR: 0.84, 95% CI: 0.69-1.02). No
significant difference in effects was found across different patient
groups, CR delivery models, doses, follow-up, or risk of bias. Conclusion
This review confirms that participation in exercise-based CR by patients
with coronary heart disease receiving contemporary medical management
reduces cardiovascular mortality, recurrent cardiac events, and
hospitalizations and provides additional evidence supporting the
improvement in HRQoL and the cost-effectiveness of CR.<br/>Copyright
&#xa9; The Author(s) 2022. Published by Oxford University Press on behalf
of the European Society of Cardiology.

<84>
Accession Number
2021700046
Title
Effects of preoperative intravenous glutamine administration on cardiac
and renal functions in patients undergoing mitral valve replacement
surgeries: A randomized double-blind controlled trial.
Source
Egyptian Journal of Anaesthesia. 39(1) (pp 203-209), 2023. Date of
Publication: 2023.
Author
F. Mostafa M.; Ahmad Ibrahim Elmorabaa H.; Mahmoud Mostafa M.; Mostafa Abd
El Gawad R.; Ismail Seddik M.; Herdan R.; Hassanien Bakr M.; Zarief Kamel
E.
Institution
(F. Mostafa, Ahmad Ibrahim Elmorabaa, Mostafa Abd El Gawad, Herdan,
Hassanien Bakr, Zarief Kamel) Department of Anesthesia and Intensive Care,
Faculty of Medicine, Assiut University, Assiut, Egypt
(Mahmoud Mostafa) Department of Cardiothoracic Surgery, Faculty of
Medicine, Assiut University, Assiut, Egypt
(Ismail Seddik) Department of Clinical Pathology, Faculty of Medicine,
Assiut University, Assiut, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Preoperative poor nutrition greatly raises the risk of
complications and increases length of stay (LOS). Glutamine deficiency may
impair immune functions, reduce myocardial adenosine
triphosphate-adenosine diphosphate (ATP-ADP) substrate and decrease
myocardial glutathione level. We evaluated the effects of preoperative
glutamine administration in patients undergoing mitral valve replacement
surgery upon cardiac and renal outcomes or hospital/ICU LOS.
<br/>Method(s): This prospective randomized double-blinded study included
60 patients above 18 up to 60 years undergoing mitral valve replacement.
For 3 days preoperatively, Group N patients received glutamine
intravenously 0.4 g/kg/day while Group C patients received intravenous
normal saline as placebo. The primary outcome was to assess the effects of
glutamine on cardiac function as reflected on proBNP (brain natriuretic
peptide) during 4 postoperative days. Secondary outcomes included renal
function, vasoactive inotropic score, duration of mechanical ventilation,
and hospital/ICU stays. <br/>Result(s): Postoperative proBNP was
significantly lower in Group N during the entire period. It was
significantly decreased on the first postoperative day in both groups in
comparison to the preoperative values. No significant changes were
recorded regarding renal functions, and duration of mechanical ventilation
between groups. Also, there was signifiacant difference between the two
studied groups regarding the vasoactive inotropic score at the 12th, 18th,
24th and 48th hours with lower scores in Group N. ICU and hospital stays
were significantly lower in Group N than Group C. <br/>Conclusion(s):
Short term of preoperative intravenous glutamine 0.4 g/kg/day decreased
the postoperative proBNP level and hospital/ICU stays in mitral valve
replacement surgery. No significant implication was reported upon
postoperative human NGAL level or kidney functions.<br/>Copyright &#xa9;
2023 The Author(s). Published by Informa UK Limited, trading as Taylor &
Francis Group.

<85>
Accession Number
2021685996
Title
Increased levels of NT-proBNP and troponin T 2 years after coronary artery
bypass grafting complicated by mediastinitis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1008825. Date of Publication: 07 Feb 2023.
Author
Risnes I.; Aukrust P.; Lundblad R.; Rodevand O.; Ueland T.; Rynning S.E.;
Saeed S.
Institution
(Risnes, Lundblad, Rodevand) Department of Cardiac Surgery, LHL Heart
Clinic, Gardermoen, Norway
(Risnes, Lundblad) Department of Thoracic and Cardiovascular Surgery, Oslo
University Hospital, Rikshospitalet, Oslo, Norway
(Risnes, Rynning, Saeed) Department of Heart Disease, Haukeland University
Hospital, Bergen, Norway
(Aukrust, Ueland) Research Institute of Internal Medicine, Oslo University
Hospital, Rikshospitalet, Oslo, Norway
(Aukrust, Ueland) Institute of Clinical Medicine, Faculty of Medicine,
University of Oslo, Oslo, Norway
(Aukrust) Section of Clinical Immunology and Infectious Diseases, Oslo
University Hospital, Rikshospitalet, Oslo, Norway
Publisher
Frontiers Media S.A.
Abstract
Background: Mediastinitis after coronary bypass grafting (CABG) increases
the risk of the internal mammary artery (IMA) graft obstruction, and has a
detrimental effect on long-term survival. The pathogenesis for this
increased mortality is poorly understood. In the present study, we aimed
to investigate the relationship between mediastinitis and persistently
elevated cardiac-specific biomarkers [troponin T (TnT) and N-terminal
pro-brain natriuretic peptide (NT-proBNP)] and C-reactive protein (CRP) at
mid-term follow-up following CABG. <br/>Material(s) and Method(s): The
epidemiologic design was of an exposed (mediastinitis, n = 41) vs.
randomly selected non-exposed (non-mediastinitis) controls (n = 41)
cohort. Serum samples for measurements of NT-proBNP, TnT, and CRP were
obtained at a median follow up time of 2.7 (range 0.5-5.2) years after
CABG surgery. <br/>Result(s): NT-proBNP (mean 65.0 pg/ml vs. 34.8 pg/ml, p
= 0.007) and TnT levels (mean 14.7 ng/L vs. 11.2 ng/L, p = 0.004) were
significantly higher in the mediastinitis group than in the control group.
Patients with mediastinitis had also higher body mass index (BMI) and were
more likely to have diabetes and previous myocardial infarction. There was
no difference in serum CRP level between the groups. After controlling for
potential confounders (previous myocardial infarction, age, and BMI), the
presence of mediastinitis was associated with higher levels of log
NT-proBNP (p = 0.02) and log TnT (p = 0.04). <br/>Conclusion(s):
Mediastinitis increases the concentrations of cardiac-specific biomarkers
NT-proBNP and TnT at mid-term follow-up, representing persistent
myocardial injury and impaired cardiac function.<br/>Copyright &#xa9; 2023
Risnes, Aukrust, Lundblad, Rodevand, Ueland, Rynning and Saeed.

<86>
Accession Number
2021685774
Title
Additional improvement in regional myocardial ischemia after intracardiac
injection of bone marrow cells during CABG surgery.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1040188. Date of Publication: 07 Feb 2023.
Author
Gowdak L.H.W.; Schettert I.T.; Rochitte C.E.; de Carvalho L.P.; Vieira
M.L.C.; Dallan L.A.O.; de Oliveira S.A.; Cesar L.A.M.; Brito J.O.R.;
Guarita-Souza L.C.; de Carvalho A.C.C.; Krieger J.E.
Institution
(Gowdak, Schettert, Rochitte, de Carvalho, Vieira, Dallan, de Oliveira,
Cesar, Krieger) Laboratory of Genetics and Molecular Cardiology, Heart
Institute (InCor-HCFMUSP), University of Sao Paulo Medical School, Sao
Paulo, Brazil
(Brito) Department of Cardiovascular Surgery, National Institute of
Cardiology, Rio de Janeiro, Brazil
(Guarita-Souza) Department of Cardiovascular Surgery, Pontifical Catholic
University of Parana, Curitiba, Brazil
(de Carvalho) Cell Technology Center, National Institute of Cardiology,
Rio de Janeiro, Brazil
(de Carvalho) Carlos Chagas Filho Biophysics Institute, Federal University
of Rio de Janeiro, Rio de Janeiro, Brazil
Publisher
Frontiers Media S.A.
Abstract
Background: Post-procedure residual ischemia is associated with worse
prognosis in patients with coronary artery diasease (CAD).
<br/>Objective(s): We evaluated whether autologous bone marrow-derived
cells (BMC) contribute to additional reduction in regional stress-induced
myocardial ischemia (SIMI) in patients undergoing incomplete coronary
artery bypass graft surgery (CABG). <br/>Method(s): In a double-blind,
randomized, placebo-controlled trial, we enrolled 143 patients (82% men,
58 +/- 11 years) with stable CAD and not candidates for complete CABG.
They received 100 million BMC (n = 77) or placebo (n = 66) injected into
ischemic non-revascularized segments during CABG. The primary outcome was
improvement on SIMI quantified as the area at risk in injected segments
assessed by cardiovascular magnetic resonance (CMR) 1, 6, and 12 months
after CABG. <br/>Result(s): The reduction in global SIMI after CABG was
comparable (p = 0.491) in both groups indicating sustained beneficial
effects of the surgical procedure over 12 month period. In contrast, we
observed additional improvement in regional SIMI in BMC treated group (p =
0.047). Baseline regional SIMI values were comparable [18.5 (16.2-21.0)
vs. 18.5 (16.5-20.7)] and reached the lowest values at 1 month [9.74
(8.25; 11.49) vs. 12.69 (10.84; 14.85)] for BMC and placebo groups,
respectively. The ischemia's improvement from baseline represented a 50%
difference in regional SIMI in favor of the BMC transplanted group at 30
days. We found no differences in clinical and LVEF% between groups during
the 12 month follow-up period. The 1 month rate of major adverse cerebral
and cardiovascular events (MACCE) (p = 0.34) and all-cause mortality (p =
0.08) did not differ between groups 1 month post intervention.
<br/>Conclusion(s): We provided evidence that BMC leads to additional
reduction in regional SIMI in chronic ischemic patients when injected in
segments not subjected to direct surgical revascularization. This adjuvant
therapy deserves further assessment in patients with advanced CAD
especially in those with microcirculation dysfunction. Clinical trial
registration: https://clinicaltrials.gov/, identifier
NCT01727063<br/>Copyright &#xa9; 2023 Gowdak, Schettert, Rochitte, de
Carvalho, Vieira, Dallan, de Oliveira, Cesar, Brito, Guarita-Souza, de
Carvalho and Krieger.

<87>
Accession Number
2022750398
Title
A Prospective Randomized Comparative Study of Oxiport Laryngoscope Blade
versus Miller Laryngoscope Blade for Intubation in Neonates and Infants
during General Anesthesia.
Source
International Journal of Pharmaceutical and Clinical Research. 15(2) (pp
491-496), 2023. Date of Publication: 2023.
Author
Kumar J.; Saurabh K.; Kumar S.
Institution
(Kumar, Saurabh, Kumar) Department of Anesthesiology, IGIMS, Bihar, Patna,
India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Aim: To compare oxiport laryngoscope blade and miller laryngoscope blade
for neonatal and infant intubations. Methodology: This controlled
interventional study conducted in the Department of Anesthesiology, IGIMS,
Bihar for one year in which 120 neonates/infants in groups of 60 each
posted for surgery in paediatric operation theatre over a period of 6
months were included in the study. Patients posted for elective surgery
were assessed during the preanaesthetic check a day prior whereas those
taken up for emergency procedures were assessed on the day of surgery.
Full-term neonates and infants up to 6 months of age of either sex
requiring general anaesthesia with endotracheal intubation for elective as
well as emergency surgery were included in the study. This comprised three
groups: thoracic, abdominal and miscellaneous surgeries. Monitoring used
included electrocardiogram and pulse rate on cardioscope, pulse oximetry,
capnometry, noninvasive BP, nasopharyngeal and skin temperature. For the
purpose of this study to quantify desaturation data, it was graded as mild
desaturation (lowest SpO2 up to 90%), moderate desaturation (lowest SpO2
between 85% and 89%) and severe desaturation (lowest SpO2< 0.05 was
considered as statistically significant. <br/>Result(s): The mean lowest
level of saturation attained in Group O was 98.37% +/- 2.28% as compared
to 97.38% +/- 3.83% in Group M and p value was <0.001 which was
statistically significant. The incidence of mild desaturation (SpO2 up to
90%) was 87.24% in Miller group and 93.75% in Oxiport group. The incidence
of moderate desaturation (SpO2 between 85% and 92.5%) was 3.26% in Miller
group and 6.25% in Oxiport group. Incidence of severe desaturation (SpO2
<85%) was 9.5% in Miller group and 0% in Oxiport group (Chi-square test P
= 0.028). Both groups were comparable with respect to the type of surgery
(abdominal, thoracic, miscellaneous). Abdominal surgeries were associated
with a higher number of severe desaturations (80%) compared to thoracic
(10%) and miscellaneous (10%) surgeries. <br/>Conclusion(s): Apneic
laryngeal oxygen insufflation with Oxiport laryngoscope blade decreases
the incidence and rate of desaturation with a better hemodynamic stability
as compared to Miller blade while intubating neonates and
infants.<br/>Copyright &#xa9; 2023, Dr Yashwant Research Labs Pvt Ltd. All
rights reserved.

<88>
Accession Number
2022914359
Title
Predictors of mitral valve haemodynamics after mitral valve repair for
degenerative mitral regurgitation.
Source
Heart. (no pagination), 2023. Article Number: heartjnl-2022-321753. Date
of Publication: 2023.
Author
Rumman R.K.; Verma S.; Chan V.; Mazer D.; Quan A.; Hibino M.; De Varennes
B.; Chu M.W.A.; Latter D.; Teoh H.; Yanagawa B.; Leong-Poi H.; Connelly
K.A.
Institution
(Rumman, Leong-Poi, Connelly) Department of Medicine, University of
Toronto, Toronto, ON, Canada
(Rumman, Leong-Poi, Connelly) Division of Cardiology, Li Ka Shing
Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
(Verma, Quan, Latter, Teoh, Yanagawa) Division of Cardiac Surgery, Li Ka
Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
(Verma, Latter, Yanagawa) Department of Surgery, University of Toronto,
Toronto, ON, Canada
(Verma, Yanagawa) Department of Pharmacology & Toxicology, University of
Toronto, Toronto, ON, Canada
(Chan) Division of Cardiac Surgery, University of Ottawa, Heart Institute,
Ottawa, ON, Canada
(Chan) School of Epidemiology, Public Health and Preventive Medicine,
University of Ottawa, Ottawa, ON, Canada
(Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute, St.
Michael's Hospital, Toronto, ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Hibino) Division of Cardiothoracic Surgery, Emory University, School of
Medicine, Atlanta, GA, United States
(De Varennes) Division of Cardiac Surgery, Royal Victoria Hospital, McGill
University Health Center, Montreal, QC, Canada
(Chu) Division of Cardiac Surgery, London Health Sciences Centre, Western
University, London, ON, Canada
(Teoh) Division of Endocrinology and Metabolism, Li Ka Shing Knowledge
Institute, St. Michael's Hospital, Toronto, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Objective: Intraoperative predictors of functional mitral valve (MV)
stenosis after surgical repair of mitral regurgitation (MR) caused by
prolapse remain poorly characterised. This study evaluated the effect of
annuloplasty size on postoperative MV haemodynamics during exercise and
evaluated predictors of MV hemodynamics. <br/>Method(s): 104 patients were
randomly assigned to leaflet resection or preservation for surgical repair
of MR in the Canadian Mitral Research Alliance CardioLink-2 study. In this
post hoc analysis, we compared MV haemodynamics between the two surgical
groups and examined the relationship between annuloplasty size and MV
haemodynamics 1 year after repair in the combined groups. Echocardiograms
were performed at baseline and intraoperatively. Exercise transthoracic
echocardiography was performed 1 year postoperatively. Multivariable
linear regression analysis was used to identify predictors of exercise MV
gradients at follow-up. <br/>Result(s): Mean age of participants was
65+/-10 years, and 83% were male. Median annuloplasty size was 34 (IQR
32-36). Dividing by the median, 48 (46%) had annuloplasty size of <34 mm
and 56 (54%) had >=34 mm. Mean and peak exercise gradients at 1 year were
11+/-5 mm Hg and 22+/-9 mm Hg in <34, and 6+/-3 mm Hg and 14+/-5 mm Hg in
>=34 (p<0.001). Rate of residual MR was similar in both groups. In
multivariable analyses, annuloplasty size of >=34 mm was associated with
lower mean and peak exercise gradients at 12 months, after adjustment for
repair type, age, sex, heart rate and body surface area (beta -4.1, 95% CI
-6 to -3, p<0.001, and beta -7 95% CI -10 to -4, p<0.001, respectively).
Intraoperative mean and peak MV gradients by transesophageal
echocardiography independently predicted mean and peak resting and
exercise gradients at follow-up (p<0.001). Similar results were obtained
in both leaflet resection and preservation. <br/>Conclusion(s):
Annuloplasty size of >=34 mm is associated with a 4 and 7 mm Hg reduction
in mean and peak exercise MV gradients, respectively, 1 year post MV
repair regardless of the repair strategy used. Intraoperative TEE MV
gradients predict exercise MV gradients 1 year post repair. Trial
registration number: NCT02552771. <br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<89>
Accession Number
2021698210
Title
Safety outcomes of anti-platelet therapy post coronary artery bypass graft
surgery: A systematic review and network meta-analysis of randomized
control trials.
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
2023.
Author
Hasan S.U.; Pervez A.; Shah A.A.; Shah S.D.A.; Aslam M.; Arshad A.; Rajput
A.S.; Zubair M.M.
Institution
(Hasan, Pervez) Aga Khan University, Karachi, Pakistan
(Shah, Shah, Arshad, Rajput) Dow University of Health Sciences, Karachi,
Pakistan
(Aslam) National Institute of Cardiovascular Diseases, Karachi, Pakistan
(Zubair) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
Publisher
SAGE Publications Ltd
Abstract
Background: Antiplatelet therapy is used to decrease the risk of graft
failure post coronary artery bypass graft surgery. We aimed to compare
dual antiplatelet therapy (DAPT) with monotherapy along with a comparison
of Aspirin, Ticagrelor, Aspirin+Ticagrelor (A+T) and Aspirin+Clopidogrel
(A+C) to determine the major and minor bleeding risk, risk of
postoperative myocardial infarction (MI), stroke, and all-cause mortality
(ACM). <br/>Method(s): Randomized Controlled Trials comparing the four
groups were included. Odds ratio (OR) and Absolute Risk (AR) were employed
to assess the mean and standard deviation (SD) with 95% confidence
intervals (CI). The Bayesian random-effects model was used for statistical
analysis. Risk difference and Cochran Q tests were used to calculate rank
probability (RP) and heterogeneity, respectively. <br/>Result(s): We
included 10 trials, consisting of 21 arms and 3926 patients. For the risk
of major and minor bleed, A + T and Ticagrelor showed the lowest mean
value of 0.040 (0.043) and 0.067 (0.073), respectively, and the highest RP
of being the safest group. While a direct comparison between DAPT and
monotherapy resulted in an OR of 0.57 [0.34, 0.95] for the risk of minor
bleed. A + T was found to have the highest RP and the lowest mean value in
terms of ACM, MI, and stroke. <br/>Conclusion(s): No significant
difference was found between monotherapy or dual-antiplatelet therapy for
the major bleeding risk safety outcome, however DAPT was found to have a
significantly higher rate of minor bleeding complications post-CABG. DAPT
should be considered as the antiplatelet modality of choice
post-CABG.<br/>Copyright &#xa9; The Author(s) 2023.

<90>
Accession Number
2021683875
Title
Role of epicardial adipose tissue in human atrial fibrillation.
Source
Journal of Arrhythmia. (no pagination), 2023. Date of Publication: 2023.
Author
Takahashi N.; Abe I.; Kira S.; Ishii Y.
Institution
(Takahashi, Abe, Kira, Ishii) Department of Cardiology and Clinical
Examination, Oita University Faculty of Medicine, Oita, Japan
Publisher
John Wiley and Sons Inc
Abstract
A recent meta-analysis among which four reports were conducted in Japan
demonstrated that epicardial adipose tissue (EAT) is closely associated
with an increased risk of atrial fibrillation (AF) recurrence after
catheter ablation. We previously investigated the role of EAT in AF in
humans. Left atrial (LA) appendage samples were obtained from AF patients
during cardiovascular surgery. Histologically, the severity of fibrotic
EAT remodeling was associated with LA myocardial fibrosis. Total collagen
in the LA myocardium (i.e., LA myocardial fibrosis) was positively
correlated with proinflammatory and profibrotic cytokines/chemokines,
including interleukin-6, monocyte chemoattractant protein-1, and tumor
necrosis factor-alpha, in EAT. Human peri-LA EAT and abdominal
subcutaneous adipose tissue (SAT) were obtained by autopsy. EAT- or
SAT-derived conditioned medium was applied to the rat LA epicardial
surface using an organo-culture system. EAT-conditioned medium induced
atrial fibrosis in organo-cultured rat atrium. The profibrotic effect of
EAT was greater than that of SAT. The fibrotic area of the organo-cultured
rat atrium treated with EAT from patients with AF was greater than in
patients without AF. Treatment with human recombinant angiopoietin-like
protein 2 (Angptl2) induced fibrosis in organo-cultured rat atrium, which
was suppressed by concomitant treatment with anti-Angptl2 antibody.
Finally, we attempted to detect fibrotic EAT remodeling on computed
tomography (CT) images, which demonstrated that the percent change in EAT
fat attenuation was positively correlated with EAT fibrosis. Based on
these findings, we conclude that the percent change in EAT fat attenuation
determined using CT non-invasively detects EAT remodeling.<br/>Copyright
&#xa9; 2023 The Authors. Journal of Arrhythmia published by John Wiley &
Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.

<91>
Accession Number
2022914673
Title
Role of supplemental regional blocks on postoperative neurocognitive
dysfunction after major non-cardiac surgeries: A systematic review and
meta-analysis of randomized controlled trials.
Source
Regional Anesthesia and Pain Medicine. (no pagination), 2022. Article
Number: rapm-2022-104095. Date of Publication: 2022.
Author
Singh N.P.; Makkar J.K.; Borle A.; Singh P.M.
Institution
(Singh) Department of Anesthesiology, Maharishi Markandeshwar Institute of
Medical Sciences and Research, Haryana, Ambala, India
(Makkar) Department of Anaesthesia and Intensive Care, Post Graduate
Institute of Medical Education and Research, Chandigarh, India
(Borle, Singh) Department of Anesthesiology, Washington University in St
Louis, School of Medicine, St Louis, MO, United States
Publisher
BMJ Publishing Group
Abstract
Background/importance: Postoperative neurocognitive dysfunction (PNCD) is
a frequent and preventable complication after surgery. The large
high-quality evidence for the efficacy of supplemental regional analgesia
blocks (RAB) for preventing PNCD is still elusive. <br/>Objective(s): The
objective of this meta-analysis was to evaluate the effect of RAB versus
standard anesthesia care on the incidence of PNCD in adult patients
undergoing major non-cardiac surgery. Evidence review: PubMed, EMBASE,
Scopus, and the Cochrane Central Registers of Controlled Trials (CENTRAL)
were searched for randomized controlled trials (RCTs) from 2017 until June
2022. The primary outcome was the incidence of PNCD within 1 month of
surgery. A random-effects model with an inverse variance method was used
to pool results, and OR and mean differences were calculated for
dichotomous and continuous outcomes. Various exploratory subgroup analyses
were performed to explore the possibility of the association between the
various patient, technique, and surgery-related factors. Grading of
Recommendation, Assessment, Development, and Evaluation guidelines were
used to determine the certainty of evidence. <br/>Finding(s): Twenty-six
RCTs comprizing 4414 patients were included. The RAB group was associated
with a significant reduction in the incidence of PNCD with an OR of 0.46
(95% CI 0.35 to 0.59; p<0.00001; I2=28%) compared with the control group
(moderate certainty). Subgroup analysis exhibited that the prophylactic
efficacy of RAB persisted for both delirium and delayed neurocognitive
recovery. <br/>Conclusion(s): Current evidence suggests that supplemental
RAB are beneficial in preventing PNCD in patients after major non-cardiac
surgery. PROSPERO registration number: CRD42022338820 <br/>Copyright
&#xa9; American Society of Regional Anesthesia & Pain Medicine 2022. No
commercial re-use. See rights and permissions. Published by BMJ.

<92>
Accession Number
2021563926
Title
Information Needs and Communication Strategies for People with Coronary
Heart Disease: A Scoping Review.
Source
International Journal of Environmental Research and Public Health. 20(3)
(no pagination), 2023. Article Number: 1723. Date of Publication: February
2023.
Author
Zwack C.C.; Smith C.; Poulsen V.; Raffoul N.; Redfern J.
Institution
(Zwack, Redfern) School of Health Sciences, Faculty of Medicine and
Health, University of Sydney, Sydney, NSW 2006, Australia
(Smith) National Heart Foundation of Australia, Brisbane, QLD 4006,
Australia
(Poulsen) National Heart Foundation of Australia, Adelaide, SA 5000,
Australia
(Raffoul) National Heart Foundation Australia, Sydney, NSW 2011, Australia
Publisher
MDPI
Abstract
A critical aspect of coronary heart disease (CHD) care and secondary
prevention is ensuring patients have access to evidence-based information.
The purpose of this review is to summarise the guiding principles,
content, context and timing of information and education that is
beneficial for supporting people with CHD and potential communication
strategies, including digital interventions. We conducted a scoping review
involving a search of four databases (Web of Science, PubMed, CINAHL,
Medline) for articles published from January 2000 to August 2022.
Literature was identified through title and abstract screening by expert
reviewers. Evidence was synthesised according to the review aims. Results
demonstrated that information-sharing, decision-making, goal-setting,
positivity and practicality are important aspects of secondary prevention
and should be patient-centred and evidenced based with consideration of
patient need and preference. Initiation and duration of education is
highly variable between and within people, hence communication and support
should be regular and ongoing. In conclusion, text messaging programs,
smartphone applications and wearable devices are examples of digital
health strategies that facilitate education and support for patients with
heart disease. There is no one size fits all approach that suits all
patients at all stages, hence flexibility and a suite of resources and
strategies is optimal.<br/>Copyright &#xa9; 2023 by the authors.

<93>
Accession Number
2021221557
Title
The GUIDE-HF trial of pulmonary artery pressure monitoring in heart
failure: impact of the COVID-19 pandemic.
Source
European Heart Journal. 43(27) (pp 2603-2618), 2022. Date of Publication:
14 Jul 2022.
Author
Zile M.R.; Desai A.S.; Costanzo M.R.; Ducharme A.; Maisel A.; Mehra M.R.;
Paul S.; Sears S.F.; Smart F.; Chien C.; Guha A.; Guichard J.L.; Hall S.;
Jonsson O.; Johnson N.; Sood P.; Henderson J.; Adamson P.B.; Lindenfeld J.
Institution
(Zile) Division of Cardiology, Department of Medicine, RJH Department of
Veterans Affairs Medical Center, Medical University of South Carolina, SC,
United States
(Desai, Mehra) Cardiovascular Division, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Costanzo) Advocate Heart Institute, Naperville, IL, United States
(Ducharme) Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
(Maisel) University of California San Diego, La Jolla, CA, United States
(Paul) Catawba Valley Health System, Conover, NC, United States
(Sears) East Carolina University, Greenville, NC, United States
(Smart) School of Medicine, Louisiana State University, New Orleans, LA,
United States
(Chien) Division of Cardiology, University of North Carolina, Chapel Hill,
NC, United States
(Guha) Cardiology, Houston Methodist DeBakey Heart and Vascular Center,
Houston, TX, United States
(Guichard) Department of Medicine, Division of Cardiology, Section for
Advanced Heart Failure, Pulmonary Hypertension and Mechanical Circulatory
Support, Prisma Health-Upstate, Greenville, SC, United States
(Hall) Baylor University Medical Center, Dallas, TX, United States
(Jonsson) Sanford Health, Sioux Falls, SD, United States
(Johnson, Sood, Henderson, Adamson) Abbott, Abbott Park, IL, United States
(Lindenfeld) Vanderbilt Heart and Vascular Institute, Nashville, TN,
United States
Publisher
Oxford University Press
Abstract
Aims: During the coronavirus disease 2019 (COVID-19) pandemic, important
changes in heart failure (HF) event rates have been widely reported, but
few data address potential causes for these changes; several possibilities
were examined in the GUIDE-HF study. <br/>Methods and Results: From 15
March 2018 to 20 December 2019, patients were randomized to
haemodynamic-guided management (treatment) vs. control for 12 months, with
a primary endpoint of all-cause mortality plus HF events. Pre-COVID-19,
the primary endpoint rate was 0.553 vs. 0.682 events/patient-year in the
treatment vs. control group [hazard ratio (HR) 0.81, P = 0.049]. Treatment
difference was no longer evident during COVID-19 (HR 1.11, P = 0.526),
with a 21% decrease in the control group (0.536 events/patient-year) and
no change in the treatment group (0.597 events/patient-year). Data
reflecting provider-, disease-, and patient-dependent factors that might
change the primary endpoint rate during COVID-19 were examined. Subject
contact frequency was similar in the treatment vs. control group before
and during COVID-19. During COVID-19, the monthly rate of medication
changes fell 19.2% in the treatment vs. 10.7% in the control group to
levels not different between groups (P = 0.362). COVID-19 was infrequent
and not different between groups. Pulmonary artery pressure area under the
curve decreased -98mmHg-days in the treatment group vs. -100mmHg-days in
the controls (P = 0.867). Patient compliance with the study protocol was
maintained during COVID-19 in both groups. <br/>Conclusion(s): During
COVID-19, the primary event rate decreased in the controls and remained
low in the treatment group, resulting in an effacement of group
differences that were present pre-COVID-19. These outcomes did not result
from changes in provider- or disease-dependent factors; pulmonary artery
pressure decreased despite fewer medication changes, suggesting that
patient-dependent factors played an important role in these
outcomes.<br/>Copyright &#xa9; 2022 The Author(s).

<94>
[Use Link to view the full text]
Accession Number
2022653695
Title
Marginal donors and organ shortness: Concomitant surgical procedures
during heart transplantation: A literature review.
Source
Journal of Cardiovascular Medicine. 23(3) (pp 167-175), 2022. Date of
Publication: 01 Mar 2022.
Author
Piperata A.; Caraffa R.; Bifulco O.; Avesani M.; Apostolo A.; Gerosa G.;
Bottio T.
Institution
(Piperata, Caraffa, Bifulco, Avesani, Gerosa, Bottio) Department of
Cardiac, Thoracic, Vascular, and Public Health Sciences, University of
Padua, Padova, Italy
(Apostolo) Cardiological Unit, Monzino Hospital, University of Milan,
Milan, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Heart transplantation represents the gold standard for end-stage heart
failure. However, due to the increasing demand and the shortage of
available organs, donor supply remains the main limitation. Marginal donor
hearts in high-risk candidates who do not meet standard listing criteria
are the only alternative when life expectancy is limited, but their use is
still debated. Surgical correction of detected coronary lesions or
valvular heart defects allows further enlargement of the number of
available organs.In this article, we offer a literature review on this
topic and report two marginal donor hearts with angiography evidence of
coronary stenosis and preserved ventricular function, which underwent
concomitant myocardial revascularization during heart
implantation.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins.
All rights reserved.

<95>
Accession Number
2020217776
Title
The Efficacy and Safety of Direct Oral Anticoagulants versus Standard of
Care in Patients without an Indication of Anti-Coagulants after
Transcatheter Aortic Valve Replacement: A Meta-Analysis of Randomized
Controlled Trials.
Source
Journal of Clinical Medicine. 11(22) (no pagination), 2022. Article
Number: 6781. Date of Publication: November 2022.
Author
Abuelazm M.; Abdelazeem B.; Katamesh B.E.; Gamal M.; Simhachalam
Kutikuppala L.V.; Kheiri B.; Brasic J.R.; Paul T.K.
Institution
(Abuelazm, Katamesh, Gamal) Faculty of Medicine, Tanta University, Tanta
31527, Egypt
(Abdelazeem) Department of Internal Medicine, McLaren Health Care, Flint,
MI 48532, United States
(Abdelazeem) Department of Internal Medicine, Michigan State University,
East Lansing, MI 48823, United States
(Simhachalam Kutikuppala) Faculty of Modern Medicine, Dr. N.T.R.
University of Health Sciences, Andhra Pradesh, Vijayawada 520008, India
(Kheiri) Electrophysiology and Arrhythmias Service, Division of
Cardiology, Department of Medicine, University of California, San
Francisco, CA 94117, United States
(Brasic) Section of High-Resolution Brain Positron Emission Tomography
Imaging, Division of Nuclear Medicine and Molecular Imaging, The Russell
H. Morgan, Department of Radiology and Radiological Science, The Johns
Hopkins University School of Medicine, Baltimore, MD 21287, United States
(Paul) Department of Clinical Medical Education, The University of
Tennessee Health Sciences Center at Nashville, Nashville, TN 38163, United
States
Publisher
MDPI
Abstract
Transcatheter aortic valve replacement (TAVR) is now considered the
mainstay of aortic stenosis management; however, the optimal
antithrombotic therapy in patent without indications for an oral
anticoagulant (OAC) is yet to be identified. Therefore, we conducted a
systematic review and meta-analysis to evaluate the efficacy and safety of
direct oral anticoagulant (DOAC) treatment versus the standard of care in
patients without indications of OACs after TAVR. We synthesized randomized
controlled trials (RCTs) from Web of Science, SCOPUS, EMBASE, PubMed, and
Cochrane until 18 August 2022. We used the risk ratio (RR) for dichotomous
outcomes with the corresponding 95% confidence interval (CI). We
registered our protocol in PROSPERO with ID: CRD42022357027. Three RCTs
with 2922 patients were identified. DOACs were significantly associated
with higher incidence of all-cause mortality (RR: 1.68 with 95% CI [1.22,
2.30], p = 0.001), mortality due to non-cardiovascular causes (RR: 2.34
with 95% CI [1.36, 4.02], p = 0.002), and the composite outcome of death,
myocardial infarction, or stroke (RR: 1.41 with 95% CI [1.13, 1.76], p =
0.002). However, DOACs were associated with decreased incidence of reduced
leaflet motion (RLM) (RR: 0.19 with 95% CI [0.09, 0.41], p = 0.0001) and
hypoattenuated leaflet thickening (HALT) (RR: 0.50 with 95% CI [0.36,
0.70], p = 0.0001). DOACs were effective to reduce RLM and HALT; however,
the clinical effect of this is still controversial. DOACs were associated
with worse efficacy and safety outcomes, including all-cause mortality.
Further RCTs investigating the optimal antithrombotic regimen after
TAVR.<br/>Copyright &#xa9; 2022 by the authors.

<96>
Accession Number
2018197887
Title
Postoperative Application of Dexmedetomidine is the Optimal Strategy to
Reduce the Incidence of Postoperative Delirium After Cardiac Surgery: A
Network Meta-Analysis of Randomized Controlled Trials.
Source
Annals of Pharmacotherapy. 57(3) (pp 221-231), 2023. Date of Publication:
March 2023.
Author
Shang L.; Hou M.; Guo F.
Institution
(Shang, Hou, Guo) Department of Anesthesiology, The First Affiliated
Hospital of Shandong First Medical University, Shandong Provincial
Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory
Critical Medicine, Shandong, Jinan, China
Publisher
SAGE Publications Inc.
Abstract
Background: Previous pairwise meta-analyses demonstrated the efficacy and
safety of dexmedetomidine in preventing postoperative delirium (POD) after
cardiac surgery; however, the optimal time of applying dexmedetomidine
remains unclear. <br/>Objective(s): This network meta-analysis aimed to
determine the optimal time of using dexmedetomidine to reduce the
incidence of POD following cardiac surgery. <br/>Method(s): We first
retrieved eligible randomized controlled trials (RCTs) from previous
meta-analyses, and then an updated search was performed to identify
additional RCTs in PubMed, Embase, and the Cochrane library from January
1, 2021 to October 31, 2021. Two authors screened literature, collected
data, and evaluated bias risk of eligible studies. Finally, we performed
Bayesian network analysis using R version 3.6.1 with the "gemtc" and
"rjags" package. <br/>Result(s): Eighteen studies with 2636 patients were
included, and all studies were identified from previous meta-analyses.
Results showed that postoperative dexmedetomidine reduced the risk of POD
compared with normal saline (NS) (odds ratio [OR], 0.13; 95% credible
interval [CrI], 0.03-0.35) and propofol (PRO) (OR, 0.19; 95%CrI,
0.04-0.66). Postoperative dexmedetomidine was associated with a lower
incidence of POD compared with perioperative dexmedetomidine (OR, 0.21;
95% CrI, 0.04-0.82). Moreover, postoperative dexmedetomidine had the
highest probability of ranking best (90.98%), followed by intraoperative
dexmedetomidine (46.83%), PRO (36.94%), perioperative dexmedetomidine
(30.85%), and NS (60.02%). Conclusion and Relevance: Dexmedetomidine
reduces the incidence of POD compared with PRO and NS in patients
undergoing cardiac surgery, and postoperative application of
dexmedetomidine is the optimal time.<br/>Copyright &#xa9; The Author(s)
2022.

<97>
Accession Number
2013831529
Title
The impact of del Nido cardioplegia solution on blood morphology
parameters.
Source
Perfusion (United Kingdom). 38(2) (pp 277-284), 2023. Date of Publication:
March 2023.
Author
Sanetra K.; Domaradzki W.; Cisowski M.; Shrestha R.; Bialek K.; Bochenek
A.; Jankowska-Sanetra J.; Pawel Buszman P.; Gerber W.
Institution
(Sanetra, Pawel Buszman) Faculty of Medicine and Health Sciences, Andrzej
Frycz Modrzewski Krakow University, Krakow, Poland
(Sanetra, Domaradzki, Shrestha, Bialek, Bochenek, Gerber) Department of
Cardiac Surgery, American Heart of Poland, Bielsko-Biala, Poland
(Cisowski) Department of Cardiac Surgery, University Hospital, Institute
of Medical Sciences, University of Opole, Opole, Poland
(Bochenek) Faculty of Medicine, University of Technology, Katowice, Poland
(Bochenek, Pawel Buszman) Center for Cardiovascular Research and
Development, American Heart of Poland, Katowice, Poland
(Jankowska-Sanetra, Pawel Buszman) Department of Cardiology, American
Heart of Poland, Bielsko-Biala, Poland
Publisher
SAGE Publications Ltd
Abstract
Background: Crystalloid cardioplegic solutions are believed to reduce
hemoglobin significantly and increase the transfusion rate. However,
recent reports indicate that the del Nido cardioplegia may preserve blood
morphology parameters. <br/>Method(s): In "The del Nido versus cold blood
cardioplegia in aortic valve Replacement" trial patients undergoing aortic
valve replacement were randomized into the del Nido (DN) or cold blood
cardioplegia (CB) group. For the subanalysis, patients who underwent blood
transfusions were excluded from the study. Red blood cell (RBC) count,
hemoglobin, white blood cell (WBC) count and platelet (PLT) count were
measured before the surgery, 24-, 48-, and 96 hours postoperatively.
Furthermore, percental variation in first-last measure was compared in
groups. In addition, indexed normalized ratio (INR) and activated partial
thromboplastin time (aPTT) were compared preoperatively and 24 hours after
the surgery. <br/>Result(s): Eighteen (24%) patients from the del Nido
group and 22 (29.3%) patients from the CB group received blood product
transfusions (p = 0.560) and were excluded from further analysis. As such,
57 patients remained in DN group and 53 patients remained in CB group. No
difference was found in RBC, hemoglobin, WBC, and platelet count in time
intervals. Percental variation in first-last measure revealed higher fall
in RBC (p = 0.0024) and hemoglobin (p = 0.0028) in the CB group. No
difference was shown in preoperative and 24-hour postoperative INR and
aPTT. <br/>Conclusion(s): The del Nido cardioplegia does not decrease
blood morphology parameters when compared to cold blood cardioplegia and
may be used alternatively regardless of bleeding and coagulopathy
risk.<br/>Copyright &#xa9; The Author(s) 2021.

<98>
Accession Number
2022839566
Title
Efficacy of erector spinae plane block for minimally invasive mitral valve
surgery: Results of a double-blind, prospective randomized
placebo-controlled trial.
Source
Journal of Clinical Anesthesia. 86 (no pagination), 2023. Article Number:
111072. Date of Publication: June 2023.
Author
Hoogma D.F.; Van den Eynde R.; Al Tmimi L.; Verbrugghe P.; Tournoy J.;
Fieuws S.; Coppens S.; Rex S.
Institution
(Hoogma, Van den Eynde, Al Tmimi, Coppens, Rex) Department of
Anesthesiology, University Hospitals of Leuven, Leuven, Belgium
(Hoogma, Al Tmimi, Verbrugghe, Coppens, Rex) Department of Cardiovascular
Sciences, Biomedical Sciences Group, University of Leuven, Leuven, Belgium
(Verbrugghe) Department of Cardiac Surgery, University Hospitals of
Leuven, Leuven, Belgium
(Tournoy) Department of Public Health and Primary Care, Geriatric
Medicine, University Hospitals Leuven, Leuven, Belgium
(Fieuws) Leuven Biostatistics and Statistical Bioinformatics Centre
(L-BioStat), Biomedical Sciences Group, University of Leuven, Leuven,
Belgium
Publisher
Elsevier Inc.
Abstract
Study objective: To investigate if an erector spinae plane (ESP) block
decreases postoperative opioid consumption, pain and postoperative nausea
and vomiting in patients undergoing minimally invasive mitral valve
surgery (MIMVS). <br/>Design(s): A single-center, double-blind,
prospective, randomized, placebo-controlled trial. <br/>Setting(s):
Postoperative period; operating room, post-anesthesia care unit (PACU) and
hospital ward in a university hospital. <br/>Patient(s): Seventy-two
patients undergoing video-assisted thoracoscopic MIMVS via right-sided
mini-thoracotomy and enrolled in the institutional enhanced recovery after
cardiac surgery program. <br/>Intervention(s): At the end of surgery, all
patients received an ESP catheter at vertebra T5 under ultrasound guidance
and were randomized to the administration of either ropivacaine 0.5%
(loading of dose 30 ml and three additional doses of 20 ml with a 6 h
interval) or normal saline 0.9% (with an identical administration scheme).
In addition, patients received multimodal postoperative analgesia
including dexamethasone, acetaminophen and patient-controlled intravenous
analgesia with morphine. Following the final ESP bolus and before catheter
removal, the position of the catheter was re-evaluated by ultrasound.
Patients, investigators and medical personnel were blinded for the group
allocation during the entire trial. Measurements: Primary outcome was
cumulative morphine consumption during the first 24 h after extubation.
Secondary outcomes included severity of pain, presence/extent of sensory
block, duration of postoperative ventilation and hospital length of stay.
Safety outcomes comprised the incidence of adverse events. <br/>Main
Result(s): Median (IQR) 24-h morphine consumption was not different
between the intervention- and control-group, 41 mg (30-55) versus 37 mg
(29-50) (p = 0.70), respectively. Likewise, no differences were detected
for secondary and safety endpoints. <br/>Conclusion(s): Following MIMVS,
adding an ESP block to a standard multimodal analgesia regimen did not
reduce opioid consumption and pain scores.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<99>
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. (no pagination), 2023.
Date of Publication: 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. <br/>Aim(s): To examine the comparative
safety and efficacy of both types of VCDs among TAVR recipients.
<br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9; 2023 The Authors.
Catheterization and Cardiovascular Interventions published by Wiley
Periodicals LLC.

<100>
Accession Number
2020848191
Title
Direct oral anticoagulant versus antiplatelet therapy following
transcatheter aortic valve replacement in patients without prior or
concurrent indication for anticoagulation: A meta-analysis of randomized
studies.
Source
Catheterization and Cardiovascular Interventions. 101(2) (pp 449-457),
2023. Date of Publication: 01 Feb 2023.
Author
Barbosa Moreira M.J.; Peixoto N.A.D.A.; Udoma-Udofa O.C.; de Lucena Silva
Araujo S.; Enriquez S.K.T.
Institution
(Barbosa Moreira) Department of Medicine, Federal University of Rio Grande
do Norte, Natal, Brazil
(Peixoto) Department of Medicine, University of Buenos Aires, Buenos
Aires, Argentina
(Udoma-Udofa) Department of Medicine, Federal University of Juiz de Fora,
Juiz de Fora, Brazil
(de Lucena Silva Araujo) Department of Medicine, Federal University of
Pelotas, Pelotas, Brazil
(Enriquez) Hospital de Especialidades Santa Margarita, Portoviejo, Ecuador
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The antithrombotic management following transcatheter aortic
valve replacement (TAVR) in patients who do not have a concurrent
indication for long-term anticoagulation therapy is an ongoing source of
debate. <br/>Method(s): We performed a systematic review and meta-analysis
to compare direct oral anticoagulants (DOACs) versus antiplatelet therapy
after TAVR in patients without a concomitant indication for chronic oral
anticoagulation. PubMed, Embase, and Cochrane databases were searched.
Only randomized controlled trials were included. Risk ratios (RR) with p <
0.05 were considered statistically significant. <br/>Result(s): Three
studies were included, with 2922 patients who underwent TAVR, of whom 1463
(50.1%) received DOACs. Patients who received DOACs therapy had
significantly higher all-cause mortality (RR: 1.68; 95% confidence
intervals [CI]: 1.22-2.30; p = 0.001) and non-cardiovascular mortality
(RR: 2.33; 95% CI: 1.13-4.80; p = 0.02). The incidence of major bleeding
was not significantly different between the groups (5.3% vs. 3.8%; RR:
1.44; 95% CI: 0.90-2.32; p = 0.13). There was no difference between DOACs
and antiplatelet therapy in terms of: ischemic stroke (RR: 1.28; 95% CI:
0.76-2.15; p = 0.35) and cardiovascular mortality (RR: 1.36; 95% CI:
0.92-2.03; p = 0.13). Lastly, the DOACs group had a significantly lower
risk of valve thrombosis than the antiplatelet group (0.8% vs. 3.2%; RR:
0.27; 95% CI: 0.14-0.51; p < 0.0001). <br/>Conclusion(s): In this
meta-analysis of randomized studies comparing DOACs to antiplatelet
therapy after TAVR in patients without a concomitant indication for
anticoagulation, DOACs were associated with a lower incidence of valve
thrombosis and a higher rate of all-cause mortality, driven by an increase
in noncardiac causes of death.<br/>Copyright &#xa9; 2022 Wiley Periodicals
LLC.

<101>
Accession Number
2020719371
Title
Design and logistical considerations for the randomized adaptive
non-inferiority storage-duration-ranging CHIlled Platelet Study.
Source
Clinical Trials. 20(1) (pp 36-46), 2023. Date of Publication: February
2023.
Author
Zantek N.D.; Steiner M.E.; VanBuren J.M.; Lewis R.J.; Berry N.S.; Viele
K.; Krachey E.; Dean J.M.; Nelson S.; Spinella P.C.
Institution
(Zantek) Department of Laboratory Medicine and Pathology, University of
Minnesota, Minneapolis, MN, United States
(Steiner) Department of Pediatrics, University of Minnesota, Minneapolis,
MN, United States
(VanBuren, Dean) Department of Pediatrics, University of Utah, Salt Lake
City, UT, United States
(Lewis) Harbor-UCLA Medical Center, Torrance, CA, United States
(Lewis) David Geffen School of Medicine at UCLA, Los Angeles, CA, United
States
(Lewis, Berry, Viele, Krachey) Berry Consultants, Austin, TX, United
States
(Nelson) Fine Point Pharma LLC, Durham, NC, United States
(Spinella) Department of Surgery and Critical Care Medicine, University of
Pittsburgh, Pittsburgh, PA, United States
Publisher
SAGE Publications Ltd
Abstract
Background: Platelet transfusion is a potentially life-saving therapy for
actively bleeding patients, ranging from those undergoing planned surgical
procedures to those suffering unexpected traumatic injuries. Platelets are
currently stored at room temperature (20degreeC-24degreeC) with a maximum
storage duration of 7 days after donation. The CHIlled Platelet Study
trial will compare the efficacy and safety of standard room
temperature-stored platelets with platelets that are cold-stored
(1degreeC-6degreeC), that is, chilled, with a maximum of storage up to 21
days in adult and pediatric patients undergoing complex cardiac surgical
procedures. Methods/Results: CHIlled Platelet Study will use a Bayesian
adaptive design to identify the range of cold storage durations for
platelets that are non-inferior to standard room temperature-stored
platelets. If cold-stored platelets are non-inferior at durations greater
than 7 days, a gated superiority analysis will identify durations for
which cold-stored platelets may be superior to standard platelets. We
present example simulations of the CHIlled Platelet Study design and
discuss unique challenges in trial implementation. The CHIlled Platelet
Study trial has been funded and will be implemented in approximately 20
clinical centers. Early randomization to enable procurement of cold-stored
platelets with different storage durations will be required, as well as a
platelet tracking system to eliminate platelet wastage and maximize trial
efficiency and economy. <br/>Discussion(s): The CHIlled Platelet Study
trial will determine whether cold-stored platelets are non-inferior to
platelets stored at room temperature, and if so, will determine the
maximum duration (up to 21 days) of storage that maintains
non-inferiority. Trial registration: ClinicalTrials.gov,
NCT04834414<br/>Copyright &#xa9; The Author(s) 2022.

<102>
Accession Number
2020213763
Title
Postoperative delirium after transcatheter aortic valve replacement: An
updated systematic review and meta-analysis.
Source
Journal of the American Geriatrics Society. 71(2) (pp 646-660), 2023. Date
of Publication: February 2023.
Author
Ma X.; Chu H.; Han K.; Shao Q.; Yu Y.; Jia S.; Wang D.; Wang Z.; Zhou Y.
Institution
(Ma, Han, Shao, Yu, Jia, Wang, Zhou) Department of Cardiology, Beijing
Anzhen Hospital, Capital Medical University, Beijing, China
(Chu, Wang) Department of Anesthesia, Qingdao Women and Children's
Hospital, Qingdao University, Qingdao, China
Publisher
John Wiley and Sons Inc
Abstract
Aims: To perform an updated systematic review and meta-analysis of
postoperative delirium (POD) after transcatheter aortic valve replacement
(TAVR). <br/>Method(s): We conducted a systematic literature search of
PubMed, Embase, and Cochrane Library databases from the time of the first
human TAVR procedure in 2002 until December 24, 2021, which was
supplemented by manual searches of bibliographies. Data were collected on
incidence rates, risk factors, and/or associated mortality of POD after
TAVR. Pooled analyses were conducted using random effects models to yield
mean differences, odds ratios, hazard ratios, and risk ratios, with 95%
confidence intervals. <br/>Result(s): A total of 70 articles (69 studies)
comprising 413,389 patients were included. The study heterogeneity was
substantial. The pooled mean incidence of POD after TAVR in all included
studies was 9.8% (95% CI: 8.7%-11.0%), whereas that in studies using
validated tools to assess for delirium at least once a day for at least 2
consecutive days after TAVR was 20.7% (95% CI: 17.8%-23.7%). According to
the level of evidence and results of meta-analysis, independent
preoperative risk factors with a high level of evidence included increased
age, male sex, prior stroke or transient ischemic attack, atrial
fibrillation/flutter, weight loss, electrolyte abnormality, and impaired
Instrumental Activities of Daily Living; intraoperative risk factors
included non-transfemoral access and general anesthesia; and acute kidney
injury was a postoperative risk factor. POD after TAVR was associated with
significantly increased mortality (pooled unadjusted RR: 2.20, 95% CI:
1.79-2.71; pooled adjusted RR: 1.62, 95% CI: 1.25-2.10), particularly
long-term mortality (pooled unadjusted HR: 2.84, 95% CI: 1.91-4.23; pooled
adjusted HR: 1.88, 95% CI: 1.30-2.73). <br/>Conclusion(s): POD after TAVR
is common and is associated with an increased risk of mortality. Accurate
identification of risk factors for POD after TAVR and implementation of
preventive measures are critical to improve prognosis.<br/>Copyright
&#xa9; 2022 The American Geriatrics Society.

<103>
Accession Number
2021648489
Title
Clinical Outcomes by Consolidation of Bone Marrow Stem Cell Therapy and
Coronary Artery Bypass Graft in Patients With Heart Failure With Reduced
Ejection Fraction: A Meta-analysis.
Source
Cell Transplantation. 32 (no pagination), 2023. Date of Publication:
January-December 2023.
Author
Jiang Y.; Yang Z.; Shao L.; Shen H.; Teng X.; Chen Y.; Ding Y.; Fan J.; Yu
Y.; Shen Z.
Institution
(Jiang, Yang, Shao, Shen, Teng, Chen, Ding, Fan, Yu, Shen) Department of
Cardiovascular Surgery of the First Affiliated Hospital & Institute for
Cardiovascular Science, Soochow University, Suzhou, China
Publisher
SAGE Publications Ltd
Abstract
Bone marrow stem cell (BMSC) transplantation during coronary artery bypass
graft (CABG) is an innovative treatment for ischemic heart disease (IHD).
We conduct a meta-analysis to examine whether patients with IHD presenting
heart failure with reduced ejection fraction (HFrEF) can be beneficent
from CABG with additional BMSC transplantation. Electronic searches were
performed on PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov from
their inception to July 2021. The efficacy was based on left ventricular
ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD),
left ventricular end-diastolic volume (LVEDV), left ventricular
end-diastolic volume index (LVEDVi), left ventricular end-systolic volume
index (LVESVi), and 6-min walk test (6MWT) change after treatment. Eight
randomized-controlled trials (RCTs) were included in this meta-analysis,
with a total of 350 patients. Results showed BMSC transplantation
significantly improved the LVEF [mean difference (MD) = 6.23%, 95%
confidence interval (CI): 3.22%-9.24%, P < 0.0001], LVEDVi (MD = -20.15
ml/m², 95% CI: -30.49 to -9.82 ml/m², P < 0.00001),
and LVESVi (MD = -17.69 ml/m², 95% CI: -25.24 to -10.14
ml/m², P < 0.00001). There was no statistically significant
difference in the improvement of LVEDD, LVEDV, and 6MWT between the cell
transplantation group and control groups. Subgroup analysis revealed that
the intervention for control group could affect the efficacy of BMSC
transplantation. Sensitivity analysis found the conclusion of LVEDD,
LVEDV, and 6MWT changes was not stable. Therefore, among patients with IHD
presenting HFrEF, BMSC transplantation during CABG is promising to be
beneficial for postoperative left ventricular (LV) function improvement.
However, according to the unstable results of the sensitivity analysis, it
cannot be concluded whether the extra step has a positive effect on left
ventricular remodeling and exercise capacity. RCTs with larger cohorts and
more strict protocols are needed to validate these
conclusions.<br/>Copyright &#xa9; The Author(s) 2023.

<104>
Accession Number
2022720383
Title
A Prospective Randomized Comparative Study of Anaesthetic and Analgesic
Advantages of Dexmedetomidine Versus Saline Infusion for Spine Surgery in
Prone Position Under General Anaesthesia.
Source
International Journal of Pharmaceutical and Clinical Research. 14(12) (pp
815-820), 2022. Date of Publication: 2022.
Author
Helawar S.; Nadkarni M.; Sudha Shree P.; Prakash K.S.
Institution
(Helawar, Sudha Shree, Prakash) Department of Anaesthesia, Kanachur
Institute of Medical Sciences, Karnataka, Mangalore, India
(Nadkarni) Department of Anaesthesia, Seth Gordhandas Sunderdas Medical
College and the King Edward Memorial Hospital, Maharashtra, Mumbai, India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Background: In this study, we wanted to evaluate the anaesthetic and
analgesic advantages of dexmedetomidine with that of saline infusion for
spine surgery in prone position under general anaesthesia. <br/>Method(s):
This was a hospital based randomized prospective comparative study
conducted among 60 patients who presented with thoracic spine surgeries of
duration 3-4 hours under general anaesthesia, in the Department of General
Anaesthesia in Seth G S Medical College, KEM Hospital, Mumbai from 2013 to
2014 after obtaining clearance from Institutional Ethics Committee and
written informed consent from the study participants. <br/>Result(s): The
sex distribution in both the groups was analysed using Pearson chi square
test and the difference was not statistically significant. The mean
isoflurane requirement in group D was 0.89+/-0.14 whereas that in group C
was 1.04+/-0.11. The difference in mean was statistically significant with
p value < 0.001. This shows that dexmedetomidine infusion in group D
decreases the isoflurane requirement. Inj. vecuronium in group D patient
was 12+/- 1.64 mg and that in group C patients was 13.66+/-1.21mg. There
was statistically significant difference in the requirement of Inj.
vecuronium between two groups. Less requirement of Inj. vecuronium in
group D patients indicated that dexmedetomidine infusion decreases the
requirement of Inj. vecuronium. The mean requirement of injection fentanyl
in group D patients was 140.33+/-17.90^gm where in as that in group C
patients was 117.50+/-29.07^gm. There was statistically significant
difference in fentanyl requirement between both the groups with p value <
0.001. Decrease in the requirement of Inj. fentanyl in group D patients
was because of analgesic action of dexmedetomidine infusion. No difference
was seen with regard to requirement of Inj. atropine between two groups.
Inj. Ephedrine requirement was compared between group D and group C using
Chi square test. There was no significant difference in the requirement of
Inj. Ephedrine. <br/>Conclusion(s): Dexmedetomidine attenuates the
pressure response to laryngoscopy, incision and extubation.
Dexmedetomidine's hypotensive effect reduces the bleeding at surgical
site. We can conclude that dexmedetomidine infusion is good anaesthetic
adjuvant in spine surgery under general anaesthesia in view of its
hemodynamic stability, anaesthetic and analgesic sparing
effect.<br/>Copyright &#xa9; 2022, Dr Yashwant Research Labs Pvt Ltd. All
rights reserved.

<105>
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. (no pagination), 2023.
Date of Publication: 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.<br/>Copyright &#xa9; 2023 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<106>
Accession Number
2021671524
Title
Ultrafiltration in cardiac surgery: Results of a systematic review and
meta-analysis.
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
2023.
Author
Hensley N.B.; Colao J.A.; Zorrilla-Vaca A.; Nanavati J.; Lawton J.S.;
Raphael J.; Mazzeffi M.A.; Wierschke C.; Kostibas M.P.; Cho B.C.; Frank
S.M.; Grant M.C.
Institution
(Hensley, Colao, Kostibas, Cho, Frank, Grant) Department of Anesthesiology
and Critical Care Medicine, Johns Hopkins University School of Medicine,
Baltimore, MD, United States
(Zorrilla-Vaca) Department of Anesthesiology, Perioperative and Pain
Medicine, Brigham and Women's Hospital, Boston, MA, United States
(Nanavati) Welch Medical Library, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Lawton) Department of Surgery, Division of Cardiac Surgery, Johns Hopkins
University School of Medicine, Baltimore, MD, United States
(Raphael) Sidney Kimmel Medical College, Department of Anesthesiology,
Thomas Jefferson University Hospitals, Philadelphia, PA, United States
(Mazzeffi) Department of Anesthesiology, George Washington University
Hospital, Washington, DC, United States
(Wierschke) Department of Surgery, Perfusion Division, Johns Hopkins
Hospital, Baltimore, MD, United States
Publisher
SAGE Publications Ltd
Abstract
Background: Ultrafiltration is used with cardiopulmonary bypass to reduce
the effects of hemodilution and restore electrolyte balance. We performed
a systematic review and meta-analysis to analyze the effect of
conventional and modified ultrafiltration on intraoperative blood
transfusion. <br/>Method(s): Utilizing the Preferred Reporting Items for
Systematic Reviews and Meta-Analysis (PRISMA) statement, we systematically
searched MEDLINE, EMBASE, Web of Science, and Cochrane Library to perform
a meta-analysis of studies of randomized controlled trials (RCTs) and
observational studies evaluating conventional ultrafiltration (CUF) and
modified ultrafiltration (MUF) on the primary outcome of intraoperative
red cell transfusions. <br/>Result(s): A total of 7 RCTs (n = 928) were
included, comparing modified ultrafiltration (n = 473 patients) to
controls (n = 455 patients) and 2 observational studies (n = 47,007),
comparing conventional ultrafiltration (n = 21,748) to controls (n =
25,427). Overall, MUF was associated with transfusion of fewer
intraoperative red cell units per patient (n = 7); MD -0.73 units; 95% CI
-1.12 to -0.35 p = 0.04; p for heterogeneity = 0.0001, I² =
55%) compared to controls. CUF was no difference in intraoperative red
cell transfusions compared to controls (n = 2); OR 3.09; 95% CI
0.26-36.59; p = 0.37; p for heterogeneity = 0.94, I² = 0%.
Review of the included observational studies revealed an association
between larger volumes (>2.2 L in a 70 kg patient) of CUF and risk of
acute kidney injury (AKI). <br/>Conclusion(s): The results of this
systematic review and meta-analysis suggest that MUF is associated with
fewer intraoperative red cell transfusions. Based on limited studies, CUF
does not appear to be associated with a difference in intraoperative red
cell transfusion.<br/>Copyright &#xa9; The Author(s) 2023.

<107>
Accession Number
2021650995
Title
Efficacy of propofol-supplemented cardioplegia on biomarkers of organ
injury in patients having cardiac surgery using cardiopulmonary bypass: A
protocol for a randomised controlled study (ProMPT2).
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
2023.
Author
Heys R.; Angelini G.D.; Joyce K.; Smartt H.; Culliford L.; Maishman R.; de
Jesus S.E.; Emanueli C.; Suleiman M.-S.; Punjabi P.; Rogers C.A.; Gibbison
B.
Institution
(Heys, Joyce, Smartt, Culliford, Maishman, de Jesus, Rogers) Bristol
Trials Centre, Bristol Medical School, University of Bristol, Bristol,
United Kingdom
(Angelini, Suleiman) Bristol Heart Institute, University of Bristol,
Bristol, United Kingdom
(Emanueli, Punjabi) National Heart and Lung Institute, Hammersmith
Hospital, London, United Kingdom
(Gibbison) Department of Anaesthesia, University Hospitals Bristol and
Weston NHS Foundation Trust, Bristol, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Introduction: Cardiac surgery with cardiopulmonary bypass and cardioplegic
arrest is known to be responsible for ischaemia and reperfusion organ
injury. In a previous study, ProMPT, in patients undergoing coronary
artery bypass or aortic valve surgery we demonstrated improved cardiac
protection when supplementing the cardioplegia solution with propofol (6
mcg/ml). The aim of the ProMPT2 study is to determine whether higher
levels of propofol added to the cardioplegia could result in increased
cardiac protection. Methods and Analysis: The ProMPT2 study is a
multi-centre, parallel, three-group, randomised controlled trial in adults
undergoing non-emergency isolated coronary artery bypass graft surgery
with cardiopulmonary bypass. A total of 240 patients will be randomised in
a 1:1:1 ratio to receive either cardioplegia supplementation with high
dose of propofol (12 mcg/ml), low dose of propofol (6 mcg/ml) or placebo
(saline). The primary outcome is myocardial injury, assessed by serial
measurements of myocardial troponin T up to 48 hours after surgery.
Secondary outcomes include biomarkers of renal function (creatinine) and
metabolism (lactate). Ethics and Dissemination: The trial received
research ethics approval from South Central - Berkshire B Research Ethics
Committee and Medicines and Healthcare products Regulatory Agency in
September 2018. Any findings will be shared though peer-reviewed
publications and presented at international and national meetings.
Participants will be informed of results through patient organisations and
newsletters. Trial Registration: ISRCTN15255199. Registered in March
2019.<br/>Copyright &#xa9; The Author(s) 2023.

<108>
Accession Number
640378701
Title
Direct oral anticoagulants versus vitamin K antagonists in patients with
atrial fibrillation and bioprosthetic valves: a systematic review and
meta-analysis.
Source
Revista espanola de cardiologia (English ed.). (no pagination), 2023.
Date of Publication: 17 Feb 2023.
Author
Martinez P.G.; Toscano A.L.A.; Mayoral M.A.M.; Miralles J.M.
Institution
(Martinez) Servicio de Cardiologia, Hospital Costa del Sol, Marbella,
Malaga, Spain. Electronic address: paulaguardia@gmail.com
(Toscano) Servicio de Cardiologia, Hospital de la Serrania de Ronda,
Ronda, Malaga, Spain
(Mayoral, Miralles) Departamento de Estadistica, Matematicas e
Informatica, Universidad Miguel Hernandez, Elche, Alicante, Spain
Publisher
NLM (Medline)
Abstract
INTRODUCTION AND OBJECTIVES: Direct oral anticoagulant (DOAC) therapy has
been shown to be safe and effective in patients with atrial fibrillation
(AF). However, outcomes in AF patients with bioprosthetic valves are
unclear, as this population has been underrepresented in clinical trials.
The aim of this study was to assess the safety and efficacy of DOACs in
this population based on the existing published literature.
<br/>METHOD(S): A systematic search and review were conducted to identify
randomized clinical trials and comparative observational studies published
from 2017 to January 2022 that compared DOACs and vitamin K antagonists
(VKAs) in AF patients with bioprosthetic valves. Hazard ratios (HR) were
collected to compare the 2 treatments in terms of cardiovascular and
all-cause mortality, stroke/systemic embolism, and major bleeding. A
meta-analysis combining the results was performed. <br/>RESULT(S): We
included 12 studies (30283 patients). DOACs and VKAs were compared based
on HRs at the 95% confidence interval. DOAC therapy was associated with a
significant 9% reduction in all-cause mortality (HR,0.91; 95%CI,
0.85-0.97; P=.0068; I2=8%), with no significant differences in the risk of
stroke/systemic embolism (HR,0.87; 95%CI, 0.67-1.14; P=.29; I2=45%) or
major bleeding (HR,0.82; 95%CI, 0.67-1.00; P=.054; I2=48.7%).
<br/>CONCLUSION(S): DOAC therapy in AF patients with bioprosthetic valves
may be associated with a significant reduction in all-cause mortality,
with no reduction in the efficacy of stroke/systemic embolism prevention
or increase in major bleeding risk.<br/>Copyright &#xa9; 2023. Published
by Elsevier Espana, S.L.U.

<109>
Accession Number
640378285
Title
Naltrexone-bupropion combinations do not affect cocaine
self-administration in humans.
Source
Pharmacology, biochemistry, and behavior. (pp 173526), 2023. Date of
Publication: 17 Feb 2023.
Author
Regnier S.D.; Stoops W.W.; Lile J.A.; Alcorn J.L.; Bolin B.L.; Reynolds
A.R.; Hays L.R.; Rayapati A.O.; Rush C.R.
Institution
(Regnier, Alcorn, Bolin, Reynolds) Department of Behavioral Science,
University of Kentucky College of Medicine, Medical Behavioral Science
Building, 1100 Veterans Drive, Lexington, United States
(Stoops) Department of Behavioral Science, University of Kentucky College
of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building,
Lexington, KY 40536-0086, USA; Department of Psychiatry, University of
Kentucky College of Medicine, 245 Fountain Court, Lexington, KY
40509-1810, USA; Department of Psychology, University of Kentucky College
of Arts and Sciences, 171. Funkhouser Drive, Lexington, KY 40506-0044,
USA; Center on Drug and Alcohol Research, University of Kentucky College
of Medicine, 845 Angliana Ave, Lexington, KY 40508, USA
(Lile, Rush) Department of Behavioral Science, University of Kentucky
College of Medicine, 1100 Veterans Drive, Medical Behavioral Science
Building, Lexington, KY 40536-0086, USA; Department of Psychiatry,
University of Kentucky College of Medicine, 245 Fountain Court, Lexington,
KY 40509-1810, USA; Department of Psychology, University of Kentucky
College of Arts and Sciences, 171. Funkhouser Drive, Lexington, KY
40506-0044, USA
(Hays, Rayapati) Department of Psychiatry, University of Kentucky College
of Medicine, 245 Fountain Court, Lexington, United States
Publisher
NLM (Medline)
Abstract
The FDA has not yet approved a pharmacotherapy for cocaine use disorder
despite nearly four decades of research. This study determined the initial
efficacy, safety, and tolerability of naltrexone-bupropion combinations as
a putative pharmacotherapy for cocaine use disorder. Thirty-one (31)
non-treatment seeking participants with cocaine use disorder completed a
mixed-design human laboratory study. Participants were randomly assigned
to the naltrexone conditions (i.e., 0, 50mg/day; between-subject factor)
and maintained on escalating doses of bupropion (i.e., 0, 100, 200,
400mg/day; within-subject factor) for at least four days prior to the
conduct of experimental sessions. Cocaine self-administration (IN, 0, 40,
80mg) was then determined using a modified progressive ratio and relapse
procedure. Subjective and cardiovascular effects were also measured.
Cocaine produced prototypical dose-related increases in
self-administration, subjective outcomes (e.g., "Like Drug"), and
cardiovascular indices (e.g., heart rate, blood pressure) during placebo
maintenance. Naltrexone and bupropion alone, or in combination, did not
significantly decrease self-administration on either procedure. Low doses
of bupropion (i.e., 100mg) blunted the effects of the cocaine on
subjective measures of "Like Drug" and "Stimulated". No unexpected adverse
effects were observed with naltrexone and bupropion, alone and combined,
in conjunction with cocaine. Together, these results do not support the
use of these bupropion-naltrexone combinations for the treatment of
cocaine use disorder. Future research should determine if novel drug
combinations may decrease cocaine self-administration.<br/>Copyright
&#xa9; 2023. Published by Elsevier Inc.

<110>
Accession Number
640377479
Title
Anterolateral Territory Coronary Artery Bypass Grafting Strategies: A
Non-Inferiority Randomized Clinical Trial: The AMI-PONT Trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2023.
Date of Publication: 20 Feb 2023.
Author
Stevens L.-M.; Chartrand-Lefebvre C.; Mansour S.; Beland V.; Soulez G.;
Forcillo J.; Basile F.; Prieto I.; Noiseux N.
Institution
(Stevens, Forcillo, Basile, Prieto, Noiseux) Division of Cardiac Surgery,
Centre Hospitalier de l'Universite de Montreal CHUM Research Centre
(CRCHUM), Montreal, QC, Canada
(Stevens, Chartrand-Lefebvre, Mansour, Beland, Soulez, Forcillo, Noiseux)
Centre Hospitalier de l'Universite de Montreal CHUM Research Centre
(CRCHUM), Montreal, QC, Canada
(Chartrand-Lefebvre, Soulez) Department of Radiology, Centre Hospitalier
de l'Universite de Montreal CHUM Research Centre (CRCHUM), Montreal, QC,
Canada
(Mansour) Division of Cardiology, Centre Hospitalier de l'Universite de
Montreal CHUM Research Centre (CRCHUM), Montreal, QC, Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The main objective was to assess whether a composite coronary
artery bypass grafting strategy including a saphenous vein graft bridge to
distribute left internal mammary artery outflow provides non-inferior
patency rates compared to conventional grafting surgery with separated
left internal mammary artery to left anterior descending coronary graft
and aorto-coronary saphenous vein grafts to other anterolateral targets.
<br/>METHOD(S): All patients underwent isolated grafting surgery with
cardiopulmonary bypass and received >=2 grafts/patients on the
anterolateral territory. The graft patency (i.e., non-occluded) was
assessed using multislice spiral computed tomography at one year.
<br/>RESULT(S): From 2012 to 2021, 208 patients were randomized to a
bridge (n=105) or conventional grafting strategy (n=103). Patient
characteristics were comparable between groups. The anterolateral graft
patency was non-inferior in the composite bridge compared to conventional
grafting strategy at one year (risk difference: 0.7% (90% CI -4.8%,
6.2%)). The graft patency to the left anterior descending coronary was no
different between groups (p=0.175). Intraoperatively, the bridge group
required shorter vein length for anterolateral targets (p<0.001) and
exhibited greater Doppler flow in the mammary artery pedicle (p=0.004).
The composite outcome of death, myocardial infarction or target vessel
reintervention at 30days was no different (p=0.164). <br/>CONCLUSION(S):
Anterolateral graft patency of the composite bridge grafting strategy is
non-inferior to the conventional grafting strategy at one year. This novel
grafting strategy is safe, efficient, associated with several advantages
including better mammary artery flow and shorter vein requirement, and
could be a valuable alternative to conventional grafting strategies.
Ten-year clinical follow-up is underway. TRIAL REGISTRATION:
ClinicalTrials.gov: NCT01585285.<br/>Copyright &#xa9; The Author(s) 2023.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<111>
Accession Number
640372908
Title
Transcatheter Aortic Valve Replacement (TAVR)-associated Acute Kidney
Injury: An Update.
Source
Cardiorenal medicine. (no pagination), 2023. Date of Publication: 17 Feb
2023.
Author
Rivera F.B.; Al-Abcha A.; Ansay M.F.M.; Magalong J.V.U.; Tang V.A.S.; Ona
H.M.; Miralles K.A.; Sausa R.; Uy R.A.F.; Lerma E.V.; Collado F.M.S.;
McCullough P.A.; Volgman A.S.
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter Aortic Valve Replacement (TAVR) is a relatively
novel minimally invasive procedure for the treatment of symptomatic
patients with severe aortic stenosis. Although it has been proven
effective in improving mortality and quality of life, TAVR is associated
with serious complications, such as acute kidney injury (AKI). SUMMARY:
TAVR-associated AKI is likely due to several factors such as sustained
hypotension, transapical approach, volume of contrast use and baseline low
GFR. This narrative review aims to present an overview of the latest
literature and evidence regarding the definition of TAVR-associated AKI,
its risk factors, and its impact on morbidity and mortality. The review
used a systematic search strategy with multiple health-focused databases
(Medline, EMBASE), and identified 8 clinical trials and 27 observational
studies concerning TAVR-associated AKI. Results showed that
TAVR-associated AKI is linked to several modifiable and non-modifiable
risk factors, and is associated with higher mortality. A variety of
diagnostic imaging modalities have the potential to identify patients at
high-risk for development of TAVR-AKI; however, there are no existing
consensus recommendations regarding their use as of this time. The
implications of these findings highlight the importance of identifying
high-risk patients for which preventive measures may play a crucial role,
and should be maximized. KEY MESSAGE: This study reviews the current
understanding of TAVR-associated AKI including its pathophysiology, risk
factors, diagnostic modalities, and preventative management for
patients.<br/>Copyright The Author(s). Published by S. Karger AG, Basel.

<112>
Accession Number
640372770
Title
Diuresis-matched versus standard hydration in patients undergoing
percutaneous cardiovascular procedures: meta-analysis of randomized
clinical trials.
Source
Revista espanola de cardiologia (English ed.). (no pagination), 2023.
Date of Publication: 16 Feb 2023.
Author
Occhipinti G.; Laudani C.; Spagnolo M.; Greco A.; Capodanno D.
Institution
(Occhipinti, Laudani, Spagnolo, Greco, Capodanno) Division of Cardiology,
University of Catania, Catania, Italy
Publisher
NLM (Medline)
Abstract
INTRODUCTION AND OBJECTIVES: Contrast-associated acute kidney injury
(CA-AKI) is a potential complication of procedures requiring
administration of iodinated contrast medium. RenalGuard, which provides
real-time matching of intravenous hydration with furosemide-induced
diuresis, is an alternative to standard periprocedural hydration
strategies. The evidence on RenalGuard in patients undergoing percutaneous
cardiovascular procedures is sparse. We used a Bayesian framework to
perform a meta-analysis of RenalGuard as a CA-AKI preventive strategy.
<br/>METHOD(S): We searched Medline, Cochrane Library and Web of Science
for randomized trials of RenalGuard vs standard periprocedural hydration
strategies. The primary outcome was CA-AKI. Secondary outcomes were
all-cause death, cardiogenic shock, acute pulmonary edema, and renal
failure requiring renal replacement therapy. A Bayesian random-effect risk
ratio (RR) with corresponding 95% credibility interval (95%CrI) was
calculated for each outcome. PROSPERO database number CRD42022378489.
<br/>RESULT(S): Six studies were included. RenalGuard was associated with
a significant relative reduction in CA-AKI (median RR, 0.54; 95%CrI,
0.31-0.86) and acute pulmonary edema (median RR, 0.35; 95%CrI, 0.12-0.87).
No significant differences were observed for the other secondary endpoints
[all-cause death (RR, 0.13; 95%CrI, 0.13-1.08), cardiogenic shock (RR,
0.06; 95%CrI, 0.00-1.91), and renal replacement therapy (RR, 0.52; 95%CrI,
0.18-1.18)]. The Bayesian analysis also showed that RenalGuard had a high
probability of ranking first for all the secondary outcomes. These results
were consistent in multiple sensitivity analyses. <br/>CONCLUSION(S): In
patients undergoing percutaneous cardiovascular procedures, RenalGuard was
associated with a reduced risk of CA-AKI and acute pulmonary edema
compared with standard periprocedural hydration strategies.<br/>Copyright
&#xa9; 2023. Published by Elsevier Espana, S.L.U.

<113>
Accession Number
640371516
Title
The platelet to lymphocyte ratio in heart failure: a comprehensive review.
Source
Romanian journal of internal medicine = Revue roumaine de medecine
interne. (no pagination), 2023. Date of Publication: 18 Feb 2023.
Author
Delcea C.; Buzea C.A.; Vijan A.E.; Badila E.; Dan G.-A.
Institution
(Delcea, Buzea, Vijan, Badila, Dan) Carol Davila University of Medicine
and Pharmacy, Bucharest, Romania
(Delcea, Buzea, Vijan, Badila, Dan) Cardiology Department, Colentina
Clinical Hospital, Bucharest, Romania
Publisher
NLM (Medline)
Abstract
Introduction. At the crossroads of heart failure (HF) and systemic
inflammation, platelets and lymphocytes are both influenced as well as
actively participating in the bidirectional relationship. The platelet to
lymphocyte ratio (PLR) could therefore be a marker of severity. This
review aimed to assess the role of PLR in HF. Methods. We searched the
PubMed (MEDLINE) database using the keywords "platelet", "thrombocyte",
"lymphocyte", "heart failure", "cardiomyopathy", "implantable cardioverter
defibrillator", "cardiac resynchronization therapy" and "heart
transplant". Results. We identified 320 records. 21 studies were included
in this review, with a total of 17,060 patients. PLR was associated with
age, HF severity, and comorbidity burden. Most studies reported the
predictive power for all-cause mortality. Higher PLR was associated with
in-hospital and short-term mortality in univariable analysis, however, it
was not consistently an independent predictor for this outcome. PLR >
272.9 associated an adjusted HR of 3.22 (95%CI 1.56 - 5.68, p<0.001) for
30-day fatality. During long-term follow-up from 6 months to 5 years, PLR
was an independent predictor of mortality in most studies, with cut-off
values ranging from > 150 to > 194.97 and adjusted HR from 1.47 (95%CI
1.06 - 2.03, p=0.019) to 5.65 (95%CI 2.47-12.96, p<0.001). PLR > 173.09
had an adjusted OR 2.89 (95%CI 1.17-7.09, p=0.021) for predicting response
to cardiac resynchronization therapy. PLR was not associated with outcomes
after cardiac transplant or implantable cardioverter-defibrillator.
<br/>Conclusion(s): Increased PLR could be an auxiliary biomarker of
severity and survival prognosis in HF patients.<br/>Copyright &#xa9; 2023
Caterina Delcea et al., published by Sciendo.